Skin & bone Flashcards
14793 – Recognised sequelae of severe burns include
1: impaired lymphocyte responsiveness
2: increased phagocytosis
3: nitrous oxide intoxication
4: haemodilution
TFTF
Refer to Robbins, 6th Ed, Ch 10, page 433-435
21068 – Tissue reactions are associated with
1: stainless steel
2: silica
3: catgut
4: asbestos
FTTT
Robbins 5th. ed. Page: 81
25375 – Contact dermatitis is
1: mediated by a subset of T lymphocytes
2: associated with complement activation
3: associated with an infiltration of lymphocytes and macrophages
4: associated with the combination of IgE and antigen
TFTF
Robbins 5th ed. Chapter: 6 Pages: 187-188
7162 – One of the following is NOT associated with the development of carcinoma of the skin
A. exposure to aniline dyes
B. arsenical dermatitis
C. chronic exposure to ultra-violet light
D. xeroderma pigmentosum
E. renal transplantation
A
Xeroderma pigmentosum, an inherited skin anomaly with enhanced sensitivity to effects of solar exposure, is associated with development of skin cancers.
A Correct: Aniline dyes are implicated in tumours of urinary epithelium. They are NOT associated with carcinoma of the skin and A is accordingly the correct answer.
22754 – Dysplastic naevi
1: virtually always occur on sun-exposed skin
2: have pale edges and a uniform central “salmon pink” papule
3: most will develop into malignant melanoma within two decades if not ablated
4: show melanocytic atypia and superficial dermal lymphocytic infiltrate
FFFT
Robbins 5th ed. Chapter: 26 Pages: 1177-1179
Unlike ordinary moles, dysplastic naevi are common on sun-protected skin. Like malignant melanoma, they are larger than moles, irregular in both outline and colour, but lack the distinct nodular development seen in MM (unless they themselves develop a focus of malignant degeneration), being macular (flat) or slightly raised (papular). Dysplastic naevi do show melanocytic dysplasia, and upper dermal lymphocytosis, do have a very significant premalignant potential; nevertheless, the majority of dysplastic naevi are stable lesions.
16911 – Dysplastic melanocytic naevi
1: very seldom occur on other than sun-exposed skin
2: usually have pale edges with a uniform central ‘salmon pink’ papule
3: most develop into malignant melanoma within two decades if not ablated
4: atypia and superficial dermal lymphocytic infiltrate
FFFT
Unlike ordinary moles, dysplastic naevi are common on sun-protected skin. Like malignant melanoma, they are larger than moles, irregular in both outline and colour, but lack the distinct nodular development seen in MM (unless they themselves develop a focus of malignant degeneration), being macular (flat) or slightly raised (papular). Dysplastic naevi do show melanocytic dysplasia, and upper dermal lymphocytosis, do have a very significant premalignant potential; nevertheless, the majority of dysplastic naevi are stable lesions.
16916 – Merkel cell carcinoma of the skin
1: is an indolent ‘adnexal’ tumour resembling basal cell carcinoma in behaviour
2: histologically resembles ‘oat cell’ bronchial carcinoma
3: most commonly arises in axillae, groins or midline anterior abdominal skin
4: shows both neuroendocrine and epithelial differentiation by cell marker studies
FTFT
Robbins pays this cancer scant attention and considers it to be rare. Not in our experience - unusual perhaps. It has a formidably aggressive biology, and morphologically resembles neuroendocrine cancers elsewhere in the body (‘oat cell’ cancer, carcinoids in various sites, islet cell tumour etc). It is most commonly present in head and neck (and extremities).
8692 – Hutchinson’s freckle (lentigo maligna)
1: commonly occurs on the foot
2: commonly occurs in adults
3: commonly occurs in sun damaged skin
4: rarely develops into a malignant melanoma
FTTF
Robbins, 6th ed, Ch 27
16906 – Malignant melanoma
1 : is usually uniformly either black or amelanotic
2: may arise in diverse mucosal sites
3: usually has irregular ‘notched’ borders
4: prognosis is predicted most accurately by the mitotic rate
FTTF
The points highlighted here are that malignant melanoma is characterised by irregularity of colour within individual lesions and usually an irregular outline. There are many factors being investigated as to relevance in terms of prognosis; the ?? nature and extent of the vertical growth phase, however, determines the biologic behaviour ??. Melanomas occur in a variety of sites other than skin (including virtually every mucosa).
16921, 23019 – Kaposi’s sarcoma
1: arises in skin and usually remains confined to skin and subcutaneous tissue
2: is less biologically aggressive when it occurs in HIV-positive individuals
3: presents as reddish, spreading and merging papules and plaques in the skin
4: is a suppressor T lymphoproliferative disorder
FFTF
Robbins 5th ed. Chapter: 11 Page: 511.
This tumour is of as yet undefined histogenesis. As seen up until about two decades ago in USA, this was an indolent tumour of ageing men of Mediterranean origin. As part of the AIDS syndrome, it is an aggressive skin neoplasm which fairly rapidly disseminates to the viscera. It is almost certainly an endothelial sarcoma of some sort; certainly not a T lymphoma.
9740 – In the genesis of malignant melanoma
1: a lesion which is macular is predictably in the radial growth phase
2: development of a nodule probably indicates potential for metastasis
3: lentigo maligna usually has a shorter preinvasive radial growth phase than superficial spreading melanoma
4: solitary dysplastic naevus has a high likelihood of malignant transformation
TTFF
Robbins, 6th ed, Ch 27
7361 – S: Carcinoma of the tongue has a propensity to metastasise to bone because R: malignant squamous cells require a high local concentration of calcium
both S and R are false
Both the statement and response are incorrect. Carcinoma of the tongue (a squamous cell carcinoma) has no special propensity to metastasise to bone ? it may of course involve bone by directext ension to the mandible. There is no evidence that malignant squamous cells require a high concentration of calcium.
23679 – Malignancies metastatic to bone are likely to be predominantly osteoblastic when derived from primary cancers in
1: colon
2: lung
3: prostate
4: kidney
FFTF
Robbins 6th. ed. Page: 1245
24264 – Which of the following tumours is/are particularly liable to produce solitary metastasis in bone
1: carcinoma of kidney
2: cancer of the lung
3: prostatic carcinoma
4: carcinoma of the thyroid
TFFT
Robbins 6th ed. Page: 266; 305; 911; 1245. The question refers to metastasis in the bone
being solitary, not bone as a single site. Ref: p1245 Robbins.
15172 – Mature bone, remodelled after a simple fracture in an adult contains
1: type 1 collagen
2: osteonectin
3: Haversian systems
4: woven bone
TTTF
Refer to Robbins, 6th Ed, page 1216-1218
