Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Plastics > Skin Lesions > Flashcards

Skin Lesions Flashcards

1
Q

What is the appearance of strawberry naevi/haemangioma?

A

Typically oval, scarlet shaped
Well defined borders
Surface may be smooth or lobulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do strawberry naevi tend to appear?

A

2-3w after birth

They are not present at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Do strawberry naevi tend to expand and get bigger?

A

Yes - reach ultimate size within 3-6m of delivery

Due to vascular nature, also seem to increase in size when child crying/straining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where is the most common place for strawberry naevi to appear?

A

Head and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If there are three or more strawberry naevi what should be considered?

A

Whole body MRI to rule out internal strawberry naevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In which groups of children are strawberry naevi most common?

A

Premature babies

Girls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the aetiology of strawberry naevi?

A

Benign, developmental vascular tumours of unknown origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are strawberry naevi managed?

A

Nearly all lesions undergo spontaneous involution
Plastic surgery to remove loose skin/fibro-fatty deposits around prev. site of lesion sometimes req.

If lesion –> airway obstruction, tracheostomy will be req.
If causing feeding/visual obstruction, intra-lesional steroids or propranolol therapy may slow proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the proper name for a port wine stain?

A

Naevus flammeus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When are port wine stains present from?

A

Birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the appearance of port wine stains?

A

Light pink –> dark red/purple
Usually involving the face
Well defined edge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do port wine stains disappear?

A

They do not reduce with age and remain unchanged in size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In 8-15% of cases port wine stains are associated with what?

A

Underlying brain and eye abnormalities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the aetiology of port wine stains?

A

Congenital lesion of unknown aetiology.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are port wine stains managed?

A

Covered with cosmetic camouflage

Laser treatment for those who are self conscious (often this is v. painful)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are other names for a salmon patch?

A

Naevus simplex, stork bite, angles kiss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are salmon patches composed of?

A

Distended and persisting fetal dermal capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the appearance of a salmon patch?

A

Irregular, dull, pinkish red, macular areas often featuring fine, linear telangiectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where are salmon patches most common?

A

Nape of the neck

also - upper eyelids, forehead, tip of nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What emphasises the appearance of a salmon patch?

A

When the child cries/exerts themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How long does it take salmon patches to disappear?

A

Usually about 1m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the aetiology of salmon patches?

A

Localised capillary telangiectatic lesion of unknown aetiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment of a salmon patch?

A

None req., may consider laser if persists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What features comprise Klippel-Trenaunay syndrome?

A

Severe AV malformations of the limbs, bone hypertrophy and port-wine stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What features comprise Sturge-weber syndrome?

A

Trigeminal distribution port wine stains + capillary haemangiomas in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What investigations can you do for suspected deeper AV malformations?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How might you treat some of the deeper AV malformations?

A

Might be able to do embolisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the appearance of chondrodermatitis nodularis chronica helicis?

A

Small, inflamed, hard, very painful nodules in the upper ear (around helix)
Tend to form scale over them and recur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How should you investigate chondrodermatitis nodularis chronica helicis?

A

Biopsy to rule out malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the aetiology of chondrodermatitis nodularis chronica helicis?

A

Repeated pressure to upper ear most likely cause

Actinic damage, cold, frost bite and repeated physical injury may be implicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How should you manage chondrodermatitis nodularis chronica helicis?

A

Non-surgical first: topical antibiotics (if lesion infected), topical corticosteroids, cryotherapy, laser therapy, curettage, electrocauterization, intralesional collagen injections, corticosteroid injections, relieving pressure on ear

Surgery - wedge resection or larger complicated reconstructive techniques

s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a dermatofibroma?

A

Nodular dermal proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the appearance of a dermatofibroma?

A

Firm, elevated or flat, hyperchromic, tender nodule which dimples when overlying dermis is squeezed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why might a dermatofibroma form a yellow-brown colour?

A

Due to iron and melanin deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Where are dermatofibromas most commonly found?

A

The limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the proposed aetiology for dermatofibromas?

A

An abnormal response to dermal injury, e.g. insect bites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How do you treat dermatofibromas?

A

No treatment req.

Intralesional steroids have been shown to initiate regression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How do you differentiate keloid scarring from hypertrophic scarring?

A

Keloid extends beyond the margin of the surgical scar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Define a keloid scar

A

Well demarcated area of fibroid tissue overgrowth that extends beyond the original defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Are keloid scars painful?

A

Can be very hypersensitive or tender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are risk factors for developing a keloid scar?

A

+ve FH
Black, Hispanic or Asian
Acromegalics, post-thyroidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the aetiology of keloid scars?

A

Genes + environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How do you manage keloid scars?

A

Avoid unessential trauma in those who are predisposed to keloid scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the xanthelasma?

A

Sharply demarcated yellowish deposit of fat underneath the skin, usually on or above the eyelids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Define seborrheic keratosis

A

Benign proliferation of epidermis keratinocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the appearance of a seborrheic keratosis?

A

Raised, yellow-brown/black lesions, greasy and usually multiple
Have a ‘stuck on’ appearance
Usually of little concern to patient but may cause itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the aetiology of seborrheic keratosis linked to?

A

Familial trait
Multiple erruptions of them can be linked to inflammatory dermatosis, severe sunburn or may be a manifestation of visceral malignancy (GI cancer usually)
Most are idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How can you manage seborrheic keratosis?

A

No treatment req.
Dermal shaving
Currettage
Cryotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is a blue naevus?

A

Area of blue or black dermal pigmentation produced by aberrant collections of pigment producing but benign melanocytes
Usually non-tender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

When do blue naevi most commonly appear?

A

During puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the treatment of blue naevi?

A

None required

May be excised if patient wants it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are combined naevi?

A

Melanocytic naevi formed by the overgrowth of melanocytic cells in the epidermis and dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What do combined naevi appear like?

A

Raised, variegated lesions, with sandy and blue/black pigmentation
Irregular borders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How do you manage combined naevi?

A

Don’t req. treatment

Biopsy if suspicious looking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the appearance of compound naevi?

A

Small, uniformly brown, as they mature become darker and raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Where is there an increased risk of a compound naevus undergoing malignant transformation?

A

Great number of them

Positive family history of malignant melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the aetiology of compound naevi?

A

Benign proliferation of melanocytes of unknown cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the management of compound naevi?

A

None

Biopsy if unsure of diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Define halo naevus

A

Melanocytic naevus surrounded by a depigmented halo of otherwise normal skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

When do halo naevi occur?

A

When pre-existing melanocytic naevus develops a ring or halo of depigmentation around it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

How long do halo naevi take to disappear?

A

Usually central melanocytic naevus gradually regresses but may take several years for the pigmented area to regain normal skin colour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the aetiology of halo naevi?

A

Unknown
?anti-melanoma Ab
?lymphocytic infiltration of halo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the treatment of halo naevi?

A

Usually none

Biopsy if unsure about diagnosis

64
Q

When do intra-dermal naevi from?

A

When junctional melanocytes stop proliferating and the overlying skin returns to normal

65
Q

What do intradermal naevi appear like?

A

Raised, non-pigmented nodules
May have terminal hair, visible capillaries
May also appear as flesh coloured, wrinkly sacs on flexor surfaces

66
Q

What is the aetiology of intradermal naevi?

A

Overgrowth of cells in the dermis of unknown aetiology

67
Q

How do you treat intradermal naevi?

A

None req.
Excised for cosmetic reasons
Biopsy if unsure of diagnosis

68
Q

What is a junctional naevus?

A

Cellular naevus with junctional activity present on histology

69
Q

What is the appearance of a junctional naevus?

A

Slightly raised/flat
Usually roughly symmetrical, pigmented lesion
Tan-brown, speckling of pigment
Usually these turn into compound naevi

70
Q

What is the aetiology of a junctional naevus?

A

Benign proliferation of melanocytes of unknown aetiology

71
Q

What is the other name for spitz naevus?

A

Juvenile melanoma (distinctive pathological features that make them v. difficult to distinguish from malignant melanoma)

72
Q

What is the appearance of a spitz naevus?

A

Rounded, blanching, pigmented lesions and surrounding halo

Overlying epidermis is fragile and can bleed/crust following minor trauma

73
Q

What is the treatment of a spitz naevus?

A

Excision with 1-2mm margin of normal skin - sent to histology (v. difficult for pathologist to know difference between spitz naevus and malignant melanoma without knowing age and clinical appearance)

74
Q

What are the features of a common wart?

A

Multiple, raised, hyperkeratotic

Very painful

75
Q

Where do warts occur?

A

In areas of recent trauma

76
Q

In which group of patients are warts even more common?

A

Immunosupressed patients (also more resistant to treatment)

77
Q

What is the aetiology of the common wart?

A

Benign cutaneous tumours caused by human papilloma virus

78
Q

How do you treat common warts?

A

Usually resolve spontaneously

Salicyclic acid paints, cryotherapy

79
Q

What are the appearance of molluscum contagiousum?

A

Shiny, pearly white umbilicated papules which grow slowly over 6-12w
Often multiple due to virus disseminating from original lesion

80
Q

What can occur in the lesions of molluscum contagiousum?

A

May become inflamed, secondarily infected or eczematised

81
Q

What is the aetiology of molluscum contagiousum?

A

Infection with pox virus (molluscum contagiousum virus - usually MCV-1 genome)

82
Q

How do you treat molluscum contagiousum?

A

Avoid close contact with other, do not share towels/clothes etc.
Will resolve on its own
Lesions can be spiked with liquid nitrogen, phenol or iodine
Topical cidofovir
If large enough - curettage and diathermy may be used

83
Q

What are actinic keratoses?

A

Hyperkeratotic lesions occurring in sun-exposed adult skin

84
Q

What to actinic keratoses carry a low risk of progression to?

A

Invasive squamous cell carcinoma (1% pa)

85
Q

Describe how actinic keratoses begin and progress

A

Start as telangiectatic capillaries
Form a yellow/brown scale over the top
Becomes rougher, thicker and hornier over time

86
Q

Where are actinic keratoses found?

A

SUN EXPOSED AREAS

87
Q

What cause actinic keratoses?

A

Excessive exposure to sunlight (UV radiation)

88
Q

What are risk factors for developing actinic keratoses?

A 
Increased age
Proximity to equator
Fair skin (types 1/2)
Outdoor activities
Occupation 
Diet high in animal fats
89
Q

What is involved in the treatment of actinic keratoses?

A

Advice - re. hat wearing, sun lotion, avoiding sun between 11am-3pm etc. - may regress lesions/stop new lesions forming

Cryotherapy/3% diclofenac
Topical 5FU can be used
Excision and biopsy if unsure of diagnosis

90
Q

What is Bowen’s disease?

A

Persistent, progressive, non-elevated, red, scaley/crusted plaque with an irregular border due to an intra-epidermal carcinoma

Basically it is squamous cell carcinoma in situ

91
Q

Does Bowen’s disease need to be treated?

A

If left untreated, it will become invasive disease

92
Q

What risk factors are implicated in Bowen’s disease?

A

Sunlight exposure
Contact with arsenic
Increasing age
Agricultural work

93
Q

How do you treat Bowen’s disease?

A

Excision is gold standard
Local application of 5FU and cryotherapy if small
Photodynamic therapy

94
Q

What is photodynamic therapy?

A

Giving photosensitizing drugs and then applying a laser/high energy light on the lesion

95
Q

Clinically, how are atypical moles defined?

A

Ill-defined/irregular borders
Irregular pigmentation
Diameter >5mm
Erythema + accentuated skin markings

96
Q

How are atypical naevi categorised?

A

Into A, B, C or D based on personal and family involvement

A/B = 90x more likely to develop malignant melanoma

C/D = 400-500x more likely to develop melanoma

97
Q

How are dysplastic naevi/atypical moles managed?

A

Monitored for early signs of malignant change

98
Q

When are congenital hairy naevi present from?

A

Birth

99
Q

How are congenital hairy naevi categorised?

A

Small - <1.5cm diam
Medium 1.5-19.5cm
Large/giant >20cm

100
Q

What is the appearance of a congenital hairy naevus?

A

Flat, round/oval, pigmented and covered in coarse hair

Regular/irregular borders

101
Q

What are patients with congenital hairy naevi at an increased risk of?

A

Developing malignant melanoma

102
Q

How are congenital hairy naevi treated?

A

Surgery - staged excision, with or without grafting or skin expansion

Laser treatment may improve appearance but does not eliminate risk of malignant transformation

103
Q

What are keratocanthomas?

A

Rapidly evolving tumours of the skin, composed of keratinising squamous cells originating in the pilosebaceous follicles

104
Q

What are the appearance of keratocanthomas?

A 
Rapidly growing (appear over a few weeks)
Raised
Circular
Well defined margins
Central ulceration
105
Q

How do you treat keratocanthomas?

A

Spontaneously resolve
Excision/curettage may leave less of a scar than spontaneous resolution
5FU/radiotherapy may be used in those who refuse surgery

106
Q

What causes keratocanthomas?

A

Exposure to sunlight

Contact with tar or mineral oil

107
Q

What malignancies are associated with keratocanthomas?

A

Rarely associated with certain types of internal malignancies

108
Q

What may a keratocanthomas be mistaken for?

A

SCC - but is much more rapidly growing!

Send off biopsy if unsure

109
Q

What is lentigo maligna?

A

Lentiginous replacement of basal keratinocytes by atypical melanocytes with no downward invasion into the underlying dermis

110
Q

What can lentigo maligna progress to?

A

Superficial/nodular melanoma

it is malignant melanoma in situ

111
Q

What is the appearance of lentigo maligna?

A

Flat, often two tone, brown lesion with irregular orders

112
Q

Where is lentigo maligna mostly found?

A

In elderly patients on sun exposed areas

113
Q

How do you manage lentigo maligna?

A

Excision biopsy or incision biopsy if not possible
After confirmation of LM - standard excision of lesion with 5mm margin/Moh’s surgery
5FU and cryotherapy may be used but recurrence is high

114
Q

What are sebaceous naevi?

A

Circumscribed lesions comprised predominantly of sebaceous glands

115
Q

What is the appearance of sebaceous naevi?

A

Circumscribed plaques, yellow or tan, velvety, found on scalp, usually present from birth
Commonly present as a bald patch

116
Q

What do sebaceous naevi most commonly malignantly transform to?

A

BCC

117
Q

What is the aetiology of sebaceous naevi?

A

May have genetic component

118
Q

What is the treatment of sebaceous naevi?

A

Excision

If excision is not feasible, then consider dermabrasion or laser removal

119
Q

Define squamous cell carcinoma

A

Malignant tumour arising from the keratinocytes of the epidermis

120
Q

What is the first sign of a squamous cell carcinoma?

A

Induration of the skin

121
Q

What is the appearance of a SCC?

A

Plaque like, ulcerated or verrucous, always firm to palpation
Irregular, erythematous border
May have raw bleeding area

122
Q

What are risk factors for developing SCC?

A 
Older age
Chronic UV exposure
Burns/old scars displaying new changes
Chronic heat exposure (erythema ab igne) 
Actinic keratoses
Bowen's disease
Chronic granulomas, esp. long standing venous ulcers
Tar exposure/Rx
Certain genetic conditions
123
Q

How do you diagnose SCC?

A

Excision biopsy + histology

124
Q

What factors influence the metastatic potential of a SCC?

A 
Anatomical site 
Size (>2cm 2x more likely to recur locally), lesion depth 
Rate of growth 
Aetiology
Degree of histological differentiate
Host immunosupression
125
Q

What is the treatment of choice for SCC?

A

Surgical excision + follow up for possible local recurrence/nodal involvement

126
Q

What are the recommended margins for the excision of SCC?

A

4mm+ for low risk tumours, 6mm+ for high risk tumours

127
Q

What kind of surgery may be useful for recurrent SCC?

A

Moh’s

128
Q

How should bowens disease be followed up?

A

Doesn’t req. follow up

129
Q

How should low risk SCC be followed up after Rx?

A

Discharge after 6m

130
Q

How should high risk SCC be followed up after Rx?

A

5 year follow up

131
Q

What makes a SCC high risk?

A 
>2cm diam
>4mm depth 
Poorly differentiated
Perineural involvement
Immunosupressed patient 
Recurrent dx
Secondary to chronic inflammation
132
Q

What is a classic presentation of a nodular BCC?

A

Painless, translucent raised lesion with pearly edges and telangiectasia with central ulceration

May bleed from minimal trauma

133
Q

What is considered a large nodular BCC?

A

=>2cm

134
Q

What tends to be the best treatment for nodular BCC?

A

Excision

Cryotherapy or curettage + cautery may be used sometimes

Moh’s surgery should be used for high risk sites if possible

135
Q

What is the typical appearance of a superficial BCC?

A

Pigmented and spreading superficially

May have eroded/ulcerated lesions

136
Q

Multiple superficial BCC may indicate what?

A

Exposure to arsenic

137
Q

What treatment options are available for superficial BCC?

A

Cryosurgery, curettage + cautery, Moh’s surgery, radiotherapy

138
Q

What is the appearance of sclerotic BCC?

A

Smooth, deeply invasive, tend to be pale yellow with ulceration, bleeding and crusting

Lesions often extend beyond visible skin

139
Q

What is the best form of treatment for sclerotic BCC?

A

Excision, Moh’s for high risk sites

140
Q

What are multifocal BCCs?

A

Lesions that display many foci of malignancy

141
Q

What do pigmented BCCs appear like?

A

Nodular BCCs that are pigmented

142
Q

How does superficial spreading melanoma present?

A

Flat or slightly elevated pigmented lesion with variegate pigmentation and surrounding discolouration
Border is asymmetric and irregular
Lesions tend to be >7mm in diameter

143
Q

What is the most common type of melanoma?

A

Superficial spreading melanoma

144
Q

What does lentigo maligna melanoma present as before it becomes malignant?

A

Lentigo maligna - this occurs when the malignant lentigo maligna cells start growing vertically instead of horizontally

Changes may be indicated clinically by a (usually blue-black) nodule developing

145
Q

How does nodular melanoma present?

A

Deeply pigmented papule or dome shaped nodule
May arise from site of previous trauma
Can grow over weeks/months
May bleed

146
Q

Where does acral lentiginous melanoma occur?

A

Hands, feet, digital and sub-ungual areas

147
Q

What does acral lentiginous melanoma look like?

A

Black, raised lesion

148
Q

What is Breslow’s thickness?

A

Microscopic depth or thickness of a melanoma

149
Q

What is sennitel node biopsy?

A

Identification and removal of first node draining an area

150
Q

What % of cancers does melanoma comprise in the UK?

A

4%

151
Q

What are the four key features of a BCC?

A

Pearly appearance
Rolled, raised edges
Central ulceration
Telangiectasia

152
Q

What kind of biopsy should be done in suspected skin cancers?

A

Excision biopsy

153
Q

What is a BCC on the nose known as?

A

Rodent ulcer

154
Q

What is melanoma a cancer of?

A

The epidermal melanocytes

155
Q

What is the ABCDE criteria for describing a potential melanoma?

A 
Asymmetry 
Border - irregular
Colour - non-uniform 
Diameter >7mm
Evolution/elevation
156
Q

What are the major and minor criteria for melanoma diagnosis?

A

Major -
Change in shape, size, colour

Minor -
Inflammation, oozing, diameter >7mm, change in sensation

157
Q

What are risk factors for actinic keratoses?

A 
Increased age
Proximity to equator
Fair skin (types 1 and 2) 
Outdoor activities/occupation 
Excessive exposure to sunlight
Diet high in animal fats

Plastics (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions