Skin, Soft Tissue

Question 1

MCC pedicled, or anastamosed free flap necrosis

Answer 1

Venous thrombosis

Question 2

Tissue expansion occurs by

Answer 2

Local recruitment, thinning of dermis and epidermis, mitosis

Question 3

TRAM flaps

Answer 3

Complications – flap necrosis, ventral hernia, infection, abdominal wall weakness
- Rely on superior epigastric vessesls

Question 4

Pressure sore stages

Answer 4

I: Erythema and pain
II: Partial skin loss with yellow debris
III: Full thickness, subcutaneous fat exposure [sharp debridement]
IV: bony cortex; muscle; adipose tissue; tendon [myocutaneous flap]

Question 5

Single best factor for protecting skin from UV radiation

Answer 5

Melanin

Question 6

UV a or b is responsible for chronic sun damage

Answer 6

UVB

Question 7

Risk factors for melanoma

Answer 7

Dysplastic, atypical, large congenital nevi

Question 8

What syndrome results in 100% risk of malnoma

Answer 8

Familial BK mole syndrome

Question 9

MC site of melanoma on men vs. women

Answer 9

Men: Back
Women: Legs

Question 10

From what cell layer does melanoma originate?

Answer 10

Neuroal crest cells (melanocytes) in basal layer

Question 11

What color melanoma is most ominous?

Answer 11

Blue

Question 12

Most common location for distant melanoma mets

Answer 12

Lung

Question 13

Most common mets to small bowel

Answer 13

Melanoma

Question 14

What stains do you use for melanoma?

Answer 14

S-100 and HMB-45 proteins

Question 15

< 2 vs > 2 cm melaoma

Answer 15

Excisional; incisional bx

Question 16

Most aggressive type of melanoma

Answer 16

Nodular; most likely to have metastsized at time of diagnosis

Question 17

Staging of melanoma

Answer 17

CAP CT; LFTs; LDH

Question 18

Surgical margins for melanoma excision

Answer 18

In situ (0.5 cm); Thin <1mm (1 cm); Intermediate 1.1-2mm (1-2 cm); Thick >2mm (2 cm)

Question 19

When do you need to resect nodes with melanoma?

Answer 19

Clinically positive; SLNB+

Question 20

When do you perform SLNB with melanoma?

Answer 20

Clinically node negative disease and tumor > 1mm deep

Question 21

For all scalp melanomas anterior to the ear and above the lip…

Answer 21

Need to include superficial parotidectomy

Question 22

First-line CTX for metastatic melanoma

Answer 22

Dacarbazine

Question 23

T/F Il-2 and tumor vaccines can be used for systemic disease

Answer 23

True

Question 24

80% Basal Cell Ca is located…

Answer 24

H+N

Question 25

Pearly appearance, rolled borders, slow and indolent growth is characteristic of what type of skin cancer

Answer 25

BCC

Question 26

Pathology of basal cell carcinoma

Answer 26

Peripheral palisaiding of nuclei and stromal retraction

Question 27

What size margins for basal cell carcinoma?

Answer 27

0.3-0.5 cm margins

Question 28

Most aggrsesive type of basal cell carcinoma

Answer 28

Morpheaform type

Question 29

Old burn scars can predispose to this kind of skin cancer

Answer 29

SCC

Question 30

Margins for SCC

Answer 30

0.5-1cm margins

Question 31

1 soft tissue sarcoma

Answer 31

1 malignant fibrous histiosarcoma

Question 32

Do you do an MRI before biopsy of a soft tissue sarcoma?

Answer 32

Yes – to rule out vascular, neuro or bone invasion

Question 33

How do sarcomas spread

Answer 33

Through blood

Question 34

Post-op CTX for soft tissue sarcomas

Answer 34

Doxorubicin

Question 35

Chronic lymphedema can pre-dispose to

Answer 35

Lymphangiosarcoma

Question 36

Syndrome a/w childhood rhabdomyosarcoma

Answer 36

Li-Fraimeni

Question 37

Tuberous sclerosis is a/w which sarcoma

Answer 37

Angiomyolipioma

Question 38

Most common mesenchymal tumor

Answer 38

Lipoma