Skin, Soft Tissue, and Breast Flashcards

1
Q

What is the treatment of Bowen’s disease?

A

Intraepithelial squamous cell carcinoma –> excision and repair of the area, ensuring clear surgical margins

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2
Q

The anticipated infection rate is what for the following wounds?

  • clean wound
  • contaminated wound
  • dirty wound
A

clean: 1.5-5%
contaminated: 15%
dirty: 40%

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3
Q

If spillage is substantial or infected tissue has entered, the wound is classified as

A

contaminated

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4
Q

A wound that has been used for drainage of an abscess or debridement of infected tissue is:

A

dirty

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5
Q

If a burn extends to the subcutaneous fat layer, it is what degree?

A

third

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6
Q

What are 2 contraindications to split-skin-thickness grafting?

A

1) presence of bacteria growth >10^5 organisms/cm2

2) growth of B-hemolytic streptococci

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7
Q

In melanomas, what does Clark classification mean? Breslow?

A

Clark: depth
Bresolow: width

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8
Q

In hidradenitis supperativa, which are usually infected which which organisms?, milder cases may be responsive to hygiene and tetracycline, but more severe cases require wider excision.

A

staph and strep

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9
Q

What are the layers of epidermis from superficial to dermis?

A

stratum corneum, stratum granulosum, stratum spinosum (prickle layer), stratum basale

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10
Q

What is Gorlin’s syndrome?

A

multiple BCCs, skin ribs on palms and soles, epithelial jaw line cysts, rib abnormalities, ectopic calcifications in the dura, and mental retardation. Benign until puberty.

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11
Q

What is Zuska’s disease?

A

Dilated laciferous ducts, which develop chronic inflammation presenting with periareolar draining sinuses = mammary fistula. Will continue to recur until completely excised (may require removal of the terminal duct into the nipple, leaving the wound open)

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12
Q

What is Mondor’s disease?

A

superficial thrombophlebitis, usually induced by surgery, infection, or trauma. Process is self-limiting and resolves within 2-10 weeks.
“lateral subcutaneous cord felt just under the skin and causing pain”

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13
Q

How can intraductal papilloma be found?

A

ductography

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14
Q

Which type of calcifications on mammography are usually benign: coarse or fine?

A

coarse

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15
Q

T/F: Any history of breast biopsy, even if benign, increases risk of breast cancer.

A

True

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16
Q

Megace is used for which kind of breast cancer?

A

metastatic

17
Q

Raloxifene, toremifene, and tamoxifen are all what kind of drug?

A

Selective estrogen receptor modulators (SERMS)

18
Q

What are the most effective drugs in treating breast cancer in postmenopausal women?

A

aromatase inhibitors

19
Q

What is the most aggressive type of DCIS? What is the treatment?

A

Comedo. As long as not multicentric, breast conservation can occur with radiotherapy following (as in all DCIS following breast conserving procedures)

20
Q

T/F: LCIS is a premalignant lesion.

A

FALSE! Though it does portend a lifetime risk of 30% of breast cancer (either breast!). Patients should be followed with examinations every 6 months and yearly mammogram

21
Q

Histologic examination of Paget’s disease of the breast reveals:

A

swollen, vacuolated Paget cells. Surgical therapy is curative.

22
Q

Which agents used for sentinel node identification can cause allergic reactions?

A

methylene blue, isosulfan

23
Q

Patients who have breast cancers under -__cm and which are node negative are given hormonal therapy and radiation therapy but spared chemo.

A

1cm or node positive

24
Q

When is tamoxifen given?

A

In ER and/or PR positive tumors in patients that are premenopausal

25
Q

T/F: Breast cancer is the most common cancer during pregnancy.

A

True

26
Q

Breast cancer during pregnancy usually has (positive/negative) ER and PR.

A

Usually PR- and ER-

27
Q

Why is mastectomy indicated in breast cancer in pregnancy unless the patient is towards the end of their gestation?

A

Radiation is required for breast-conserving procedures, but radiation is contraindicated in pregnancy.

Ostensibly breast conservation therapy could be performed if radiotherapy could be given postpartum.

28
Q

What is the most common site of distant metastasis for breast cancer? How is it treated?

A

Bone. They are usually lytic lesions (in the vertebral pedicles) treated with bisphosphonates to stop bone demineralization and reduce pathologic fractures/need for radiation.

29
Q

What is the follow-up after breast cancer?

A

Routine clinical exams every 3-6 months for the first 5 years and yearly mammogram

30
Q

Breast implants in what plane show better mammography results than the subglandular?

A

submuscular

31
Q

Breast cancer in males constitutes ___% of all breast cancer cases.

A

<1%

32
Q

What is the histology of cystosarcoma phyllodes?

A

large polygonal cells with abundant cytoplasm and lymphoid infiltration

33
Q

What are the potential treatments for occult primary breast cancer and how is the prognosis different than for other patients with breast cancer?

A

same prognosis as other node-positive breast cancer
can either do
1) modified radical mastectomy with chemotherapy; or
2) axillary node dissection with radiation and chemotherapy

34
Q

What type of breast cancers have a large surrounding lymphoid reaction and are poorly differentiated?

A

medullary; tend to be hormone receptor negative, but still with pretty favorable prognosis

35
Q

Which breast cancers have a typical “indian file, lining up” pattern of cells?

A

infiltrating lobular carcinoma (tend to be multicentric, higher rates of bilaterality). Tend to be hormone receptor positive