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7- Surgery > Superficial Swellings > Flashcards

Superficial Swellings Flashcards

1
Q

Common skin lesions

A 
Lipoma 
Sebaceous cyst 
Dermoid cyst 
Ganglion 
Keloids, hypertrophic scars
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2
Q

What is a soft tissue

A

Non epithelial

Extraskeletal mesenchyme which is not lymphohematopoietic tissue, viscera and glia

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3
Q

Types of soft tissue

A 
Fibrous CT
Adipose tissue 
Skeletal muscle 
Blood vessels 
Lymph vessels 
Peripheral nervous system
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4
Q

Epidermis layer

A 
Stratum corneum 
Stratum lucidum 
Stratum granuulosum 
Stratum spinosum 
Stratum basale
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5
Q

Type of cells in stratum basale

A

Basal cells

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6
Q

Type of cells in s Tatum spinosum

A

Prickle cells

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7
Q

Type of cells in stratum granulosum

A

Granular cells

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8
Q

Where do you find stratum lucidum

A

Palms

Sole

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9
Q

Stratum corneum type of cells

A

Kératinized cells

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10
Q

Type of cells in epidermis

A 
Melanocytes
Langerhans
Merkel
Hair 
Nails
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11
Q

Classification of soft tissue swelling

A

Intact & abnormal epidermis
Normal skin (beneath skin )
Overlying epidermis destroyed

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12
Q

Steps in history of lumps

A 
Age, sex, ethnic group, occupation 
Duration 
Cause 
First symptom 
Other symptoms 
Progression 
Persistence
Multiple , single ?
Systemic symptoms 
FHx
SHx
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13
Q

Examination of lump

A 
Site 
Size
Shape 
Surface 
Edge 
Color 
Temp 
Tenderness
Depth 
Mobility 
Composition (consistency , fluctuation , fluid thrill, translucency, resonance, pulsality, compressibility , bruit )
Local tissue state 
Regional lymph node 
Réduciibility
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14
Q

Exam to test fluctuation of lump

A

Pascals law

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15
Q

Signs of composition of lump

A 
Consistency 
Fluctuation 
Translucency 
Fluid thrill
Pulsatility
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16
Q

macule characteristics

A

Flat, distinct , discolored

Less than 1cm

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17
Q

Papule characteristics

A

Small
Well defined
Raised

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18
Q

Vesicle characteristics

A

Small fluid filled sac
Fluid => clear, white, yellow or mixed with blood
Less than 0.5cm

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19
Q

Bulla characteristics

A

Large
Filled with fluid => clear or blood stained
Thick
More than 0.5cm

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20
Q

Wheal characteristics

A

Pale skin swelling
Surrounded by erythema
Very itchy
Defined

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21
Q

Cyst characteristics

A 
Small sac 
Red and swollen
Blackhead in the center
White , yellow, green discharge 
Tender 
Move under skin
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22
Q

Nævus characteristics

A

Benign
Growth on the skin
Cluster of melanocytes
Can be raised

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23
Q

Papilloma characteristics

A

Benign growths

Warts and verrucae

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24
Q

Tumor characteris tics

A

Can be skin colored , waxy, like a scar, or thick
Grows
Can see small blood vessels

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25
Q

Harmatoma charcateritics

A

Benign lesions

Aberrant disorganized growth of mature tissue

26
Q

Ulcer characteristics

A

Round open sore
Outer border raised and thick
Skin discoloration inn area
Red and warm

27
Q

Lump investigations

A 
USG 
XRAY 
CT SCAN 
MRI 
excision/incision biopsy
28
Q

Excision biopsy definition

A

Removal of entire lump through cut through the skin

29
Q

Incision lump

A

Cut of skin to remove sample of lump for diagnosis

30
Q

Lipoma definition

A

Overactive distended fat cluster which is palpable

31
Q

Lipoma characteristics

A 
Spherical 
Well defined 
Slip sign positive 
Non tender with l’ovulation
Soft but solid like 
Pseudo fluctuate 
No trans illumination
32
Q

Lipoma treatment

A

Excision biopsy

33
Q

Sebaceous cyst definition

A

Slow growing

Distended sebum filled sebaceous glands

34
Q

Sebaceous cyst characteristics

A 
Spherical 
Smooth 
Well defined 
Non tender
From skin and subcutaneous 
Punctum (very important )
Not attached deeply
35
Q

3 complications of sebaceous cyst

A

Sebaceous horn
Cocks peculiar tumor
Calcification

36
Q

Dermoid cyst definition

A

Pièce of skin trapped deep to normal skin

37
Q

Ganglion definition

A

Myxomatous degeneration of fibrous tissue

38
Q

Ganglion characteristics

A 
Spherical 
Joint and capsule ( wrist, hands )
Smooth 
Transilluminate 
Slow growth
Painless
Irreducible 
Cross fluctuate 
Viscous gelatinous material
39
Q

Differential of ganglion

A

Bursae

Cystic protrusion

40
Q

Ganglion treatment

A

Excision biopsy

41
Q

What is epidermal inclusion cyst

A

Transplantation of skin into soft tissue during injury leading to cyst filled with keratin and desquamated cells

42
Q

What is a subcutaneous bursae

A

Fluid filled cavities developing between tendons bones and skin

43
Q

Condition of subcutaneous bursae

A 
Painful
Site of repeated trauma 
Fast  growth
Circular
Indistinct edge
Soft or spongy
Transilluminate , fluctuate
44
Q

Treatment of bursae

A

Excision biopsy

45
Q

Keloids definition

A

Benign firm tumor like fibrous swelling arising from scar

46
Q

Keloidscharacter

A

Extend beyond scar
No spontaneous regression
Recurs after simple excision
Raised , very vascular, itchy , painful

47
Q

Complications keloids

A 
Ilcers 
Infection
Malignant change 
Itching
Tenderness
48
Q

Treatment keloids

A

Excision + radiotherapy

Or excision + steroid injection o

Triple therapy => surgery, radiation , steroid

Compression therapy

Button therea[py

Zinc oxide

Ear clip

Silicone cream

49
Q

Hypertrophic scar treatment

A

Reassurance
Left alone
Spontaneous regression

50
Q

Benign papilloma characteristics

A 
Plaques, Pedunculated, or variable shape
Normal color
Soft
Incompressible 
Not enlarged
51
Q

Treatment of benign papilloma

A

Excision biopsy

52
Q

I

A
53
Q

Type of malignant tumor common in blacks

A

Squamous cell carcinoma

54
Q

Type of tumor common in whites

A

Basal cell carcinoma

Malignant melanoma

55
Q

Risks factor of malignant skin cancer

A 
Chronic ulcers 
Solar and ionizing radiations 
Carcinogenic chemicals
Discoid lupus
Hydradenitis  suppurativa 
Albinism 
Xeroderma pigmentosa
Advancing age
56
Q

Percentage of SCC in blacks

A

5%

57
Q

2nd commonest skin cancer

A

SCC

58
Q

Scc macro

A

Ulcerated lesion
Raised everted edges
Indurated/ oedematous base
Dirty/nodular floor

59
Q

Histo SCC

A

Well differentiated
Keratinizing lesiosn
Nest cells

60
Q

SCC investigations

A

X rays

Biopsy

61
Q

Treatment SCC

A

See slide

7- Surgery (13 decks)

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