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tumours/cancers Flashcards

1
Q

what is seborrhoea keratosis

A

benign feature which is very common in ageing skin

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2
Q

what is the appearance of seborrhoea keratosis

A

“stuck on”

greasy, hyperkeratotic surface

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3
Q

what causes a seborrhoea keratosis

A

benign proliferation of epidermal keratinocytes

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4
Q

what is Gorlin’s syndrome

A

autosomal dominant familial cancer syndrome

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5
Q

what is Gorlin’s syndrome also called

A

Naevoid basal cell carcinoma

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6
Q

what are the symptoms of Gorlin’s syndrome

A 
early onset/multiple BCCs
palmar pits
jaw cysts
ectopic calcification flax
skeletal abnormality
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7
Q

what is xeroderma pigmentosum

A

defect in one of seven nucleotide excision repair (NER) genes which increases susceptibility to cancer

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8
Q

what are the symptoms of xeroderma pigmentosum

A

hugely photosensitive
early onset skin cancers
photo damage
neurological damage

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9
Q

what is Bowen’s disease

A

squamous cell carcinoma in situ

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10
Q

who gets Bowen’s disease

A

mostly females

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11
Q

what is the appearance of Bowen’s disease

A

scaly, erythematous plaque
irregular border
no dermal invasion

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12
Q

what is actinic keratosis

A

very common, precancerous skin lesions associated with SSC or BCC

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13
Q

what is the appearance of Actinic keratosis

A

located on sun-exposures areas
variable epidermal dysplasia
rough, scaly patch

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14
Q

what are the two main types of skin cancer

A

melanoma

non-melanoma

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15
Q

what are the two types of non-melanoma

A

basal cell carcinoma (BCC)

squamous cell carcinoma (SCC)

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16
Q

what is cancer

A

an accumulation of abnormal cells that multiply through uncontrolled division and spread via invasion and/or distant metastasis via the blood and lymphatic systems

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17
Q

how does cancer occur

A

multi-step gene damage via dynamic colonal diversification

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18
Q

what is colonal evolution

A

a series of mutations that accumulate in successive generations

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19
Q

what is a oncogene

A

over-active form of a gene that positively regulates cell division

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20
Q

give an example of a oncogene

A

RAS

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21
Q

what is a proto-oncogene

A

normal, not yet mutation form of a oncogene

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22
Q

what is a tumour suppress gene

A

inactive or non-function form of a gene that negatively regulates cell division

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23
Q

give an example of a tumour suppressor gene

A

p53

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24
Q

what are the risk factors to skin cancer

A

sun exposure/UV radiation
genetic predisposition
immunosuppression
environmental carcinogens

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25
what does UVB do
direct DNA damage
26
how does UVB cause DNA damage
causes a CC to TT mutation by damaging CPDs and pyrtomodone-pyrimidome
27
how are CPDs and pyrtomodone-pyrimidome formed
covalent bonding between adjacent pyrimidines of the same DNA strand
28
how is UVB damage repaired
nucleotide excision repair (NER) however this is error prone
29
what does UVA do, why
indirect oxidative damage as it penetrates more deeply into the skin
30
how does UVA cause damage
DNA bases are oxided especially deoxyguanosien to form 8-oxo-deoxyguanosine this causes a GC to AT mutation
31
how is UVA damage repaired
base excision repair (BER)
32
give examples of genetic conditions which was predisposed you to skin cancer
``` albinism Gorlin's syndrome xeroderma pigmentosum Bowen's disease actinic keratosis epidermoylsis bullosa ```
33
why would someone be immunosuppressed
genetic condition UC and crohn's organ transplant chronic UV exposure
34
why does chronic UV exposure cause immunosuppression
langerhans cells are depleted and their ability to present antigens is reduced. there is a reduction in secretion of anti-inflammatory cytokines
35
what is the most serious type of skin cancer
melanoma
36
who gets melanoma
young-middle aged. | more common in females
37
what cells cause melanoma
arises from melanocytes scattered along the basal layer
38
what does survival depend on
tumour depth | ucleration
39
what is breslow's thickness
the deepest point a tumour is from the granular layer in mm
40
what is the 5 yr survival rate for breslow thickness <1mm
95-100%
41
what is the 5 yr survival rate for breslow thickness >4mm
50%
42
what is the 5 yr survival rate for metastases
5%
43
what are the 4 types of melanoma
1. superficial 2. acral/mucosal lentiginous 3. lentigo meligna sun-damaged 4. nodular
44
how do all melanoma types develop (apart from nodular)
grow as macules before the cells invade the dermis forming expansile masses with mitoses
45
how do nodular melanoma develop
they are simple tumours of nodular tissue
46
what is the ABCDE of skin cancer
``` Asymmetry irregular Border dark and/or multiple Colours large Diameter Evolution ```
47
what is the treatment of melanoma
primary excision sentinel node biopsy regional lymphadenectomy targeted drugs
48
what are the margins required if <1mm thick
1cm
49
what are the margins required if >1mm thick
2cm
50
when would you do a sentinel node biopsy
if >1mm thick or mitoses are present
51
when would you do a regional lymphadenectomy
if sentinel node biopsy is positive
52
what is the most common type of cancer
Basal cell carcinoma (BCC)
53
where does BCC arise from
keratinocytes within the basal layer
54
what mutation causes BCC
mutation of PCHT1
55
what are the main subtypes of BCC
nodular superficial infiltrative (morphoeic)
56
describe the appearance of a infiltrative BCC
poor margins which will make resection difficult
57
describe the general appearance of BCC
``` located on sun-exposed sites Slow growing lump or non-healing ulcer May be shiny Central ulceration “rodent ulcer” Translucent, pearly with visible blood vessels. Painless ```
58
describe the appearance of a superficial BCC
scaly plaque
59
what is the treatment for BCC, why?
excision as they almost never metastasise
60
where does SSC arise from
suprabasal layer
61
what are the precursors to SSC
bowen's disease actinic keratosis viral lesions (HPV)
62
describe the appearance of SSC
``` Warty/crusty lump or ulcer Grows faster Bleeding Pain Poorly differentiated (rare) = high risk Well differentiated (common) = low risk Ear, lip and scalp are high risk sites ```
63
what is the treatment of SSC
removal then test to see if it's spread

derm (mine) (11 decks)

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