UV - Photoaging and Cancer

Question 1

what UV cant pass through window glass

Answer 1

UVB

Question 2

what are the theraputic qualities of UV light

Answer 2

anti inflammatory
immunosuppressive
antiproliferative
apoptotic

Question 3

what are acute skin effects of UV radiation

Answer 3

erythema (sunburn)

immune suppression

Question 4

what is vit D soluble in

Answer 4

fat

Question 5

what metabolism is vitamin D essential for

Answer 5

calcium and phosphorous metabolism

Question 6

what is the major role of vitamin D

Answer 6

increases the flow of calcium into the blood stream by promoting absorption from food in the intestines, re absorption of calcium in the kidneys- allows mineralisation of bone

Question 7

what makes up vitamin D

Answer 7

fat soluble vitamins: vit D2, vit D3, calcitriol

Question 8

what is calcitriol and what does it do

Answer 8

is the biologically active hormonal form of vitamin D- used by the body to form and maintain healthy strong bones

Question 9

what is the result of vit D deficiency in children

Answer 9

rickets

Question 10

what is the result of vit D deficiency in adults

Answer 10

osteomalacia (muscular weakness, bone pain and bone fractures)
long term osteoperosis

Question 11

how much sunlight should you get a day

Answer 11

15-20mins

if high risk of skin cancer less/ get vit D from diet

Question 12

what groups of people are at risk of getting vit D deficiency

Answer 12

darked skin people, photosensitive people, premature babies, bad diet, vegans/vegetarians, lack of sunlight, eldery, eating disorders, people who cover up for religion, people with malabsorption/ bowel problems

Question 13

how can you confirm suspected vit D deficiency

Answer 13

measure serum vit D

also can measure calcium and phosphate

Question 14

what is the management for vit D deficiency

Answer 14

vit D, calcium and phosphate supplements

advise lifestyle changes

Question 15

what are the steps of carcinogenesis

Answer 15

initiation (clonal expansion in single cell)
promotion (cell proliferation and angiogenesis)
progression
transformation (multiple changes in growth regulation resulting in de-differentiation, autonomous growth, invasive behaviour)

Question 16

how does skin protect itself from UV damage

Answer 16

producing melanin and thickening

DNA repair mechanisms or killing damaged cells (apoptosis)

Question 17

what are the 6 sequences leading to a non melanoma skin cancer

Answer 17

1. epidermal keratinocyte DNA damage by UV
2. mutation of tumour suppressor genes and loss of apoptotic function
3. mutation of proto-oncogenes
4. colonal selection of non-apoptosing mutated cells
5. UV suppresses normal cell mediated immune response against tumour cells
6. grows into tumour

Question 18

why are MM the most serious form of skin cancer

Answer 18

metastasise early

Question 19

how do BCC cause damage

Answer 19

local invasion rather than metastasis

Question 20

describe what as nodular basal cell carcinoma looks like as it progresses

Answer 20

initially reddish, dome shaped with translucent surface and dilated surface capillaries
as it expands, centre may show necrosis and ulceration leaving rolled edge

Question 21

describe the appearance of a superficial BCC

Answer 21

flat and expands gradually, red, scaly, with a slight raised whipcord’ margin

Question 22

what non MM cancer is associated with intermittent ‘burning’ episodes

Answer 22

basal cell

Question 23

what non MM cancer is associated with life long exposure to sun

Answer 23

Squamous cell carcinoma

Question 24

what cells do squamous cell carcinomas arise from

Answer 24

keratinocytes

Question 25

how does an SCC usually present

Answer 25

scaly expanding and ulcerating nodule

Question 26

do SCC’s usually metastasise

Answer 26

no

Question 27

what pre malignant lesions predispose to SCC

Answer 27

actinic keratoses

bowen’s disease

Question 28

what is bowens disease

Answer 28

epidermal carcinoma in situ

Question 29

what are the stages of melanocytic naevi

Answer 29

junctional
compound
intradermal

Question 30

what is a junctional melanocytic naevi

Answer 30

naevus cells in dermoepidermal junction

tend to be flat/ slighlty elevated with smooth surface and uniform pigmentation

Question 31

what is a compound melanocytic naevi

Answer 31

naevus cells at dermoepidermal junction and upper dermis
lesions slightly elevated or dome shaped, often pigmented
hairs may project from surface

Question 32

what is an intradermal melanocytic naevi

Answer 32

naevus cells in dermis
dome shaped, verrucous (warty)
pedunculated or sessile
often flesh coloured occasionally hairy and may display surface telangiectasia

Question 33

what are features of benign pigmented lesions

Answer 33

well defined margin, even pigmentation, symmetrical, not changing/ changing very slowly

Question 34

what are the clinical features of MM

Answer 34

asymmetry 
border irregular 
multiple colours
diameter >6mm
history of increasing size/ changing shape

Question 35

what is involved in the normal process of skin aging

Answer 35

skin thins
lose elastic and collagen fibres
subcutaneous fat is lost 
fine wrinkles develop
number of hair follicles, sweat and sebaceous glands decreases
skin drys

Question 36

what are the features of photoaging

Answer 36

solar elatosis- skin coarse and yellow, looses elasticity quickly
irregular pigmentation, freckling, lentigo
telangiectasia and atrophy, easy bruising
roughness and dryness
deep wrinkling

Question 37

what therapeutic effects does UV radiation have in psoriasis and dermatitis

Answer 37

anti inflammatory
immunosuppressive
antiproliferative
apoptotic

Question 38

what is PUVA

Answer 38

psoralen + UVA

Question 39

what UV is used for phototherapy

Answer 39

narrowband UVB

Question 40

sunbeds are classified as a carcinogen in the same category as tobacco true/ false?

Answer 40

true