UV - Photoaging and Cancer Flashcards

1
Q

what UV cant pass through window glass

A

UVB

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2
Q

what are the theraputic qualities of UV light

A

anti inflammatory
immunosuppressive
antiproliferative
apoptotic

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3
Q

what are acute skin effects of UV radiation

A

erythema (sunburn)

immune suppression

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4
Q

what is vit D soluble in

A

fat

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5
Q

what metabolism is vitamin D essential for

A

calcium and phosphorous metabolism

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6
Q

what is the major role of vitamin D

A

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

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7
Q

what makes up vitamin D

A

fat soluble vitamins: vit D2, vit D3, calcitriol

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8
Q

what is calcitriol and what does it do

A

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

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9
Q

what is the result of vit D deficiency in children

A

rickets

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10
Q

what is the result of vit D deficiency in adults

A

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

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11
Q

how much sunlight should you get a day

A

15-20mins

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

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12
Q

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

A

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

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13
Q

how can you confirm suspected vit D deficiency

A

measure serum vit D

also can measure calcium and phosphate

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14
Q

what is the management for vit D deficiency

A

vit D, calcium and phosphate supplements

advise lifestyle changes

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15
Q

what are the steps of carcinogenesis

A

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)

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16
Q

how does skin protect itself from UV damage

A

producing melanin and thickening

DNA repair mechanisms or killing damaged cells (apoptosis)

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17
Q

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

A
  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
18
Q

why are MM the most serious form of skin cancer

A

metastasise early

19
Q

how do BCC cause damage

A

local invasion rather than metastasis

20
Q

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

A

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

21
Q

describe the appearance of a superficial BCC

A

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

22
Q

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

A

basal cell

23
Q

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

A

Squamous cell carcinoma

24
Q

what cells do squamous cell carcinomas arise from

A

keratinocytes

25
how does an SCC usually present
scaly expanding and ulcerating nodule
26
do SCC's usually metastasise
no
27
what pre malignant lesions predispose to SCC
actinic keratoses | bowen's disease
28
what is bowens disease
epidermal carcinoma in situ
29
what are the stages of melanocytic naevi
junctional compound intradermal
30
what is a junctional melanocytic naevi
naevus cells in dermoepidermal junction | tend to be flat/ slighlty elevated with smooth surface and uniform pigmentation
31
what is a compound melanocytic naevi
naevus cells at dermoepidermal junction and upper dermis lesions slightly elevated or dome shaped, often pigmented hairs may project from surface
32
what is an intradermal melanocytic naevi
naevus cells in dermis dome shaped, verrucous (warty) pedunculated or sessile often flesh coloured occasionally hairy and may display surface telangiectasia
33
what are features of benign pigmented lesions
well defined margin, even pigmentation, symmetrical, not changing/ changing very slowly
34
what are the clinical features of MM
``` asymmetry border irregular multiple colours diameter >6mm history of increasing size/ changing shape ```
35
what is involved in the normal process of skin aging
``` 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 ```
36
what are the features of photoaging
solar elatosis- skin coarse and yellow, looses elasticity quickly irregular pigmentation, freckling, lentigo telangiectasia and atrophy, easy bruising roughness and dryness deep wrinkling
37
what therapeutic effects does UV radiation have in psoriasis and dermatitis
anti inflammatory immunosuppressive antiproliferative apoptotic
38
what is PUVA
psoralen + UVA
39
what UV is used for phototherapy
narrowband UVB
40
sunbeds are classified as a carcinogen in the same category as tobacco true/ false?
true