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Primer DIT > video 18 Dermatology > Flashcards

video 18 Dermatology Flashcards

1
Q

What stratum is decreased in psoriasis and which one increased?

A

Stratum Granulosum is decreased and the stratum Spinosum is increased.

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2
Q

How is composed tight junction?

A

It composed of Claudins and occludins.

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3
Q

To what junctions work with Cadherins ?

A

Adherens Junction, and it is calcium dependent adhesion proteins. * Loss of E-Cadherin promotes metastasis.

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4
Q

Which junction is support via Keratin interaction?

A

Desmosome (macula adherents ), autoantibodies -> pemphigus vulgaris.

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5
Q

Which junction permit electrical and chemical communication between cells?

A

Gap junction. Cardiac cells myosin.

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6
Q

Which junction is involved in bullous pemphigoid?

A

Hemidesmosome connects keratin in basal cells to underlying basement membrane. Autoantibodies for bollous pemphigoid.

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7
Q

Which proteins maintain the integrity of basolateral membrane?

A

The integrins the maintain integrity of basolateral membrane by biding to collagen and basement membrane.

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8
Q

What cells are responsible for the skin color?

A

Melanocytes.

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9
Q

4 years male who present to the the service with a pruritus eruption, red rash, antecedent patient with asthma, the eruptions are located in antecubital fossae, mother said that the eruptions starts on the face. What is the diagnostic?

A

Atopic dermatitis also called Eczema.

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10
Q

25 years female coming to the service because noted some warts “like a cauliflower” in her hands, at the examination there are papules, soft, tan-colored, dermatoscopy findings: epidermal hyperplasia, hyperkaratosis and koilocytosis. Which is the causal agent for this pathology?

A

HPV caused Verrucae.

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11
Q

What is the difference between intradermal and junctional nevi?

A

Intradermal nevi are papular and the junctional nevi are flat macules.

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12
Q

What kind of hypersensitivity is the allergic contact dermatitis?

A

Type IV hypersensitivity reaction that follows exposure to allergen. Lesion occur at site of contact (e.g. Nickel, poison ivy, neomycin).

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13
Q

There are four things that created acne:

A

1) Hyperketarosis.
2) Sebum over production.
3) Bacterial.
4) Inflamation.

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14
Q

Which is the treatment for Hyperketarosis acne?

A

Topical retinoic acid, Isotrtioin (Accutane).

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15
Q

Acne developed by sebum overproduction, which are the treatments ?

A

Isotrtioin, Spironolactone and Oral Contraceptives pills.

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16
Q

Acne developed by propionibacterium acne proliferation which is the treatment?

A

1) Antibiotics: Erythormycin, Tetracycline, Doxycycline, Minocycline and topical Clindamycin.
2) Benzoyl peroxide.

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17
Q

What is the treatment for Acne developed by inflammation?

A

Steroids

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18
Q

35 years old female, coming to the service because she noted “stains on my skin in the elbows”, at the examination we find Papules and plaques with silvery scaling, in her elbows, also we find its in her knees too, and visible Auspitz signal, on the dermatoscopy findings: increased of the stratum Spinosum and decreased of stratum Granulosum. What is the Auspitz sign? And which is the treatment for this patient?

A

1) Auspitz sign: pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off.
2) Topical steroids.

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19
Q

Which are the epidermis layers?

A

Corneum, Lucidum, Granulosum, Spinosum and Basalis.

“California Likes Girls in String Bikinis”

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20
Q

What is the characteristics over Seborrheic keratosis, and how is it look?

A

Flat, greasy, pigmented squamous epithelial proliferation with keratin-filled cysts (Horn cysts), looks “stuck on”.

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21
Q

Where can you find Seborrheic keratosis ?

A

Lesions on head, trunk and extremities.

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22
Q

Which is the more common benign neoplasm of older persons?

A

Seborrheic keratosis

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23
Q

How is the number of melanocytes, melanin production and tyrosinase activity in Albinism?

A

Normal melanocytes number, low melanin production -> due to low tyrosinase activity

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24
Q

How is the risk of skin cancer in Albinism?

A

Increased

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25
Q

A 34- years old woman, who presented with irregular areas of complete depigmentation, Which is the most likely diagnosed, and what is it caused?

A

Vitiligo, caused by autoimmune destruction of melanocytes.

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26
Q

A 26 weeks pregnant women coming to the service because she noted “stains on her face”, since 16 week, which is the most likely diagnosed, and how do you confirm the diagnosed?

A

Melasma or Chloasma is a Hyperpigmentation associated with pregnancy (“mask of pregnancy”) or OCP use. Melas a is usually diagnosed visually or with assistance of a Wood’s lamp.

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27
Q

Where is the most common area that melasma affect?

A

Face “mask of pregnancy”

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28
Q

Impetigo can be caused by…

A

S. Aureus or S. Pyogenes. Also is highly contagious, honey colored crusting.

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29
Q

Patient with a skin infection in her left leg that presented acute, painful, this infection started after a trauma when her skin breaks. You are thinking in an infection caused by S. Aureus or S. Pyogenes, about what disease we are talking?

A

Cellulitis, spreading infection of deeper dermis and subcutaneous tissues.

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30
Q

Deeper tissue injury infection usually from anaerobic bacteria or S. Pyogenes?

A

Necrotizing fasciitis.

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31
Q

Where does crepitus come from?

A

Crepitus results from methane and CO2 production.

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32
Q

“Flesh-eating bacteria”

A

Necrotizing Fasciitis.

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33
Q

patient with fever, generalized erythematous rash, the disease is caused by exotoxins, which is the most common diagnosed?

A

Staphylococcal Scalded Skin Syndrome. Exotoxin destroys keratinocytes attachments in stratum Granulosum only.

34
Q

Irregular, white, painless plaques on tongue that cannot be scrapped off, which is the causal agent of this disease?

A

Hairy leukoplakia by EBV.

35
Q

Which is the Blistering skin disorder that is potentially fatal autoimmune skin with IgG antibody against desmoglein?

A

Pemphigus Vulgaris.

36
Q

In pemphigus Vulgaris which structure of the desmosomes are affected by IgG antibody?

A

Desmoglein.

37
Q

How is flaccid intraepidermal bullae caused?

A

It is caused by acantholysis (keratinocytes in stratum Spinosum are connected by desmosomes), oral mucosa also involved.

38
Q

What does immunofluorescence reveals in pemphigus vulgaris?

A

It reveals antibodies around epidermal cells in a reticular (net-like) pattern.

39
Q

How is the Nikolsky sign in pemphigus vulgaris ?

A

It is the separation of epidermis upon manual stroking of skin, and it is positive.

40
Q

Which structure is affected by IgG antibody in Bullous pemphigoid?

A

IgG against hemidesmosomes, and the Nikolsky sign is negative.

41
Q

Patient diagnosed by celiac disease, present pruritic papules, vesicles, and bullae in the elbows, which is the most likely diagnosed?

A

Dermatitis herpetiformis.

42
Q

Which is more severe pemphigus vulgaris or bullous pemphigoid ?

A

Bullous pemphigoid is less severe than pemphigus vulgaris.

43
Q

Patient with vesicles, macules, papules and Target lesions, what is the group of risk from this diseases?

A

Erythema multiforme is associated with infections (e.g. Mycoplasma pneumoniae, HSV), drugs (e.g. Sulfa drugs, beta lactams, phenytoin), cancers and autoimmune disease.

44
Q

Wich drugs are involve with Steven-Jhonson Syndrome?

A

Sulfa drugs, Allopurinol and penicillin.

45
Q

Which characteristics are found in Steven-Jhonson Syndrome?

A

SJS is characterized by fever, bullea formation and necrosis, sloughing of skin, high mortality rate.

46
Q

When is Steven-Johnson syndrome called SJS-Toxic Epidermal Necrolysis?

A

A more severe form of SJS with >30% of the body surface are involved is Toxic Epidermal Necrolysis. 10-30% involvement denotes SJS-TEN.

47
Q

Pruritic, Purple, Polygonal, Planar Papules and Plaques, those all are part of the Which disease?

A

Lichen Planus, 6 P’s.

48
Q

Which is the premalignant lesion caused by sun exposure ?

A

Actinic Keratosis

49
Q

Actinic keratosis is a risk factor for what kind of skin cancer?

A

Risk of squamous cell carcinoma is proportional to degree of epithelial dysplasia.

50
Q

What is the Acanthosis Nigricans?

A

Piper all hyperplasia causing symmetric, Hyperpigmentation thickening of skin, especially in neck or axilla.

51
Q

What another disease is associated with Acanthosis Nigricans ?

A

Hyperinsilunemia and Visceral malignancy (gastric adenocarcinoma).

52
Q

Painful inflammatory lesion subcutaneous, erythema nodosum is associated with…

A

-Sarcoidosis. -coccidioidomycosis. -Histoplasmosis. -TB. -Streptococcal infections. -Leprosy. -Crohn disease.

53
Q

How many weeks need the pityriasis rosea to self-resolving?

A

6-8 weeks.

54
Q

Which is the most common skin cancer?

A

Basal cell carcinoma. Found in sun-exposed areas of body, rarely metastasize.

55
Q

Which skin cancer is chacracterized by “palisading” nuclei in the biopsy?

A

Basa cell carcinoma.

56
Q

Histopathology: keratin “pearls”. Appears on face, lower lip, ears, hands. Those all are characteristics for which skin cancer?

A

Squamous cell carcinoma. Second most common skin cancer.

57
Q

Which variant of the squamous cell carcinoma grows rapidly (4-6weeks) and may regress spontaneously over months?

A

Keratoacanthoma.

58
Q

Which is the common skin cancer with significant risk of metastasis?

A

Melanoma, depth of tumor correlates with risk of metastasis.

59
Q

What is the ABCDE of melanoma means?

A

A(asymmetry), B(border irregularity), C(color variation), D(diameter >6mm) and E(evolution over time).

60
Q

How many types of melanoma exists ?

A

There are at least 4 different types of melanoma: 1)superficial spreading. 2)nodular. 3)lentigo maligna. 4)acral lentiginous.

61
Q

Which is the primary treatment for melanoma?

A

Excision with appropriately wide margins.

62
Q

What are some of the hallmark features of necrotizing fasciitis? What organism cause this infection?

A
  • Rapidly-spreading cellulitis.
  • Tenderness beyond the red border (underlying fascial infection).
  • Strep pyogenes (group A strep).
63
Q

What infectious agent cause painless white patches on the tongue that cannot be scraped off?

A

Oral hairy leukoplakia due to EBV.

64
Q

Which skin disorder matches with pruritic, purple, polygonal papules?

A

Lichen Planus.

65
Q

Which skin disorder matches with life threatening rash with bullae?

A
  • Steven-Jhonson Syndrome.
  • Toxic epidermal Necrolysis.
  • Pemphigus vulgaris.
66
Q

Which skin disorder matches with pruritus associated with asthma?

A

Atopic dermatitis.

67
Q

Which skin disorder matches with pruritic vesicles associated with celiac disease?

A

Dermatitis herpetiformis.

68
Q

Which skin disorder matches with allergy to nickel?

A

Contact dermatitis.

69
Q

Which skin disorder matches with thickened scr especially around face/chest?

A

Keloid.

70
Q

Which skin disorder matches with antibodies against epidermal basements membrane?

A

Bullous pemphigoid.

71
Q

Which skin disorder matches with antibodies against cell-cell adhesions?

A

Pemphigus vulgaris

72
Q

Which skin disorder matches with parakeratotic scaling?

A

Psoriasis

73
Q

Which skin disorder matches with keratin-filled cysts?

A

Seborrheic keratosis

74
Q

Which skin disorder matches with sand-paper, predisposition to squamous cell cancer?

A

Actinic keratosis.

75
Q

Which skin disorder matches with skin rash and proximal muscles weakness?

A

Dermatomyositis.

76
Q

Which skin disorder matches with honey-crusting lesions common about the nose and lips?

A

Impetigo.

77
Q

Which skin disorder matches with hyperkaratosis and koilocytosis ?

A

Verrucae.

78
Q

Which skin disorder matches with histology shows palisading nuclei?

A

Basal cell carcinoma.

79
Q

Keratin pearls on skin biopsy

A

Squamous cell carcinoma.

80
Q

Most common malignant skin tumor?

A

Basal cell carcinoma

Primer DIT (9 decks)

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