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Medicine Year 2 (Bear) > Week 225 Malignant Melanoma > Flashcards

Week 225 Malignant Melanoma Flashcards

1
Q

Week 225

What is the most common commensal bacteria on skin?

A

Staph Epididimis (>90% in some areas)

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2
Q

Week 225

Which bacteria is associated with acne?

A

Propiniobacterium Acnes

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3
Q

Week 225

Which type of exotoxin can cause scalded skin syndrome?

A

Exfoliative Exotoxins - these break down dermasones.

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4
Q

Week 225

Which Exotoxins cause Toxic Shock syndrome?

A

Superantigens. Threse bind irreversibly to T cells, producing hyperactivtion and increased cytokine production.

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5
Q

Week 225

Which types of infections tend to be caused by Streptococcus Pyogens?

A
  • Deeper spreading infections with systemic symptoms
  • Ecthyma
  • Erisypelas
  • Cellulitis
  • Necrotising Fasciitis
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6
Q

Week 225

Which bacteria is the usual cause of Impetigo?

A
  • Staph. Aureus - Localised infection confined to the epidermis (this is why it doesn’t scar).
  • V contagious
  • Rarely causes systemic symptoms
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7
Q

Week 225

What condition is this?

A

Impetigo

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8
Q

Week 225

What is Bullous impetigo?

A
  • Painless, fluid filled blisters
  • Caused by exfoliative toxin
  • Blisters may have pruritic skin around them
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9
Q

Week 225

What is this infection?

A
  • This is Ecthyma
  • Localised infection which spreads to dermis - DOES scar
  • Crusted/ulcerated lesions
  • mostly on legs
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10
Q

Week 225

Which bacteria usually causes Ecthyma?

A

Strep. Pyogens.

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11
Q

Week 225

What is folliculitis?

A

Superficial Infection of 1+ Hair follicles

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12
Q

Week 225

What is a Furuncle?

A

This is a boil. A small abscess formed from 1+ infected hair follices and sebaceous glands.

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13
Q

Week 225

What is a Carbuncle?

A
  • Large deep abscess formed from a group of contigious follicles.
  • Usually caused by Staph Aureus
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14
Q

Week 225

What is topical Fusidic acid or Mupirocin used for?

A

Used for mild/local skin infections

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15
Q

Week 225

Which oral antibiotics are recommended for widespread infections caused by Staph Aureus?

A
  • Flucloxacillin or Erythromycin
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16
Q

Week 225

What oral antibiotics are used for an infection caused by Strep. Pyogenes?

A

Penicillin OR Erythromycin

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17
Q

Week 225

What is this infection?

A
  • This is Erysipelas
  • Infection of dermis and subcut tissue
  • Well demarcated, raised border
  • Erythematous, hot swolen region
  • May progress to systemic if not treated
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18
Q

Week 225

What is the difference between Erysipelas and Cellulitis?

A
  • Cellultis is in subcut tissue only. This means that it is less well demarcated than Erysipelas.
  • Likely progress to systemic symptoms
  • Strep Pyogens likely cause of both
  • Lymphangitis can occur in either
  • Nephritis (rare) can occur in either
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19
Q

Week 225

Which condition is this?

A

This is necrotising Fasciitis. The large dark bullae are classical symptoms. If you leave it without surgical management, it gets this bad!

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20
Q

Week 225

What is the usual cause of Necrotising Fasciitis?

A

Strep pyogenes. USually gains access through prior trauma or lesions.

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21
Q

Week 225

Which age group does Scalded skin syndrome usually occur in?

A

Infants/young children

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22
Q

Week 225

What is the antibiotic treatment for Cellulitis or Erysipelas?

A

Flucloxacillin or Erythromycin

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23
Q

Week 225

What is the treatment for Necrotising Fasciitis?

A

Immediate surgical debridement, with IV Benzylpenicillin + Clindamycin + Gentamicin

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24
Q

Week 225

Corynebacteria are normal commensals, that can sometimes cause minor pathologies in moist areas. So what’s this?

A

This is Erythrasma. Hyperpigmented Macular patches. Pink on black skin, bron on white. Well demarcated, and lichenified (leathery skin).

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25
Q

Week 225

What is this condition?

A

This is pitted keratolysis. Yup. Pretty gross, right?

Pits in superficial skin of sole of foot. Commensal bacteria roduce keratinases, which break the skin down.

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26
Q

Week 225

What is this condition?

A

This is Erythema migrans. “Bullseye”. This is a classical symptom of Lyme disease, caused. by Borellia Burdoferi.

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27
Q

Week 225

Which spirochaete is the cause of this infection? What is it commonly called?

A

This is SYPHILIS. Niiiiiiiice.

Caused by Treponema Pallidum - a spirochaete (Gram -ve bacterium).

Tends to start with a solitary red papule, then prgree to a secondary rash 3-4 months after infection.

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28
Q

Week 225

What is this? What is it caused by?

A

This is Lupus Vulgaris. Caused by TB.

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29
Q

Week 225

What is the name of this infection?

A

This is a fishtank Granuloma caused by Mycobacterium Marinum

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30
Q

Week 225

What is the name of this infection?

A

This is thrush. Candidiasis. Caused by C. Albicans ( a fungus) usually.

And yes, it happens in vaginas too, but I’m starting to feel queazy with all of these infections so I skipped that one.

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31
Q

Week 225

What are the treatments for ORal thrush?

A

Amphotericin, Nystatin or Miconazole in lozenge/suspension/gel

32
Q

Week 225

What are the treatments for cutaneous thrush (Think athletes foot)?

A

Topical Azoles i.e. Clotrimazole

33
Q

Week 225

What is the name given to this infection? What causes it? How is it treated?

A

This is Pityriasis Versicolor. This is casued by a fungus, M. Globosa/M.Furfur

It is treated with topical Azoles i.e. Miconazole, Fluconazole

34
Q

Week 225

What is seen here?

A

This is Seborrhoeic dermatitis

  • Reaction to Malassezia infection (fungus)
  • Dandruff, usually on scape and face.

Treat with topical Azoles, i.e. Ketoconazole

35
Q

Week 225

Dermatophyte infections are confined to dead, cornified layers of skin and other tissue. Which areas are the following confined to?

  1. Tinea Corporis
  2. Tinea Manuum
  3. Tinea Cruris
  4. Tinea Pedis
  5. Tinea Capitis
  6. Tinea unguium
  7. Tinea Incognito
    8.
A
  1. Ringworm - trunk or limbs
  2. Hands
  3. Jock itch (niiiice) - found on groin and upper thigh
  4. Athletes foot - Interdigital clefts or sock pattern (on foot)
  5. Scalp
  6. Nails
  7. Infection hidden by steroids - comes back way worse afterwards!
36
Q

Week 225

What are the treatments for Tinea. spp infections (dermatophytes)?

A

Clotrimazole

If nails/Hair, give oral: e.g. Itraconazole, terbinafine, Greiseofulvin

37
Q

Week 225

What is this?

A

This is MEASLES

  • Forms a Morbilliform rash
  • -ve SS RNA virus
  • Transmitted via respiratory droplets
  • Spreads via local lymph nodes to organs and skin
38
Q

Week 225

What is this? What is it a symptom of?

A

This is Koplik’s Spots, a symptom of Measles (AKA Rubeloa)

39
Q

Week 225

What types of infections tend to cause Vesicular Rashes?

A

DNA viruses, e.g. Herpes - HSV Rashes, Varicella Zester

Exceptions inc. slapped cheek syndrome

40
Q

Week 225

Which infection is this?

A

Herpes Simplex virus. Type 1 is oral - on the left. Type 2 is sexual - on the right.

41
Q

Week 225

What is this?

A

This is Chickenpox.

  • Varicella virus
  • PaPular –> Vesicular –> Pustular/crusted rash
  • Prodromal phase - fever, malaise, anorexia
42
Q

Week 225

What is this infection?

A

This is shingles (Zoster virus)

ss enveloped DNA virus

43
Q

What is this infection?

A

This is mol luscum contagiosum, a viral infection, Enveloped DS DNA virus.

Usually infects the skin of children.

44
Q

Week 225

What infection is this? What is the usual history?

A

This is ORF. Parapox virus. Ds DNA Virus.

History: Often by contact with sheep or reindeer.

45
Q

Week 225

What is this?

A

HPV - Common wort. Raised wart with rough edges.

46
Q

Week 225

What type of Wart is this?

A

This is a filliform wart.

47
Q

Week 225

What is the treatment for HEadlice?

A

Malathlon

Permethrin

(Lotion)

48
Q

Week 225

What are the treatments for Scabies?

A

Contagious - spread by mites.

Permethrin - topical.

Antihistamine - to decrease inflammation.

49
Q

Week 225

What is a macule?

A

This is an UNRAISED localised area of colour/texture change,

50
Q

Week 225

What is a papule?

A

This is an area of elevation of the skin <5mm in diameter.

51
Q

Week 225

What is a Nodule?

A

This is elevation of skin >5mm in diameter

52
Q

Week 225

What are Bulla?

A

A large blister (>5mm) consisting of clear fluid within/below the epidermis

53
Q

Week 225

What is a vesicle?

A

A small (<5mm) blister filled with clear fluid.

Often occur in viral infections e.g. dermatitis herpetiformis

54
Q

Week 225

What is a Pustule?

A

This is a visible collection of free pus in the epidermis or deemirs (Either blister or spot)

Usually a sign of infection

55
Q

Week 225

What is a cyst?

A

A cyst is a nodule consisting of an epithelial-lined cavity filled with fluid or semi-solid material

56
Q

Week 225

What is a wheal?

A

This is a transitory, compressible papule or plaque or dermal OEDEMA. May be red or white in colour.

Usually signifies urticaria.

57
Q

Week 225

What is a plaque?

A

A palpable, plateau-like elevation of skin, usually >2cm in diameter.

58
Q

Week 225

What is a Scale?

A

Accumulation of thickened horn layer of Kerratin, in the form of readily detachable fragments.

59
Q

Week 225

What is an ulcer?

A

An area of skin loss extending into the dermis (through epidermis). USually due to impaired vascular or nutrient supply to the skin.

60
Q

Week 225

What are Keratinocytes?

A

These are cells of the epidermis, produced by stem cells in stratum germinativum.

61
Q

week 225

What are Melanocytes?

A

These are cells of the epidermis.

Located in the stratum germinativum - produce melanin

62
Q

Week 225

What are Langerhan cells?

A

These are cells of the epithelium. They are located in the stratum spinosum. Antigen presenting immune cells in the skin.

63
Q

Week 225

What are the five layers (strata) of the epidermis?

A
  • corneum - flattened sheets
  • lucidum - thin layer of dead cells
  • granulosum - dying cells
  • spinosum - langerhans cell
  • germanitavum - one cell thick
64
Q

Week 225

What is the dermis? What important structures are within it?

A

Thickest layer - up to 4mm

  • Provides tensile strength to skin and has supportive function
  • Contains blood suppy, connectuve tissue and nerve endings
  • Contains messners corpuscles, pacinian corpuscles, and sebaceous glands.
65
Q

Week 225

Which glands produce mily sweat and odour?

A

Apocrine glands

66
Q

Week 225

What are the names of the two layers of the dermis?

A

Papillary layer

Reticular Layer

67
Q

Week 225

Which skin types are most at risk of cancer?

A

1 and 2

68
Q

Week 225

What is Xeroderma pigmentosum?

A

Autosomal recessive disorder of DNA repair after UV.

69
Q

Week 225

What are the signs of a melanoma?

A

Asymmetry

Border Irregularity - Border usually irregular & may be poorly defined i.e. fade into skin

Colour Irregularity

Different colours/shades & colour change should

↑suspicion. Not always pigmented

Diameter - >6mm
- Moles below this size usually benign

Evolving
- ~All have hx of change in shape/size/colour over weeks/months

May be pruritic/painful or asymptomatic; may ulcerate

N.B.
May occur in nail bed/under nail - spread of pigment
to skin to side of nail suspicious

70
Q

Week 225

Which gene is mutated (usually) in Squamous cell carcinoma?

A

p53 Tumour Suppressor Gene

71
Q

Week 225

What is Bowen’s Disease? How do you treat it?

A

Carcinoma in situ - remains in epidermis.

  • Erythematous placques
  • Scaling/crusting
  • Well defined irregular border
  • Treated with: Diclofenac
    (anti-inflam),
    5-Fluorouracil (chemo),
    Imiquimod (immunomodulator)
72
Q

Week 225

What is a basal cell carcinoma?

A

Neoplasm of stem cell in basal layer of dermis.

Those with Gorlin syndrome are 90% likrly to have BCC in their lifetime.

  • They are slowly enlargig, and often bleed on trauma.
  • Therapy is usually either excision, Topical therapy or radiation.
73
Q

Week 225

What condition is this?

A

Sebherreic Keratoses

“bron black stuck on warts”

BENIGN

74
Q

Week 225

What condition is this?

A

Keratomacanthoses

This is a BENIGN condition. Umbilicated/kerratinous core.

75
Q

Week 225

What condition is this?

A

This is pyogenic Granuloma

BENIGN

Tendency to bleed, rapidlyoccur at point of previous trauma.

76
Q

Week 225

What condition is this?

A

Dermatofibroma

This is BENIGN

Multiple often seen in SLE or immunocompromised.

77
Q
A

Medicine Year 2 (Bear) (30 decks)

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