Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology Y2 JC > Week 3 > Flashcards

Week 3 Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

Define counter transferance

A

The effect the patients feelings have on you, and the reaction of yours to this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define fundamental attribution error

A

Judgemental clinicians blaming the patient rather than seeing something that is wrong e.g obese patient due to overeating rather than hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Man presents with a painless lump that has slowly grown over a while, it is pearly translucent and has visible blood vessels. It also has a central dip. Diagnosis? Treatment?

A

Basal cell carcinoma of the cystic type

Surgical removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elderly Man presents with a crusty thick lesion that is scaling on his scalp. It has progressed from just a flat red area, to scaley then just got worse. He mentions he worked in the navy and didnt use sunscreen. Diagnosis? Treatment?

A

Squamous cell cancer
(Common on sun exposed areas like scalp, ears, lip, common for high risk metastasis)
Excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the relevance of breslows thickness?

A

Measure of melanoma from the granular layer to the deepest point of the tumour. It is a sign of prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some of the features you look for in determining a benign or malignant lesion

A

ABCDE
Asymmetry, border, colour (multiple colours), diameter (6-7mm), evolution (changed over weeks/ months)
Ugly duckling sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the genetic predisposition for developing skin cancer?

A

Type I skin
DNA repair syndrome- xeroderma pigmentosum, gorlins syndrome, albinism
Epidermolysis bullosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

give some examples of driver mutations for cancer

A 
RAS
B-RAF
EGF
Rb 
TP53
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

UVA is worse to be exposed to than UVB. T/F why?

A

F
UVB has a shorter wavelength so has greater penetration into the DNA to directly effect it by creating pyrimidine dimers
UVA has a long wavelength and so causes indirect DNA damage by oxidative mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the effects of chronic UV exposure on the immune system

A

Becomes immunosuppressive due to the keratinocytes secreting IL-10 to downregulate it. As well as making the langerhan cells less effective to present antigens to dendritic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mutations of the CDK2A or CDK4 proteins carry a high risk of what cancer

A

Familial melanoma mutations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mutations of the RAS, BRAF, MAPK pathway can lead to what skin cancer?

A

Melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In basal cell carcinoma what tumour suppresor gene isn mutated?

A

PTCH1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Embryologically what is the development of melanocytes?

A

Melanoblasts Migrate from the neural crest to the skin, uveal tract, leptomeninges to then become melanocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 5 types of melanocytic naevi

A 
Congenital
Usual type
Dysplstic
Spitz
Blue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the development of naevus

A

Multiple naevus (melanocytes) collect in a ‘nest’ originating from the epidermal junction that then progressively descend into the dermis. So junctional naevus, compound naevus, then intradermal naevus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are melanocytic naevi?

A

Naevus clusters that grow uncontrollably and can be precursors to melanoma

18
Q

What are the different types of melanocytic naevi

A 
Congenital
Usual type
Dysplastic
Spitz (commoner in kids)
Blue
19
Q

Describe the pathology of melanoma

A

Beginning from the melanocytes in the basal layer they begin to proliferate uncontrollably then invade into the dermal layer.

20
Q

55 year old female presents with a dark raised macuole that is irregular, with a diameter of around 10mm on her cheek, it is different shades. She mentions that it was previously a birth mark but has changed over the last two months. It has some dark patches surrounding the central macuole. She is a type I skin and used to be a lifeguard. Diagnosis?

A

Melanoma

Specifically, (odds would be) lentigo maligna as its a sun exposed site

21
Q

What are the two growth phases of melanoma?

A

RGP (radial growth phase) where progress into a macuole e.g superficial stage
VGP (vertical growth phase) where progress into skin depth

22
Q

What is the term for a melanoma originating in the mouth or sole of the foot?

A

Acral/ mucosal lentiginous

23
Q

Nodular melanoma originates as a flat patch that then gains height T/F?

A

FALSE; extremely fatal as growth is so rapid it goes from normal to nodule.

24
Q

What is a sentinel node biopsy?

A

Where you identify sentinel nodes around the melanoma by injecting dye then excise them to send for biopsy to see if cancerous

25
Q

Man of 70 years presents with a lesion on his abdomen, it is pigmented, raised, quite rough on the surface and has an almost greasy appearance. Regular border. Diagnosis?

A

Benign seborrhoeic

26
Q

Elderly women presents with a scaley, crusted erythmatous patch on her leg. It was a small patch but has gradually gotten bigger over the year. Shes used emollients but it hasnt gotten any better. Diagnoiss?

A

Bowens disease as it is scaley, not BCC as it doesnt involve the dermis so wouldnt be scaley.

27
Q

Women with pre-existing bowens disease on her hand now presents with a raised nodule with a central ulcer in the same spot. It arose quite suddenly. Likely diagnosis?

A

Squamous cell carcinoma

Bowens is a known precursor and on the hand which is a sunexposed area makes diagnosis of scc likely

28
Q

What are some known precursor lesions to squamous cell cancer?

A

Bowens disease
Actinic keratosis
Viral lesions

29
Q

Elderly man presents with multiple scaley lesions on his scalp. Theyve been there for a long time. Histology shows partial thickness dysplagia of epidermal keratinocytes. Diagnosis? Treatment?

A

Actinic keratosis
Aldara an immunomodulator
Efudix - cytotoxic medication

30
Q

Elderly man presents with a pigmented raised lesion with a regular border on his back. It has a dimpled surface and looks stuck on. Diagnosis

A

Seborrhoeic keratoses

31
Q

70 year old man presents with a multi-coloured lesion on his forearm. It wasnt present 2 months ago and is quite itchy. It has an irregular border and isnt symmetrical. Diagnosis?

A

Melanoma

32
Q

What would the transition of a junctional naevus, compound naevus and intradermal naevus appear as on the skin?

A

Junctional; flat pigmented and fat
Compound; raised and brown
Intradermal; raised but skin coloured

33
Q

Can melanoma be non-metastasising?

A

Yes during the radial growth phase where it is just spreading across the epidermis it is classed as in-situ
When get to the vertical growth phase then it is metastising ability

34
Q

Define a chronic leg ulcer

A

An open lesion between the knee and ankle joint lasting more than 4 weeks

35
Q

What are some of the possible causes of chronic leg ulcers?

A

Varicose veins, vasculitis, malignancy, inflammatory, arterial insufficiency

36
Q

Haemocidrin presence is a sign of what?

A

Venous stasis
It is the discolouration of the skin due to rbc leaking out of venules/ capillaries and appearing brown due to the presence of iron

37
Q

Man with known stenting presents with a punched out red ulcer medially on his proximal calf. He has some hair loss and limbs are cold. What may the cause be of his ulcer?

A

Arterial insufficiency

38
Q

Man presents with chronic venous ulcer. Why must an ABPI be performed? What is a normal range?

A

To see if the arterial supply is good enough for compression stockings. 0.8-1.2

39
Q

What is the time frame for an ulcer to heel ?

A

12 weeks. If not in this time reconsider diagnosis

40
Q

If an ulcer is covered in ‘slough’ then what methods are there to remove it. As it inhibits healing

A 
Hydrogels to soak it up
Scrape it off
Maggot therapy
Honey
Can put zinc paste around it to prevent leakage into other areas of skin
41
Q

What is the long term treatment for ulcers after they heal?

A

Compression stockings for life and use emollients

42
Q

What is the most common cancer in 15-24 year olds?

A

Melanoma

Dermatology Y2 JC (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions