skin neoplasms

Question 1

Arsenic is a risk factor for which skin neoplasm?

Answer 1

squamous cell carcinoma

Question 2

What are the biopsy findings that are characteristic of basal cell carcinoma?

Answer 2

basophilic-staining basal epiderma cells arranged in palisades

Question 3

Why can’t shave biopsies be done for suspicious melanotic lesions?

Answer 3

not enough tissue for clear dx and cannot be used to measure lesion depth

Question 4

What are the 4 kinds of melanoma?

Answer 4

superficial spreading, nodular, acral lentiginous(involving palms, soles, and nails), lentigo maligna (long lasting in situ phase before any vertical growth)

Question 5

What is nodular melanoma?

Answer 5

most growth occurs vertically; rapidly invasive lesion, difficult to detect

Question 6

How is melanoma treated surgically?

Answer 6

In situ: 0.5 cm margin
2 mm thick: 2 cm margin with possible lymph node dissection
chemo and radiation if metastatic

Question 7

What are common sites of metastatic melanoma?

Answer 7

lung, brain, GI tract, but really can go anywhere

Question 8

What is the most important prognostic factor in melanoma?

Answer 8

thickness of lesion: >0.76 mm is associated with incr. risk of mets

Question 9

How does treatment for PEA differ from treatment for Vfib/Vtach without pulse?

Answer 9

Vfib and pulseless vtach should be treated with CPR, 2 rounds of shocks, then alternating epinephrine (or vasopressin) with shocks. consider antiarrhythmics if refractory
In contrast, PEA is treated just with epinephrine and vasopressin. evaluate and treat causes.

Question 10

What are causes of PEA?

Answer 10

Hs and Ts: hypovolemia, hypoxia, hyperkalemia, hypothermia, acidosis (H ions). tamponade, tension pneumothorax, thrombosis (MI or PE), toxins