Dermatology

Question 1

[Merocrine Exocrine gland] MOA

Answer 1

Secretes via Exocytosis

Question 2

[Apocrine Exocrine gland] MOA

Answer 2

Secretes via Membrane-bound vesicles = Cell lysis releases entire contents of cytoplasm & cell membrane

Question 3

[Merocrine Exocrine gland] Examples (3)

Answer 3

1. Salivary
2. Eccrine Sweat
3. Apocrine Sweat

Question 4

[Apocrine Exocrine gland] Examples

Answer 4

Mammary glands

Question 5

[Holocrine Exocrine gland] Examples (2)

Answer 5

1. Sebaceous
2. Meibomian

Question 6

What germ layer are Melanocytes derived from

Answer 6

Neural Crest

Question 7

What are Langerhan cells

Answer 7

[Stellate shaped Dendritic cells] found in skin and acting as APC

Question 8

Langerhan cells Histo

Answer 8

Stellate shaped with [Racquet shaped intracytoplasmic granules] known as Birbeck granules

Question 9

What cell line are Langerhan cells derived from

Answer 9

Myeloid Cell line

Question 10

Name the Psoriasis drugs that are Topical Vitamin D analogs and why they help (3)

Answer 10

Calcipotriene / Calcitriol / Tacalcitol

These bind to intranuclear Vitamin D R –> Inhibits Keritinocyte proliferation & differentiation

Question 11

Cyclosporine MOA

Answer 11

Inhibits NFAT (Nuclear Factor of activated T cells) from entering nucleus –> Impairs IL2 production –> Impairs T-cell activation

Question 12

Etanercept MOA

Answer 12

[TNF-a decoy receptor] that binds up TNFa

Question 13

Identify and describe the histology

Answer 13

[Contact Dermatitis Type 4 Hypersensitivity]; [Spongiosis (edema in the intercellular spaes of epidermis)

CD = Weeping, Erythematous, papulovesicular

Question 14

Describe the Histology for Lichen Planus

Answer 14

Hypergranulosis (thickening of Stratum Granulosum)

Question 15

[Chediak Higashi] MOD and Presentation (3)

Answer 15

Defective Neutrophil Phagolysosome formation –> Neuro problems/ Albinism / Immunodeficiency

Question 16

[Eczema Atopic Dermatitis] MOD and its associations (2)

Answer 16

Type 1 Hypersensitivity –> inflammatory skin DO triggered by environmental AND food antigens

associated with [allergic rhinitis] and asthma

Question 17

Describe Compound Nevi

Answer 17

Benign [Melanocyte proliferations] involving BOTH Epidermis AND Dermis –> raised papules with symmetrical borders

Question 18

Describe the MOD and long term SE of Chronic topical Steroid administration (3)

Answer 18

[Dermis Atrophy] –> Drying, Telangiectasia, Ecchymoses

Question 19

Dimpling (Retraction) of overlying skin in a women with Breast CA indicates what pathology

Answer 19

Malignant infiltration of Suspensory Ligaments

Question 20

What does the Microscopy (2) and Skin Biopsy show for Herpes Family infections?

Answer 20

Microscopy = Tzanck Smear = [Cowdry Intranuclear inclusions] + [Multinucleated Giant Cells]

Skin Biopsy = Acantholysis (Desmosome-connected Stratum Spinosum separation)

Question 21

This microscopy taken from upper eyelid indicates what?

Answer 21

Xanthelasma (Lipid Laden Macrophages–> Foam cells) seen in Hyperlipidemia

• Think biliary obstruction/cirrohosis*
• Other [SubQ Xanthomas] can appear on Tendons & finger extensor tendons*

Question 22

Identify; MOD; Histology (2)

Answer 22

Cherry Hemangioma;

small red papules that INC with aging & don’t regress;

Capillary proliferation + [capillary venules in papillary dermis]

Question 23

Identify Dz; List the main characteristics (9)

Answer 23

Psoriasis

PSORIASIS: Plaque/Silver scales/Onycholysis/[Rigid border=Well Demarcated]/[Inappropriate Nail Discoloration]/[Auspich sign]/[Scales tht are WAFTER like]/[Dilated blood vessel]/[Skinny Suprapapillary plates (thin stratum granulosum + parakeratotic corneum)]

Question 24

Vitiligo MOD

Answer 24

Autoimmune destruction of some [Stratum Basale Melanocytes] –> absence of melanocytes in some areas

Question 25

Photoaging (looking older) MOD (3)

Answer 25

UVA makes you Age by —>

1. [epidermal atrophy + flattened rete ridges]
2. DEC Collagen Fibrils
3. INC degradation of [Dermal Collagen & Elastin]

Question 26

Urticaria is a Type __ Hypersensitivity. Describe the Histo

Answer 26

[Type 1 Hypersensitivity (IgE mediated)]; [Epidermal and Dermal Edema from INC microvasculature permeability]

Question 27

Best Prognostic factor for Metastatic Melanoma

Answer 27

[Vertical Growth Depth Breslow]

Early Horizontal growth = low metastatic potential–> Nodular –> Vertical

Question 28

Glomangioma MOD

Answer 28

PAINFUL bluish tumor under the finger nail that comes from [Dermal Glomus smooth m.] which regulate temperature

Question 29

Describe histology for Actinic Keratosis (3) and which CA this may lead to

Answer 29

1. Hyperkeratosis
2. Parakeratosis
3. Keratinocyte atypia

may —> SQUAMOUS cell carcinoma

sandpaper-like texture

Question 30

Dz

Answer 30

Bullous Pemphigoid

Supepidermal blisters

Question 31

Identify the lesions and what their caused by

Answer 31

Solar Lentigo; sun exposed skin in mid-elderly

Question 32

Difference between Zero and 1st order kinetics

Answer 32

zero order = Amount of drug metabolized in a unit of time doesn’t care about serum concentration and is constant

1st order = Amount of drug metabolized in a unit of time CHANGES with serum concentration

Question 33

In Healthcare financing, what is Capitation?

Answer 33

Medical group provides care to all employees in exchange for a set montly fee

Question 34

Phenotypic mixing

Answer 34

Coinfection of host cell by 2 viral strains –> Virions with 1 strain and unchanged parental genome of other. Lack of actual genetic exchange –> next generation revert to unchanged parental genome