Pathology Flashcards

1
Q

Localised overgrowth of blood vessels in the dermis =

A

Haemangiomas causes a port wine stain

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2
Q

melanoblasts migrate from neural crest to ++_

A

skin
uveal tract
leptomeninges

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3
Q

gene that determines balance of pigment in skin and hair

A

MC1R (melanocortin 1 receptor)

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4
Q

MC1R turns __ to __melanin

A

phaeo to eu

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5
Q

hair colour caused by phaeomelanin

A

red

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6
Q

1 defect in MC1R =

2 defects =

A

freckles

red hair and freckles

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7
Q

ephilides

A

freckles - patchy increase in melanin pigmentation

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8
Q

actinic/solar lentigines

A

age/liver spots
increased melanin and basal melanocytes
face, forearms and dorsal hands
elongated rete ridges in epidermis

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9
Q

acquired naevi in childhood = junctional naevus -

A

melanocytes proliferate and cluster at DEJ

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10
Q

acquired naevi in adolescence = compound naevus -

A

junctional clusters and groups of melanocytes in dermis

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11
Q

acquired naevi in adults = intradermal naevus -

A

no junctional activity, entirely dermal

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12
Q

dysplastic naevi 2 types =

increase in melanoma risk

A

sporadic - slight risk increase

familial - 100% increase risk

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13
Q

dysplastic naevi histological findings

A

architectuarl and cellular atypia
host-reaction inflam and fibrosis
epidermis not effaced (unlike melanoma)

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14
Q

characteristics of halo naevi

A

peripheral depigmented halo

inflammatory regression and overrun by lymphocytes

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15
Q

Blue skin pigmentation is caused by

A

brown deep in skin scatters light

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16
Q

blue naevi characteristics

A

entirely dermal and consist of pigment rich dendritic spindle cells.

17
Q

Characteristics of spitz naevi

A

in <20yos
large spindle +/epithelioid cells
most entirely benign

18
Q

rare sites for malignant melanoma

A
oesophagus
meninges
eye
biliary tract
anus
19
Q

Radial growth phase of melanoma =

A

macules grow either entirely in situ or with dermal microinvasion

20
Q

Vertical growth phase of melanoma =

A

invade dermis with formation of expansile mass with mitoses

only VGP metastasise

21
Q

melanomas that have a radial and vertical growth phase (RGP and VGP)

A

superficial spreading
acral/mucosal lentiginous
lentigo maligna

22
Q

melanoma type that only has a VGP (vertical growth phase)

A

nodular

23
Q

common site of nodular melanoma

grows quickly in __ causing __ to stretch thin

A

trunk
dermis
epidermis stretched thin

24
Q

suffix b added to staging of melanoma -

A

ulceration

25
Q

If have advanced melanoma which is difficult to treat with Sx alone =

A

chemo, immunotherapy or gene therapy

26
Q

C-kit mutations are usually in ___ melanomas

Rx -

A

acral

imatinib

27
Q

melanomas on intermittently sun-exposed areas have __ mutation
Rx -

A

BRAF

dabrafenib + vemurafenib (combo with a MEK inhibitor)

28
Q

benign melanocytic lesions (3)

A

ephilides (freckles)
lentigines (macule)
naevi

29
Q

classification of congenital melanocytic naevi by size

A

small <1.5cm diameter
medium 1.5-19.9cm
large 20+cm

30
Q

congenital naevi characteristics that are different from acquired

A

larger
slightly raised
more rugose and elevated as they age

31
Q

neoplastic melanocytes along the basal layer with can become invasive
usually on ace of elderly with sun damage =

A

lentigo maligna melanoma

32
Q

macule with irregular border and colour which has a slow RGP and rapid VGP (develops nodule)

A

superficial spreading melanoma

33
Q

blue-black/red-skin coloured nodule which may be ulcerated/bleed and develops rapidly over months
no surrounding macular pigmentation =

A

nodular melanoma

34
Q

Hutchinson sign =

in ___

A

pigmented extension into nail fold

acral lentiginous melanoma

35
Q

multiple black/brown greasy “stuck-on” lesions often on trunk with a regular border

A

seborrheic keratoses

36
Q

Rx for seborrheic keratoses

A

reassure
freeze
curette

37
Q

firm nodule of dermal connective tissue, brown/grey
may be caused by insect bites
reassure and excise

A

dermatofibroma

38
Q

talon noir =

A

subcorneal haematoma = black heel

due to trauma