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review / wrong answers > DIT review - MSK 3 > Flashcards

DIT review - MSK 3 Flashcards

1
Q

Describe histologic features of psoriasis

A
  • Acanthosis (epidermal hyperplasia)
  • Increase in stratum spinosum and decrease in stratum granulosum
  • Parakeratosis (hyperkeratosis with retention of keratinocyte nuclei in the stratum corneum)
  • Munro microabscesses (neutrophils within the stratum corneum)
  • Auspitz sign (pinpoint bleeding due to thinning of epidermis above elongated dermal papilla)
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2
Q

Describe gross appearance of seborrheic keratosis

A
  • Raised, discolored plaques that have a coin-like, “waxy/greasy” appearance
    • “Stuck on”
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3
Q

Describe histology of seborrheic keratosis

A

Keratin pseudocysts

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4
Q

What is Lesser-Trelat sign

A
  • multiple seborrheic keratosis appearing suddenly
    • Suggestive of GI malignancy
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5
Q

Describe defect behind albinism

A
  • Congenital lack of pigment due to enzyme defect (e.g. tyrosinase) that impairs melanin production
  • Normal melanocyte number with decreased melanin production
  • Increased risk of skin cancer
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6
Q

Describe defect behind vitiligo

A

Localized loss of skin pigment due to autoimmune destruction of melanocytes

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7
Q

What are pathogens that cause impetigo

A
  • Superficial bacterial skin infection
  • Usually due to Staph aureus or Strep pyogenes
  • Honey-colored crusting
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8
Q

What is Erysipelas

A
  • Infection involving upper dermis and superficial lymphatics
  • Usually from Strep pyogenes
  • Well-define demarcation between infected and normal skin
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9
Q

Pathogens and skin layers involved in cellulitis

A
  • Acute, painful spreading of infection to deeper dermis and subcutaneous tissue
  • Usually from Strep pyogenes or staph aureus
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10
Q

In what skin disorder do you see crepitus

A

Necrotizing fasciitis

  • Results in crepitus from the methane and CO2 production
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11
Q

In what skin layer does epidermolysis occur in staph scalded skin syndrome

A
  • Results in epidermolysis of stratum granulosum
  • Leads to sloughing of skin (+Nikolsky sign)
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12
Q

What pathogen is the cause of hairy leukoplakia

A

Ebstein Barr virus (EBV)

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13
Q

What is seen on histology in molluscum contagiosum

A
  • Cytoplasmic inclusions within keratinocytes (molluscum bodies)
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14
Q

Describe histology of pemphigys vulgaris

A
  • Acantholysis of stratum spinosum
  • Basal layer remains attached = “tombstone” appearance
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15
Q

Describe immunofluorescence of pemphigus vulgaris

A
  • Immunofluorescence will have a fish net appearance à IgG and C3 deposits in a “chicken wire” pattern
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16
Q

What is the defect in dermatitis herpetiformis

A
  • Deposits of IgA at tips of dermal papillae
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17
Q

Presentation and disease associated with dermatitis herpetiformis

A
  • Pruritic papules, vesicles, and bullae (often found on elbow)
  • Associated with Celiac disease
18
Q

What layer of the skin is seperated in SJS?

A

Epidermal-dermal junction

19
Q

Classic presenation of SJS?

A
  • Fever, bullae, necrosis, targetoid lesions
  • Sloughing of skin at epidermal-dermal junction
  • Usually 2 mucus membranes involved
20
Q

Drugs that cause SJS?

A
  • Seizure medications (Ethosuximide, Carbamazepine, Lamotrigine, Phenytoin, Phenobarbitol)
  • Sulfa medication
  • Penicillin
  • Allopurinol
21
Q

What defines Toxic epidermal necrolysis (TEN)

A

More severe form of Stevens-Johnson that involves >30% of body surface

22
Q

Describe presentation of Lichen planus

A
  • 6 P’s = pruritic, purple, polygonal, planar, papules and plaques
  • Wickham striae (reticular white lines) = mucosal involvement
  • Think of a witch (idk why Lichen makes me think of witches)
    • Witches wear purple and have a bunch of warts – 6 Ps
    • Wicken = Wickham striae
23
Q

Histology of Lichen planus

A
  • Inflammation of dermal-epidermal junction
  • Saw-tooth appearance
    • Witches torture people = sawtooth
24
Q

What are hyperkeratotic scaly plaque, often appearing on face, back, or neck

Precursor to squamous cell carcinoma

A

Actinic keratosis

25
Q

What epidermal layer is especially hyperplastic in acanthosis nigracans?

A

statrum spinosum (definition of acanthosis is increased stratum spinosum)

26
Q

Common causes of erythema nodosum

A
  • Painful inflammatory disorder of subcutaneous fat, usually on anterior shins
  • Associated with sarcoidosis, coccidioidomycosis, histoplasmosis, TB, strep, leprosy, IBD
27
Q

What is pityriasis rosea

A
  • Initial lesion (“herald patch”) followed by scaly erythematous plaques in a “Christmas tree” distribution on trunk
  • Self-resolving in 6-8 weeks
28
Q

What other disease is associated with Lichen planus

A

hepatitis C

29
Q
A
30
Q

What is the most common skin cancer?

A

Basal cell carcinoma

31
Q

What skin cancer is most likely to be malignant?

A

Melanoma

32
Q

What tumor presents with nodules of cells with peripheral palisading?

A

Basal cell carcinoma

33
Q

Describe gross appearance of basal cell carcinoma

A
  • Elevated nodule with central, ulcerated crater with rolled borders surrounded by dilated vessels (telangiectasias) = “pink, pearl-like papule”
34
Q

What carcinoma appears on lower lip vs. upper lip

A

THINK: This is BS:

  • B = basal cell upper lip
  • S = squamous cell lower lip
35
Q

Histology of squamous cell carcinoma

A

Keratin pearls

36
Q

What is keratocanthoma

A

well-differentiated squamous cell carcinoma that develops rapidly and regresses spontaneously

37
Q

Mutation commonly associated with melanoma

A

BRAF kinase mutation

38
Q

What are the ABCDEs of melanoma

A
  • Asymmetry, border irregularity, color variation, diameter > 6 mm, evolution
39
Q

Tumor marker of melanocytes

A
  • S-100 tumor marker (neural crest cell marker)
40
Q

Radial vs. Vertical growth of melanoma

A
  • Radial growth
    • Horizontal growth along epidermis and superficial dermis
    • Low risk of metastasis
  • Vertical growth
    • Into deep dermis
    • Increases risk of metastasis
    • Breslow thickness is most important prognostic factor
41
Q

Treatment for melanoma

A
  • Vemurafenib for patients with BRAF V600E mutation

review / wrong answers (140 decks)

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