Block2 Flashcards
(489 cards)
1
Q
Irreversible/uncontrolled death of cells
A
Necrosis
2
Q
Which cell death may produce exudate (high protein with neutrophils)
A
Necrosis
3
Q
Programmed cell death
A
Apoptosis
4
Q
Which cell death process occurs in ganglion cells during development
A
Apoptosis
5
Q
Cell death process critical in fine-tuning the developing retina
A
Apoptosis
6
Q
4 types of necrosis
A
Coagulative
Liquefactive
Caseous
Fat
7
Q
Which cell death process has inflammation
A
Necrosis
8
Q
Structural boundary of cell is maintained, but internal proteins are denatured
A
Coagulative necrosis
9
Q
Which type of necrosis is due to ischemia/infarction
A
Coagulative necrosis
10
Q
Ischemia of CNS causes which type of necrosis
A
Liquefactive
11
Q
Type of necrosis that leaves pus and fluid –> forming an abscess
A
Liquefactive
12
Q
Necrosis type that usually has an infectious etiology
A
Liquefactive
13
Q
Cheesy proteinaceous dead cell mass
A
Caseous necrosis
14
Q
Most often type of necrosis observed in Tb infections
A
Caseous
15
Q
Death in adipose tissue - small white lesion
A
Fat necrosis
16
Q
Cell death type usually in subcutaneous tissue because of trauma
A
Fat necrosis
17
Q
Necrosis type due to ischemia of organs in the body (NOT CNS)
A
Coagulative
18
Q
Enzyme that initiates the arachidonic acid path
A
Phospholipase A2 (PLA2)
19
Q
What will steroids do to the arachidonic acid path
A
They will stop the arachidonic path
20
Q
Which enzyme to steroids inhibit
A
PLA2
21
Q
2 pathways in arachidonic path
A
LOX and COX
22
Q
Aspirin (NSAIDs) block which arm of the arachidonic path
A
COX
23
Q
The 2 arms of the COX path are
A
PGI2 and TXA2
24
Q
What does aspirin neutralize in the COX path
A
Platelets –> cannot regenerate
25
Which arm of the COX path inhibits platelet aggregation
PGI2
26
Which arm of the COX path promotes platelet aggregation
TXA2
27
Major driver in pain and fever
PGE2
28
PGE2 comes from which pathway in the arachidonic acid path
COX
29
Which arachidonic acid path plays huge role in lungs and asthma
LOX
30
Leukotrienes are involved in which path of the arachidonic acid path
LOX
31
2 inflammatory cytokines leading to fever
IL1 and TNFalpha
32
Primary cytokine that acts on liver to produce APR
IL6
33
What are 3 acute phase reactants (APRs)
Ferritin, fibrinogen, CRP
34
Granulomas are seen in which kind of inflammation
Chronic
35
Epithelium macrophages surrounded by lymphocytes
Granuloma
36
Chronic inflammation: Play a key role in IgE-mediated reactions
Basophils/mast cells
37
Chronic inflammation: can release histamine
Basophils/mast cells
38
Chronic inflammation: contain major basic proteins, which is toxic to parasites
Eosinophils
39
Cardinal signs of acute inflammation
Rubor/calor
Tumor
Dolor
Functio laesa
40
Latin for red
Rubor
41
Latin for heat
Calor
42
Latin for swelling
Tumor
43
Latin for pain
Dolor
44
Latin for loss of function
Functio laesa
45
Which of the cardinal signs of inflammation is not due to histamine
Dolor
46
What is dolor due to
PGE2 (prostaglandins)
47
Primary leukocytes in acute infection
Neutrophils
48
4 steps in neutrophil adhesion and margin action
1- IL1 and TNF increase expression of selectin molecules
2- neutrophils weakly bind to endothelial selecting and roll along surface
3- neutrophils stimulated to express ligands for cellular adhesion molecules
4- neutrophils adhere firmly to ICAMS and VCAMS
**then they emigrate, migrate, ,phagocytize, degranulate and kill what has been eaten
49
Function of IL8
Cleanup
50
Which molecules slow neutrophil movement
Selectin
51
Which molecules stop neutrophils movement
CAMs
52
Neutrophils often form what kind of fluid and why
Exudate bc of lots of cells and proteins
53
What molecules produce histamine
Basophils, platelets and mast cells
54
What molecules produce serotonin
Platelets
55
What two amines cause vasodilation and increased vascular permeability
Serotonin and histamine
56
What is the major effect of bradykinin
Pain
57
What makes aspirins affect on the COX system different than other NSAIDs
Aspirin neutralizes TXA2 which irreversibly prevents sticky platelets
Most NSAIDs target TXA2 as well, but are reversible
58
Cytokine in liver that helps monitor inflammation
IL6
59
Cytokine - PMN chemotaxis
IL8
60
Thelper cells are classified as ____ and TH2 cells drive a ____-mediated response
CD4....antibody
61
Identify the most likely type of necrosis to occur in the brain after a stroke
Liquefactive necrosis
62
TXA2 and PGI2 are products of which path
Arachidonic acid - COX path
63
Mnemonic for 4 types of hypersensitivities
ACID
64
Type 1 HS
Anaphylactic/atopic
65
Type 2 HS
Cytotoxic
66
Type 3 HS
Immune complex
67
Type 4 HS
Delayed (cell mediated)
68
Which HS type is IgE drive
Type 1
69
Type 1 HS late phase response
Arachidonic acid pathway
70
Potency of leukotrienes relative to histamine
Leukotrienes 1000x more potent
71
Cytokine driving IgM to IgE
IL4
72
Cytokine involved in massive IgE production
IL13
73
Initial phase of type 1 HS is drive by
Histamine
74
Late phase of type 1 HS is driven by
Prostaglandins and leukotrienes
75
Cytokine activating eosinophils (IgM to IgA)
IL5
76
IgE in parasites
IfE binds to worm and Fc portion is free
| - Eosinophils collide with parasite, crosslink, and release MBP
77
IgE in mast cells (allergic reactions)
predocked onto mast cell waiting for allergen/antigen to come bind
78
Antibodies driving Type 2 HS
IgG and IgM
79
HS type dealing with transfusion reactions and hyperacute transplant rejection
Type 2 HS
80
If tissue is rejected within minutes --> preformed Abs
Type 2 HS
81
Classic and corneal rejection are what type of HS
Type 4 HS
82
Antihuman IgG is known as
Coombs serum
83
Detects Ab bound to RBCs
direct antiglobulin test (DAT)
84
Detects plasma Abs
Indirect antiglobulin test (IAT)
85
If you want to find out what is destroying the RBCs, which test do you do
DAT
86
Abs driving type 3 HS
IgG and IgM
87
Ab is directly bound to cells in which HS type
Type 2
88
Ab is not bound to cell, but instead bind to immune complexes in which HS
Type 3
89
Local example of type 3 HS
Arthus
90
Systemic example of type 3 HS
Serum sickness
91
Most common cause of serum sickness
Oral drugs
92
Only cell driven HS
Type 4
93
Key cells in Type 4 HS
T-helper cells and macrophages
94
Phlyctenular keratoconjunctivitis (PKC) is an example of what type of HS
Type 4 HS
95
Blister-forming keratoconjunctiviti that occurs due to a type 4 HS reaction to antigens of bacterial origin
PKC
96
Clinician is worried that an Rh-neg mom is going to have an Rh-pos baby. What is she worried about?
Type 2 HS
97
A patient is given a TB skin test. Which HS is being tested and which cells are expected to mediate a positive test result
Type 4....Th1 cells
98
Contact dermatitis, TB skin test, corneal transplant rejection are what type of HS
Type 4 HS
99
Arthus reaction and serum sickness are what HS type
Type 3 HS
100
Asthma and anaphylaxis are examples of which HS types
Type 1 HS
101
3 common triggers for type 1 HS
Food, drugs and stinging insects
102
Flat lesion <1cm
Macule
103
Example of macule
Freckle
104
Elevated solid skin lesion < 1cm
Papule
105
Example of papule
Mole, acne
106
Small fluid-filled blister <1cm
Vesicle
107
Example of vesicle
Shingles
108
Vesicle containing pus
Pustule
109
Example of pustule
Pustular psoriasis
110
Transient smooth papule or plaque
Wheal
111
Example of wheal
Hives
112
Flaking off of stratum corneum
Scale
113
Example of scale
Eczema
114
Dry exudate
Crust
115
Example of crust
Impetigo
116
Classic triad for lupus
Fever
Joint pain
Malar rash
117
Lupus is which type of HS
Type 3 HS
118
Is lupus more common in men or women
Women, but more severe in men
119
Common cause of death in lupus
Cardiovascular disease, renal failure, infection
120
Most common type of lupus
Systemic lupus erythematosis
121
Lab tests for lupus
ANA
Anti-dsDNA
Anti-sm
122
Is ANA specific or sensitivity for lupus
Sensitive
123
Are anti-dsDNA and anti-sm specific or sensitive for lupus
Specific
124
Which antibodies indicate a poor prognosis of lupus
Anti-dsDNA
125
Ocular issues will be seen in how many lupus patients
20%
126
Drugs associated with drug-induced lupus
Quinidine
Isoniazid
Hydralazine
Procainamide
127
Will drug induced lupus be confirmed by anti-dsDNA or anti-sm
Neither, only from transient ANA
128
How do you treat GCA
Steroids
129
If GCA is not treated quick enough, what could happen
Blindness
130
Affects large and medium arteries (ophthalmic and aorta often involved )
GCA
131
Lesions of small and medium arteries
Polyarteritis nodosum
132
Which type of lupus affects only the skin
Discoid lupus
133
Excessive fibrosis
Scleroderma
134
Leading cause of death in scleroderma pts
Pulmonary involvement
135
How often is ANA positive in scleroderma pts
95%
136
Widespread, rapid, going internal type of scleroderma
Diffuse
137
Limited to skin, fingers and face, benign and characterized by CREST
Limited scleroderma
138
C in CREST
Calcinosis
| - calcium deposits in soft tissue
139
R in CREST
Raynaud phenomenon
| - vasospasm in digits (white->blue->red)
140
E in CREST
Esophageal dysmotility
141
S in CREST
Sclerodactyly (claw fingers)
142
T in CREST
Telangiectasia
| - small, dilated vessels near skin
143
CREST syndrome deals with
Limited scleroderma
144
Lab test for diffuse scleroderma
Anti-scl70 Ab
145
Lab test for limited scleroderma
Anti-centromere Ab
146
Destruction of exocrine glands
| - attacks moisture producing glands
Sjogren syndrome
147
Classic triad seen in Sjogren syndrome
Dry mouth, dry eyes and arthritis
148
Positive lab tests in Sjogren syndrome
ANA and RF
149
Most common cause of arthritis
Osteoarthritis (OA)
| - friction/overuse disease
150
Which is more systemic, osteoarthritis or rheumatoid arthritis
RA
151
Which will have higher ESR/CRP, RA or OA
RA
152
Type of HS - RA
Type 3
153
Inflammation of synovial membranes/joints of hands, feet, wrists
RA
154
RF is an autoantibody to what antibody
IgM/IgG
155
Used to diagnose RA
RF
156
How many RA pts will have ocular manifestations
25%
157
Keratoconjunctivitis sicca i seen in how many RA pts
15-25%
158
15% of all cases of scleritis are caused by
RA
159
Which is painful: scleritis or conjunctivitis
Scleritis
160
Most common form of arthritis in kids
JIA
| Juvenile idiopathic arthritis
161
is ANA positive or negative in JIA
Positive
162
Is RF positive or negative in JIA
Negative in 50% of fcases
163
Most common cause of uveitis in children (80%)
JIA
164
Arthritis without having RF (RF negative)
Seronegative spondyloarthropathies
165
HLA-B27 is strongly associated with
Seronegative spondyloarthropathies
166
Examples of seronegative spondyloarthropathies (pair)
psoriatic arthritis
Ankylosis spondylitis
Inflammatory bowel disease
Reactive arthritis
167
Which of the spondyloarthropathies can cause a patient to develop uveitis
Psoriatic arthritis
Ankylosis spondylitis
Reactive arthritis
168
Bamboo spine is seen in
Ankylosis spondylitis
169
Classic triad of reactive arthritis
Conjunctivitis/uveitis, urethritis, arthritis
170
Often associated with sarcoidosis
Uveitis and hyeprcalcemia
171
Granulomatous skin lesions are seen in what disease
Sarcoidosis
172
X-ray shows bilateral adenopathy and coarse reticular opacities
Sarcoidosis
173
Aspirin selectively inhibits which arm of the COX path (more than it inhibts the other)
TXA2
174
If JIA patients are positive for RF, what does that mean
They will have a worse outcome
175
Buildup of atherosclerotic plaque in lumen of common carotid
Carotid stenosis
176
Where is the plaque buildup usually located in carotid stenosis
Near bifurcation of carotid or in internal carotids just distal to bifurcation
177
What does carotid stenosis do to blood flow
Decreases it
178
What can carotid stenosis lead to
Thrombosis at stenotic site or formation of emboli
179
In carotid stenosis, which arteries are most typically occluded
MCA
ACA
Ophthalmic A(monocular blindness)
180
What is carotid stenosis often accompanied by
Bruit
181
Severity of carotid stenosis is defined by
Degree of narrowing of lumen
182
Surgery to remove the artheroscleritic build up
Carotid endarterectomy
183
Is carotid endarterectomy usually done on asymptomatic pts? Why or why not?
No because of high risk
184
What are 2 alternatives to surgery for carotid stenosis
Angioplasty and stenting
185
Carotid stenosis pts may gradually develop complete filling occlusion of a long segment of internal carotid
This is called
Carotid occlusion
186
Trauma-induced tear in the intimate lining of vessel
Carotid/vertebral dissection
187
Pt's may claim to hear a popping sound in what carotid occlusion typ
Carotid/vertebral dissection
188
Flap of tissue concluding the vessel
Carotid/vertebral dissection
189
Presentation in carotid/vertebral dissection
Pain in distribution areas (orbital with carotid a, neck/occipital pain with vertebral a)
Signs of transient ischemic attacks
Horner's syndrome ipsilaterally
190
Large artery vasculitis is known as
Temporal arteritis (GCA)
191
Vasculitis is typically in which 3 arteries
Superficial temporal
Vertebral
Ophthalmic
192
What nerve is vulnerable to temporal arteritis
Optic nerve
193
Signs of temporal arteritis indicate an emergency to prevent what
Blindness
194
How to treat GCA
Glucocorticoids (anti-inflammatory)
195
presentation of GCA
Visible loss of blood perfusion to affected side of face
Fever and aches/pains
Jaw claudification (pain when chewing)
196
What demographics does GCA usually affect
White women over 70
197
Most common origin for orbital disorder in adults
Graves' disease
198
Hyperthyroid syndrome
Graves' disease
199
Explain the mechanism of grave's disease
Ab have a stimulatory effect on TSH receptors, activating T3/T4
200
Presentation of grave's disease
Often a goiter
Tachycardia
Fatigue, weight loss, anxiety, heat intolerance, sweating, increased appetite
201
Antibodies in Graves' disease also induce excess production of what
Glucosaminoglycans in orbital fat and EOMs
202
Thyroid-associated ophthalmopathy
```
Periocular swelling
Lid retraction
Eyes bulge (exophthalmos)
Diplopia and disconjugate gaze
Frequent complaints of F or pain during eye movements
```
203
Oculomotor deficits in Graves' disease
Typically impaired elevation and abduction
204
What type of patients is laryngeal carcinoma more common in
Smokers
205
Does the CNS have lymphatics
No
206
Does lymphoma typically makes its way into the brain
No, not unless primary CNS lymphoma
207
Is laryngeal carcinoma likely to invade CNS
No
208
Most common form of this carcinoma originates in parotid gland
Salivary gland carcinoma
209
Is salivary gland carcinoma likely to lead to visual system disturbances
No
210
If it spreads to cranial sinuses, what kinds of carcinoma are likely to invade intracranially
Craniopharyngeal and nasopharyngeal carcinomas
211
Benign form of lymphoma initiated in lymphatics or blood
Chronic lymphocytic lymphoma (b cell lymphoma)
212
Is primary CNS lymphoma common
No, rare and develops from glial cells
213
In what type of patients are cutaneous viral infections of greatest concern
Immunosuppressed patients
214
Umbilicated papule typically appearing in clusters are usually dealing with what
Molluscum contagiosum
215
What time of infection is molluscum contagiosum
Viral
216
What is a sign of healing in Molluscum contagiosum
Erythema (redness) around lesions
217
Can Molluscum contagiosum be transferred
Yes, sexual partners are at risk
218
Can Molluscum contagiosum clear on its own
Yes, typically it clears in 6 months unless in an immunosuppressed patient
219
What may Molluscum contagiosum look like in immunosuppressed patients
Diffuse lesion, unilateral conjunctivitis
220
There are more than 150 types of this virus
HPV
221
Virus including warts
HPV
222
Is HPV considered pre-malignant
Yes, in the cervix
223
Most common warts infection often seen in school aged kids and resolve spontaneously
Verruca vulgaris
224
In what layers of the skin is verruca vulgaris
Confined to epidermis
225
What is pahtognomonic for warts
Black dots, helps distinguish it from a callus
226
3 main predisposing factors of Verruca vulgaris
Impaired immunity
Pregnancy
Occupation (handling raw meat)
227
Which HPV types cause conjunctival papilloma
6 and 11
228
Where is Conjunctival papilloma usually at and what does it look like
Usually in fornix or palpebral conj and it is pedunculated (not flat)
229
Grouped vesicles with erythematous base
Herpes simplex virus (HSV)
230
What percent of genital cases of HSV are absent of symptoms
70%
231
Can HSV be transmitted, even if the pt is asymptomatic
Yes
232
HSV1 is located in which parts of the body
Above neck
233
HSV2 is located in which parts of the body
Below waist
234
Is HSV always present if the pt is infected, or does it remain latent
Remains latent in root ganglia after primary infection
235
Where does recurrence of HSV symptoms typically occur
An region innervated by the infected nerve
236
Can you get rid of HSV
No, it is for life and recurrence can happen at any time
237
What are some of the triggers of recurrence of HSV
```
Irritation
Menstruation
Medication
Other infections
Immunosuppressive
```
238
What is the lesion type in HSV
Erythemetous papules that rupture easily, forming erosions
239
Most common sites of primary HSV infection
Mouth, anogenitalia, digits
240
HSV1 shedding is detected in 40% of what patients
Herpetic facial paralysis (bell palsy)
241
Ocular infections due to HSV
Recurrent dendritic keratitis
Disciform enotheliitis
Uveitis
Blepharoconjunctivitis
242
Major cause of corneal scarring and vision loss? Which HSV can usually call this?
Recurrent dendritic keratitis
| HSV1 unless neonate (HSV2 if get it from mom during birth)
243
How is Varicella zoster virus transmitted
Airborne droplets and directly
244
Infects mucosa of upper respiratory tract, replicates in mononuclear phagocyte system then it spreads to skin/mucous, then to sensory nerves
Varicella zoster virus
245
What type of lesions after Varicella zoster virus reactivates
Pain and vesicular lesions
246
Why are HSV and VZV infections similar
Remain latent in nerve until reactivated by stress or immunosuppression
247
What dermatomes are VZV most commonly seen
Trigeminal, cervical, thoracic, lumbar, or sacral
248
Primary VZV is seen as
Chickenpox, very diffuse
249
After VZV remains latent for a while and reappears as herpes zoster, how does it look on the body
Stays dermatomal
250
Ocular involvement in VZV
Hutchinson's sign
Belpharoconjuncitivits
Episcleritis
Facial palsy
251
What is hutchinsons sign
Rash at tip of nose indicating VZV
252
3 acute inflammatory dermatoses
Urticaria
Eczema
Erythema multiforme
253
3 chronic inflammatory dermatoses
Psoriasis
Seborrheic dermatitis
Lichen planus
254
Presentation is wheals (hives) typically on trench, distal extremities and ears
Urticaria
255
What antibody can urticaria depend on
IgE
256
Is Urticaria always IgE dependent
No
257
Seen as red, oozing, crusted lesions that develop into scaling plaques
Eczema
258
Most common type of eczema marked by itching, burning or both
Contact dermatitis
259
Most famous example of allergic contact dermatitis
Poison ivy
260
Antigen responsible for allergic contact dermatitis (eczema)
Urushiol
261
Skin reactions caused by psoralen in plants and exposure to UV-A sunlight
Phytodermatitis
262
Is the skin more likely to rupture in urticaria or eczema
Eczema
263
Known for honey-colored lesions
Impetigo
264
Bacteria responsible for Impetigo
Staph. Aureus
| Group a beta-hemolytic streptococci
265
2 forms of Impetigo are based on
Size of lesions
266
Lesions in Impetigo contagiosa
Crusty pustules
267
Types of lesions in Impetigo bullosa
Bulla
268
Most common sites of Impetigo
Face/nose
269
Deeper infection of Impetigo, resulting in erosion to dermis
Ecthyma
270
Staphylococcal infection of hair follicle
Folliculitis
271
Areas of body that Folliculitis is most commonly found
Axilla, face and legs
272
Occurs in setting of staphylococcal Folliculitis
Furuncule
273
Firm nodule that develops an abscess, sometime with a central pustule
Furuncule
274
Composed of multiple, coalescing furuncules
Carbuncle
275
Contains subcutaneous abscesses, superficial pustules and draining pus
Carbuncle
276
Beta-hemolytic strep colonize skin and sprea along superficial lymph vessels
Erysipelas
277
Where is Erysipelas typically seen
Face and booty
278
Usually seen with a erythematous expanding plaque
Erysipelas
279
Associated with people with arthritis, myopathy, enteropathy and AIDS
Psoriasis
280
Areas that Psoriasis usually affects
Elbows, knees, scalp, lumbosacral, intergluteal cleft, glans penis
281
Lesions are well demarcated, salmon colored, covered with silver-white loose scales
Psoriasis
282
30% of cases have nail involvement with pitting and discoloration
Psoriasis
283
Chronic inflammatory that has acanthosis
Psoriasis
284
What is acanthosis
Epidermal thickening
285
What is Psoriasis mediated by
T cells
| - strong association with HLA-C
286
More common chronic inflammatory infection than Psoriasis
Seborrheic dermatitis
287
Involved regions wth high densities of sebaceous glands
Seborrheic dermatitis
288
Most common clinical expression of Seborrheic dermatitis
Dandruff
289
In infants, the most common sign of Seborrheic dermatitis is
Cradle cap
290
Early Seborrheic dermatitis is similar to
Eczema
291
Late Seborrheic dermatitis is similar to
Psoriasis
292
Pruritic, purple, polygonal papules with wickham striae
Lichen planus
293
Resolve spontaneously after 1-2 years
Lichen planus
294
Blistering disease in kids is usually
Impetigo
295
Blistering disease in adults is usually
Pemphigus
296
Most common variant of pemphigus
Pemphigus vulgaris
297
80% of pemphigus cases are
Pemphigus vulgaris
298
Pemphigus variant involving mucosa and skin in face, axial, and pressure points
Pemphigus vulgaris
299
Lesions are superficial vesicles and bullpen that rupture easily --> dried serum, crust
Pemphigus vulgaris
300
Pemphigus vulgaris deals with antibodies to
IgG
301
Immunofluorescence shows IgG deposited in what kinds of pattern in Pemphigus vulgaris
Fishnet pattern
302
Lesions are Bullae filled with clear fluid that do not rupture easily
Bulbous pemphigoid
303
Has a subepidermal, nonacantholytic blister (no epidermal thickening)
Bulbous pemphigoid
304
Antigens are proteins in hemidesmosomes that attach basal cells to basement membrane
Bulbous pemphigoid
305
Immunofluorescence shows what pattern of deposits in Bulbous pemphigoid
Linear
306
Are blackhead caused by dirt
No
307
Do certain foods worsen acne
No
308
Will scrubbing the face daily help clear up acne
No
309
Will acne disappear after 20s
No
310
Does stress exacerbate acne
No
311
Adolescent acne
Acne vulgaris
312
Andorgenic hormones cause abnormal keratinization of follicles
- hereditary
Acne vulgaris
313
Disorder of sebaceous follicles
Acne vulgaris
314
Bacteria involved in acne
Propionibacterium acnes
315
4 stages of acne
Black heads (open comedones)
White heads (closed comedones)
Papules
Pustules
316
Acne classification: usually just comedones
Mild acne
317
Acne classification: more inflammatory and may heal with scars
Moderate acne
318
Acne classification: larger, deeper and more numerous papules or pustules; occurs on trunk
Cystic
319
Type of acne: leaving pitted scars on face or hypertrophic scars on back; tx is difficult if it the trunk is involved
Sequelae
320
What makes Rosacea and acne different
Rosacea doesn't have comedones
321
Lesions appear on flush areas (nose, cheeks, forehead, chin)
Rosacea
322
Ocular involvement of this is blepharoconjunctivits
Rosacea
323
Precipitating factors of Rosacea
Sun, excessive face washing, irritating cosmetics
324
Seen in middle-aged men with Rosacea
Rhinophyma
325
What is rhinophyma and where on the body is it seen
Disfiguring sebaceous hyperplasia
Makes the nose look big and bubbly
326
Roses-cheeked completion in Rosacea patients
Prereosacea
327
Facial erythema and tenagiectasias
Prerosacea
328
Do patients with prerosacea ever develop inflammatory lesions typical of Rosacea
No
329
Loss of melanocytes/pigment
Vitiligo
330
Loss of pigmentation in Vitiligo can be caused by
Infection
Dermatitis
Chemical irritation
Idiopathic
331
Enhanced pigment transfer from melanocytes
Melasma
332
Melasma is associated with
Pregnancy and oral contraceptives
333
When will Melasma resolve
Spontaneously after hormone administration is discontinue
Sun can accentuate it
334
Localized hyperplasia of melanocytes; oval tan-brown macule or patches
Lentigines (lentigo)
335
Birthmarks are known as
Lentigines (lentigo)
336
Does Lentigines (lentigo) darken in the sun
No
337
Cafe Au lait spots
Lentigines (lentigo)
338
Too many cafe au lait spots may signal
Neurofibromatosis type 1
339
Develop with age and sun exposure (liver spots)
Solar (actinic) lentigines
340
Where are scabies mites seen
predominantly between fingers and on the wrists
341
Where are scabies rashes commonly seen
Axilla, trunk, genitalia, knees
342
Pathognomoic lesion of scabies
The burrow
343
Moles are known as
Nevocellular nevi (nevus)
344
Any neoplasm of melanocytes; brown, uniformly pigmented papules with well-defined borders
Nevocellular Nevi
345
Type of nevi: flat, can grow to form the other kind
Junctional nevi
346
Type of nevi: contain cords of nevus cells in dermis, raised, dome-shaped
Compound nevi
347
Larger than most acquired nevi and are abnormally shaped
| - familiarly precursors of malignant melanoma
Dysplastic nevi
348
Spotty and dark in the middle, surrounded by lighter area; no distinct borders
Dysplastic nevi
349
Thickened hyperigmented skin; velvet like texture, affecting flexural areas
Acanthosis nigricans
350
Most of the time, Acanthosis nigricans is: benign or malignant
Benign (80%)
351
Clinical marker for obesity and insulin resistance
Acanthosis nigricans - benign
352
Crater like morphology with center containing keratin mass
Keratoacanthoma
353
Does Keratoacanthoma have a malignant risk
No
354
Sharply demarcated plaques, in pts after 30-40 yoa
Seborrheic keratosis
355
If singular or very few, does Seborrheic keratosis have a malignant risk
No
356
If there are hundreds of plaques in Seborrheic keratosis, is there a malignant risk
Yes
357
Occur on exposed skin of fair-skinned elders; from chronic overexposure to UV light (face and behind ears)
Actinic keratosis
358
Ill-defined erythematous macule or papules with scaly surface
Actinic keratosis
359
If left untreated, Actinic keratosis can lead to
Squamous cell carcinoma
360
Is Actinic keratosis benign, pre-malignant or malignant
Pre-malignant
361
Red, scaling plaques; common in men over 60yo
Squamous cell carcinoma
362
Is Squamous cell carcinoma benign or malignant
Malignant
363
Risk factors for Squamous cell carcinoma
Sun exposure
Fair complexion
Carcinogens
(Anything irritating to skin)
364
Cutaneous horns are often associated with
Squamous cell carcinoma
365
Usually discovered with small and respectable
Squamous cell carcinoma
366
Common, slow growing, and usually curative is taken out; rarely metastasizes; pearly papules
Basal cell carcinoma
367
Is Basal cell carcinoma benign or malignant
Malignant
368
Where is Malignant melanoma typically seen in males
Upper back
369
Where is Malignant melanoma typically seen in females
Back and legs
370
Most important clinical sign of Malignant melanoma
Change in color, size or shape in pigmented lesion
371
Rule for malignancy
ABCD rule
372
ABCD rule: A
Asymmetry
373
ABCD rule: B
Border irregularity
374
ABCD rule: C
Color
375
ABCD rule: D
Diameter >1 cm
376
Risk factors for malignant melanoma
Intermittent sun exposure - BAD sunburns
Fair skin
Dysplastic nevus syndrome
377
Best prognosis of malignant melanoma is with tumors that grow in which direction
Horizontally
378
Common melanoma in Caucasians
Superficial spreading melanoma
379
Common melanoma type in dark-skinned
Acral-lentiginous melanoma
380
Metastasis in malignant melanoma in unlikely if the tumor is
< .76 mm
381
Top cancer sites in men
Prostate
Lung
Colorectal
382
Top cancer sites in women
Breast
Lung
Colorectal
383
Leading cancer deaths in men and women
Lung
384
New, uncoordinated growth
Neoplasm
385
Discontinuous spread of a malignant neoplasm to distant sites
Metastasis
386
4 primary targets of genetic damage
- growth-promoting proto-oncogenes (dominant)
- growth-inhibiting tumor suppressor genes (recessive - 2 hit required)
- apoptosis-regulating genes
- dna repair genes
387
Most common target in human tumors
P53
388
Function of p53
Cells cycle arrest and initiation of apoptosis
389
Loss of p53 results in
Unprepared dna damage --> may lead to malignancy
390
Path of neoplasia
Normal --> hyperplasia --> metaplasia --> dysplasia --> neoplasia --> infiltration --> metastasis
391
An abnormality in cell size and appearance
Dysphasia
392
Alteration of normal growth regulatory mechanism (lost control)
Neoplasia
393
6 hallmarks of cancer
```
Evading apoptosis
Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Tissue invasion and metastasis
Limitless replicating potential
Sustained angiogenesis
```
394
Slow growing:benign or malignant
Benign
395
Encapsulated: benign or malignant
Benign
396
Non invasive: benign or malignant
Benign
397
Well differentiated: benign or malignant
Benign
398
Rapidly growing: benign or malignant
Malignant
399
Invasive: benign or malignant
Malignant
400
Matastasis: benign or malignant
Malignant
401
Poorly differentiated: benign or malignant
Malignant
402
Benign tumor of glandular epithelial tissue
Adenoma
403
Malignant tumor of glandular epithelial tissue
Adenocarcinoma
404
2 benign types of tumors
Adenoma and lipoma
405
Malignant tumor of epithelial tissue
Carcinoma
406
Malignant tumor of immune system
Lymphoma
407
Fingerlike projections growing on surface
Papillomas
408
Malignant tumors of bone, muscle, or connective tissue
Sarcoma
409
Tumor where muscle and bone connect
Osteosarcoma
410
Most common tumor (aside from the eye) in retinoblastoma
Osteosarcoma
411
Osteosarcoma usually involves which bone
Femur
412
Most common childhood ocular cancer
Retinoblastoma
413
60% of RB cases are: non-hereditary or hereditary
Non hereditary
414
Which type of RB affects 1 eye: non-hereditary or hereditary
Non hereditary
415
Which type of RB has a huge risk of osteosarcoma and sarcoma: nonhereditary or hereditary
Hereditary
416
Type of RB affecting both eyes: nonhereditary or hereditary
Hereditary
417
Hereditary RB mutation occurs where
Germ cell line
418
Most common type of RB
Non hereditary
419
Top cancer sites in men
Prostate
Lung
Colorectal
420
Top cancer sites in women
Breast
Lung
Colorectal
421
Leading cancer deaths in men and women
Lung
422
New, uncoordinated growth
Neoplasm
423
Discontinuous spread of a malignant neoplasm to distant sites
Metastasis
424
4 primary targets of genetic damage
- growth-promoting proto-oncogenes (dominant)
- growth-inhibiting tumor suppressor genes (recessive - 2 hit required)
- apoptosis-regulating genes
- dna repair genes
425
Most common target in humor tumors
P53
426
Function of p53
Cells cycle arrest and initiation of apoptosis
427
Loss of p53 results in
Unprepared dna damage --> may lead to malignancy
428
Path of neoplasia
Normal --> hyperplasia --> metaplasia --> dysplasia --> neoplasia --> infiltration --> metastasis
429
An abnormality in cell size and appearance
Dysphasia
430
Alteration of normal growth regulatory mechanism (lost control)
Neoplasia
431
6 hallmarks of cancer
```
Evading apoptosis
Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Tissue invasion and metastasis
Limitless replicating potential
Sustained angiogenesis
```
432
Slow growing:benign or malignant
Benign
433
Encapsulated: benign or malignant
Benign
434
Non invasive: benign or malignant
Benign
435
Well differentiated: benign or malignant
Benign
436
Rapidly growing: benign or malignant
Malignant
437
Invasive: benign or malignant
Malignant
438
Matastasis: benign or malignant
Malignant
439
Poorly differentiated: benign or malignant
Malignant
440
Benign tumor of glandular epithelial tissue
Adenoma
441
Malignant tumor of glandular epithelial tissue
Adenocarcinoma
442
2 benign types of tumors
Adenoma and lipoma
443
Malignant tumor of epithelial tissue
Carcinoma
444
Malignant tumor of immune system
Lymphoma
445
Fingerlike projections growing on surface
Papillomas
446
Malignant tumors of bone, muscle, or connective tissue
Sarcoma
447
Tumor where muscle and bone connect
Osteosarcoma
448
Most common tumor (aside from the eye) in retinoblastoma
Osteosarcoma
449
Osteosarcoma usually involves which bone
Femur
450
Most common childhood ocular cancer
Retinoblastoma
451
60% of RB cases are: non-hereditary or hereditary
Non hereditary
452
Which type of RB affects 1 eye: non-hereditary or hereditary
Non hereditary
453
Which type of RB has a huge risk of osteosarcoma and sarcoma: nonhereditary or hereditary
Hereditary
454
Type of RB affecting both eyes: nonhereditary or hereditary
Hereditary
455
Hereditary RB mutation occurs where
Germ cell line
456
Most common type of RB
Non hereditary
457
Visible whiteness in pupil
Leukocoria
458
3 ways cancer spreads
Direct invasion and extension
Seeding in body cavities
Metastatic spread through blood/lymph
459
Cancer enters blood vessels
Intravasation
460
Cancer exits vessels and enters tissue
Extravasation
461
Development of new blood vessels
Angiogenesis
462
Cancer grading scheme uses what 3 letters
TNM
463
Cancer grading: T
Primary tumor
| - higher number, bigger it is
464
Cancer grading: N
Regional lymph nodes (axillary to clavical)
465
Cancer grading: Tx
Can't assess primary tumor
466
Cancer grading: t0
Breast free of tumor
467
Cancer grading: t1
<2cm
468
Cancer grading: t2
2-5 cm
469
Cancer grading: t3
>5 cm
470
Cancer grading: nx
Cannot assess
471
Cancer grading: n0
No lymph nodes
472
Cancer grading: n1
1-3 axillary nodes
473
Cancer grading: n2
4-9 axillary nodes
474
Cancer grading: n3
10+ axillary or spread to clavical nodes
475
Cancer grading: M
Distant metastasis
476
Cancer grading: mx
Cannon assess
477
Cancer grading: m0
No spread
478
Cancer grading: m1
Distant spread present
479
Mnemonic for 7 signs of cancer
Caution
480
7 signs of cancer: C
Change in Bowel/bladder
481
7 signs of cancer: a
A sore throat that wont heal
482
7 signs of cancer: u
Unusual bleeding or discharge
483
7 signs of cancer: t
Thickening or lump
484
7 signs of cancer: i
Indigestion of difficulty swallowing
485
7 signs of cancer: o
Obvious change in wart or mole
486
7 signs of cancer: n
Nagging cough or hoarseness
487
Is there usually pain associated with early stage of malignancy
No
488
Grading a tumor deals with
Cellular differentiation
489
Staging a tumor deals with
Progression/spread
