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Clinical Pathology > Diseases of the Skin and Eye > Flashcards

Diseases of the Skin and Eye Flashcards

1
Q

Virus that can cause scarring of the cornea and conjunctiva

A

VZV

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2
Q

2 forms of chlamydia that damage the cornea and conjunctiva

A

Trachoma: tropical disease. Common cause of blindness.

Chlamydia types d-k- mild disease: acquired during birth from infection in genital tract.

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3
Q

6 causes of cateracts

A 
Senile degeneration
Rubella
Down's syndrome
Irradiation
Uveitis-inflammation of uvea (middle eye)
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4
Q

2 retinal infections

A

Toxoplasma: cat is host. Congenital infection causes severe bilateral disease. Aquired causes focal inflmmatory disease.
Toxocara Canis: from infected dog faeces, larva may migrate to retina and die causing localised inflammation.

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5
Q

3 types of retinal vascular disease

A

Ischaemia
Hypertensive retinopathy- flame shaped haemorrhages and exudates
Diabetic Retinopathy-dot and blot haemorrhages and exudates

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6
Q

2 types of macular degeneration

A

Dry macular degeneration (90%) Age related, common >60yrs. Progressive visual impairment, no treatment.
Wet macular degeneration (10%) New vessel growth beneath retina. Treat with drugs and lazers. Drugs inhibit vessel growth, injected directly into the eye.

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7
Q

2 types of tumours of the eye

A

Retinoblastoma

Melanoma

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8
Q

Retinoblastoma

A

Rare, 10% familial. Loss of Rb gene. Tumour in the retinal, treat with enucleation.

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9
Q

Melanoma

A

Arise in the melanocytes of the uveal tract (iris, ciliary body or choroid)
Type 1: good prognosis
Type 2: poor. Treat with radiotherapy and surgery.

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10
Q

Another word for genital warts

A

Condylomas

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11
Q

Superficial bacterial infection

A

Impetigo

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12
Q

Deep bacterial infection

A

Cellulitis

NF

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13
Q

Fish tank granuloma

A

Caused by mycobacteium marium.

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14
Q

Leprosy

A

Mycobacterium leprae. Chronic granulomatous infection. can involve nerves.

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15
Q

3 stages of eczma

A

Acute dermatitis
Subacute dermatitis
Chronic

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16
Q

Acute dermatitis

A

Red skin, weeping, serous exudate with or without vesicles.

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17
Q

Subacute dermatitis

A

Red skin, less exudate, really itchy and crusty

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18
Q

Chronic dermatitis

A

Skin thick and leathery, secondary to scratching

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19
Q

Spngiosis

A

Intercellular oedema within epidermis that you find in eczma

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20
Q

Clinical characterisitics of dermatitis

A

Chronic inflammation-predominantly superficial dermis. Epidermal hyperplasia and hypekeratosis.

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21
Q

5 types of dermatitis

A 
Atopic eczma
Contact irritant dermatitis
contact allergic dermatitis
Seborrhoeic dermatitis
Nummular dermatitis
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22
Q

Coin shaped lesions, a type of dermatitis

A

Nummular dermatitis

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23
Q

Removal of psoriasis scab causes small bleeding points

A

Auspitz sign

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24
Q

Microscopic appearace of psoriasis

A

Psoriasiform Hyperplasia

  • regular elongated club shaped rete ridges
  • thinning of epidermis over dermal papilla
  • parakeratoti (contain nuclei) scale
  • collections of nuclei (munro microabscesses)
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25
Q

Pathogenesis of psoriasis

A

Massive cell turnover and inflammation

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26
Q

Causes of psoriasis

A

Genetic. Associated with MS/IBD

Environmental triggers-infection, stress, trauma, drugs, smoking.

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27
Q

Assocations of psoriasis

A

Arthropathy
CVD
Cancer (Basal cell carcinoma)

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28
Q

Discoid LE

A

Lupus that only affects the skin

29
Q

Systemic LE-

A

Visceral disease

30
Q

Microscopic appearance of lupus

A

Thin, atrophic epidermis. Infalmmation and destruction of adnexal structures.
Immunofluorescence shows LE band due to IgG deposited in basement membrane. i.e. antigens are sandwiched between keratinocytes and basement membrane.

31
Q

Dermatomyositis

A

Perocular oedema (puffy eyes)
Photo sensitive distribution-heliotropic rash.
Myositis-prox muscle weakness. Can check for creatinine kinase.

32
Q

Assocations of dermatomyositis

A

Visceral cancer

33
Q

Microscopy of dermatomyositis

A

Dermal mucin

34
Q

Bullous dieases

A

Fluid filled blisters

35
Q

Pemphigus

A

Superifical blisters. Immunofluorescence- intercellular

36
Q

Pemphigoid

A

Deeper blisters- subepidermal. Immunofluorescence-basement membrane

37
Q

Pathogenesis of pemphigus

A

Loss of cohesion between keratinocytes resulting in an intracepidermal blister. Affects mucous membranes-mouth, anus etc.

38
Q

Pathogenesis of pemphigoid

A

Subepidermal.

Elderly-large tense bullae, do not rupture easily, Can be localised or extensive.

39
Q

Dematitis herpteiformis

A

Young patients. Small, intensly itchy blisters. IgA deposition in dermal papillae in IMF. Neutrophil microabscesses in dermal papillae.

40
Q

Acanthosis nigrans

A

Dar warty lesions in armpits, associated with internal malignancy.

41
Q

Necrobiosis lipodica

A

Red and yellow plaques on legs. Associated with DM

42
Q

Erythema nodosum

A

Red nodules on shins. Associated with infections elsewhere e.g. lung.

43
Q

Connective tissue tumours in the skin

A

Dermatofibroma

44
Q

Porphyria Cutanea Tarda (PCT)

A

20% inhertied, 80% acquired (hep C or alcohol)
Enzyme deficiency- uroporphyrinogen decarboxylase. Results in a build up of porphyrin in the skin-tissue damage when exposed to sunlight. Blisters and scarring. Porphyrins in urine-go dark on light exposure

45
Q

Most common malignant tumour

A

Basal cell carcinoma

46
Q

Are metastases common in BCC?

A

No, rare

47
Q

Causes of BCC

A

Sun exposure-pale skin more susceptivle
Radiotherapy
Immunosuppression
Gorlin’s syndrome

48
Q

Early clinical manifestation of BCC

A

Nodule

49
Q

Late clinical manifestation of BCC

A

Roden tulcer with rolled edge. Ill defined and infiltrative. Tumour composed of islands of basaloid cells with peripheral palor. Can be pigmented.

50
Q

Squamous cell carcinoma risk factors

A

UV radiation- tropical counties.
Radiotherapy
Hydrocarbon exposure-tars, mineral iols, soot
Chronic scars/ulcers e.g. Marjolin’s ulcer
Immunosuppression
Drugs e.g. for melanoma

51
Q

Appearance of SCC

A

Nodule with ulcerated, crusted surface and trabeculae of squamous cells showing cytological atypia.
5% metastasise- typically in lip, ear and perineum
High risk if bigger than 2cm or thicker than 4mm

52
Q

Pre malignant disease that predisposes you to SCC

A

Actinic keratosis

53
Q

Actinic keratosis

A

(grandpa) Scaly lesion with erythematous base. Only rarely progresses to invasive disease
May spontaneously resolve

54
Q

Benign melanocytic cancer

A

Naevi (moles0

55
Q

Malignant melanocytic cancer

A

Melanoma

56
Q

2 types of naevi

A

Superficial-congenital or aquired

Deep-blue naevi (mongolion spot)

57
Q

Families with increased incidence of melanoma. Multiple clinically atypical moles

A

Dysplastic naevus syndrome

58
Q

Melanoma

A

Much rare than BCC and SCC. Incidence is increasing. Very dangerous and can metastasize widely.

59
Q

Diagnosis of melanoma

A 
Asymetrical
Borders uneven
Colour variation
Diameter >6mm
ABCD
60
Q

Causes of melanoma

A

Sun exposure-short intermittent sever exposure
Race-rarer in people with darker skin
Family history-dysplastic naevus syndrome
Giant congential naevi-10% turn malignant

61
Q

Lentigo maligna

A

Slow growing, flat, pigmented patches that grow on the faces of elderly people. Chronic skin damage. May eventually invade dermis to become lentigo maligna melanoma, which have the potential to metastasis

62
Q

Acral lentigenous melanoma

A

Palms and soles. Commonest form in afro caribbeans- no marked skin damage as opposed to lentigo maligna

63
Q

Commonest type of melanoma in britain

A

Superficial spreading malignant melanoma

64
Q

Clinical appearace of superficial spreading malignant melanoma

A

Fat macule

Late- blue/black nodule

65
Q

Genetic predisposition in superficial spreading malignant melanoma

A

BRAF mution-possible targe for anticancer agents

66
Q

Nodular melanoma

A

Starts as a pigmented nodule, sometimes with ulceration. Poor prognosis.

67
Q

Prognostic factors for melanoma

A

Breslow thickness- measure the thickness from granular layer of epidermis to base of tumour. 5yr survival rates. If 4mm 45-60% 5yr survival

68
Q

Site of melanoma that give rise to a poorer prognosis

A

BANS- back, arms, neck scalp

69
Q

Treatment for melanoma

A

Surgery

BRAF inhibitors.

Clinical Pathology (53 decks)

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