Exam Questions to review Flashcards

Question

Rash on the chest + mucin on bx think of?

Answer 1

Reticular erythematous mucinosis (REM) Remember* possible association with internal malignancy and thyroid disease. Hashimoto disease and hyperthyroidism, and malignancies of the lung, breast, and colon.

Answer 2

D. Alcian blue

Answer 3

C. Systemic glucocorticoid therapy

Answer 4

B. answer There are four distinct variants of pretibial myxedema: non-pitting, plaque- like, nodular, and elephantiasic. The elephantiasic variant is the most uncommon and it occurs in less than 1% of patients with pretibial myxedema.

Answer 5

Patients with PCMZL tend to be younger, with no systemic systems, express IgG, IgA, or IgE, and have a predominant of Th1 cytokine inflammatory background. Marginal zone lymphoma patients tend to be older, have systemic symptoms and show expression of IgM.

Answer 6

C. Cylindromas Cylindromas, solitary or multiple, usually arise on the scalp as firm, rubbery, pink-to-red or bluish papulonodular lesions. When they are numerous, covering the entire scalp, they cause hair loss (‘‘turban tumor’’). Histologically they consist of dermal nodules without connection to the overlying normal-appearing epidermis. Subcutaneous extension may occur. They show lobular growth with a typical jigsaw puzzle pattern. A thick periodic acid-Schiff-positive basal membrane covers each lobule characterized by peripheral palisading of small hyperchromatic cells and larger central cells with vesicular nuclei. Cellular pleomorphism and mitoses are usually absent

Answer 7

C. Brooke-Spiegler syndrome Brooke-Spiegler syndrome is a rare autosomal dominant syndrome mutation in CYLD with numerous adnexal tumors, mainly localized on the scalp and face, histologically cor- responding to spiradenomas, cylindromas, and trichoepitheliomas. Malignant transformation of lesions occurs in 5% to 10% of patients, heralded by rapid tumor growth, bleeding, or ulceration. The occurrence of malignant transformation of trichoepithelioma into basal cell carcinoma is very rare or even questioned by some authors, arguing it actually represents unrecognized cases of basal cell carcinoma or collisions of two independent neoplasms, namely basal cell carcinoma and trichoepithelioma. Additionally, patients have an increased risk of developing adenocarcinoma of the salivary glands. Regular clinical follow-up is fundamental, as the risks of malignant transformation and disease severity are not assessable ex ante on the basis of only genotypic and phenotypic characteristics. Acral melanoma was a casual association in our case.

Answer 8

B. Keratolytic agents Keratolytic agents such as urea, salicylic acid, or lactic acid have been used as first-line treatments because of their safety and efficacy in the treatment of NHNA, improving hyperkeratosis by producing lysis of the stratum corneum. Recurrence of the lesions has been reported after cessation.

Answer 9

There is glycosylation of elastin by chronic ultraviolet radiation. Histology will show Masses of elastotic material filling the reticular dermis, separated from the atrophic epidermis by a thin grenz zone

Answer 10

D. CD68 marker CD68 marker is a marker for macrophages. CD68 is a protein highly expressed by cells in the monocyte lineage, including monocytic phagocytes, osteoclasts, and circulating macrophages, and by tissue macrophages, Kupffer cells, and microglia. It may play a role in macrophage phagocytic activities. Histology* --> Diffuse infiltrate of histiocytes, mainly in the upper dermis. The cells have oval or reniform vesicular nuclei and ill-defined pale cytoplasm.

Answer 11

D. Methotrexate Methotrexate is the most effective treatment. It controls both arthritis and skin lesions. It is the first choice of treatment.

Answer 12

Most commonly breast cancer, ovarian adenocarcinoma, ovarian neuroectodermal tumor, cutaneous squamous cell carcinoma, melanoma, papillary serous endometrial cancer, nasopharyngeal cancer, and hepatocellular carcinoma.

Answer 13

D. Myeloperoxidase Myeloperoxidase is a lysosomal enzyme specific to cells with a monocytic lineage, including the myeloblasts that are constituent cells in myeloid sarcoma. Ki-67, also known as Mib-1, is a nuclear marker expressed in all active stages of the cell cycle.

Answer 14

C. Polyarteritis nodosa Polyarteritis nodosa is a medium-vessel vasculitis often affecting numerous organs, while classically sparing the lungs. It is commonly associated with hepatitis B infection, and may also be triggered by blood dyscrasias such as hairy cell leukemia. However, Essential thrombocythemia is not a known trigger of polyarteritis nodosa.

Answer 15

b. Lipoid proteinosis “string of beads on eyelid”

Answer 16

Answer: b. Lymphangiomyomatosis a. Dental enamel pits MINOR b. Lymphangiomyomatosis c. Gingival fibromas MINOR d. Confetti skin lesions MINOR e. Retinal achromic patch MINOR

Answer 17

d. Xanthoma disseminatum

Answer 18

a. Erythema multiforme

Answer 19

c. Acute hemorrhagic edema of infancy

Answer 20

C. T – cell  HHV-7 infects CD4+ T cells, epithelial cells in the salivary glands, and cells in the lungs and skin. HHV-7 is frequently shed in saliva at high levels throughout life in most adults and children. The virus has been detected in breast milk and establishes latency in CD4+ cells.

Answer 21

"Papuloerythroderma of Ofuji", Elderly Japanese men. NOT Eosinophilic pustular folliculitis (Ofuji’s disease) which is seen in 30 yo Japanese men

Answer 22

Persistent livedo reticularis associated with systemic arterial thrombi; labile hypertension, recurrent neurologic symptoms. = Vascular coagulopathy

Answer 23

D. Amphotericine B

Answer 24

E. Lymphoma PTCH1 mutations have been found in sporadic trichoepitheliomas, bladder carcinoma, and SCC of the esophagus.

Answer 25

B. ITS gene has been mapped 1q21 

Answer 26

C. Cycling in normal epidermis slow 

Answer 27

D. Nicotinic acid  Certain medications have been reported to cause ichthyosis. These include cholesterol lowering agents (e.g. triparanol, nicotinic acid), targeted cancer therapy (e.g. BRAF inhibitors, EGFR inhibitors), allopurinol and many more.

Answer 28

B. Thrombosis  Approximately 5% of patients treated with IFN-β-1b for multiple sclerosis develop skin necrosis at the site of injection secondary to a localized vasculopathy

Answer 29

A. Dowling-Degos disease  Onset is typically during the third to fourth decade of life. The reticulated hyperpigmentation is admixed with and sometimes composed of lentigo-like brown macules; small brown papules with variable hyperkeratosis may also develop. These findings progressively increase overtime, initially appearing in the axillae (Fig. 67.26) and groin followed by the intergluteal and inframammary folds, neck, trunk, and inner aspects of the arms and thighs.

Answer 30

A. Trichoepithelioma 

Answer 31

B. supratrochlear artery  The paramedian forehead flap recruits the forehead skin for nasal reconstruction, it is based on the blood supply of the supratrochlear artery

Answer 32

B. C1q  Note: Screening for angioedema is C4* Hereditary vs. acquired? C1q Angioedema? C4

Answer 33

E. Chromium sesquioxide

Answer 34

A. Subcutaneous T-cell lymphoma 

Answer 35

E. Speckled Speckled: suggests anti-U1-RNP ( MCTD, Sjogren syn.)

Answer 36

C. Increased salivation 

Answer 37

D. Stains – for NSE  NSE = Neuron specific enolase

Answer 38

D. Low expression of canthelicidin in involved skin 

Answer 39

A. Cowden syndrome 

Answer 40

A) Acute military TB

Answer 41

C) Syringoma: electrofulgeration, monopolar, monoterminal

Answer 42

Alcian blue, colloidal iron or toluidine blue

Answer 43

Cetuximab, an EGFR inhibitor

Answer 44

D) mycosis fungoides MF is all over the place, no Grenz zone

Answer 45

c. nail plate lesions

Answer 46

b. lichen planus Lichen planus grows it doesn't 'onycholysis'

Answer 47

B. Angioid streaks Gronblad-Srandberg syndrome = PXE

Answer 48

A. Graft-versus-host Disease

Answer 49

B. Picornaviridae non-enveloped, linear +ve sense ssRNA virus

Answer 50

D. Muir-Torre syndrome

Answer 51

B. Bullous plaque or nodule

Answer 52

D. causes limitation of interphalangeal and metacarpophalangeal joint extension

Answer 53

B. dapsone.

Answer 54

D. The course is self-limiting over 4 to 6 weeks.

Answer 55

D. Erysipelothrix rhusiopathiae

Answer 56

C. faciale.

Answer 57

C. copper transporting protein. "Monkey holding a bag of copper coins"

Answer 58

A. Acute myelocytic

Answer 59

B. interferes with IL-2 production by T cells.

Answer 60

C. Diabetes insipidus

Answer 61

Colonic carcinoma

Answer 62

Blue: Cobalt aluminate Green: Chromic oxide, Copper phthalocyanine Red: Mercury sulfide Yellow: Cadmium sulfide

Answer 63

Dapsone (foot drop) and thalidomide

Answer 64

Epidermodysplasia verruciformis

Answer 65

Onychomatricoma is a rare benign fibroepithelial tumor that is distinguished by clinical features including, splinter hemorrhages in the proximal nail plate, thickened yellow nail plate, and a longitudinal overcurvature. Pathognomonic fx is 'Honeycomb-like (woodworm-like) cavities'

Answer 66

C. TOC is surgical excision Complete excision, as well as surgical removal of the normal nail matrix proximal to the tumor, is recommended to prevent recurrence.

Answer 67

C. Bilateral presentation Most presen- tations of LPP are bilateral; however, there are some reports of a unilateral presentation. Unilateral LPP in the axilla is extraordinarily rare. Tx: Clobetaosl

Answer 68

B. Verhoeff-van Gieson e Correct. AEGCG was confirmed via follow-on Van Gieson staining in the United States, which showed elastophagocytosis at the periphery of the granuloma and a paucity of elastic fibers in the center. Bodian used for nerve fibers, Ziehl-Neelson for acid-fact organisms, Alcian for mucin which is not found in AEGCG

Answer 69

Annular elastolytic giant cell granuloma (AEGCG). The hallmarks of AEGCG are annular erythematous plaques with central clearing in the setting of distinct histologic findings of multinucleated giant cells with elastolysis and elastophagocytosis. Although elastin staining is required for definitive diagnosis, other features on the H&E slide, including rare intracytoplasmic elastin fibrils, aid in the diagnosis. Other features include the absence of necrobiosis and mucin deposition.

Answer 70

C. Spindle cell neoplasm characterized by slitlike irregular vascular spaces, formation of new vessels surrounding preexisting vessels, a lymphoplasmacytic infiltrate, and HHV8+ staining

Answer 71

Cryotherapy Liquid nitrogen cryotherapy is easily applied and may be successful as a primary therapy for localized KS or as a supplemental therapy for lesions that respond slowly or incompletely to other treatments.

Answer 72

smooth muscle actin and vimentin

Answer 73

C. Acral extremities Acral extremities are the most common location of both solitary and multiple glomus tumors. Approx 90% of patients with multiple glomus tumors had tumors in their extremities.

Answer 74

E. Hydroxychloroquine HCQ is part of sweet's syndrome treatment. AML is commonly assoc with sweet's. Also, GI/GU tumors. G-CSF and AZA has been implicated as a cause of drug-induced sweet's.

Answer 75

Progressive macular hypomelanosis PMH is associated with Cutibacterium acnes (formerly Propionibacte- rium acnes). Benzoyl-peroxide and clindamycin are treatments.

Answer 76

Primary cutaneous cribriform carcinoma (PCCC). The histopathology of a dermal Answers: tumor consisting of anastomosing basophilic cells with ductal differentiation in a cribriform pattern without evidence of primary visceral adenocarci- noma is most consistent with PCCC. PCCC is a rare, indolent form of cutaneous adenocarcinoma most commonly located on the upper extremities. It is characterized by small sieve-like spaces of variable size and shape and is surrounded by desmoplastic stroma; it is usually confined to the dermis.

Answer 77

D. GATA-3 GATA3 has a high negative predictive value in distinguishing primary cribriform carcinoma from metastatic breast cancer and is found to be superior in detecting both primary and metastatic breast carcinoma when compared with GCDP-15 and mammaglobin.

Answer 78

B. M alcicornis Branching fire corals, scientifically known as M alcicornis, are endemic to the Bahamas causing a subtype of contact dermatitis.

Answer 79

Carcinoma telangiectodes is a form of cutaneous metastasis that results from local intravascular or intralymphatic invasion, seen almost exclusively in breast cancer. Histopathology will show tumoral emboli within dilated dermal vessels.

Answer 80

C. Sulfonamides

Answer 81

B. Trichophyton tonsurans

Answer 82

D. fish handlers.

Answer 83

E. touch perception.

Answer 84

E. Visible and infrared

Answer 85

D. Steatocytoma multiplex

Answer 86

B. Rochalimaea henselae

Answer 87

B. Rochalimaea species.

Answer 88

Microsporum canis

Answer 89

Trichophyton mentagrophytes

Answer 90

Phenytoin = "Dilantin"

Answer 91

Noonan's syndrome

Answer 92

Nicotinic acid --> Acanthosis nigricans OCPs --> Erythema nodosum