HCP 2

Question 1

Mechanism of a melanoma that metastasizes to the liver

Answer 1

Cell has acquired genetic mutations that have allowed it to proliferate without cell cycle checkpoints (cell proliferation) -> clonal expansion (radial growth characterized by growth horizontally) -> metastatic subclone begins to secrete Matrix metalloproteinases 2 & 9 which cleave collagen in epidermal layer, lose functional loss of E-cadherin a glycoprotein which allows cells to stick to each other -> loosening -> vertical growth -> pass through ECM via actin cytoskeleton (cleaved products promote gradient) -> degrade Basement membrane -> Intravasation from Basement membrane into blood stream -> Platelets adhere to metastatic clone which allow it to evade lymphocytes -> form aggregates and emboli formation -> adhere to basement membrane of hepatocyte -> extravasation from bloodstream into hepatocyte -> metastatic deposit -> growth, diversification and angiogenesis

Question 2

MOA lidocaine

Answer 2

blocks sodium channels -> prevents action potential -> inhibitions of sensory signal

Question 3

basal cell carcinoma

Answer 3

PTCH/SMO dysfunction, independently activated SMO -> activates GLI1 -> unregulated transcription

Question 4

squamous cell carcinoma

Answer 4

p53 dysfunction

Question 5

healing tissue called? histology?

Answer 5

granulation tissue, loose connective tissue, pink, soft granular gross appearance, thin-walled delicate capillaries,

Question 6

melanin synthesis

Answer 6

tyrosine -> catalyzed by tyrosinase to 3,4 dihydroxyphenyalanine (DOPA) -> melanin

Question 7

growth factors transcribed prior to cell cycle progression

Answer 7

cyclin D?

Question 8

layers of epithelium

Answer 8

stratum corneum, stratum lucidum, stratum granulosum, stratum, spinosum, stratum basale

Question 9

stratum corneum

Answer 9

20-30 layers dead flattened, anucleated cells, keratin filled keratinocytes

Question 10

stratum lucidum

Answer 10

only in thick skin, 2-3 layers dead, flattened anucleated cells

Question 11

stratum granulosum

Answer 11

3-5 layers keratinocytes with distinct keratohyaline granules

Question 12

stratum spinosum

Answer 12

several layers of keratinocytes joined by desmosomes; langerhan cells

Question 13

stratum basale

Answer 13

cuboidal to low columnar cells in contact with basement membrane, mitosis, melanocytes, and merkel cells

Question 14

layers of dermis

Answer 14

papillary layer and reticular layer

Question 15

papillary layer consists of

Answer 15

loose connective tissue,

Question 16

reticular layer consist of

Answer 16

thick dense irregular type 1 collagen, nerves, deep plexus of blood vessels extending into subcutaneous layer