Inflammatory Skin Diseases, Skin Tumours, The Eye - Skin and Soft tissue pathology

Question 1

herpes Varicella Zoster can cause scarring of the eye. What nerve needs to be inolved for this to happen?

Answer 1

Trigemminal nerve

Question 2

Chlamydia has 2 forms which affect the eye. What is the tropical disease that infect the corneum and conjuctiva causing blindess?

Answer 2

Trachoma

Question 3

What can cause cataracts?

Answer 3

1) Senile degeneration
2) Rubella
3) Down’s Syndrome
4) Irradiation
5) Diabetes Mellitus
6) Uveitis

Question 4

Retinal infections can be caused by this parasite. The cat is the host of the parasite and the oocyst are in the faeces.

Answer 4

Toxoplasma

Question 5

Retina Infections can be caused by this parasite. It can be transferred from infected dog faeces. The larva then migrate to the retina and die causing inflammation.

Answer 5

Toxocara canis

Question 6

What can cause retinal vascular disease?

Answer 6

1) Ischaemia
2) Hypertensive Retinopathy
3) Diabetic retinopathy

Question 7

Flame shaped haemorrhages and exudates seen by an opthalmoscope are associated with ….

Answer 7

Hypertensive retinopathy

Question 8

dot and blot haemorrhages and exudates seen by an opthalmoscope are associated with . . .

Answer 8

Diabetic retinopathy

Question 9

What type of macular degeneration is age related and affects 60+ ?

Answer 9

Dry Macular degeneration

Question 10

What type of macular degeneration is due to new vessel growth beneath the retina. and is treated with drugs and lasers?

Answer 10

Wet macular degeneration

Question 11

Deletion of the long arm of chromosome 13 and the loss of the RB gene leads to what kind of eye tumour?

Answer 11

Retinoblastoma

Question 12

Tumors arising from the melanocytes that reside within the uvea giving color to the eye are called?

Answer 12

Uveal Melanoma

Question 13

What common viral infection presents as genital warts?

Answer 13

HPV

Question 14

Out of HSV1 and HSV2 which causes cold sores / genital herpes?

Answer 14

HSV1 = cold sores
HSV2 = genital herpes

Question 15

Which out of the following is a superficial / deep bacterial infection of the skin?

1) Impetigo
2) Cellulitis

Answer 15

1) Impetigo - superficial
(usually caused by staph aureus infection)

2) Cellulitis - deep
(usually caused by strep pyogenes)

Question 16

What skin infection is granulomatous and involves nerves leading to loss of sensation?

Answer 16

Leprosy (mycobacterium Leprae)

Question 17

What mycobacterium usually affects those who work with fish causing a fish tank granuloma?

Answer 17

Mycobacterium Marinum

Question 18

What is an abscess?

Answer 18

collection of pus

Question 19

What fungal infections like hot, moist areas and are caused by Trichophyton species?

Answer 19

1) ringworm
2) Tinia pedis (athletes foot)
3) Tinea cruris (groins)

Question 20

What are the 3 stages of Dermatitis (eczema)?

Answer 20

1) Acute Dermatitis = red, weeping serous exudation (with or without vesicles)
2) subacute dermatitis - red skin, less exudate, itching, crusting
3) Chronic dermatitis - thick/leathery skin secondary to scratching

Question 21

What is spongiosis?

Answer 21

intracellular oedema within the epidermis

Question 22

What is Atopic Eczema?

Answer 22

Type 1 hypersensitivity reaction to an allergen. Often associated with asthma and hay fever.
eczema that starts in childhood. Often has a family history.

Question 23

what is contact irritant dermatitis?

Answer 23

direct injury to to skin by an irritant.
OR
allergic reaction

Question 24

What is nummular dermatitis?

Answer 24

coin shaped lesions on the skin

Question 25

What does Psoriasis look like?

Answer 25

Red oval plaques on skin. scaly.

Question 26

what are the histological features of Psoriasis?

Answer 26

1) elongated rete ridges 2) Thinning of epidermic over dermal papiallae 3) Parakeratotic scale 4) Neutrophils in scale

Question 27

Chromosome 6p2 is implicated in what skin condition?

Answer 27

Psoriasis

Question 28

A butterfly rash on nose and cheeks is characteristic of what condition?

Answer 28

Systemic Lupus Erythematosus

Question 29

an auto-immune disorder primarily affecting connective tissued of the body. Can affect any part of the body but most importantly the kidneys

Answer 29

Lupus Erythematosus

Question 30

What investigations are used to identify the presence of autoantibodies in the skin?

Answer 30

Immunofluorescence

Question 31

A heliotroic rash and peri-ocular oedema and muscle weakness are assosiated with . .

Answer 31

Dermatomyositis *dermomyositis is associated with underlying cancer in 25% of cases

Question 32

Formation of fluid filled blisters is associated with?

Answer 32

Bullous diseases

Question 33

What is the difference between Pemphigus and Pemphigoid?

Answer 33

Pemphigus = superficial (intra-epidermal bulla - with intracellular immunoflouresence) Pemphigoid = Deep (sub epidermal bulla) - with basement membrane immunoflouresence

Question 34

A group of disorders characterised by the loss of cohesion between keratinocytes resulting in an intraepidermal blister is called . . .

Answer 34

Pemphigus

Question 35

In pemphigus where are the autoantibodies directed?

Answer 35

In Pemphigus, autoantibodies are directed at the intercellular material. *can be detected by IMF (immunoflourescence)

Question 36

Diseases characterised by subepidermal blisters which are large and do not rupture easily are called...

Answer 36

Bullous Pemphigoid

Question 37

In bullous pemphigoid where are the autoantibodies directed?

Answer 37

In bullous pemphigoid the autoantibodies are directed at the glycoproteins in the basement membrane. *can be detected by IMF

Question 38

Small itchy blisters associated with coeliac disease?

Answer 38

Dermatitis Herpetiformis

Question 39

In what condition is IgA deposition detected in dermal papillae on IMF?

Answer 39

Dermatitis Herpetiformis

Question 40

What systemic disease can be associated with dermatomyositis?

Answer 40

visceral cancer

Question 41

What systemic disease is associated with dermatitis herpetiformic

Answer 41

coeliac disease

Question 42

What systemic disease is associated with acanthosis nigricans (dark warty lesions in armpits)

Answer 42

internal malignancy

Question 43

What systemic disease is associated with necrobiosis Lipoidica (red/yellow plaques on leds)?

Answer 43

Diabetes Mellitus

Question 44

What systemic disease is associated with Erythema Nodosum (red tender nodules on shins)?

Answer 44

infections elsewhere esp. lungs

Question 45

What skin lesions are associated with metabolic disorders?

Answer 45

1) Xanthoma (yellow plaques often on eyelids) (hyperlipeamis) 2) Gout 3) Porphyria ( a group of disorders caused by defective synthesis of haem)

Question 46

What virus can caused acquired Porphyria Cutanea Tarda?

Answer 46

Hepatitis C | porphyria is the defective syntheis of haem

Question 47

what is the commonest malignant tumour of the skin?

Answer 47

Basal Cell Carcinoma

Question 48

Where does squamous cell carcinoma usually occur

Answer 48

sun exposed sites

Question 49

What type skin cancers are rodent ulcers associated with?

Answer 49

Basal Cell Carcinoma

Question 50

A nodule with ulcerated, crusted surface is associated with what type of skin cancer?

Answer 50

Squamous cell carcinoma

Question 51

What is the pre-malignant disease that leads to squamous cell carcinoma?

Answer 51

Actinic Keratosis | dyslpasia to squamous epithelium is very common chronic sun exposed sites

Question 52

What are Naevi

Answer 52

Benign collections of melanocytes

Question 53

What is the criterial for assessing moles (Naevi)?

Answer 53

``` ABCD Assymetrical? Borders uneven? Colour variation? Diameter (greater than 6mm) ``` Then melanoma

Question 54

what inherited condition increases risk of melanoma?

Answer 54

1) Dysplastic Naevus Sydrome has many large atypical moles that have an increased risk of becoming malignant. 2) Giant congenital naevi have a small risk of becoming malignant.

Question 55

A small growing, flat pigmented patch that occurs on the face of elderly people?

Answer 55

Lentigo Maligna *proliferation of atypical melanocytes along basal layer of epidermis. **Late in disease melanocytes may invade the dermis causing lentigo maligna melanom - with a potential to metastasise.

Question 56

What areas of skin is affected by acral lentigenous melanoma?

Answer 56

Palms and soles (sometimes subungual aka beneath finger nail)

Question 57

What melanoma is caused by BRaF mutations. It is also the commonest type of melanoma in britain.

Answer 57

Superficial spreading melanoma

Question 58

Invasive atypical melanocytes invade the dermis to produce nodules of tumour cells - what type of tumour is this?

Answer 58

Nodular Melanoma

Question 59

What is Breslow Thickness?

Answer 59

It is a measure of prognosis (5year survival %) of a tumour. 4mm thickness = 45-60% survival

Question 60

Why is the sentinel node significant in skin tumours?

Answer 60

The sentinal node is the lymph node which drains from the melanoma first. If it is positive when removed, the rest of the lymph nodes in the area are removed to try and stop disease progression.

Question 61

What is the treatment for skin cancer?

Answer 61

1) surgery (excision of area and lymph nodes if sentinel node is positive) 2) BRAF inhibitors in melanoma