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Quiz 5 (test 3) Flashcards

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1
Q

True or false… in regards to breast disease, the older the patient the greater the likelihood that it is malignant

A

True

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2
Q

What are three common symptoms of breast disease (not specific for cancer, fibrotic growths, or cysts)?

A

Pain

Palpable masses

Nipple discharge

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3
Q

Mammography screenings should start at age ___. Why?

A

~40 years

Younger women have denser breast tissue making it difficult to identify a mass.

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4
Q

Mammography detects ___, shows ___, and identifies ___.

A

Density

Architectural distortions

Calcification

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5
Q

___% of breast cancers that are not detected by mammography can be detected by ___.

A

~10%

Palpitation

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6
Q

True or false… mammography can be used to help guide biopsy needle in order to sample a growth

A

True

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7
Q

Mammography is __-__% predictive

A

85-95%

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8
Q

What is acute mastitis? What causes it?

A

Breast abscesses and necrosis. It may be infectious or non-infectious

Can be caused by plugged ducts

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9
Q

Acute mastitis is typically associated with whom?

A

Women who are breast feeding?

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10
Q

Fat necrosis of breasts is usually associated with what?

A

Trauma (such as from a seat belt during an accident)

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11
Q

What are the fibrocystic changes that can occur in breasts?

A

Fibrosis

Cysts

Palpable changes that can make detection of breast cancer difficult

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12
Q

There is a higher risk of breast cancer in the ___ types of breast cysts

A

Aggressively proliferative

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13
Q

Breast cysts typically occurs in ___-___ olds and typically (does/does not) occur after menopause

A

20-40

Does not occur after menopause

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14
Q

True or false… breast cysts rarely calcify and can be readily distinguished from cancer on a mammogram.

A

False. It can calcify. It can look like cancer on mammogram.

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15
Q

What are the most common benign neoplasms of the breast? Describe them.

A

Fibroadenomas

Mostly CT
Well circumscribed

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16
Q

True or false.. you should always remove benign neoplasms of the breast

A

False.. dont typically remove unless uncomfortable

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17
Q

Breast carcinoma rarely occurs in women under ___ years of age.

A

25

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18
Q

Who is breast carcinoma most common in?

A

The more affluent societies have the highest incidence regardless of race; suggests mostly caused by environment

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19
Q

Breast carcinoma has a ___% incidence by 70 years of age; fatality in 1 out of ___

A

~30%

9

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20
Q

5-10% of breast carcinoma cases are inherited. What gene is involved?

A

BRCA1 and BRCA2 are the most common inherited genes. - single strong gene factor

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21
Q

Family “tendency” (__-__% risk) means what?

A

20-30%

Not a single strong gene but a pattern of occurrence in family

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22
Q

What % of breast carcinoma cases are considered sporadic, meaning no family pattern, just chance?

A

70-80%

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23
Q

There are about ___ new breast cancer cases in the US each year.

A

250,000

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24
Q

What are three risk factors for breast carcinoma?

A

Diet high in animal fat

Obesity

Delayed first pregnancy

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25
What are the symptoms of breast carcinoma?
Pain Masses (assessed by palpitation, mammography, ultrasound, MRI, or tissue biopsy) Swollen, pitted surface (peau d' orange) and enlarged axillary lymph nodes
26
What is the prognosis of breast carcinoma based on?
Size Axillary node status Distant metastasis
27
The five year survival rate of stage 0 is ___ The five year survival rate of stage 4 is ___
92% 13%
28
If the breast tumor expresses estrogen/progesterone receptors, what kind of treatment may be used?
Hormonal treatment
29
Generally, all types of breast cancer are ____, originating from ____ in the ____.
Adenocarcinomas Epithelial cells Terminal ducts
30
Invasive carcinoma makes up ___% of breast cancer cases
75-85%
31
Most types of breast cancer are ___ and the incidence (increases/decreases) with age and have invasive and non-invasive types
Ductal Increases
32
____ are procedures that remove smaller breast masses
Lumpectomies
33
Benign epithelial lesions typically express ___ changes. (__% of women have microscopic cysts associated with epithelial tissue_)
Fibrocytic 60%
34
Cervical cancers are ___-associated. ___ neoplasms represent most cervical cancers
HPV Squamous cell
35
What do you do to detect early cervical cancers?
Pap smear
36
What are some risk factors for developing cervical cancer?
Multiple sex partners Immunosupression Early age of first sexual contact Oral contraceptives for over 5 years Nicotine use
37
What are some thing that can cause abnormal bleeding of the endometrium?
Polyps Endometritis Endometrial hyperplasia Cancers Anovultory cycles
38
What are three causes of endometrial polyps
HTN Obesity Late menopause
39
Less than __% of endometrial polyps progress to cancer
2%
40
Leiomyomas are ___ neoplasms. They are ___-dependent. They cause bleeding and are painful. They may cause ___. They are (very/rarely) frequent.
Benign smooth muscle neoplasms Estrogen-dependent Infertility Very frequent (10-15%)
41
What kind of cancer is endometrial cancer?
Adenocarcinoma
42
What are three risks for endometrial cancer?
Obesity Diabetes HTN
43
What is the treatment for endometrial cancer?
Hysterectomy-treatment of choice Radiation/chemotherapy adjunctive
44
What is the most common cause of endometritis (infections)?
IUDs
45
True or false... endometrial hyperplasia can progress to cancer
True
46
Endometrial hyperplasia has an exaggerated response due to excessive ___.
Estrogen. (Excessive ovarian activity)
47
What is the treatment for endometrial hyperplasia?
Progesterone Hysterectomy
48
What is preeclampsia?
Secondary hypertension in pregnant women of at least 20 weeks gestation. Often associated with diabetes Exact cause is unknown but appears to be associated with abnormal circulation in the placenta
49
Is a follicular ovarian mass a non-neoplastic cyst or a neoplastic cyst?
Non-neoplastic
50
Is an endometrioid ovarian mass neoplastic or non-neoplastic?
Neoplastic
51
Most neoplastic ovarian masses (are/are not) sporadic. Contraceptives (increase/decrease) risk. __% are hereditary due to the ___ genes. What is the treatment?
Are sporadic Decrease risk 10% hereditary due to the BRCA 1&2 genes Treatment: total hysterectomy + removal of surrounding tissue + chemotherapy
52
What are three symptoms of ovarian masses?
Pelvic pain Pelvic mass Abdominal bleeding
53
True or false.. there are effective screening techniques for ovarian masses
False. Unlike cervical cancer, there is no effective screening for ovarian cancer
54
Natural estrogens are ___ hormones. Synthesized estrogens may be ___
Steroid Non-steroidal
55
True or false.. Estrogens and progestins can cross cell membranes and activate estrogen receptors inside the cells, thus modulating the expression of genes.
True
56
What are the three stages of the menstrual cycle?
Menstrual stage - menses Follicular stage - proliferative Luteal stage - secretory
57
True or false... as populations age, they spend more time in menopause (females) or andropause (males)
True
58
Name and describe the three different types of natural estrogens
E1 - estrone - predominant during menopause E2 - estradiol - predominant during reproductive years E3 - estratriol - predominant during pregnancy
59
Name one steroidal synthetic estrogen and one non-steroidal synthetic estrogen
Steroidal - ethinyl estradiol Non-steroidal - diethylstilbesterol
60
What are six physiological functions of estrogen?
Sexual maturity Increased CNS excitability Increased endometrial and uterine growth Maintain skin elasticity Reduce bone resorption Increase blood coagubility
61
What are the clinical uses of estrogen supplementation?
Primary hypogonadism Postmenopausal problems
62
What are the guidelines for clinical use of estrogens?
Always use the smallest dose for the shortest period of time possible Sometimes local creams are preferred to minimize exposure
63
What are seven adverse effects to estrogen supplementation?
Postmenopausal bleeding Nausea Breast tenderness Migraines HTN Hyperpigmentation Increases some cancers (breast and endometrial)
64
What are three contraindications for the use of estrogen supplementation?
Liver disease (slows metabolism) Breast/endometrial cancers Thrombolytic disorders
65
Progestins are made from ___. They are present in males, but less than females. ___ is the most important progestin in humans
Cholesterol Progesterone
66
Progesterone is the precursor to what?
Estrogen Androgen Adrenocortical steroids (cortisol) Testosterone Estradiol
67
What is the half life of progestins?
~5minutes (very short acting)
68
What are the effects of progestins?
Increase fat deposition Decrease CNS excitability (antiseizure - opposite of estrogen) Increase aldosterone - increase Na retention - increase BP - increase water retention and blood volume Increase body temperature
69
What are three clinical uses of progestins?
Replacement therapy Oral contraception Long-term ovarian suppression (dysmenorrhea or endometriosis) - in contrast to estrogens, no problem with bleeding or clotting
70
When is the use of progesterone contraindicated?
Breast cancer is a risk Severe HTN or heart disease is a risk
71
Which is more effective for contraception, combination or progestin only?
Combination (progesterone and estrogen). It decreases ovulation close to 100% Progestin only decreases ovulation 50-80%
72
In addition to decreasing ovulation, what else does combination contraceptives do? What about progestin-onlys?
Combination - decreases ovulation, conception, implantation Progestin only - decreases ovulation, thickens mucus and reduces sperm penetration, impairs implantation
73
What are the three different types of combinations of contraceptives?
Monophasic - constant doses of both estrogen and progesterone Biphasic - dosage of one or both change one time during cycle Triphasic - dosages change 2 times per cycle
74
What is the "minipill"?
Progestin only Has fewer side effects but less effective Usually a secondary option because of drawbacks
75
Implantable contraceptive systems can be effective for ___ years.
2-4 years (Norplant system)
76
In addition to oral contraceptives, what are some delivery forms for contraceptives?
Implantable Injections Intravaginal rings IUDs (with or without estrogen/progestin) Transdermal combinations.
77
True or false... the side effects of combination contraceptives are permanent even after discontinuation
False. They reverse
78
Combination contraceptives can cause (reduced/increased) ovarian function and size. (Reduced/increased) breast size and tenderness. (Reduced/increased) HR and BP. (Hyper/hypo)-pigmentation, especially around the eye. Mild ____, breakthrough ___, and ___. May interact with what drugs? (Reduce/increase) sebum production in skin.
Reduced ovarian function/size Increased breast size/tenderness Increased thrombolytic events Increased HR and BP Hyperpigmentation Nausea, bleeding, headaches Can interact with antibiotics that disrupt GI flora. (Normal absorption of contraceptives from GI system is dependent on this flora) Reduce sebum production, causing dry skin but reduces acne
79
What are the side effects of estrogen-only replacement?
Increase risk of ovarian, endometrial, and breast cancer after 10 years of use. Nausea, breast tenderness, migraines, HTN. These effects are dose dependent
80
What are the uses for progestins?
Oral contraception Menstural disorders, irregularity, heavy discharge Acne
81
Name three antagonists of progestins.
Tamoxifen Mifepristone Danazol
82
What is tamoxifen?
Partial antagonist Blocks actions of estrogen in breast. Used to treat breast cancers
83
What is mifepristone?
Morning after contraceptive Blocks progesterone and glucocorticoid receptors Prevents implantation of fetus 99% effective if used within 3 days
84
What is danazol?
Suppresses ovarian function Has a masculinizing effect
85
What is clomiphene (clomid)?
Partial estrogen agonist Ovulation-inducing for promoting fertilization and pregnancy increased risk of multiple births (twins)
86
True or false... testosterone is an androgen
True
87
What are some uses of testosterone?
Converts to estradiol Replacement therapy for males Gynecological disorders (reduces breast size (gynecomastia) Has protein anabolic effects (helps replace muscle loss) Growth stimulation - can prematurely close growth plates in growing adolescents Counter some age-related loss of muscle mass
88
True or false... testosterone can cause masculinization effects in women. It is abused for muscle and strength building. It can cause acne, aggressiveness
True
89
True or false... ketoconzaole can inhibit the synthesis of testosterone. It is used to treat prostate carcinoma in men
True
90
What is oxytocin used for?
Induce/augment labor
91
What is metoclopramide?
D2 antagonist that stimulates prolactin and lactation
92
___% of calcium is stored in bones
99%
93
In the adult, the ___ are the primary site of hematopoeises
Bones
94
Bone undergoes constant remodeling. ___ bone resists compression forces. ___ bone is thick and resists bending forces
Medullary Cortical
95
The ____ is a tough fibrous membrane that covers bone surfaces except at joints. It is well innervated.
Periosteum
96
Osteogenesis imperfecta is deficient or defective type ___ collagen (too little bone).
1
97
What are the symptoms of osteogenesis imperfecta?
``` Generalized osteopenia Multiple fractures and bone deformities Malformed teeth (dentin deficiency) ``` Blue sclera
98
What is an achondroplastic dwarf?
And individual with reduced function of growth plates
99
What is osteopetrosis?
Defective osteoclasts Bone is brittle and too dense
100
What is osteomalacia?
Softening bone due to vitamin D deficiency Delayed eruption of teeth and defects in the dentin and enamel
101
What is Albers-Schoenberg disease?
Impaired osteoclasts, reduces bone resorption. Associated with... Anemia Bone fractures Blindness Deafness
102
What is is osteitis deformans?
Mixed stages of osteolysis and osteogenesis
103
What is another term for adult rickets?
Osteomalacia
104
True or false... GI malabsorption syndrome and/or lack of sunlight exposure can lead to acquired bone disease
True. Scurvy and rickets
105
True or false. Hyperparathyroidism can be a form of acquired bone disease
True Constantly releases Ca2+ Adenoma in parathyroid can cause it
106
Who is osteoporosis common in?
Elderly women after menopause
107
True or false.. Osteomalacia is vitamin D deficiency. Lack of normal mineralization (usually kidney related)
True
108
What are the genetic and behavioral causes of osteoporosis?
Genetic: age, low estrogen, fair hair and skin, tall and thin Behavior: inactivity, smoking/alcohol, malnutrition, medicaiton (chronic corticosteroids)
109
____ people in the US have osteoporosis. ___ are women over ___ years of age and have at least one osteoportoic fracture.
10 million 1/3 women over 50
110
What is kyphosis?
Abnormal forward curvature of the spine
111
What is scoliosis?
Abnormal lateral curvature of the spine
112
What are the 6 different types of fractures?
Complete Closed (overlying tissue intact) Comminuted (bone splintered/crushed) Displaced Open (fractured bone pierces skin) Greenstick (bone cracks through only one side (common in children not adults)
113
Osteomyelitis is inflammation of bone/marrow. What are the two ways of getting it?
Blood-born (hematogenous spread (pyogenic infections such as staph aureus or salmonella) Direct (trauma from compound fractures)
114
What is pott disease?
Granulomatous osteomyelitis associated with TB or fungi. Common in the spine
115
How is diabetes related to osteomyelitis?
Can cause osteomyelitis due to poor circulation in the extremities. If chronic, can form a drainage site and can even become osteosarcoma
116
Osteoarthritis is a degenerative joint disease. It has loss of ____ with secondary changes in ___. It presents in some degree in most people over ___ years of age. Symptoms (worsen/are relieved) with excessive use. Its due to wear and tear. It is the most common type of joint pain. There are (no/considerable) inflammatory changes. Bones swellings are called ___.
Articular cartilage Bone 65 Worsen No inflammatory changes Heberden nodes
117
Rheumatoid arthritis is more systemic and bilateral than osteoarthritis. Most common form is of ____ disease. It has a ___% prevalence. It is most common in what race? What race is it least common in?
Autoimmune 1% Caucasians Asians
118
Rheumatoid arthritis onset of age is ___. __% of cases are female. (Juvenile RA). Associated with joint swelling, pain, and tenderness that (worsens/is relieved) with use. Can cause extreme distortions of joints and surrounding bone (deforming and debilitating).
25-50 75% female Is relieved by use
119
RA may have systemic symptoms such as ___, ___ and ___. Other areas also affected are...
Fever, weakness, malaise Ulcers Pulmonary nodules and fibrosis Carditis and pericarditis Vasculitis
120
What are some other inflammatory arthritities?
Psoriatic arthritis Other autoimmune diseases (lupus erythematosus, scleroderma) Post-infections (rheumatic fever) Infections (staph/strep/TB) Gout (cystillaized uric acid) Lyme disease, if not treated - arthritis and neurological consequences
121
What is the primary cause of gout?
Reduced renal excretion of purine (uric acid's break down product)
122
What is the primary treatment of gout?
Allopurinol. Decreases the synthesis of purines
123
What are the symptoms of gout?
Hot, swollen, pain in joints, progressive joint destruction, gouty tophi (crystallized aggregates of uric acid)
124
What is pseudo-gout?
Crystal deposits of calcium pyrophosphate
125
Name three ways to treat gout.
Colchicine Allopurinol Indomethacine
126
What are ganglion cysts?
A cyst resulting from CT around joints. Often painful
127
What is Marfan syndrome?
Hereditary connective tissue disease caused by a mutated fibrillin gene with the following symptoms.. Spider-like fingers Tall growth Necrosis of aorta
128
Malignant carcinomas spread to bone tumors most likely to come from the ___, ___, ___, ___, and ___
Lungs Prostate Breast Thyroid Kidneys
129
Bone tumors most likely seen in maxilla or mandible are...
Osteomas - immature bone Giant cell tumor - benign, but aggressive Fibrous dysplasia - not malignant Osteosarcoma - most often in adolescent or older patient Ewing sarcoma - seen in 10-20 year olds. 2nd most frequent sarcoma after osteosarcoma
130
How many bone sarcomas occur per year in the US?
8000
131
What is the most frequency form of bone malignancy? Who is most likely to get it? Where is most frequent?
Osteosarcoma Most likely in adolescents or geriatric patients Usually in long bones or sometimes the mandible
132
What are benign tumors of the cartilage? Do not see in the mandible or maxilla.
Osteocondroma
133
What is chrondrosarcoma?
Malignancy of cartilage
134
What is fibrous dysplasia?
Fibrous/ fibro-osseous tumor Benign medullary bone that does not properly mature Often in the jaws
135
What is the 2nd most frequent sarcoma after osteosarcoma?
Ewing sarcoma
136
How many soft tissue tumors are found each year in the US?
12,000
137
Name 6 different soft tissue tumors.
Lipoma Liposarcoma Fibrous tumors Fibrosarcoma Rhabdomyosarcoma Smooth muscle tumors
138
Describe lipomas
Very common Don't usually require treatment
139
Are liposarcomas malignant?
Yes
140
True or false... fibrous tumors are usually reactive
True
141
What are malignant neoplasms of fibroblasts?
Fibrosarcoma
142
What are rhabdomyosarcomas?
Skeletal muscle tumors Most frequently in head and neck region Rare
143
What are two types of smooth muscle tumors?
Benign leiomyomas Leiomyosarcomas (deep soft tissue)
144
True or false... muscular dystrophy is a nonifnlammatory myopathy and is the most common in duchenne muscular dystonia
True
145
What are the symptoms of muscular dystrophy?
Progressive weakness of voluntary muscles and breakdown of muscle tissue Can occur anytime and anywhere Represents a group of genetic disease
146
Congenital myopathies tend to present with congenital ___ and ___
Hypotonia Weakness
147
What is rhabdomyolysis?
Diffuse destruction of skeletal muscles
148
Rhabdomyolysis may develop with ____. Can be cause by some drugs such as ___. Describe acute rhabdomyolysis.
Flu episode Statins Acute: muscles are tender and swollen
149
What are some denervation diseases?
ALS Polio Typically result in muscle degeneration
150
Myasthenia Gravis is an inflammatory myopathy. What are its symptoms?
Weakness in skeletal muscles responsible for breathing and mobility Worsens with activity and improves with rest Often includes other skeletal muscles such as those for eyelids, facial movement, chewing, talking, and swallowing.
151
What causes myasthenia Gravis?
Auto-antibodies kill Ach receptors; thymus may contribute to formation Not inherited
152
What is the treatment for myasthenia Gravis? What is the prognosis?
Acetylcholinesterase inhibitors - pyridostigmine Immunosuppressants - prednisone, rituximab Prognosis is usually good with proper treatment
153
Name three cell types of the skin
Squamous cells Basal cells Melanocytes
154
What are the appendages of the skin?
Apocrine glands (sweat, milky with odors - located near hair follicles) Eccrine glands (found widely distributed, sweat is watery for thermo control) Sebaceous (also located near hair follicles, secrets oily sebum for lubrication and to prevent water loss)
155
What is a macule?
Flat Circumscribed <5mm
156
What is a papule?
Elevated dome or flat topped <5mm
157
What is a nodule?
Elevated dome > 5mm
158
What is a plaque?
Elevated Flat-topped lesion >5mm
159
What does lichenfication mean?
Thickened skin due to repeated rubbing
160
What is a pustule?
Discrete, pus-filled raised lesion
161
What is a scale?
Dry, plate-like excrescence, imperfect cornification
162
What is a vesicle?
Fluid-filled Raised area <5mm
163
What is acantholysis?
Loss of intercellular adhesion keratinocytes | Epidermis falls apart and sloughs off
164
What is acanthosis?
Diffuse epidermal hyperplasia (thicker than normal)
165
What is excoriation?
Traumatic breakage of the skin (for example as a result of intense scratching)
166
What is a bulla?
Fluid-filled raised area >5mm
167
What is dyskeratosis?
Abnormal keratization Deeper in epidermis than normal
168
What is hyperkeratosis?
Hyperplasia of stratum corneum
169
What is spongiosis?
Intercellular edema of epidermis
170
What is papillomatosis?
Surface elevation caused by hyperplasia
171
What is a cyst?
Fluid filled sac lined with true epithelium
172
What is a granuloma?
Chronic inflammatory lesion consisting of granulation tissue
173
What is an abscess?
Acute inflammatory lesion with pus, surrounded by a fibrous wall
174
What is cellulitis?
Acute diffuse swelling along fascial planes separating muscle bundles
175
# Define each of the following descriptive words Calor Tumor Rubor Dalor Funcio laesa Urticaria
Calor - warm Tumor - swelling Rubor - reddening Dolor - painful Funcio laesa - loss of function Urticaria (hives) - associated with mast cell degrandulation and resulting swelling, redness, and itching.
176
Name 4 different types of acute inflammatory skin pathologies
Urticaria (hives) Eczematous dermatitis Allergic contact dermatitis Erythema multiforma
177
Urticaria is ___ mediated by antigens and ___. Treat with ___ or ___.
Hypersensitivity IgE Antihistamine Steroids
178
Eczematous dermatitis (___ most common, delayed hypersensitivity reaction). Can be prurience, edematous or oozing plaques/vesicles. Can be caused by drugs, reaction to UV or irritating chemicals. Can be associated with ___ or ___.
Contact dermatitis Asthma or allergic rhinitis
179
Allergic contact dermatitis - ___ memory of the reaction so that future contacts cause an [increased/decreased] dermatitis reaction.
Cellular Increased
180
What is erythema multiforma?
Hypersensitivity to infections and drugs Dermal edema Can have blisters and necrosis Wide range of expressions and severity
181
What is Stevens Johnson syndrome?
A type of severe, life threatening reaction of erythema multiforma due to reaction to medicines such as sulfonamides and salicylates Can also be a reaction to infections such as herpes virus or fungal infections. Advanced can have epidermal necrosis with blisters T-cells attacking antigen and surrounding cells (basal cells)
182
What drugs cause Stevens johnsons syndrome? ___ cells attack what cells?
Sulfonamides Salicylates (aspirin) T cells attack basal cells
183
Name three types of chronic inflammatory skin diseases
Psoriasis Lichen planus Systemic lupus
184
What is psoriasis? What is it sometimes accompanied by? What is the treatment? What does it look like?
Inciting antigen, auto-rejection or environmentally induced Can be accompanied by some increase in heart attacks and arthritis Treatment includes NSAIDs and immunosuppressant drugs Well-marked by pink to salmon colored plaques Regular acanthosis in epidermis-thinning of epidermis (with increased bleeding)
185
What does lichen planus look like? Who does it most commonly occur in? How long does it take to resolve? What causes it?
Lace-like white markings, referred to as "wickham striae". Hyperkeratosis and epidermal hyperplasia. Occurs in extremities and oral cavity Middle age Resolves after 1-2 years although often persists in oral cavity Unknown inciting mechanisms- although hyperactive T cells may be involved.
186
What is systemic lupus erythematosus? What is it caused by? How do you manage it?
Chronic autoimmune response. Affects skin. Can cause butterfly rash on face Caused by environmental factors/triggers such as drugs, UV radiation, viruses, stress Manage with NSAIDs, steroid, antiimmune drugs. Can cause long-term effects such as blood clots seizures, even heart attacks
187
What is impetigo?
Infectious dermatosis (usually caused by staph and strep infections superficial).
188
What is infectious dermatosis? How do you treat it?
Bacterial infection on face and extremities Contagious through contact (primarily kids) Honey color crust, pustules, use topical antibiotics such as tetracycline
189
Fungal skin infections such as tinea (ring worm) or candida) often infect ____ patients. Very common presentation is...
Immunocompromised Erythematosus macules, often pruritic
190
What are some viral infections of the skin?
Warts (HPV). Contagious by direct contact. Can auto-inoculate and spread/epidermal hyperplaisa Papillo mitosis
191
What is the prominent feature of pemphigus?
Bulbous blistering Painful flaccid blister like. Deep erosions and crust after ructions. Hypersensitivity reaction.
192
How do you treat dermatitis herpetiformis?
Use immunosuppressive treatment Tend to be auto-immune responses
193
What does herpes simplex look like?
Group vesicles Epidermal acantholysis Vesicles Sloughing
194
Herpes zoster has ____ distribution. What is the danger with that?
Dermatomal distribution Can get trigeminal nerve involvement and can be very dangerous spreading to surrounding tissue such as eye or brain
195
VCV can cause ___ later in life in those who experienced ___ when young. What does it look like?
Shingles Chicken pox Expresses as a band of rash that often itches, burns or throbs. It may persist for weeks to months. Usually relieved by anti-inlfammtories or opioid analgesics In extreme cases it becomes like an intense neuralgia and does not respond to traditional analgesics Not contagious, typically does not repeat, but can in some cases
196
What is pemphigus? How do you treat it? What kind of cells are associated with it?
Has acanthosis Blister formation Autoimmune Typically treat with steroids Pemphigus vulgaris has tzank cells.
197
Acne is infected hair follicles. What is the difference between blackheads and white heads?
Blackheads - opened comodones Whiteheads - closed comodones Causes cysts, pustules, abscesses, and scarring
198
True or false... drugs such as contraceptives, steroids, and testosterone make acne worse.
True? I'm confused though because earlier in the study guide it says that estrogen contraceptives reduce sebum production and are used for acne. ??
199
What causes acne vulgaris?
Hormone changes (increase of sex hormones) Blocks hair follicle and sebaceous glands Hair follicle have proliferation of lining cells and cellular plug and traps bacteria, cellular debris, and sebum Gland ruptures and contents spreads to form cysts, abscesses, and scarring, area is inflamed and swollen
200
What do you use to treat acne vulgaris?
Antibiotics (tetracycline) Keratolytics Drying agents Vitamin A (topical and systemic - accutane) *do not use in pregnancy!! UV exposure
201
What is perioral dermatitis? Who is most commonly found in? What causes it?
Follicular papules, vesicles and pustules Found in young women Long-term steroid use or cosmetic use. Hormonal changes
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What is the appearance of seborrhea keratosis?
Coin-like plaques stuck on appearance. Tan to dark brown glandular surface. Found in the elderly or middle age Can be generally spread
203
What dos actinic keratosis look like? What causes it? Is it malignant?
Brown to red, rough scaly texture UV exposure in fair-skin people It is premalignant
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Melanocytic nevi (moles) are ___ neoplasms from ___. They are variable in appearance. They have ___-defined borders and not predisposed to cancer. Pigmented nevus.
Benign Melanocytes Well-defined borders.
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Dysplastic nevi have ___, ___ borders. They are ___. If > ___ lesions, have increased risk for melanoma.
Irregular, assymetric borders Sporadic >10
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Most malignant skin conditions are __-induced free radicals, especially in fair skinned persons
UV
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What is the most common skin malignancy? Describe it. How do you remove it?
Basal cell carcinoma Least aggressive. Slow growing. But can be disfiguring if not removed early and can ulcerate and bleed. Most common worldwide Remove with local incision. Does not metastasize
208
What is the second most common skin malignancy? Describe it.
Squamous cell carcinoma. Intermediate aggression. No metastasis. Red scaling plaques - locally aggressive. Often presents as a scaling ulcerative nodule. Can have keratin pearls (islands of neoplastic skin cells) Remove with surgery
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What is the least likely, but most aggressive skin malignancy? Describe it.
Melanoma Metastasizes Warnings: rapid enlargement of nevus; new pigmented lesion not from pre-existing nevi. Irregular borders, irregular surface and colors Usually is superficial and spreads Caused by UV exposure and genetics Poor prognosis if metastasized (common sites are lungs, liver, and brain)
210
Common sites of melanoma metastasis is ___, ___, and ___. It has a [high/low] mitotic rate. Lack of immune response to slow spread especially once it hits lymph nodes. Superficial lesions are typically [good/bad] prognosis. Poor prognosis with metastatic disease, high mitotic rate and poor immune response.
Lungs, liver, brain High Good

Human Disease And Therapeutics (13 decks)

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