Skin

Question 1

What are the layers of the skin

Answer 1

Corneum
Lucidum
Granulosum
Spinosum
Basalis

Californians Like Girls in String Bikinis

Question 2

Wha is the pressure threshold for skin pressure injury

Answer 2

60mmHg

Question 3

When lying, the sacral pressure is ____ mmHg

Answer 3

150

Question 4

When sitting the ischial pressure is ___ mmHg

Answer 4

300

Question 5

When lying, what are the dependent areas of the skin?

Answer 5

back of the head
scapupa
spinous process
elbow
sacrum
posterior calf
heel

Question 6

This solar radiation is responsible for acute and chronic skin effects

Answer 6

UVB

Question 7

This type of infection is due to exposure to a body of salt water

Answer 7

Type III

due to V. vulnificus

Question 8

[diagnose]

common in obese, smokers

painful, affecting the apocrine gland bearing areas (axilla, perineum, inframammary gland, inguinal folds)

Tender, deep nodules that expand, coalesce, spontaneously drain, form persistent sinus tract

Answer 8

Hidradenitis suppurativa / Acne inversa

Question 9

[Hurley Classification for H. suppurativa]

single/multiple nodules without sinus tract or scarring

Answer 9

Stage I

Tx: Clindamycin

Question 10

[Hurley Classification for H. suppurativa]

abscess, sinus tract, scarring

Answer 10

Stage II

clindamycin

Question 11

[Hurley Classification for H. suppurativa]

diffuse, interconnected sinus tracts and abscesses

Answer 11

Stage III

Tx: Radicala excision, laser treatment, biologic agents

Question 12

[diagnose]

presents as nodules and spread to form draining tracts following dental extraction

(+) sulfur granules

Answer 12

Actinomycosis

Tx: penicillin and surgical debridement

Question 13

[diagnose]

rapidly enlarging necrotic lesion with undetermined border surrounding erythema

associated with IBD, RA, hema malignancy, IgA gammopathy

Answer 13

pyoderma gangrenosum

Tx: steroirds, cyclosporine

Question 14

[SSSS vs TEN]

exotoxin affecting the granular layer

Answer 14

SSSS

Question 15

[SSSS vs TEN]

immune mediated affecting the dermoepidermal junction

Answer 15

TEN

Question 16

[diagnose]

“stuck on” yellow or light brown, papules/plaques with velvety, greasy texture

Answer 16

seborrheic keratoses

Question 17

[diagnose]

arise in sun-exposed areas. premalignant lesion to SCC, atypical appearing keratinocytes

Answer 17

Actinic Keratosis (solar keratosis)

Question 18

[nevi]

occur in a swimming trunk distrubution

Answer 18

giant hairy nevi (congenital)

Question 19

[Nevi: acquired/congenital]

premalignant to melanoma

Answer 19

congenital

Question 20

[diagnose]

benign neoplasm of the extremity

arise from the neuromyoarterial apparatus with blue, subungual discoloration associated with severe pain, point tenderness and cold sensitivity

Answer 20

glomus tumor

Question 21

nonmelanoma skin cancers are typically a disease of the ___ skinned people

Answer 21

fair-skinned

Question 22

[diagnose]

most common type of skin cancer

Answer 22

basal cell CA

Question 23

most common subtype of basal cell CA

Answer 23

nodular (rodent ulcer)

Question 24

most aggressive subtype of basal cell CA

Answer 24

morpheaform

Question 25

the most common malignant eyelid tumor

Answer 25

basal cell CA

Question 26

most common upper lip CA

Answer 26

basal cell CA

Question 27

[diagnose: basal cell CA type] waxy, pearly appearing papule with raised, well-demarcated border crusting that bleeds with minor trauma, telangectasia over the translucent surface or central ulceration

Answer 27

nodular BCC

Question 28

[diagnose: basal cell CA type] waxy, pearly appearing papule with raised, well-demarcated border crusting that bleeds with minor trauma, telangectasia over the translucent surface or central ulceration With increased content of brown or black pigment common in darker skinned people

Answer 28

pigmented BCC

Question 29

[diagnose: basal cell CA type] marked bluish or gray cystic nodules

Answer 29

cystic BCC

Question 30

[diagnose: basal cell CA type] scaly, patch-like or papule form that varies in color from pink to red or brown

Answer 30

superficial BCC

Question 31

[diagnose: basal cell CA type] Well-defined border, less prone to ulceration, aggressive varian

Answer 31

micronodular BCC

Question 32

[diagnose: basal cell CA type] ill-defined borders that extend beyond clinically visible margins scar-like appearance in a plaque or papule formation that can be mistaken for scar tissue ulceration, bleeding, crusting are uncommon

Answer 32

morpheaform and infiltrating BCC

Question 33

Skin CA associated to exposures to arsenic, tar, polycyclic aromatic hydrocarbons

Answer 33

squamous cell CA

Question 34

[diagnosis] arise from the basal layer of the dermis in association with an area of pre-existing skin damage

Answer 34

squamous cell CA

Question 35

[diagnosis] enlarging bumps that may have irregular or reddened surface shallow ulcer with heaped up edges

Answer 35

squamous cell CA

Question 36

[diagnosis] skin CA associated with cranial nerve dysfunction

Answer 36

squamous cell CA

Question 37

[biopsy] preferred techniques for nonmelanoma skin CA

Answer 37

shave or incisional biopsy

Question 38

staging of these cancers are not affected by the depth of the lesion

Answer 38

BCC and SCC

Question 39

vigilance biopsy is important in these lesions

Answer 39

1. old burn wounds 2. chronic nonhealing wounds 3. scars

Question 40

how many sunburns in early life has been associated with a doubled risk of developing malignant melanoma after life

Answer 40

five or more

Question 41

Xeroderma pigmentosum is a risk factor for this skin CA

Answer 41

malignant melanoma

Question 42

melanocytes are derived from what tissues

Answer 42

neural crest tissues

Question 43

[diagnosis: melanoma subtypes] these generally arise in a preexisting nevus, most common subtype of malignant melanoma

Answer 43

superficial spreading, malignant melanoma

Question 44

[diagnosis: melanoma subtypes] worst prognosis due to the prominence if vertical gorwuth

Answer 44

nodular type malignant melanoma

Question 45

[diagnosis: melanoma subtypes] older patient, slowly growing, large (>3cm), flat lesions

Answer 45

lentigo maligna

Question 46

[diagnosis: melanoma subtypes] located in the subungual regions and glaborous skin or palms and soles

Answer 46

acral lentigenous

Question 47

[diagnosis: melanoma subtypes] rare but aggresive subtype propensity toward perineural invasion and recurrence

Answer 47

desmoplastic

Question 48

[malignant melanoma] most common site of metastasis

Answer 48

lung, liver

Question 49

[malignant melanoma] most common non-cutaneous site

Answer 49

ocular

Question 50

[malignant melanoma] with the worst prognosis

Answer 50

mucosal melanomas

Question 51

[treatment of nonmelanoma skin CA} for low-risk BCC and SCC of the trunk or extremity

Answer 51

excision with postoperative margin assessment (POMA) 4-6mm margins

Question 52

[treatment of nonmelanoma skin CA} for face, ears, and areas where preservation of uninvolved tissues is critical for cosmesis and function; for irregularly shaped tumors to ensure clear margins

Answer 52

Mohs Surgery excision with complete circumferential and peripheral deep margin assessment or intraoperative frozen section

Question 53

[treatment of nonmelanoma skin CA} for small, superficial lesions, high recurrence rates

Answer 53

curettage and electrodessication visible tumor, 2-4mm margin

Question 54

[treatment of nonmelanoma skin CA} precancerous lesions and very small, superficial BCC and SCC

Answer 54

cryosurgery

Question 55

[treatment of nonmelanoma skin CA} for extensive lesions precluding surgical resection

Answer 55

Radiation 50-60 Gy delivered over 4-6 weeks

Question 56

Cite the ABCDE rule in diagnosing malignant melanoma

Answer 56

``` Asymmetry Border Irregularity Color variation Diameter Evolution ```

Question 57

[biopsy: malignant melanoma] for cosmetically sensitive areas

Answer 57

incisional or punch biopsy

Question 58

[biopsy: malignant melanoma] best diagnostic when an enlarged lymph node is palated

Answer 58

FNAB

Question 59

[Clark Stage] Papillary dermis + Reticular dermis

Answer 59

Clark IV

Question 60

[Clark Stage] papillary dermis + reticular dermis + SQ

Answer 60

Clark V

Question 61

[Clark Stage] melanoma in situ

Answer 61

Clark I

Question 62

contrast used in Sentinel Lymph node biopsy

Answer 62

methylene blue or isosulfan blue

Question 63

drug of choice for isolated limb perfusion technique

Answer 63

melphalan