Skin and Subcutaneous

Question 1

Layers of skin

Answer 1

S. corneum
S. lucidum - only in thick skin
S. granulosum
S. spinosum
S. basale

Question 2

90% cells of the epidermis

Answer 2

keratinocytes

Question 3

melanocytes are found in which skin layer?

Answer 3

S. basale

Question 4

found in the epidermis of the nipple
possible source of Paget’s disease of the nipple

Answer 4

Toker cells

Question 5

Coagulation necrosis

Answer 5

acid

Question 6

Liquefactive necrosis

Answer 6

alkaline

Question 7

Initial management for acidic injury

Answer 7

dilution of the offending agent for 30 minutes

Question 8

Initial management for alkaline injury

Answer 8

dilution of the offending agent for 2 hours

Question 9

most common sites of pressure injury

Answer 9

ischial tuberosity (28%)
greater trochanter (19%)
sacrum (17%)
heel (9%)

Question 10

Stage of Pressure:
non blanching erythema over intact skin

Answer 10

Stage 1

Question 11

Stage of Pressure:
partial thickness injury with blistering or exposed dermis

Answer 11

Stage 2

Question 12

Stage of Pressure:
Full thickness injury extending to but not including, fascia and without undermining any adjacent tissue

Answer 12

Stage 3

Question 13

Stage of Pressure:
Full thickness skin injury with destruction or necrosis of muscle, bone, tendon or joint capsule

Answer 13

Stage 4

Question 14

Solar radiation responsible for acute and chronic skin effects

Answer 14

UVB (320-290nm)

Question 15

Painful skin infection affecting apocrine gland bearing areas of the body

Answer 15

Hidradenitis suppurative / acne inversa

Question 16

infection that present as nodules and spread to form draining tracts caused by actinomyces

Answer 16

Actinomycosis

Question 17

Treatment for actinomycosis

Answer 17

Penicillin + surgical debridement

Question 18

Rapidly enlarging, necrotic lesion with undermined border and surrounding erythema

said to be linked to IBD, RA, hematologic malignancy and IgA gammopathy

Answer 18

Pyoderma Gangrenosum

Question 19

Etiology of SSSS and TEN
Site of SSSS and TEN

(+) Nikolsky sign

Answer 19

Etiology:
SSSS: Exfoliative toxins A and B
TEN: Immune mediated

Site:
SSSS: S. granulosum
TEN: DErmo-epidermal junction

Question 20

separation of epidermis from dermis with lateral skin pressure

Answer 20

Nikolsky sign

Question 21

Drugs that causes SJS or TEN

Answer 21

teN SALAD
nevirapine
*sulfonamides
*allopurinol
lamotrigine
anti convulsants
NSAID (oxicam)

Question 22

most common skin lesion with malignant potential

Answer 22

Solar (Actinic) Keratoses

Question 23

serves as a premalignant lesion for SCC

Answer 23

Solar (Actinic) Keratoses

Question 24

Glomus tumors most common affects which part of the body?

Answer 24

hands

Question 25

most common type of skin cancer

Answer 25

Basal Cell Carcinoma

Question 26

most common malignant eyelid tumor and usual for upper lip malignancy

Answer 26

Basal Cell Carcinoma

Question 27

Most common variant for BCC

Answer 27

Nodular BCC

Question 28

Most aggressive variant for BCC

Answer 28

Morpheaform and infiltrating BCC

Question 29

Specific for squamous epithelium

Answer 29

epidermal cytokeratin antibody

Question 30

Classic appearance of SCC

Answer 30

hollow ulcer with "heaped up" edges

Question 31

Ominous sign of perineural invasion that indicates an aggressive tumor for SCC

Answer 31

Cranial nerve dysfunction (particularly the facial trigeminal distribution)

Question 32

Responsible for the majority of deaths from skin cancer

Answer 32

Malignant melanoma

Question 33

Most common subtype of melanoma ; arises from pre-existing nevus

Answer 33

Superficial spreading (70%)

Question 34

Worst prognosis for melanoma

Answer 34

nodular melanoma

Question 35

Type of melanoma that occurs in older patients, grows slowly and usually at > 3 cm upon diagnosis

Answer 35

Lentigo maligna

Question 36

Type of melanoma located in the subungual region and glabrous skin of palms and soles

Answer 36

Acral lentiginous

Question 37

A melanoma that has propensity toward perineural invasion and recurrence ; occurs mostly on head and neck of the elderlies (6th to 7th decade)

Answer 37

Desmoplastic

Question 38

Most common site of metastasis for malenoma

Answer 38

lung and liver

Question 39

Most common site of metastasis for melanoma

Answer 39

lung and liver

Question 40

Most common site of metastasis for non-cutaneous site *melanoma

Answer 40

ocular melanoma

Question 41

Mainstay treatment for melanoma cancer

Answer 41

Wide surgical excision with 1-2 cm margin depending on the tumor thickness

Question 42

Management for nonmelanoma skin cancer

Answer 42

surgical resection with 4-6mm margins Moh's surgery - excellent for face, ears and locations where preservation of uninvolved tissues is critical for cosmetics

Question 43

Commonly used drug in melanoma for isolated limb perfusion

Answer 43

melphalan