Week 3

Question 1

Name 6 of the Weinberg hallmarks of cancer

Answer 1

Resisting cell death
sustaining proliferative signalling
Inducing angiogenesis
Evading growth suppressors
Enabling replicative immortality
Activating invasion and metastasis

Question 2

Identify 5 risk factors for skin cancers

Answer 2

UV radiation
Genetics- e.g. skin type
Age
Chemical exposure-Coal tar pitch, Soot, Creosote, Petroleum products, such as mineral oil or motor oils, Shale oils, Arsenic
immune suppression- Ulcerative colitis and Crohns, immunosuppressant drugs, organ transplant recipients

Question 3

UVA radiation causes ________ ________ _________ to DNA bases in keratinocytes. Meanwhile UVB causes ________ __________ _______ to keratinocytes. DNA damage also leads to ____________.

Answer 3

Indirect oxidative damage
Direct DNA damage
immunosuppression

Question 4

Those with skin type 1 do not tan because they possess __________ rather than ____________ which absorbs UV less efficiently.

Answer 4

Eumelanin

Pheomelanin

Question 5

What are pyrimidine dimers?

Answer 5

Covalent bonding between adjacent

pyrimidines on the same DNA strand

Question 6

Name the two major types of UVB-induced DNA lesions. How are they normally repaired? What mutation results?

Answer 6

Cyclobutene Pyrimidine dimers
pyrimadine-pyrimadone photoproducts
DNA excision repair
CC-TT and C-T

Question 7

UVA primarily oxidises _________ to _________________. It often mispairs with Deoxyadenosine. They are mainly repaired by _____ _________ _________.

Answer 7

deoxyguanosine
8-oxo-deoxyguanosine
base excision repair

Question 8

Name two drugs which target BRAF mutations in melanoma treatment. Name one that targets MEK

Answer 8

Vemurafenib
Dabrafenib
Trametinib

Question 9

How does Nodular melanoma differ from the three other varieties?

Answer 9

It exhibits a vertical growth phase (VGP) only without Radial Growth Phase (RGP). Therefore it is more likely to penetrate the dermis and become malignant.

Question 10

Metastasis of Malignant Melanoma is likely to effect dermal __________ first then regional _______ ____ and then ___________ spread.

Answer 10

lymphatics
lymph nodes
haematogenous

Question 11

Name the four types of malignant melanoma

Answer 11

Lentigo malignant melanoma
Nodular malignant melanoma
Superficial spreading malignant melanoma
Acral lentiginous malignant melanoma

Question 12

Identify the 5 diagnostic criteria for malignant melanoma

Answer 12

Asymmetry of mole
Border irregularity
Colour variation
Diameter >6mm
Elevation

Question 13

What factors influence the prognosis of malignant melanoma?

Answer 13

Breslow depth
Ulceration
lymph node/haematogenous spread

Question 14

What genetic conditions predispose to skin cancers

Answer 14

xeroderma pigmentosa
albinism
Gorlin’s syndrome
Epidermolysis Bullosa

Question 15

Give an alternative name for freckles

Answer 15

Ephilides (Ephelis)

Question 16

What are freckles? What gene mutation causes it?

Answer 16

Patchy increases in melanin pigmentation that occurs after UV exposure
Melanocortin 1 Receptor Gene

Question 17

What are age/liver spots also known as? Where are they distributed and why?

Answer 17

Actinic/solar lentigines
hands, forearms, face
UV exposure

Question 18

What is cryotherapy used for?

Answer 18

viral warts
seborrheic keratosis
actinic keratosis
skin tags

Question 19

Name the four types of malignant melanoma

Answer 19

Lentigo
Nodular
Superficial Spreading
Acral lentiginous

Question 20

What sets apart nodular malignant melanoma from the other varieties?

Answer 20

It exhibits a vertical growth phase (VGP) alone whereas the rest show a VGP and a Radial Growth Phase

Question 21

Summarise the diagnostic criteria for malignant melanoma

Answer 21

Asymmetry of mole
Border irregularity
Colour variation
Diameter >6mm
Elevation

Question 22

What three factors effect the prognosis of malignant melanoma?

Answer 22

Breslow depth?
Evidence of ulceration?
Lymph node/haematogenous spread?

Question 23

What is the ideal treatment of malignant melanoma?

Answer 23

Curative excision

Question 24

What is the most common form of skin cancer?

Answer 24

Basal cell carcinoma

Question 25

Identify some of the clinical features of BCC?

Answer 25

``` Slow growing node Translucent 'rodent ulcer'-central ulceration of node visible blood vessels locally invasive, minimally metastatic ```

Question 26

Name the four types of BCC

Answer 26

Superficial Nodular Morpheic Pigmented

Question 27

How does squamous cell carcinoma present?

Answer 27

Scaly/crusty (hyperkeratotic) plaques show ulceration located on sun-exposed sites

Question 28

Arsenic ingestion is associated with what skin cancer

Answer 28

SSC

Question 29

Define Melanocytic Naevi

Answer 29

Benign neoplasms of the melanocytes which are either acquired or congenital

Question 30

Acquired melanocytic naevi begin as flat brown _________ and are called _________ naevi. Those that embrace the junction and the dermis are called _________ naevi and by adulthood the raised palpable naevi are called __________ naevi

Answer 30

macules junctional compound intradermal

Question 31

What form of naevi have an increased risk of melanoma?

Answer 31

Atypical (dysplastic) naevi

Question 32

Define a chronic leg ulcer

Answer 32

An open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks

Question 33

Why use ABPI to investigate leg ulceration?

Answer 33

It determines whether the ulceration is a result of arterial disease

Question 34

Identify 5 possible causes of leg ulceration

Answer 34

``` Venous insufficiency (majority) Arterial disease diabetes Rheumatoid arthritis arteriovenous disease ```

Question 35

Identify some of the treatments of leg ulcers

Answer 35

``` Pain relief compression bandaging Manual de-sloughing Leg elevation de-sloughing agents (honey/hydrogel) ```

Question 36

Shingles and chickenpox are caused by infection by what virus?

Answer 36

herpes Zoster virus which lies dormant in cranial nerve/dorsal route ganglia

Question 37

Name the 5 layers of the scalp in order

Answer 37

``` Skin Connective tissue Aponeurosis Loose connective tissue Periosteum ```