ABSITE ch 18 plastics skin soft tissue

1. Main cell type in epidermis; provide mechanical barrier

Keratinocytes

2. Neuroectodermal cells in epidermis; transfer melanin to neighboring keratinocytes

Melanocytes

3. Primary structural proteins for the epidermis

Dermis

4. Antigen presenting cells in epidermis; role in type IV hypersensitivity reactions

Langerhans cells

5. Sensory nerves that detect pressure

Pacinian corpuscles

6. Sensory nerves that detect warmth

Ruffini�s endings

7. Sensory nerves that detect cold

Krause�s end-bulbs

8. Sensory nerves that detect tactile sense

Meissner�s corpuscles

9. Glands producing aqueous sweat

Eccrine sweat glands

10. Glands producing milky sweat

Apocrine sweat glands

11. Predominant collagen type in skin

 Type I

12. Ability to regain shape

Elasticity

13. Skin change caused by loss of tensile strength and elasticity

Cushing�s striae

14. Grafts including all epidermis and part of the dermis

Split-thickness skin grafts

15. Skin graft type with less contraction

Full-thickness skin grafts

16. Method of blood supply for skin graft for days 0-3

Imbibition

17. Method of blood supply for skin graft for days 3+

Neovascularization

18. Tissue types unlikely to support skin graft (poorly vascularized)

Tendon, bone, XRT areas

19. Primary blood supply for TRAM flap

Superior epigastric vessels

20. Most important determinant of TRAM flap viability

Periumbilical perforators

21. Pressure sore with erythema and pain but no skin loss

Stage I

22. Pressure sore with partial skin loss and yellow debris
 Stage II

23. Pressure sore with full-thickness skin loss and subcutaneous exposure

Stage III

24. Pressure sore involving bony cortex

Stage IV

25. Single best factor for protecting skin from UV radiation

melanin

26. Rays responsible for chronic sun damage

UV-B

27. Disorder which predisposes patients to melanoma

Xeroderma pigmentosum

28. Most common site for melanoma

Back (men), legs (women)

29. Most common location for distant melanoma mets

Lung

30. Least aggressive melanoma, with minimal invasion

Lentigo maligna

31. Most common type of melanoma, originating from sun-exposed areas

Superficial spreading melanoma

32. Most aggressive form of melanoma

Nodular

33. Aggressive melanoma type originating largely on palms and soles

 Acral lentigus

34. Margin needed for thin melanoma

1cm

35. margin needed for intermediate thickness melanoma

2cm

36. margin needed for thick melanoma

3cm

37. most common malignancy in US

basal cell

38. carcinoma originating from basal epithelial cells and hair follicles

basal cell

39. more aggressive type of basal cell carcinoma with collagenase production

morpheaform type

40. carcinoma of skin that often presents with overlying erythema, papulonodular with
crust and ulceration

squamous cell

41. carcinoma that commonly develops in postradiation areas or old burn scars

squamous cell

42. risk factors for squamous cell carcinoma of skin

actinic keratoses, xeroderma pigmentosum, bowen�s disease,

immunosuppression, arsenic, coal tar, chlorophenols, nitrates, HPV, sun, fair
skin, XRT

43. risk factors for metastasis of squamous cell cancer

poorly differentiated, greater depth, recurrent leasions, immunosuppression

44. most common soft tissue sarcomas (2)

malignant fibrous histiosarcoma, liposarcoma

45. biopsy technique for sarcoma

excisional if <4cm, longitudinal incisional if >4cm

46. most common form of spread of sarcoma

hematogenous

47. desired margins for sarcoma excision

3-5cm

48. sarcomas requiring postop XRT

high-grade, close margins, >5cm

49. 5-year survival of sarcomas (after complete resection)

40%

50. common sarcomas in children; often proximity to vital structures precludes full
resection

head and neck sarcoma (ex: rhabdomyosarcoma)

51. most common visceral and retroperitoneal sarcomas

leiomyosarcomas, liposarcomas

52. risk factors for angiosarcoma (2)

PVC, arsenic

53. Risk factor for lymphangiosarcoma

Chronic lymphedema

54. Vascular sarcoma involving skin, mucous membranes, or GI tract; assoc.

w/immunocompromise
 Kaposi sarcoma

55. #1 soft tissue sarcoma in children

rhabdomyosarcoma

56. treatment of rhabdomyosarcoma

excision, doxorubicin-based chemotherapy

57. sarcoma originating from metaphyseal cells; increased incidence around knee

osteosarcoma

58. soft tissue tumors associated with LiFraumeni syndrome

childhood rhabdomyosarcomas, others

59. soft tissue tumors associated with neurofibromatosis

CNS tumors, peripheral sheath tumors, pheochromocytoma

60. Soft tissue tumors associated with tuberous sclerosis

Angiomyolipoma

61. Soft tissue tumors associated with gardners syndrome (2)

Familial adenomatous polyposis, intra-abdominal desmoids

62. Yellow deposits of cholesterol + histiocytes

Xanthoma

63. Growth with viral origin that can be contagious and autoinocuable

Warts

64. Premalignant lesions in sun-exposed areas

Actinic keratoses

65. Non-premalignant lesion, can be pigmented darkly

 Seborrheic keratosis

66. Skin lesion associated with squamous cell carcinoma

Arsenical keratosis

67. Neuroendocrine tumor with red/purple papulonodular indurated plaque

Merkel cell carcinoma

68. Proteins specific for merkel cell carcinoma (3)

Neuron-specific enolase, cytokeratine, neurofilament protein

69. Painful tumor composed of blood vessels and nerves; benign

Glomus tumor

70. Tumors commonly found in fascial planes, often anterior abdominal wall

Desmoids tumors

71. Squamous cell cancer in situ; 10% conversion rate to SCCA

Bowen�s disease

72. Rapidly growing lesion with central keratin-filled crater; involutes spontaneously
over several months

Keratoacanthoma

73. Disease associated with increased sweating

Hyperhidrosis

74. Treatment of hyperhidrosis

Sympathectomy

75. Infection of apocrine sweat glands, typically in axilla or groin

Hidradenitis

76. Benign lesion with creamy keratin material within

 Epidermal inclusion cyst

77. Benign lesion in scalp without epidermis

Trichilemmal cyst

78. Benign lesion over tendons; filled with collagenous material

Ganglion cyst

79. Benign lesion found along body fusion planes (midline abdomen, sacrum, occiput,
nose)

Dermoid cyst

80. Congenital coccygeal sinus with ingrown hair

Pilonidal cyst