Melanocytes are
located in epidermis
located in dermis
originated from the neural crest
originated from adipoblasts
dendritic cells
pseudo-unipolar cells
place of melanin anabolism
place of melanin catabolism
Which of the following is the correct pathway of melanin synthesis?
Tyrosine (oxidaton by tyrosinase) --> di-hydroxy phenylalanine (oxidation by tyrosinase) --> melanin
Tyrosine (oxidaton by tyrosinase) --> di-hydroxy methylmelanin (oxidation by tyrosinase) --> melanin
Tyrosinase (oxidaton by tyrosine) --> di-hydroxy methyllalanine (reduction by tyrosine) --> melanin
Di-hydroxy methylalanine (oxidaton by tyrosinase) --> tyrosine (reduction by tyrosinase) --> melanin
Di-hydroxy methylalanine (oxidaton by tyrosine) --> tyrosinase (reduction by tyrosine) --> melanin
What are the three most common types of skin cancer?
malignant melanoma
basal cell melanoma
malignant basal keratoses
basal cell carcinoma
squamous cell carcinoma
merkel cell carcinoma
Which of the following is the commonest skin cancer
Which of the following is the easiest skin cancer to treat
Squamous cell carcinoma rarely metastasises.
Melanoma is the most common cancer in elderly
Melanoma metastises
very early
only if untreated
to most body sites
almost exclusively to joints and liver and heart only
commonly to lymph nodes
Melannoma is the moset rapidly increasing common cancer type
What are the predisposing factors for melanoma?
exposure to sun
alcohol abuse
DNA repair mechanism mutations
P16 gene
CDKN2A
PK20 gene
CD150C
dysplastic naevi
skin colour
number of pre-existing moles
The types of melanoma are
Nodular Melanoma
Acral lentiginous melanoma
Lentigo maligna melanoma
Superficial spreading
Lego malaria melanoma
Occular mesenchymous melanoma
Cranial melanoma
Chronic hepatocyte melanoma
ABCD rule in melanoma diagnosis stands for
A – aplasticity B – Border irregularity C – colour D – distance
A – asymmetry B – Border irregularity C – colour D – diameter
A – asymmetry B – Border integrity C – change in size D – distance
A – aplasticity B – basal cell symetry C – colour D – diameter
A – aplasticity B – Border integrity C – change in size D – distance
Initial diagnosis of melanoma is performed by
examination using bright light and magnification
histology using ziehl-neelsen stain
biopsy followed by ELISA
ELISA
biopsy followed by PCR
Common antibodies used in diagnosis of melanoma by immunohistochemistry include
Melan M
Melan A
HMB 45
S 100
CDK 150
JK 480
Diagnosis of melanoma is performed by
+/- immmunohistochemistry
+/- immunocytochemistry
special stain histology
H/E stain histology
laparoscopy
Melanin does not always have to be present in melanoma
In histological examination of melanoma, which if the following are typically observed?
Prominent nucleoli
Missing nucleoi
Irregular nucleoi
Popcorn cells
Reed-Strenberg cells
Large cells
Small cells
Special stains are the most common diagnostic tool in melanomas
Melanin is a
big strong cookie booboo
strong reducing agent
strong oxidising agent
reactively inert molecule
Special stains can be used for the diagnosis of amelanotic melanomas
Immunohistochemistry can be used for the diagnosis of amelanotic melanomas
Immunocytochemistry is used in diagnosis of melanoma in
Difficult cases
Metastasis
Micro invasion
None of the above
All of the above
Reed-Sternberg melanoma
The target protein for S100 is ❌, HMB45 is ❌ and Melan A is sometimes found in ❌.
Clinical staging is based on
histological staging of primary tumour
histological staining of metastasis
lymph node involvement
basal cell involvement
metastases
age of the patient
Breslow ❌ measures the ❌ whereas Clark ❌ measure the ❌. Breslow method is ❌ than Clark method.
Clinical staging does NOT rely on the histological measurement of
Ulceration
Lymphoid infiltration
Mitotic activity
Vascular ivasion
Dendritic necrosis
Microscopic satellites
Treatment of melanoma is the same regardless of the stage
Treatment of melanoma can include the removal of
all metastases
sentinel lymph node/s
primary tumour, minimum 5mm
primary tumour, minimum 2mm
all moles
Biological therapy of melanoma often consists of
BRAF inhibitor drug regimes
Interleukin alpha inhibitor drug regime
Low salt and fat intake diet
Broad spectrum drugs
Localised irradiation
BRAF 600 gene is found in about half the melanoma patients
Punch skin biopsy is the only method of obtaining histological tissue for diagnosis of melanoma.