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Dermatology > 9: Geriatric Skin Disorders - Mahoney > Flashcards

9: Geriatric Skin Disorders - Mahoney Flashcards

1
Q

decrease in skin lipids –>

A

dryness

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2
Q

decreased cell replacement –>

A

roughness, delayed healing

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3
Q

decreased DNA repair –>

A

increased malignancies

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4
Q

fragmentation of collagen/elastin –>

A

wrinkles, increase in ulcers

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5
Q

reduced connective tissue support of blood vessels –>

A

increased purpura

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6
Q

decreased sensation –>

A

increased injury

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7
Q

impaired thermoregulation –>

A

vulnerable to heat and cold

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8
Q

reduced function of sebaceous glands –>

A

decreased lipids

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9
Q

reduced function of sweat glands –>

A

risk of overheating

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10
Q

decreased langerhans cells –>

A

delayed healing and increase in infection

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11
Q

reduced subq fat –>

A

increased risk of injury

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12
Q

flattening of DE junction –>

A

increased risk of skin tears and blisters

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13
Q

reduced linear nail growth –>

A

onychogryphosis, longitudinal striations, brittle nails

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14
Q

decreased melanocytes –>

A

increase in malignancies

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15
Q

extrinsic changes to skin with aging

A

pruritus
spider veins
age spots
easy bruising and skin breaks

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16
Q

ulcer over bony prominences

pressure over time leads to ischemia and tissue damage

A

decubitus ulcer

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17
Q

NPUAP stages I-IV

A

I: non-blanchable erythema
II: necrosis with superficial to partial thickness skin loss
III: necrosis with full-thickness skin loss to fascia
IV: extensive necrosis into m and bone

18
Q

tx decubitus ulcer

A
  • change position
  • better mattress
  • keep ulcer dry
  • nutritional consult
  • infection control measure
19
Q

why xerosis?

A

due to decrease in lipids combined with impaired epidermal barrier function (greater loss of water from skin)

20
Q

asteatotic eczema =

A

xerosis

21
Q

pruritus is most commonly caused by…

A

xerosis

leads to local excoriations

22
Q

PHILL is itchy

A 
polycythemia vera
HIV
iron deficiency anemia
liver and renal dysfuntion
lymphoma
23
Q

venous hypertension leads to inflammatory rxn accompanied by leukocye activation and release or red cells into tissue which break down into hemosiderin depositions

A

stasis dermatitis

24
Q

infection of subQ fat

A

cellulitis

- deeper than erysipelas and does not have a distinct border

25
Q

infection of dermis and upper subQ tissue

A

erysipelas

26
Q

diagnosis of herpes simplex

A

tzanck smear

- positive result is finding of multinucleate giant cells

27
Q

common cause of plantar xerosis in elderly, especially resistant to routine moisturization

A

tinea pedis

- diagnosis confirmed with KOH

28
Q

4 types of onychomycosis

A
  • distal subungual
  • proximal subungual
  • total subungual
  • superficial white
29
Q

staining for onychomycosis

A

sabouraud’s medium or PAS staining

30
Q

pathology of onychomycosis

A

fungus produces keratinase which destroys nail and leads to the thickening, discoloration and loosening with accumulation of subungual debris

31
Q

oral terbinafine for onychomycosis produces a complete cure ….

A

1/3 of time

32
Q
  • primary manifestation is burrow found between fingers
  • highly pruritic and wil lhave overlapping signs of scratching which can hide diagnosis and be attributed to simply itchy skin in elderly
A

scabies

  • diagnosed by microscopic identification
  • treat with promethrin
33
Q

pt complains of intense itching and you worry about systeic cause … what screening tests are appropriate?

A 
CBC
ALT and AST
Creatinine
HIV screening
Check for interdigital papules or blisters
34
Q

nummular eczema

A

similar to all forms of eczema which will have an inflammatory phase with vesicles and oozing, followed by a dry, crusty phase

35
Q
  • appears as dry, cracking skin on plantar surface of foot or toes
  • pts will have some type of allergic hx, usually hayfever or environmental allergens
A

atopic eczema

36
Q

in elderly, due to decreased ability to mount a delayed hypersensitivity reaction due to reduced number of langerhands cells and tcells and to diminished vascular reactivity

A

eczema contact dermatitis

  • shoes, nickel, fragrances, baslam of peru are common sources
37
Q

tx psychodermatological disorder

A

topical steroids and anti-anxiety medications

38
Q

FIEF drugs cause …

A

furosemide
ibuprofen
enalapril
flu vaccine

bullous pemphigoid

tx is topical steroids and tacrolimus along with DMARDs

39
Q

hyperkeratosis that looks like it has been stuck onto the skin

A

seborrheic keratosis

*sudden appearance of multiple lesions may signal internal malignancy known as leser-trelat syndrome

40
Q

erythematous, dome-shaped, 1-10 cm nodule iwth keratin plug in center

A

keratoacantoma

Dermatology (24 decks)

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