Aquifer Case 16: Skin Lesions Flashcards Preview

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Flashcards in Aquifer Case 16: Skin Lesions Deck (30)
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1
Q

what is a primary skin lesions?

A

uncomplicated lesions that represent initial pathologic change, uninfluenced by secondary alterations such as infection, trauma, or therapy

ex: macule, patch, papule, plaque, nodule, tumor, vesicle, bulla, pustule and wheal

2
Q

what is a secondary skin lesion?

A

changes that occur as consequences of progression of the disease, scratching, or infection of the primary lesions

3
Q

what is a macule?

A

change in the color of the skin; flat

less than 1 cm

4
Q

what is a patch?

A

macule greater than 1 cm in diameter

aka flat colored lesion

5
Q

what is a plaque?

A

solid, raised, flat-topped lesion greater than 1 cm in diameter

6
Q

what is a nodule?

A

a raised solid lesion and may be in the epidermis, dermis, or subcutaneous tissue

generally larger and deeper than a papule

7
Q

what is a papule?

A

a solid raised lesion that has distinct borders and is less than 1 cm in diameter

8
Q

what is a tumor?

A

solid mass of the skin or subcutaneous tissue; larger than a nodule

9
Q

what is a vesicle?

A

raised lesion less than 1 cm in diameter and is filled with clear fluid

10
Q

what is a bulla?

A

circumscribed fluid filled lesion that is greater than 1 cm in diameter

11
Q

what is a pustule?

A

circumscribed elevated lesion that contains pus

12
Q

what is a wheal?

A

area of elevated edema in the upper epidermis

13
Q

what is the skin cancer screening recommendation?

A

annual skin cancer screening by full body skin examination by a health care provider is an I recommendation by USPSTF

14
Q

what features of a skin lesion must be noted?

A
  1. associated symptoms
  2. arrangement of lesions
  3. distribution of skin lesions
  4. shape of indivual lesions
  5. size of lesions `
15
Q

what are the risk factors for non melanoma skin cancer?

A
  1. previous skin cancer of any type gives 36% to 52% five-year risk of second skin cancer
  2. 80% of lifetime sun exposure is obtained before 18 years of age (single greatest risk factor)
  3. celtic ancestry
  4. fair complexions
  5. people who burn easily
  6. people who tan poorly and freckle
  7. red, blonde, or light brown hair
    Increasing age
  8. use of coal-tar products
  9. tobacco use
  10. soralen use (PUVA therapy)
  11. male&raquo_space;> female
  12. living near equator (UV exposure)
  13. outdoor work
  14. chronic osteomyelitis sinus tracts
  15. burn scars
  16. chronic skin ulcers
  17. xeroderma pigmentosum
  18. human papillomavirus infection
16
Q

what are the risk factors for melanoma skin cancer?

A
  1. previous melanoma
  2. Celtic ancestry
  3. fair complexion
  4. burning easily
  5. tan poorly and freackle
  6. red, blonde or light brown hair
  7. early adulthood and later in life
  8. intense, intermittent exposure and blistering sunburns in childhood and adolescence
  9. radiation exposure
  10. melanoma in first or second degree realtive
  11. familial atypical mole-melanoma syndrome
  12. male
  13. living near equator (UV exposure)
  14. indoor work
  15. higher incidence in those with more education and/or income
  16. nonfamilial dysplastic nevi
  17. large number of benign pigmented nevi
  18. giant pigmented congenital nevi
  19. nondysplastic nevi (markers for risk, not precursor lesions)
  20. xeroderma pigmentosum
  21. immunosuppression
  22. previous nonmelanoma skin cancer
  23. other malignancies
17
Q

where is eczema usually located?

A

behind the ears and on flexor surfaces

18
Q

what does squamous cell carcinoma usually look like?

A

scaly and red with a raised base usually in sun exposed areas

can be a patch, plaque or nodule +/- scaling and ulceration

borders are usually irregular and bleed easily

heaped up edges are fleshy rather than clear with BCC

19
Q

what does actinic keratoses look like?

A

scaly keratotic patches more easily felt than seen

20
Q

what does basal cell carcinoma look like?

A

plaque or nodule with waxy, translucent appearance usually with ulceration and/or telangiectasia

usually no itching or change in skin color

21
Q

what does melanoma look like?

A

slowly spreading irregular outlines that bleed with minor trauma

22
Q

what does psoriasis look like?

A

usually bilateral and involves extensor surfaces of elbows and knees

usually scaly elevated lesions

23
Q

what does seborrheic keratoses look like?

A

elevated hyper pigmented lesions with a well-circumscribed border, stuck on appearance and variable tan brown black color

usually on the face and trunk

24
Q

which fungal infections need systemic antifungals?

A

tinea unguium (onychomycosis)

tinea wapitis

25
Q

what is an incisional biopsy?

A

take out part of the skin lesion

26
Q

what is an excision biopsy?

A

remove the whole lesion with a 2-3 mm margin

27
Q

what is a shave biopsy?

A

for when the lesion is elevated above the surface

28
Q

what should be included in a consent form?

A
  1. name of procedure
  2. diagnosis
  3. risk of procedure
  4. benefits of procedure
  5. alternative to procedure
29
Q

what tests do you do when evaluation BPH?

A
  1. examine prostate
  2. presence of classic lower urinary tract symtpoms
  3. serum BUN and creatinine
  4. serum PSA
  5. urinalysis
30
Q

how do you treat BPH?

A
  1. behavior modification = avoid fluids before bed, reduce consumption of mild diuretics like caffeine or alcohol, limit salt, maintain voiding schedule
  2. alpha adrenergic antagonist like tamsulosin

5-alpha-reductase inhibitors are more effective in males with larger prostates: finasteride and dutasteride