exam 1 Flashcards by britt rank

3 ways to describe a rash

color, morphology, size

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3 morphology of primay lesion

fluid filled vs solid
color
scale or no scale

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distrubution of a rash can either be ____ or ____

diffuse (all over) or localized

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describe symmetrical distrubution

bilateral in the same area of the boday

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acral sites on the body are where?

palms, soles of feet, no and ears

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with a blister, a lesion that is <1cm

vesicle

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with a blister, a lesion that is >1cm

bullae

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what is Nikolsky sign?

when skin sloughs off when pressed aginst it

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Dyshidrotic eczema
* Herpes simplex
* Impetigo
* Varicella/zoster
* Tinea pedis
* Scabies
* Contact dermatitis
* Hand foot and mouth
* Polymorphic light eruption
* Grover’s disease
* Arthropod assaults
* Erythema multiforme
* Dermatitis herpetiformis
* Id reaction

are all examples of

Vesicles (≤1 cm)

fluid filled lesions

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Bullous impetigo
Bullous tinea
Trauma/thermal
Bullous erythema multiforme
Staph scalded skin
Stephens Johnson Syndrome
Toxic epidermal necrolysis
Autoimmune blistering disease
Bullous drug eruption
Lichen planus
Porphyria cutanea tarda
Diabetic bullae

are all examples of

Bullae (≥1 cm
fluid filled lesions

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algorithm

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moph. prime. lesion

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(same size and shape)
usually solitary papules and dome-shaped

Monomorphic
(inflammatory lesions)

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(varied size and shape),
multiple, often confluent, flat-topped

Polymorphic
(vascular reaction)

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*Petechiae
*Coagulation disorders
*Leukocytoclastic vasculitis
*Henoch-Schonlein purpura
*Ecchymoses
*Meningococcemia
*Rocky Mountain Spotted
Fever
*Vascular ulcers

are all examples of

Purpuric/non-blanchable
(polymorphic/vasculr)

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*Kawasaki disease
*Staph scalded skin
*Toxic shock syndrome
*Red man syndrome
*Angioedema
*Autoimmune blistering
diseases
*Erythema multiforme
*Erythema nodosum
*Drug eruption
*Urticarial vasculitis

Persistent/blanching
(polymorphic/vasculr)

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*Rosacea
*Urticaria

are all exaples of

Transient
(polymorphic/vasculr)

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*Furuncles
*Carbuncles
*Epidermoid cysts
*Cellulitis
*Erythema nodosum
*Acne vulgaris
*Mycosis fungoides

are all examples of

Nodules
Monomorphic
Inflammatory Lesions

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Macules and papules
*Arthropod assaults
*Spider and cherry angiomas
*Scabies
*Acne
*Keratosis pilaris
*Candidiasis
*Pyogenic granulomas
*Granuloma annulare
*Viral exanthems
*Early psoriasis lesions
*Pityriasis rosea (w/o scale)
*Secondary syphilis (the
‘great imitator’)
*Pityriasis lichenoides
*Grover’s disease

are all examples of

Monomorphic
Inflammatory Lesions

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red scaly lesion with epitheial disruption

Eczematous

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red scaly lesion with no epitheial disruption

Papulosquamous

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Atopic dermatitis
* Irritant contact dermatitis
* Allergic contact dermatitis
* Dyshidrotic eczema
* Nummular eczema
* Stasis dermatitis
* Scabies
* Secondary lesions (DH, tinea, etc.)
* Seborrheic dermatitis
* Polymorphic light eruption
* Lichen planus
* Eczematous reaction patterns
* Cutaneous T cell lymphoma
* Xerotic eczema
* Exfoliative erythroderma

are all examples of

Eczematous
Epithelial Disruption

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Psoriasis
Tinea
Lupus erythematosus
Discoid lupus
erythematosus
Cutaneous T cell
lymphoma (mycosis
fungoides)
Pityriasis rubra pilaris
Lichen planus
Darier’s disease
Exfoliative erythroderma

are all examples of

Prominent plaques
Papulosquamous
No Epithelial Disruption

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Pityriasis rosea
Keratosis pilaris
Seborrheic dermatitis
Tinea
Lichen planus
Secondary syphilis
Guttate psoriasis
Pityriasis lichenoides
(PLC or PLEVA)

are all examples of

Papules
Papulosquamous
No Epithelial Disruption

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are flat or slightly elevated with a central core, circumscribed, painful lesions with a smooth, hard surface

Corns

A superficial area of hyperkeratosis is called a

callus

They may be flat, raised, dome-shaped, smooth, rough, or hairy. Their color ranges from pink, tan, gray, blue, and shades of brown, to black.

nevi (moles)

There is a strong association between _______ and the number of nevi.

sun exposure

Atypical nevi tend to occur on heavily sun damaged skin, classically ______ in men and on the ____ in women

upper back legs

areas of hyperpigmentation on the face and neck that are associated with pregnancy or hormonal variation

melasma

Alterations in color in dark-skinned persons are best seen in what 7 areas

the sclera conjunctiva buccal mucosa tongue lips nail beds palms.

Sharp, oval, or circular; depigmented halo around nevus; may undergo many morphologic changes; usually disappears and halo repigments (may take years)

Halo nevus

occurence for Halo nevus

Usually on back in young adult ## Footnote Usually benign; biopsy indicated because same process can occur around melanoma

occurence for Intradermal nevus

Cells limited to dermis ## Footnote No indication for removal other than cosmetic

occurence for Junction nevus

Nevus cells lining dermoepidermal junction ## Footnote Should be removed if exposed to repeated trauma

occurence for Compound nevus

Nevus cells in dermis and lining dermoepidermal junction ## Footnote Should be removed if exposed to repeated trauma

occurence for Blue nevus

Nevus cells in dermis ## Footnote Typically benign, but should be removed if changes occur

Dome-shaped; raised; flesh to black color; may be pedunculated or hair bearing

Intradermal nevus

Flat or slightly elevated; dark brown

Junction nevus

Slightly elevated brownish papule; indistinct border

Compound nevus

May be present at birth; may cover large area; hair growth may occur after several years

Congenital nevus

Normal Nevus color

Uniformly tan or brown; all nevi on one person tend to look alike

Normal Nevus shape

Round or oval with a clearly defined border that separates the nevus from surrounding skin

Normal Nevus surface

Begins as flat, smooth spot on skin; becomes raised; forms a smooth bump

Normal Nevus size

Usually less than 6 mm (size of a pencil eraser)

Normal Nevus number

Typical adult has 10–40 nevi scattered over the body

Normal Nevus location

Usually above the waist on sun-exposed surfaces of the body; scalp, breast, and buttocks rarely have normal nevi

Atypical Nevus color

Mixture of tan, brown, black, and red/pink; nevi on one person often do not look alike

Atypical Nevus shape

Irregular borders may include notches; may fade into surrounding skin and include a flat portion level with skin

Atypical Nevus surface

May be smooth, slightly scaly, or have a rough, irregular, “pebbly” appearance

Atypical Nevus size

Often larger than 6 mm and sometimes larger than 10 mm

Atypical Nevus number

Many persons do not have increased number; however, persons severely affected may have more than 100 nevi

Bleeding into the skin results in ecchymoses (i.e., bruising); pinpoint bleeding from capillaries is called (smaller than 0.5 cm in diameter)

petechiae

atypical nevus location

May occur anywhere on the body, but most commonly on back; may also appear below the waist and on scalp, breast, and buttocks

Bleeding into the skin results in ecchymoses (i.e., bruising); pinpoint bleeding from capillaries is called larger than 0.5 cm in diameter)

purpura

lesion that occur as initial spontaneous manifestations of a pathologic process

primary

that result from later evolution of or external trauma to a primary lesion

secondary

Clostridium gas gangrene smells like

rotten apples

Proteus infection smell like

mousy

Pseudomonas infection (especially burns) smell like

grapelike

Tuberculous lymphadenitis (scrofula) smells like

stale beer

Anaerobic infection; scurvy smells like

putrid

Phenylketonuria smells like

mousy/ musty

A flat, circumscribed area that is a change in the color of the skin; less than 1 cm in diameter

Macule ## Footnote Freckles, flat nevi, petechiae

An elevated, firm, circumscribed area; less than 1 cm in diameter

papule

A flat, nonpalpable, irregularly shaped macule greater than 1 cm in diameter

patch

**Elevated, firm, and rough lesion with flat top surface greater than 1 cm in diameter**

plaque

Elevated, irregular-shaped area of cutaneous edema; solid, transient, variable diameter

wheal

Elevated, firm, circumscribed lesion; deeper in dermis than a papule; 1–2 cm in diameter

nodule

Elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter

tumor

Elevated, circumscribed, superficial, not into dermis; filled with serous fluid; less than 1 cm in diameter

vesicle

Vesicle greater than 1 cm in diameter

bulla

Elevated, superficial lesion; similar to a vesicle but filled with purulent fluid**

pustule

Elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material

cyst

Fine, irregular, red lines produced by capillary dilation

Telangiectasia

Heaped-up, keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size

scale

Rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation; often involves flexor surface of extremity

Lichenification

Irregularly shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing

keloid

Loss of the epidermis; linear hollowed-out, crusted area

Excoriation

Linear crack or break from the epidermis to the dermis; may be moist or dry

fissure

Loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla

erosion

Loss of epidermis and dermis; concave; varies in size

ulcer

Dried serum, blood, or purulent exudates; slightly elevated; size varies; brown, red, black, tan, or straw-colored

crust

Thinning of skin surface and loss of skin markings; skin translucent and paper-like

Atrophy

lesion arrangement that Following a nerve or segment of the body

Zosteriform (dermatomal)

lesion arrangement that is Interlocking or coalesced circles (formed by enlargement of annular lesions)

Polycyclic

lesion arrangement Pink macules with purple central papules

Iris/target lesion

lesion arrangement Snakelike or wavy line track

Serpiginous

lesion arrangement Netlike or lacy

Reticulate

lesion arrangement Measles-like: maculopapular lesions that become confluent on the face and body

Morbilliform

lesion border Well demarcated or defined, able to draw a line around it with confidence

Discrete

lesion border Poorly defined, have borders that merge into normal skin or outlying ill-defined papules

Indistinct

lesion border Margin of lesion shows greater activity than center

active

lesion border Nonsmooth or notched margin

Irregular

lesion border Center of lesion depressed compared with the edge

Border raised above

lesion boarder Expanding at margins

**Advancing**

Associated Changes Within Lesions An erythematous border surrounds lighter skin

centeral clearing

Associated Changes Within Lesions Peeling or sloughing of skin

Desquamation

Associated Changes Within Lesions Hypertrophic stratum corneum

Keratotic

Associated Changes Within Lesions Central umbilication or dimpling

Punctation

Associated Changes Within Lesions Dilated blood vessels within lesion blanch completely, may be markers of systemic disease

Telangiectasias

type of arrangement

linear

lesion arrangement ** Round, active margins with central clearing**

annular

10 physical exam charachteristics of skin lesions

Size (measure all dimensions) Shape Color Blanching Texture Elevation or depression Attachment at base Exudates Configuration Location and distribution

11 red flags in skin assessment

* Fever * Ill appearance * Extreme of age (young or old) * Purpura or petichiae * Generalized or musculoskeletal pain * Immunocompromised * Lymphadenopathy * Commonly offending drugs * Nonhealing chronic lesion * Chronic, irregular, and evolving lesion greater than 6 mm * Oral lesions

Most common inflammatory skin disorder can be caused by Irritant contact dermatitis Allergic contact dermatitis Atopic dermatitis Can be more severe in Black/Hispanic population- papular and lichenification (article) can be present

Eczematous dermatitis

Deep-seated infection of the pilosebaceous unit Staph aureus most common organism Acute onset of tender red nodule with center filled with pus.

Furuncle (boil)

Inflammation and infection of the hair follicle and surrounding dermis

Folliculitis

Characterisitic Findings itching primary lesions: erythema, papules, vesicles secondary lesions excoriations in acute stage from scratiching lichenification in chronic forms

dermatitis

what is this an example of

lichification

Group of noncandidal fungal infections that involve the stratum corneum, nails, or hair;

tinea ## Footnote Tinea Corpus Tine Cruris Tine Capitus Tinea Pedis

Chronic and recurrent disease of keratinocyte proliferation; salmon or silvery pink scaling on extensor surfaces

Psoriasis

Nonspecific reaction pattern associated with obesity, certain endocrine syndromes or malignancies, or as an inherited disorder

Acanthosis nigricans

Most common form of skin cancer usually in elderly but getting younger head & neck area rarely metastasizes pearly nodule with telangictasia Rolled borders

basal cell carcinoma

precancerous lesions

**Actinic keratosis**

Squamous CellCarcinoma causes

sun, burns, chronic inflammatory disease and scars, aging

Scaly pink/red patch Scaling crusting Central ulceration/erosion Lips mouth and ears Papule that bleeds, scale, sore that won’t heal can metastasize

squamous cell carcinoma

Upper back & legs Horizontal growth papule to plaque to nodule variation in color irregular border asymmetry >6 mm

malignent melanoma

Neoplasm of the endothelium and epithelial layer of the skin causing painless, flat or raised purple, red, or brown patch/nodules Commonly associated with human immunodeficiency virus (HIV) infection

Kaposi sarcoma

A superficial benign neoplasm of epidermal cells that presents as a papule or plaque with a characteristic “pasted-on” appearance. These lesions are usually acquired later in life (middle age and beyond) and tend to grow slowly.

Seborrheic Keratosis ( not malignant)

Causes yellow greasy scales and erythema on the scalp- may be related to stress, fatigue, yeast

Seborrheic dermatitis ( dandruff)

Growth of terminal hair in women in the male distribution pattern on the face, body, and pubic areas

Hirsutism

Inflammation of the paronychium

Paronychia

Fungal infection of the nail

**Onychomycosis **

Loosening of the nail plate from the nail bed that begins at the distal groove

Onycholysis

Central depression of the nail with lateral elevation of the nail plate- what are these associated with?

Koilonychia (spoon nails) ## Footnote ** iron deficiency anemia, syphilis, fungal dermatoses, hemochromatosis, and hypothyroidism**

Whitening of the proximal half to three-quarters of the nail bed- associated with liver disease, chf, dm and aging

White banding (Terry nails)

Benign dermatosis that usually arises in the third trimester of a first pregnancy

Polymorphic eruption of pregnancy

Caused by blocked sweat ducts and trapped sweat beneath the skin

Miliaria rubra (prickly heat)

Common, contagious superficial skin infection Most common bacteria is staphylococcus aureus, not usually MRSA. Can be treated with topical or oral treatment.

Impetigo

Measles virus infects by invasion of the respiratory epithelium

Measles (rubeola)

Occurs on the lower legs in some patients with venous insufficiency

Stasis dermatitis

Atypical squamous cells confined to the upper layers of epidermis

Actinic keratosis

Eczema in black skin:

thicker cohesion: papular and lichenified areas sometimes soft ivory in color but commonly dark brown

Keloids: a higher tendency to scar in _____ especially in darker skin

darker skin

-refers to nodes that are abnormal either in size, consistency, or number ## Footnote can be localized or general

Lymphadenopathy

Generalized if lymph nodes are enlarged in __or more noncontiguous areas I.e. inguinal and occipital localized if only one area is involved.

hard node suggests ____

malignancy

Warm and tender nodes may be related to ____

inflammation/infection

2 things to examine for Enlarged node-

examine regions they drain and nodes elsewhere in the chain Examine spleen

enlarged Submandibular & submental nodes

dental problems

enlarged nodes in Preauricular

same side conjunctivitis lymphoma

enlarged Occipital nodes

common in childhood infections

enlarged Inguinal nodes

STDs Leg and foot infections Pelvic malignancy

enlarged Axillary nodes

hand and arm infections lymphoma breast cancer

enlarged nodes

Lymphadenopathy

inflamed & enlarged nodes

Lymphadenitis:

Inflammation of one or more lymphatic vessels nodes Draining into area

Lymphangitis:

**excess accumulation of lymph fluid**

Lymphedema

Congenital malformation of nodes ## Footnote (transilluminates; hemangiomas do not)

Lymphangioma

Wavelike motion when nodes are palpated

Fluctuant:

Nodes feel connected and move as unit

matted

lymphadenopathy in >2 extrainguinal sites for 3 months Kaposi’s sarcoma CMV infection; TB

HIV infection

9 red flags with headaches

Stiff neck/fever Abrupt onset of severe pain Neurological deficit (AMS) Progressively worsening headache Vomiting New onset in persons 50 years or older worst headache of life ice pick (lancinating) pain unrelenting w/ treatment

headache that : not directly related to a specific cause**

Primary:

headaches that have an underlying cause Cerebrovascular, menningeal irritation, facial or cervical disfunction

secondary

elongated head prominent nose and lower jaw heavy eyebrow ridge coarse facial features

Acromegaly

congenitally small skull

Microcephaly:

acorn shaped head due to skull enlargement

Paget’s disease

acromegaly, Cushings syndrome, Grave’s disease, hypothyroidism are all examples of

Endocrine facies:

Cushing’s syndrome facial 4 charachteristics

moon face telangiectasis hirsutism paper thin and erythematous skin

small non-tender nodes that feel like BBs under the skin

Shotty—

exopthalmos, periorbital swelling, upper lid retraction fine, moist skin fine hair staring or startled expression goiter

Grave’s Disease

ptosis periorbital swelling thickening of nose and lips prominent tongue dull facial expression

Hypothyroidism

Paralysis of upper and lower parts of face lax eyelid flat nasolabial fold drooping corner of mouth

Facial Palsy (Bell’s Palsy)

is the most common cause of bilateral or unilateral enlargement of the parotid gland in children.

Mumps

premature suture union, while brain continues to grow

Craniosyostosis: premature suture

birth trauma bleeding into periosteum bound by suture lines on palpation, firm at first, later becomes softer and fluctuant generally resolves in 2 weeks to 3 months

Cephalohematoma

subcutaneous edema common form of birth trauma on palpation, feels soft with poorly defined margins resolves in days

Caput succedaneum

sutures are palpable til __ months of age

fontanels closed by 2 years of age diamond shaped 4-5 cm

fontanels closed by 2 months of age triangular shpaed 0.5 to 1 cm

posterior

mouth breathing allergic shiners

Perennial Allergic Rhinitis

are tiny, bright ruby-red to dark blue/black, round papules that may become brown with time. They occur in virtually everyone older than 30 years and increase numerically with age

Cherry angiomas

* Itching is typically present. often report allergy history (allergic rhinitis, asthma). * For irritant or allergic contact, exposure history is important. *

Eczematous Dermatitis

Acute phase characterized by erythematous, pruritic, weeping vesicles * Subacute eczema characterized by erythema and scaling * Chronic stage characterized by thick, lichenified, pruritic plaques

Eczematous Dermatitis

Self-limiting inflammation of unknown cause. Sudden onset with occurrence of a primary (herald) oval or round plaque. * Herald lesion is often missed. * Eruption occurs 1–3 weeks later and lasts for several weeks. * Pruritus may be present with the generalized eruption. * Often occurs in young adults during the spring time.

Pityriasis Rosea

Pain, itching, or burning of the dermatome area usually precedes eruption by 4–5 days. * After eruption resolves, there may be persistent pain called postherpetic neuralgia.

Herpes Zoster (Shingles)

Single dermatome that consists of red, swollen plaques or vesicles that become filled with purulent fluid (Fig. 9.53) * Does not cross midline * Can still occur in immunized patients * Disseminated lesions in immunosuppressed or older adults

**Herpes Zoster (Shingles)**

* Persistent sore or lesion that has not healed * May have crusting * May itch

basal cell

* Pink growth with a slightly elevated rolled border and a crusted indentation in the center; as the growth slowly enlarges, tiny blood vessels may develop on the surface. * Scar-like area that is white, yellow, or waxy and often has poorly defined borders; the skin appears shiny and taut.

basal cell

(thin-walled, contains clear lymph fluid)

* Cystic hygroma

(tends to feel spongy; appears reddish blue, with color depending on size and extent of blood vessel involvement; Valsalva maneuver may enlarge the mass)

* Hemangioma

Objective Data * Red streaks in the skin after the course of the lymphatic collecting duct * Appears as a tracing of rather fine lines streaking up the extremity * Sometimes indurated and palpable to gentle touch

Acute Lymphangitis

Subjective Data * Enlarged lymph node * Pain, malaise, possibly fever * Minor trauma to the skin distal to the area of

Acute Lymphangitis

Infection and inflammation of a lymph node; may affect a single or localized group of nodes

Acute Suppurative Lymphadenitis

Subjective Data * Enlarged lymph nodes * Pain from enlarged lymph nodes

Acute Suppurative Lymphadenitis

Objective Data * Involved node usually firm and tender * Overlying tissue edematous; skin appears erythematous, usually within 72 hours * When abscess formation is extensive, nodes fluctuant * Mycobacterial adenitis characterized by an inflammation without warmth that may or may not be slightly tender

Acute Suppurative Lymphadenitis

Subjective Data * Painless cystic masses * Usually manifest during the first year of life and often enlarged after an upper respiratory infection * Asymptomatic when in the posterior triangle of the neck, but if found anteriorly, may cause airway or swallowing problems

Congenital malformation of dilated lymphatics

Objective Data * Soft, non-tender, and easily compressible spongy fluid-containing mass without discrete margins * Most present at birth and apparent early in life, usually in the neck or axilla, less commonly in the chest or extremities * May be large enough to distort face and neck * Diagnosis through physical examination and imaging studies (ultrasound, computed tomography, or magnetic resonance imaging), which show a thin-walled, multiloculated cystic mass

Congenital malformation of dilated lymphatics

Massive accumulation of lymphedema throughout the body; the most common cause of secondary lymphedema worldwide

Lymphatic Filariasis (Elephantiasis)

Subjective Data * Swelling of limb or body area * Travel to infected areas: Asia, Africa, the Western Pacific, India, Philippines * Many patients are asymptomatic, but some may develop fever with lymphangitis and lymphadenitis, chronic pulmonary infection, and progressive lymphedema

Lymphatic Filariasis (Elephantiasis)

Objective Data * Lymphedema of the entire arm or leg; the genital regions (vulva, scrotum, breasts) * Diagnosis can be made by identification of microfilariae microscopically in blood

Lymphatic Filariasis (Elephantiasis)

Malignant neoplasm of the lymphatic system and the reticuloendothelial tissues

Non-Hodgkin Lymphoma

Subjective Data * Painless enlarged lymph node(s) * Fever, weight loss, night sweats, abdominal pain, or fullness * Family history

Non-Hodgkin Lymphoma

Objective Data * Nodes may be localized in the posterior cervical triangle or may become matted, crossing into the anterior triangle. * Nodes usually well defined and solid

Non-Hodgkin Lymphoma

Malignant lymphoma

Hodgkin Lymphoma

Objective Data * Clinical presentation variable * Most commonly, painless enlargement of the cervical lymph nodes, often in the posterior triangle, that is generally asymmetric and progressive (Fig. 10.24) * Nodes sometimes matted and firm, almost rubbery * Usually asymmetric; may occasionally be enlarged in similar patterns on both sides of the body * Nodal size may fluctuate

Hodgkin Lymphoma

Subjective Data * Painless enlarged lymph nodes * May have abdominal pain, sometimes fever * May have history of infectious mononucleosis

Hodgkin Lymphoma

Infectious mononucleosis

Epstein-Barr Virus Mononucleosis

Subjective Data * Malaise, fatigue, acute or prolonged (longer than 1 week) fever, headache, sore throat, nausea, abdominal pain, and myalgia * Prodromal period may last 1–2 weeks

Epstein-Barr Virus Mononucleosis

Objective Data * Generalized lymphadenopathy most commonly in the anterior and posterior cervical nodes and the submandibular lymph nodes and less commonly in the axillary and inguinal lymph nodes * Epitrochlear lymphadenopathy is particularly suggestive of infectious mononucleosis * Hepatomegaly; symptomatic hepatitis or jaundice is uncommon, but elevated liver enzymes are common. * Splenomegaly to 2–3 cm below the costal margin is typical; massive enlargement is uncommon * Moderate to severe pharyngitis with tonsillar enlargement, occasionally with exudates * Petechiae at the junction of the hard and soft palate frequently seen * Diagnosis with mononucleosis spot test

Epstein-Barr Virus Mononucleosis

Subjective Data * No significant symptoms * History of eating raw or rare meat or uncooked eggs * History of direct contact with cat feces, cleaning the litter box, gardening in feces-contaminated soil

Toxoplasmosis ## Footnote Zoonosis, caused by the parasite Toxoplasma gondii

Objective Data * Single node, chronically enlarged and non-tender * Node is usually in the posterior cervical chain

Toxoplasmosis

Subjective Data * Fever—usually high grade and persistent over 3–4 days * Sometimes associated with a mild respiratory illness and lymphadenopathy

Roseola Infantum (HHV-6) ## Footnote Infection by human herpes virus 6

Objective Data * Adenopathy, discrete and not tender, involves the occipital and postauricular chains and may last for some time * When the fever diminishes, a morbilliform fine maculopapular rash occurs, spreading from the trunk to the extremities; the child begins feeling much better

Roseola Infantum (HHV-6) ## Footnote Infection by human herpes virus 6

Subjective Data * Burning, itching lesions * May report enlarged lymph nodes

Herpes Simplex (HSV) ## Footnote Infection by human herpes virus 1 (HSV-1) or human herpes virus 2 (HSV-2)

Objective Data * Discrete labial and gingival vesicles or ulcers * May have enlargement of the anterior cervical and submandibular nodes * These nodes tend to be somewhat firm, quite discrete, movable, and tender; the frequency of this condition and the symptoms are generally sufficient to establish the diagnosis; a viral culture can be obtained if necessary

Herpes Simplex (HSV) ## Footnote Infection by human herpes virus 1 (HSV-1) or human herpes virus 2 (HSV-2)

Subjective Data * Enlarged lymph nodes * Initial symptoms include severe fatigue, malaise, weakness, persistent unexplained weight loss, fevers, arthralgias, and persistent diarrhea

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) ## Footnote Viral infection that attacks the body’s immune system

Objective Data * Generalized lymphadenopathy * In children there may be a prolonged clinical latent period, but initial signs may include neurodevelopmental problems with loss of developmental milestones * Progressive infection characterized by decreasing CD4+ T-lymphocyte count and increasing viral load level

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) ## Footnote Viral infection that attacks the body’s immune system

Subjective Data * Slow-growing painless lumps, either in front of ear or under jaw * Difficulty opening the mouth * Tongue numbness or weakness

Salivary Gland Tumor ## Footnote Tumor in any of the salivary glands, but most commonly in the parotid

Objective Data * Benign tumors usually smooth, malignant often irregular * Facial weakness, fixation of the lump, sensory loss, and ulceration

salivary gland tumor ## Footnote Tumor in any of the salivary glands, but most commonly in the parotid

Subjective Data * Weight gain, constipation, fatigue, and cold intolerance (Table 11.1) Objective Data * Normal-size thyroid, no goiter, or nodule(s)

Hypothyroidism

Subjective Data * Weight loss * Tachycardia * Diarrhea * Heat intolerance

Hyperthyroidism

Objective Data * Normal-size thyroid, goiter, or nodule(s) * Fine hair * Brittle nails * Exophthalmos * Tachycardia

Hyperthyroidism

In hyperthyroidism ______ intolerance weight _____ ______ emotional state ______ hair ____ skin ______ nails _____ eyes ______ neck ________ cardiac _______ GI _____ menstrual _____ neuromuscular

heat intoleranece weight loss Nervous, easily irritated, highly energetic Fine, with hair loss; failure to hold a permanent wave Warm, fine, hyperpigmentation at pressure points Thin, with tendency to break; may show onycholysis Bilateral or unilateral exopthalmos, lid retraction, double vision Goiter, change in shirt neck size, pain over the thyroid Tachycardia, dysrhythmia, palpitations Increased frequency of bowel movements; diarrhea rare Scant flow, amenorrhea Increasing weakness, especially of proximal muscles

In hypothyroidism ______ intolerance weight _____ ______ emotional state ______ hair ____ skin ______ nails _____ eyes ______ neck ________ cardiac _______ GI _____ menstrual _____ neuromuscular

cold intolerance weight gain Lethargic, complacent, disinterested hair Coarse, with tendency to break skin Coarse, scaling, dry Thick fingernails Puffiness in periorbital region No goiter no cardiac changes constipation Menorrhagia Lethargic, but good muscular strength

subjective data * * Cognitive impairment, slowed mentation, poor concentration, decreased short-term memory, social withdrawal, psychomotor retardation, depressed mood, and apathy * Constipation * Muscle pains * Hearing problems, deafness

Myxedema ## Footnote Skin and tissue disorder usually due to severe prolonged hypothyroidism

Objective Data * Coarse thick skin, thickening nose, swollen lips, puffiness around eyes * Slow speech * Mental dullness, lethargy, mental problems * Weight gain * Thin brittle hair, with bald patches

Myxedema

Subjective Data * Palpitations * Heat intolerance * Weight loss * Fatigue * Increased appetite * Tachycardia

Graves Disease ## Footnote Overactive thyroid caused by autoimmune antibodies to thyroid-stimulating hormone receptor

Objective Data * Diffuse thyroid enlargement; most commonly with prominent eyes (exophthalmos)

Graves Disease ## Footnote Overactive thyroid caused by autoimmune antibodies to thyroid-stimulating hormone receptor

Subjective Data * Weight gain * Nausea * Fatigue Objective Data * Enlarged nontender smooth thyroid

Hashimoto Disease ## Footnote Underactive thyroid caused by autoimmune antibodies against thyroid gland

pain begins unilaterally but may become generalized and may lateralize to the opposite side and/or radiate to the face or neck. typical onset at approximately age 6 years through adolescence. Black people and those of Hispanic descent more affected

migraine

pain occurs in episodic clusters of attacks.

cluster headaches

mild to moderate nonthrobbing pressure or squeezing pain that can occur anywhere in the head or neck. The pain often starts slowly as a dull and aching discomfort that progresses to holocranial pain and pressure.

tenision headache

exam 1 Flashcards

(226 cards)