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Flashcards in FMS-Derm Deck (145)
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0
Q

What accounts for approximately 20% of the body’s weight?

A

skin

1
Q

What is the largest organ of the body?

A

skin

2
Q

What is the primary function of the skin?

A

protect the body against:

  1. microorg. 3. loss of body fluids
  2. UV radiation 4. stress of mechanical forces
3
Q

T/F: The skin regulates body temperature.

A

TRUE

4
Q

The skin is involved in the production of which vitamin?

A

Vitamin D

5
Q

What are some genetic & environmental factors that affect the integumentary system?

A
  1. skin becomes thinner, drier, wrinkled, & demonstrates changes in pigmentation
  2. shortening & decreasing in number of capillary loops
  3. fewer melanocytes & Langerhans cells
  4. atrophy of sebaceous, eccrine, & apocrine glands
  5. changes in hair color
  6. fewer hair follicles & growth of thinner hair
6
Q

flat circumscribed area of altered color that is <1cm

A

macule

7
Q

raised, solid lesion <5mm-1cm

A

papule

8
Q

flat, pigmented lesion >5mm-1cm

A

patch

9
Q

> 5mm flat-topped, raised leesion

A

plaque

10
Q

transient swelling due to dermal edema

A

Wheal

11
Q

solid, round circumscribed elevation of 1-2cm

A

nodule

12
Q

elevated, solid lesion that may be clearly demarcated, deeper in the dermis & >2cm

A

tumor

13
Q

<1cm papule containing clear fluid

A

vesicle

14
Q

large (>5mm-1cm), circumscribed , fluid-containing elevation

A

Bulla

15
Q

papule containing purulent fluid

A

pustule

16
Q

encapsulated nodule containing fluid, cells, or keratin

A

cyst

17
Q

small, dilated superficial blood vessels

A

telangiectasia

18
Q

thick stratum corneum due to increased proliferation or keratincytes

A

scale

19
Q

focal area of thickened skin with accentuation of skin lines due to rubbing/scratching

A

lichenification

20
Q

irregular, elevated, enlarging scar caused by excessive collagen formation during healing, following surgery or other skin trauma

A

keloid

21
Q

thin to thick fibrous tissue healed dermal layer or deeper, healed wound or surgical incision

A

scar

22
Q

shallow abrasion, linear hallowed-out, crusted area

A

excoriation

23
Q

linear, split in epidermis &/or crack in dermis (can be moist or dry)

A

fissure

24
Q

partial loss of epidermis, heals without scarring

A

erosion

25
Q

loss of epidermis & dermis, surface excudate &/or crusting often present; heals with scarring

A

ulcer

26
Q

thinning of skin surface & loss of skin markings

A

atrophy

27
Q

What are pressure ulcers a result of?

A

any unrelieved pressure on the skin

  • pressure
  • shearing forces
  • friction
  • moisture
28
Q

What are some risk factors of pressure ulcers?

A
  1. immobilization
  2. incontinence
  3. debilitation
29
Q

You are a PA doing rounds & you notice one of your elderly patients that has limited movement has not changed positions for sometime. What should you be worried about this patient developing?

A

pressure ulcers

30
Q

T/F: chronic diseases accompanied by anemia, edema, renal failure, malnutrition, sepsis, & urinary or fecal incontinence puts patients at risk for pressure ulcers.

A

TRUE

32
Q

T/F Coarse bed sheet used for turning patients over do not present any risk of causing pressure ulcers.

A

FALSE (they do!!! It produces a shearing force)

33
Q

T/F Epinephrine infusion is a risk factor for pressure ulcers in the critically ill patient.

A

FALSE! (Norepinephrine infusion is a risk factor)

34
Q

IDENTIFY THE RISK FACTORS OF PRESSURE ULCERS IN A CRITICAL ILL PATIENT:
An 76 year old elderly woman was admitted to the hospital for 2 months for treatment of her anemia, renal insufficiency, fecal incontinence, and severe burn from spilling boiling water on her while cooking for her family on Sunday morning.

A

Pressure ulcer risk factors for the critically ill

  1. Age greater than 60 years
  2. Anemia
  3. Renal insufficiency
  4. fecal incontinence
  5. length of hospital stay
35
Q

T/F Individuals with darkly pigmented skin are at higher risk for pressure ulcers than white pigmented skin.

A

OF COURSE THEY ARE!!!!!!! ALWAYS ALWAYS ALWAYS.

***early signs of skin damage may not be clearly visible in DARK PIGMENTED PEOPLE

36
Q

Non-blanchable erythema of intact skin is what stage of a pressure ulcer?

A

stage 1

37
Q

Partial thickness skin loss involving epidermis or dermis is in what stage of a pressure ulcer?

A

stage 2

38
Q

Full thickness skin loss involving damage or loss of subcutaneous tissue is what stage of a pressure ulcer?

A

stage 3

39
Q

Full thickness skin loss involving damage or loss of subcutaneous tissue is what stage of a pressure ulcer?

A

stage 4

40
Q

A patient was just checked into the ER with a pressure ulcer covered with eschar. What stage of a pressure ulcer would u describe this as?

A

UNSTAGEABLE!!!!!!! - the wound is cover by eschar - dead or decaying tissue

41
Q

What are elevated, rounded, firm, and has claw like margins that extend beyond the original site of injury due to excessive collagen formation during dermal connective tissue repaid?

A

Keloids

42
Q

Which type collagen is increased during the development of a Keloid?

A

Type III

43
Q

Who are Keloids most commonly found in?

A

darkly pigment skin types and pt’s with burn scars

44
Q

Pruritis is the most common symptom of what disorders?

A

primary skin disorders

45
Q

What is itch carried by?

A

specific unmyelinated C-nerve fibers

46
Q

What is itch triggered by?

A

a number of itch medicators-

  1. Histamine
  2. Seratonin
  3. Prostaglandins
  4. Brandykinins
  5. Neuropeptides
  6. Acetylcholine
47
Q

Chronic itching leads to persistent scratching. What can result because of this?

A

Infections and Scarring

48
Q

What are the treatments for chronic itching?

A

treated with antihistamines, minor tranquilizers, and topical steroids.

49
Q

What can modulate the itch response?

A

CNS

50
Q

T/F Pain stimuli at lower intensities can induce itching.

A

true

51
Q

What is the most common inflammatory disorders?

A

Dermatiti or eczema

52
Q

There are various types of dermatitis. What are the general characteristics of dermatitis?

A

pruritis, lesions with indistinct borders, and epidermal changes including erythema, papules, and scales
**KNOW THIS - see the name - be able to describe it! :)

53
Q

What type of reaction is allergic contact dermatitis caused by?

A

hypersensitivity type 4 reaction

54
Q

In allergic contact dermatitis an allergen comes into contact with the skin, binds to ______ to form _______.

A

binds to carrier protein to form sensitizing antigen

55
Q

In contact dermatitis an allergen comes into contact with the skin, binds to the carrier protein to form sensitizing antigen. What processes the antigen? What becomes sensitized to the antigen?

A

Langerhans cells process the antigen, carry to T cells to become sensitized to antigen.

56
Q

What are the manifestations of allergic contact dermatitis?

A
  1. Erythema
  2. Swelling
  3. Pruritis
  4. Vesicular Lesions
57
Q

Type 1 hypersensitivity inludes activation of mast cells, eosinophils, T-lymphocytes, other inflammatory cells. What inflammatory disorder is a type 1 hypersensitive disorder?

A

Atopic dermatitis

58
Q

What are the manifestations of Atopic dermatitis?

A

red, weeping crusts and chronic inflammation, lichenification

59
Q

T/F Irritatnt contact dermatitis is an immunological inflammatory reaction

A

FALSE!!! it is a non-immunologic inflammation.

60
Q

A patient comes into the ER with signs of chemical irritation from acids or prolonged exposure a substance causing irritation. What would you, a PA, diagnose this patient with?

A

IRRITANT CONTACT DERMATITIS!!!!!!!

61
Q

What is the treatment of irritant contact dermatitis?

A

Removal of the stimulus

62
Q

What occurs in the leg as a result of venous stasis, edema, and vascular trauma?

A

Stasis dermatitis

63
Q

A patient comes into Mississippi College PA clinic and describes a history of erythema, followed by pruritus, then scaling, petechiae, and then finally today she is showing an ulcer on her legs after coronary artery bypass graft surgery. What would be the diagnosis of this patient?

A

Stasis Dermatitis

64
Q

Heather comes into Enterprise Medical Clinic with red rash covering her checks and nose including her nasolabial folds. This diagnosis will develop into scaly, white, or yellowish plaques.

A

Seborrheic dermatitis.

65
Q

T-cell immune mediated skin disease that is scaly, thick, silvery, elevated lesions, usually on scalp, elbows, knees caused by a high rate of mitosis in the basal cell layer. This describes what disorder?

A

Psoriasis - a papulosquamous disorder

66
Q

Is Psoriasis chronic?

A

Yes

67
Q

Is Psoriasis a relapsing, proliferative skin disorder?

A

yes

68
Q

T/F Psoriasis is thinking of the dermis.

A

FALSE!! Shows evidence of dermal and epidermal thickening

69
Q

What is the epidermal turnover in psoriasis?

A

26-30 days to 3-4 days

70
Q

Why do the dermis and epidermis thicken and form the thick scaly lesions in psoriasis?

A

the cellos do not have time to mature or keratinize. Epidermis turn over goes from 26-30 days to 3-4 days instead.

71
Q

A patient comes into the family practice clinic in Enterprise, MS complaining of having a big circular, 3-4 cm demarcated salmon pink colored lesion on her chest approximately 3 weeks ago. Shorty after a lot of smaller similar lesions appeared across her body. What would you diagnose this patient with?

A

Pityriasis rosea - HERALDS PATCH!!!

72
Q

Pityriasis rose usually occurs during what months?

A

winter

73
Q

T/F Pityriasis rosea is a chronic inflammatory papulosquamous disorder.

A

false!!!!!! benign, self limiting, inflammatory disorder

74
Q

What is thought to be the cause of Pityriasis rosea?

A

Herpes like virus

75
Q

Nonscaling violet colored, 2-4mm lesion, found on the patients wrists, ankles, lower legs, and genitalia.

A

Lichen planus - Papulosquamous disorder

76
Q

T/F Lichen planus is a benign, inflammatory disorder of the skin and mucous membranes.

A

True

77
Q

What is thought to be the origin of lichen planus?

A

Unknown origin, BUT T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells are involved

78
Q

A papulosquamous disorder causing inflammation of the pilosebaceous follicle?

A

Acne vulgaris

79
Q

Inflammation of the skin that develops in adulthood. Erythematotelengiectatic, papulopustular, phymatous, and ocular lesions.

A

Acne Rosacea

80
Q

What is associated with chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun?

A

Acne Rosacea

81
Q

inflammatory, autoimmune disease with cutaneous manifestations, though to be an altered immune response to an unknown antigen or response to UV wavelengths with the development of self-reactive T and B cells, decreased number of regulatory T cells and increased proinflammatory cytokines

A

Lupus erythematosus

Autoantibodies and immune complexes causes tissue damage

82
Q

What is restricted to the skin, photosensitivity, butterfly pattern over the nose and cheeks, subtype of SLE

A

discoid lupus erythematosus

83
Q

diseases that have different causes and clinical courses but share the common characteristic of vesicles, or blister, formation

A

vesiculobullous disorders

Pemphigus and Erythema multiforme

84
Q

blister or bubble, rare, chronic blister-forming disease of the skin and oral mucous membranes, blisters form in deep or superficial epidermis

A

pemphigus

85
Q

autoimmune disease caused by circulating IgG autoantibodies, the antibodies and complement act against the cell surface adhesion molecule, desmoglein in the suprabasal layer of the epidermis

A

pemphigus

86
Q

loss of intracellular connections

A

acantholysis

87
Q

type of pemphigus that is severe

A

pemphigus vulgaris

88
Q

type of pemphigus that is on the face and chest, milder form

A

pemphigus foliaceus

89
Q

type of pemphigus that is variant of pemphigus foliaceous associated with SLE

A

pemphigus erythematosus

90
Q

more benign disease than pemphigus vulgaris, bound IgG and blistering of the subepidermal skin layer, subepidermal blistering and eosinophils distinguish pemphigoid from pemphigus

A

bullous pemphigold

91
Q

acute recurring disorder of skin and mucous membranes, associated with allergic or toxic reactions to drugs or microorganisms

A

erythema multiforme

92
Q

caused by immune complexes formed and deposited around the dermal blood vessels, basement membranes and keratinocytes, “bull’s eye” or target lesion

A

erythema multiforme

93
Q

surrounded by rings of alternating edema and inflammation

A

erythematous regions

94
Q

bullous lesions from erosions and crusts when they rupture, affects the mouth, air passages, esophagus, urethra and conjuctivae

A

erythema multiforme

95
Q

what are the severe forms of erythema multiforme?

A

stevens-johnson sydrome and toxic epidermal necrolysis

96
Q

infection of hair follicles, staph is the common causes

A

folliculitis

97
Q

“boils” are an inflammation of the hair follicles, develop from preceding folliculitis; spread through follicular wall into the surrounding dermis, staph is the most common causative organism

A

furuncles

98
Q

collection of infected hair follicles, erythematous, painful, swollen mass that drains through many openings, abscesses may develop, chills, fever, malaise

A

carbuncles

99
Q

infection of the dermis and subcutaneous tissue, staph or strep are the common cause

A

cellulitis

100
Q

an acute superficial infection of the upper dermis (a superficial form of cellulitis) and strep is the most common cause

A

erysipelas

101
Q

a superficial lesion of the skin, caused by coagulase-positive staph or strep

A

impetigo

102
Q

8 types, DNA virus

A

Herpes simplex virus

103
Q

usually causes infection of the cornea, mouth and labia, contact with infected saliva, “cold sore” or “fever blister” the most commmon manifestation

A

HSV-1

104
Q

HSV-1 infection of the cornea

A

herpes keratitis

105
Q

HSV-1 infection of the mouth

A

gingivostomatitis

106
Q

HSV-1 infection of the labia

A

labialis

107
Q

gential infections, skin to skin mucous membrane contact during viral shedding, vertical transmission from mother to neonate is associated with significant neonatal morbidity and mortality

A

HSV-2

108
Q

An initial infection from varicella zoster can be followed years later by ________ _______.

A

Herpes zoster

109
Q

What virus causes these symptoms? Pain and paresthesia localized to the affected dermatome (cutaneous area innervated by a single spinal nerve) followed by vesicular eruptions along a facial, cervical, or thoracic lumbar dermatome

A

Herpes zoster

110
Q

Warts are benign lesions caused by _______ and are diagnosed by ______.

A

human papilloma virus

visualization

111
Q

Highly-contagious, sexually transmitted venereal warts that present as cauliflower type lesions in moist areas- along the glans of the penis, vulva and anus

A

Condylomata acuminata

112
Q

Primary cause of cervical cancer

A

oncogenic HPV

113
Q

Fungi causing superficial skin lesions are called

A

dermatophytes

114
Q

Fungal disorders called mycoses caused by dermatophytes are called

A

tinea

115
Q

Which fungal infection affects the scalp?

A

Tinea captitis

116
Q

Which fungal infection affects the feet?

A

Tinea pedis

117
Q

Which fungal infection causes “ringworm”?

A

Tinea corporis

118
Q

Which fungal infection causes jock itch?

A

Tinea cruris

119
Q

Which fungal infections affect the nails?

A

Tinea ungium or onychomycosis

120
Q

Candidiasis is a fungal infection caused by_________ ______ that is normally found where?

A

Candida albicans

skin, GI tract, and vagina

121
Q

What could cause Candida albicans to change from a commensal organism to a pathogen?

A
local environment of moisture and warmth
systemic administration of antibiotics 
pregnancy
diabetes mellitus
Cushing's disease
debilitated states
younger than 6 months of age
immunosuppresion
neoplastic diseases
122
Q

Results from immune complexes in the small blood vessels that develops from drugs, bacterial infections, viral infections or allergens

A

Cutaneous vasculitis

123
Q

How do the lesions of Cutaneous vasculitis present?

A

palpable purpura progressing to hemorrhagic bullae with necrosis and ulceration

124
Q

Due to type 1 hypersensitivity reactions to allergens; histamine release causes endothelial cells of the skin to contract and causes leakage of fluid from the vessels

A

Urticaria (hives)

125
Q

What is the treatment of urticaria?

A

antihistamines and steroids

126
Q

Sclerosis of the skin that can progress to internal organs- associated with several antibodies

A

Scleroderma

127
Q

How do the lesions caused by scleroderma present themselves?

A

Lesions exhibit massive deposits of collagen with inflammation, vascular changes, and capillary dilation

128
Q

How does the skin present when scleroderma is present?

A

skin is hard, hypo pigmented, taut, and tightly connected to underlying tissue

129
Q

How does scleroderma affect the facial skin?

A

Facial skin becomes very tight

Mouth may not open completely

130
Q

What are some of the side effects of scleroderma?

A

Facial skin becomes very tight
Fingers become tapered and flexed
Nails and fingertips can be lost from atrophy
Mouth may not open completely

131
Q

50% of patients with scleroderma die within ___ years.

A

five years

132
Q

Lyme disease and Rocky Mountain Fever can be caused by what insect?

A

tick

133
Q

Malaria, yellow fever, dengue fever, filariasis, and St. Louis encephalitis may be caused by which insect?

A

mosquitoes

134
Q

Bites from flies may cause what?

A

Painful bites

Urticaria and mild bleeding

135
Q

What are four types of benign tumors found on the skin?

A

Seborrheic Keratosis, Keratoacanthoma, Actinic Keratosis, Nevi (moles)

136
Q

Four different types of malignancies found on the skin.

A

Basal Cell Carcinoma, Squamous Cell Carcinoma, Malignant Melanoma, Kaposi Sarcoma

137
Q

What is a skin injury due to exposure to extreme cold?

A

Frostbite

138
Q

Which area of the hot hiker man’s body might be affected after reaching the summit of Everest?

A

Fingers, toes, ears, nose, cheeks

139
Q

The burning reaction the hot hiker man felt on areas of his body affected by frostbite were caused by what occurring in his hot body?

A

Alternating cycles of vasoconstriction and vasodilation.

140
Q

In this hair loss disease, there is no loss of hair on the frontal hairline.

A

Female-pattern alopecia

141
Q

Disease caused by genetic predisposition response to androgens

A

male-pattern alopecia

142
Q

Autoimmune T-cell–mediated inflammatory disease against hair follicles that results in baldness

A

Alopecia Areata

143
Q

Abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women

A

Hirsutism

144
Q

Acute or chronic infection of the cuticle

A

Paronychia

145
Q

Fungal or dermatophyte infection of the nail plate

A

Onychomycosis