General Inspection and Skin Flashcards
(87 cards)
1
Q
Antiseptic soap + water
A
most effective when hands are visibly soiled
2
Q
Alcohol based hand sanitizer
A
used when hands are not visibly soiled, between patients, and after removing gloves. Does not kill C diff or norovirus
3
Q
NAD
A
No apparent distress, no acute distress
4
Q
Tripoding
A
bend over slightly, use of accessory muscles to try to breath better (common in COPD)
5
Q
Build
A
Slender (ectomorph), Muscular (mesomorphic), Stocky (endomorphic)
6
Q
Marfan Stigmata
A
usually tall and thin
arms, legs, fingers, toes may seem out of proportion (too long)
spine may be curved
joints may be weak and easily dislocated
long, narrow face and teeth may be crowded
lens subluxations (lens of eye moves away from typical position)
Floppy valves
Increased risk of aortic aneurysm
Dolichocephaly (elongated head)
Dissecting aortic aneurysm with exsanguination (severe blood loss)
7
Q
Cachexia
A
Loss of body mass
8
Q
Anorexia
A
loss of appetite
9
Q
Supine
A
lying face upward
10
Q
Alert and oriented x3
A
Time, place, person
11
Q
Obtunded
A
open eyes, responds slowly and confused
12
Q
Lethargic
A
drowsy, responds to questions but falls asleep
13
Q
Fruity breath
A
indicative of DKA
14
Q
Tooth Decay
A
may indicate poor hygiene, bulimia, methamphetamine
15
Q
Allergic rashes are almost always ___
Infected skin lesions are usually ____
A
itchy; painful
16
Q
Pallor
A
grey/white - could indicate anemia
17
Q
Erythema
A
red; flushing vs polycythemia; infection, drug reaction
18
Q
Cyanosis
A
blue; central - tongue, mouth; peripheral - lips, hands, feed
19
Q
jaundice
A
yello
20
Q
cherry red appearance
A
may be CO poisoning
21
Q
Excessive sweat
A
hyperhidrosis
22
Q
Turgor
A
adults - back of hand
children - abdomen
23
Q
Scabies
A
usually interdigital
24
Q
pityriasis rosea
A
herald patch
25
Skin tag
often seen on neck or in axilla, usually benign, may be a sign of diabetes or pre-diabetes if numerous
26
Measles
highly contagious (90% of susceptible household contacts acquire disease, most contagious during prodrome), routine vaccine at 12 mos and 4-6 yrs
Stages
Incubation (10-12 days)
Prodromal w enanthes (3-5 days) - fever, dry cough, coryza, conjunctivitis (& photophobia), KOPLIK SPOTS
Final stage - maculopapular rash and high fever; rash starts at head and neck and spreads distally; fades after reaches feet
Complications: encephalitis, pneumonia, DIC
27
Prodrome/Catarrhal stage
Initial phase
28
Coryza
Cold
29
Conjunctivitis
pink eye
30
Koplik spots
white spots in buccal mucosa (inside of mouth on cheeks) with red areas around them
31
Enanthem
eruption on infectious surface
32
maculopapular
flat and raised skin lesions
33
encephalitis
inflammation of brain
34
Disseminated Intravascular Coagulation (DIC)
abnormal blood clotting throughout the body's blood vessels
35
ABCDE's
```
A - asymmtetry
B - borders
C - color
D - diameter
E - elevation/depression
E - evolution in size, symptoms, morphology
```
36
Annular
cycle that is centrally clear; ringworm most common
37
Discoid
shaped like a disc
38
Arciform
partial, arc
39
Linear
line; typically poison ivy or contact dermatitis
40
Serpiginous
wavy margin
41
Reticular
net-like structure
42
Polycyclic
many circles
43
Stellate
star
44
Morbilliform
Measles-like?
45
primary lesions
develop from previously normal skin
46
What could cafe-au-lait spots + axillary freckling indicate
neurofibromatosis
47
Macule
less than 1 cm in diameter; freckles, flat moles, pityriasis rosea, acanthuses nigricans
48
Palpable elevations (solid bumps)
```
papule
nodule
cyst
wheal
plaque
tumor
```
49
Papule
elevated, firm circumscribed area less than 1 cm in diameter
Ex: warts, fibrous papule, dermatofibroma
50
Nodule
elevated, firm, circumscribed lesion, deeper in dermis than a papule, 1-2 cm in diameter
Ex: lipomas, erythema nodosum
51
Cyst
elevated, circumscribed, encapsulated lesion, in dermis or subcutaneous layer, filled with liquid or semi-solid material
Ex: cystic acne, sebaceous cyst
52
Wheals
elevated, irregular-shaped area of cutaneous edema, variable diameter, solid, transient
Ex: insect bite, urticaria (hives), allergic rxn
53
Urticaria
hives
54
Plaque
elevated, firm, rough lesions with flat top surface, greater than 1 cm in diameter
Ex: psoriasis, seborrheic dermatitis, actinic keratosis (this is precancerous)
55
Palpable elevations with fluid filled cavities
Vesicle
bulla
pustule
burrow
56
Vesicle
Elevated, circumscribed, superficial lesion, filled with serous fluid, not into the dermis, less than 1 cm in diameter
Ex: chickenpox (varicella), shingles (varicella zoster)
57
Bulla
elevated, circumscribed, superficial lesion, filled with serous fluid, not into the dermis (same as vesicle), GREATER than 1 cm in diameter
Ex: blister, burns, bulls pemphigoid (autoimmune disorder)
58
pustule
elevated, superficial lesion; similar to vesicle, but filled with purulent fluid
Ex: acne, impetigo
59
Burrow
tunnel, may include papule, pustules, lichenified areas and excoriations
Ex: scabies
60
Scabies
linear rash with sarcoptes scabiei (itch mite/parasitic mite that burrows into skin and causes scabies)
61
Secondary lesions
result from changes in primary lesions due to over treatment, excess scratching, infection
Ex: scale, crust, lichenification, scars, keloid, erosion, excoriations, fissure, ulcer
62
Scale
heated-up keratinized cells, flake of dead exfoliated epidermis, irregular, thick or thin, oily or dry, variable size
Ex: dry skin, psoriasis, flaking skin of seborrheic dermatitis, dandruff
63
Crust
dried serum, blood or purulent exudate, slightly elevated, size varies
Ex: honey crusted = impetigo, eschar - scab or abrasion wound or burn
64
Lichenification
rough, thickened epidermis, secondary to persistent rubbing, itching, skin irritation, often involves flexor surface
Ex: chronic dermatitis
65
Hypertrophic scar
thin to thick fibrous tissue that replaces normal skin following injury to the dermis
66
Keloid scar
irregular, elevated, progressively enlarging scary (usually itchy, can be treated with kenolog)
67
Erosion
non-scarring shallow defect in skin; epidermis is lost due to pressure or friction, depressed, moist, glistening, follows rupture of a vesicle or bulla
Desquamation = shedding of epidermal cells
68
Excoriation
loss of epidermis, linear hollowed-out crusted areas
Ex: abrasion, scratching
69
Fissure
linear crack or break from the epidermis to the dermis; may be moist or dry
Ex: Athlete's foot, Cheilosis, anal fissure
70
Ulcer
loss of epidermis and dermis, varies in size and depth, concave
Ex: decubitus ulcers, stasis ulcers
71
Atrophy
thinning of the skin; loss of skin markings, skin is translucent and paperlike
Ex: aged skin or striae (stretch marks), Cushing's syndrome, normal pregnancy, someone on high dose of steroids
72
Psoriasis
Scales, plaques, inflammation, lichenification
73
Vascular lesions: does it blanch?
Blanching lesions: due to vascular dilation; inflammation lesions (allergic rxn, hives)
Non-blanching lesions: extravascular (RBC outside of blood vessel); hemorrhagic (purport, petechia), non-vascular (nevus)
74
Petechia/Purpura
deep red or reddish purple, fading with time
Petechia are flat 1-3 mm diameter
Purport are flat or palpable; greater than 3 mm less than 10 mm
Rounded, irregular, flat, may suggest a bleeding disorder
non-blanching
Ex: Rocky Mountain spotted fever, meningococcemia, Henoch-Schonlein, purpura
75
Ecchymosis (bruise)
at largest - purple, blue, fading to green, yellow, and brown with time
1 cm or greater in size
shape is variable;e
secondary to trauma
may indicate bleeding disorder if widespread
non-blanching
76
Spinder angioma
fiery red in color, from v small to 2 cm
central body, sometimes raised, surrounded by erythema and radiating "legs"
central pressure causes blanching
>5 associated with liver disease
77
Telangestasia
```
Superficial veins
bluish in color
variable size from very small to several inches
may resemble a spider or be linear
blanching
```
Ex: acne rosacea
78
Cherry angioma
```
bright, ruby red
1-3 cm diameter
round, flat or sometimes raised
may be surrounded by pale halo
number increase with age
non-blanching
```
79
Hemangioma
congenital anomaly
proliferation of blood vessels leads to a mass that resembles neoplasm
most undergo spontaneous regression
80
Tumor
elevated, solid lesion
margins varibale
deep in dermis
greater than 2 cm in diameter
Ex: neoplasms, benign tumors
lipomas (vary greatly w size)
81
neoplasm
an abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should
82
Benign Nevus
```
round or oval
Sharp/well-demarcated border
uniform color (tan or brown or skin colored)
< 6 mm in size
flat or raised
```
83
Actinic ketosis
superficial
hyperkeratotic papules
precancerous
84
seborrheic ketatosis
whitish yellow to brown
papules & plaques
appear "stuck on"
ebnign
85
Basal cell carcinoma
most common skin cancer
occurs on sun exposed areas (commonly face)
slow growing
rare fatal (less than 0.1% of patient deaths)
rarely spreads to other parts of body
can damage vital organs, bones, blood vessels if left untreated
86
Squamous cell carcinoma
less common than basal cell, more aggressive, tends to ulcerate, risk related to total lifetime UV exposure
87
Mycosis Fungoides (Cutaneous T-Cell Lymphoma)
Premycotic phase: symptomatic scaly, red rash in non-sun exposed areas. difficult to diagnose
Patch phase: thin, reddened, eczema-like rash
Plaque phase: small papule or nodules which may be reddened
Tumor phase: tumors form and may develop ulcers
