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Dermatology > Intro To Derm > Flashcards

Intro To Derm Flashcards

1
Q

What are the 7 “rights”?

A

patient
drug
dose
route
time
indication
signature

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2
Q

What things are included on a prescription?

A

clinic info
pt name, age, DOB
date of service
medication name
strength/formulation
command
amount
formulation
route
frequency
duration
indication
quantity
refills
your name & signature

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3
Q

What does DAW mean?

A

dispense as written

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4
Q

When should you check the DAW box on a prescription?

A

when writing the brand name medication and DO NOT want the pharmacy to fill with a generic version

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5
Q

When should you check the generics permitted box on a prescription?

A

when you write a name brand on the prescription line but are okay with a generic brand being substituted

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6
Q

Can you check both the DAW box AND the generics permitted box on the same prescription?

A

no

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7
Q

If a generic name is written on the prescription line should you check the generics permitted box?

A

no

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8
Q

What question(s) can be asked for the “O” part of the derm HPI?

A

Onset: when it started

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9
Q

What question(s) can be asked for the “L” part of the derm HPI?

A

Location: where did it start? has it changed? how has it changed?

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10
Q

What question(s) can be asked for the “D” part of the derm HPI?

A

Duration: acute vs chronic, intermittent vs constant

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11
Q

What question(s) can be asked for the “C” part of the derm HPI?

A

Characteristics: is it itchy? is it painful?

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12
Q

What question(s) can be asked for the “A” part of the derm HPI?

A

Aggravating/alleviating: cold, heat, travel, meds, products

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13
Q

What question(s) can be asked for the “R” part of the derm HPI?

A

Radiation: has it spread?

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14
Q

What question(s) can be asked for the “T” part of the derm HPI?

A

Treatments tried: topical or systemic, OTC

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15
Q

What question(s) can be asked for the “S” part of the derm HPI?

A

Severity: would you say mild, moderate, or severe? how does it impact your daily life? how does it impact your sleep?
Similar episodes: has this happened before?

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16
Q

Pruitic

A

Itchy

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17
Q

What are some derm questions to ask at a routine preventative exam?

A

have you noticed anything new or changing skin lesions since your last visit?
do you have a history of excessive sun exposure?
do you have a personal or FH of chronic skin conditions or skin cancer?

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18
Q

What are constitutional symptons?

A

fevers, chills, changes in appetite, change in weight

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19
Q

PMH questions

A

recent illnesses, allergies, meds, atopic history, transfusions
any history of skin problems?

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20
Q

Social History Questions

A

smoking, alcohol, substance abuse
travel, occupation, exposures
sexual history (SDI/STI)

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21
Q

Pertinent Family History Questions

A

any skin cancers, psoriasis, atopy that you know of in your family?

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22
Q

What should you examine during a physical exam?

A

Skin
Hair
Nails

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23
Q

What are you doing during a physical exam?

A

inspect color, lesions, and palpate

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24
Q

What are general tips for the physical exam?

A

start with vitals and general appearance
expose appropriately (only the area being inspected)
use proper lighting and magnification PRN
measure (and chart this)

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25
Q

What/where are you inspecting the skin?

A

inspect color and for lesions
all over the body including mucous membranes (mouth) and genitals PRN

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26
Q

What are some examples of color to look for when inspecting the skin?

A

hypopigmentation
hyperpigmentation
depigmentation
erythema
pallor
cyanosis
juandice

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27
Q

Where is it important to look for lesions?

A

intertriginous areas (folds)
extensor and flexor surfaces
waistband

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28
Q

What are examples of lesion patterns and shapes?

A

linear
clusters
serpiginous
annular
dermatomal

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29
Q

What are 3 things you may want to do when inspecting a lesion?

A

measure
mark
photograph

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30
Q

What is included in palpating the skin?

A

moisture: is the skin dry, oily, moist?
temperature: is the skin warm or cool (use back of hands/fingers to feel)?
texture: is the skin rough or smooth?
Mobility or turgor

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31
Q

turgor

A

ease with which the skin lifts and returns to normal

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32
Q

How do you describe skin turgor findings?

A

tenting/no tenting
sluggish/brisk
elastic/inelastic
good/poor

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33
Q

What are things to note when inspecting and palpating the hair?

A

quantity
distribution
texture

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34
Q

What are some descriptive words to use when inspecting the hair?

A

sparse
patchy
silky
oily/greasy
coarse
dry

35
Q

Should you look at the scalp?

A

YES

36
Q

What are you looking for when inspecting the scalp?

A

redness
scaliness

37
Q

What are some things to note when inspecting and palpating the nails?

A

color
shape
lesions

38
Q

What is pitting?

A

indents on the nail

39
Q

What does clubbing look like?

A

when the finger/nail is arched

40
Q

Auspitz sign

A

when slight scratching of a scaly lesion (removal of the scale) revels pinpoint bleeding within a lesion

41
Q

Nikolsky Phenomenon

A

When the epidermis is dislodged from the dermis by shearing pressure, resulting in erosion and a red base (top layers slip away from deeper layers when rubbed)

42
Q

Koebner Phenomenon

A

when a skin lesion appears at the site of trauma or injury

43
Q

what is the greatest magnification you can get with a hand lens?

A

7x

44
Q

What is woods lamp?

A

black light
allows you to see subtle color changes in melanin pigmentation easier

45
Q

diascopy

A

firmly pressing a slide against skin to determine whether redness is due to capillary dilation (erythema – blanches) or extravasation of blood (purpura – does not blanch)
dilation=dilatation

46
Q

dermoscopy

A

hand lens with built in lighting and magnification (10x-30x)
permits noninvasive inspection of epidermis and beyond
helpful in distinguishing between benign and malignant patterns of growth (helps with decision to biopsy or not)

47
Q

What are common allergy tests?

A

patch testing
prick testing

48
Q

What is acetowhitening?

A

application of vinegar
genital verruca/verrucae: white

49
Q

What is a culture and sensitivity test?

A

swab can be taken from skin cells, blood, pus, sputum
this test can confirm the presence of bacteria, virus, fungus, and direct antimicrobial choice

50
Q

What is KOH (potassium hydroxide) Examination?

A

distinguishes fungal infections (looking for budding yeast and/or hyphae)

51
Q

What is Tzanck smear?

A

scraping an ulcer base to look for giant multinucleated cells
this is NOT commonly performed anymore (PCR test is better)
THINK HSV

52
Q

What is scabies test (skin scraping)?

A

unroofing a lesion or burrow (with a scalpel and mineral oil) to find mites, ova, or feces on microscopy

53
Q

What are 3 types of biopsies?

A

shave
punch
excisional

54
Q

What is a shave biopsy?

A

superficial layer removed with a blade
does not require sutures

55
Q

What is a punch biopsy?

A

tubular knife cuts through epidermis, dermis, and SQ tissue
sutures are sometimes required depending on diameter

56
Q

What is an excisional biopsy?

A

remove lesion in entirety
margins examined to ensure they are clear
requires sutures

57
Q

Ecchymosis

A

bruise

58
Q

Eschar

A

dark colored crust of dead tissure

59
Q

fissure

A

thin crack in the skin

60
Q

follicular

A

lesions arising from hair follicles

61
Q

maceration

A

moist. peeling skin, often whitish in color
pruny skin

62
Q

nummular

A

round, coin-shaped lesion
discoid

63
Q

pedunculated

A

on a stalk
lesion on a stalk

64
Q

pruritus

A

itching

65
Q

verrucous

A

wart-like

66
Q

petechiae

A

pinpoint bleeding into the skin
does NOT blanch
small red, purple, or brown spots

67
Q

Purpura

A

larger bleeding into the skin
does NOT blanch
may be palpable
internal bleeding from small blood vessels

68
Q

What is Mohs Procedure?

A

skin-sparing procedure used often for the face and to remove malignancies in the most efficient way possible
done outpatient and ONLY by dermatologists

69
Q

Atopic History

A

Eczema, nasal allergies, asthma

70
Q

Erythema

A

Redness
blanches
capillaries being dilated

71
Q

Pallor

A

More pale

72
Q

Depigmentation

A

Loss of melanin

73
Q

Intertriginous

A

in the folds
where there is more moisture
think fungal

74
Q

Lesion Pattern: Linear

A

following along a line

75
Q

Lesion Pattern: Clusters

A

Grouped together

76
Q

Lesion Patterns: Serpiginous

A

snake like

77
Q

Lesion Patterns: Annular

A

ring shaped
Central clearing

78
Q

Lesion Pattern: Dermatomal

A

following the nerve innervations

79
Q

Example of Dermatomal lesion

A

shingles
chicken pox

80
Q

Positive Auspitz =?

A

psoriasis

81
Q

Positive Nikolsky Phenomenon =?

A

Stevens Johnsons Syndrome

82
Q

verruca/verrucae

A

lesion turns white

83
Q

What is the most common thing culture and sensitivity tests can confirm?

A

bacteria

84
Q

Telangiectasias

A

spidery type of vessels (rosacea)

Dermatology (3 decks)

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