midterm Flashcards
(158 cards)
1
Q
what are the 3 layers of the skin?
A
epidermis, dermis, hypodermis
2
Q
what layers are in the epidermis?
A
stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale
3
Q
what is the function of the stratum corneum?
A
the outer most layer of the epidermis. Has corneocytes which are dead kertatinocytes and they make up ceramides, cholesterol and fatty acids forming this layer.
4
Q
what is the latin name for the stratum corneum?
A
horny layer
5
Q
where is the stratum lucidum found in the body?
A
on the palms of hands and soles of feet
6
Q
what are found in the stratum granulosum?
A
lamellar bodies which are formed by the keratinocytes. lamellar bodies are packed with lipids, ceramides, cholesterol, and fatty acids.
7
Q
what cells are found in the stratum spinosum?
A
keratinocytes which produce keratin and langerhans which contribute to the skin’s immune response.
8
Q
what layer does melanocytes live?
A
stratum basale
9
Q
how many layers does the dermis have?
A
- the papillary and reticular
10
Q
what cells in the dermis produce collagen and elastin?
A
fibroblasts
11
Q
what is the function of the dermis?
A
holds nerve endings, blood vessels, and lymph vessels for the skin
12
Q
where does vitamin D synthesis occur?
A
the dermis
13
Q
what is the function of the subcutaneous layer?
A
provide insulation, shock absorption and energy storage
14
Q
how is cellulite formed?
A
when collagen and elastin stretch to rapidly or excessively in the fat layer then dimpling occurs.
15
Q
what is a macule?
A
non palpable lesion that has localized changes in skin color that is not raised or depressed.
16
Q
what is a papule?
A
superficial solid lesion less than 0.5 cm. palpable lesion.
17
Q
what is a nodule?
A
a palpable solid round lesion that can involve the epidermis, dermis or subcutaneous tissue
18
Q
what is a plaque?
A
a plateau like elevation above the skin surface. well defined frequently formed by a confluence of papules
19
Q
what is a wheal?
A
hives. typically disappears within 12-48 hours
20
Q
what is a crust?
A
serum, blood, or purulent exudate that has dried on the skin surface.
21
Q
what is desquamation?
A
scaling of the skin mainly the epidermis (stratum corneum)
22
Q
what is a pustule?
A
circumscribed superficial cavity of the skin that contains a purulent exudate. can be in a hair follicle
23
Q
what is a vesicle?
A
cavity containing fluid that is less than 0.5 cm
24
Q
what is a bulla?
A
cavity containing fluid greater than 0.5 cm
25
what is an ulcer?
skin defect due to a loss of epidermis and upper papillary dermal layer. can extend into subcutaneous tissue.
26
what is an erosion?
defect only of the epidermis. heals without a scar
27
what is a fissure?
sharply defined linear or wedge shaped tear in the epidermis
28
what causes impetigo?
staph aureus and strep pyogenes
29
what are the two forms of impetigo?
bullous and non-bullous
30
Describe non-bullous impetigo
superficial skin infection that manifests as clusters of vesicles or pustules that rupture and develop honey colored crust
31
Describe bullous impetigo
infectious skin condition that manifests as clusters of vesicles or pustules that enlarge rapidly to form bullae that burst and form honey colored crust or varnish
32
what is used to treat impetigo?
topical Mupirocin 2% ointment TID x 10 days
oral antibiotics if cannot tolerate topical (erythromycin, cephalexin, etc.)
honey, tea tree oil, centella asiatica
33
what is folliculitis?
infection of the hair follicle caused by staph aureus bacteria.
34
what is sycosis barbae?
a folliculitis of the beard and chin area in men
35
what is the treatment for folliculitis?
change razors, hygiene improvement, topical benzoyl peroxide, topical mupirocin TID for 5-7 days, oral cephalexin, or TMP Sulfa (good for MRSA)
36
What is pseudomonas folliculitis?
hot tub folliculitis caused by pseudomonas bacteria contamination. can be self limiting but can use ciprofloxacin if skin lesions persist
37
what are the stages of necrotizing fasciitis?
erythema, edema, fever, crepitus, skin bullae or necrosis
38
what is erythrasma?
bacterial infection with corynebacterium miniutissimum affects 3rd and 4th toe web and genital area. resembles tinea (fungal infection)
39
what is Scarlett's fever?
infection caused by strep pyogenes. Sx followed by strep throat. can cause strawberry tongue if untreated. sandpaper skin, desquamation, fever, nausea, vomiting, headache, abdominal pain
40
what is rheumatic heart disease?
occurs due to acute rheumatic fever. causes inflammation and thickening of mitral valve mainly but other valves as well. can affect joints, CNS
41
What is pitted keratolysis?
caused by micrococcus sedentarius infection in the stratum corneum. associated with hyperhidrosis
42
what are furuncles and carbuncles?
walled off collection of pus that is red hot tender firm or fluctuant. furuncles are from infected hair follicles (folliculitis)
carbuncles are deep abscess of several follicles. both are caused by staph aureus
43
what is erysipelas?
superficial cellulitis of skin in the epidermis and superficial lymphatics caused by strep group A
44
what is cellulitis?
infection of the dermis and subcutaneous tissue of the skin following a crack, abrasion, bite or wound caused by strep pyogenes. commonly on legs
45
what is periorbital cellulits?
occurs on anterior eyelid with erythema, eyelid swelling and ocular pain. treated with amoxicillin
46
what is orbital cellulitis?
a serious form of eye cellulitis that is emergent. use non contrast CT to differentiate between periorbital vs orbital. Involves orbital fat tissue and extraoccular muscles
47
what is erysipeloid?
an infection affecting the fingers due to handling raw seafood and meats. symptoms include burning and itching. self limiting but can use antibiotics such as penicillin or ciprofloxacin
48
what is pilonidal cysts?
an abnormal pocket of skin that contains hair and skin debris. typically near tailbone before butt crack.
49
how are pilonidal cysts treated?
surgery. I &D
50
where does scabies bites occur?
below the neck on abdomen, back, pubic area, penis, axillary fold, finger webs, wrists, legs and nipples
51
what is the treatment for scabies?
5% permethrin cream leave on for 8-12 hours then shower off, wash laundry in hot water and dry hot
52
what is the treatment for lice?
1% permethrin lotion leave on for 10 mins repeat for 7-9 days. clean fomites/laundry/furniture, mechanical removal/shaving hair
53
what is the name for bedbugs?
cimicosis
54
what is the treatment for bed bug bites?
oral antihistamines, topical anti itch cream, topical corticosteroids
55
what insect causes lyme disease?
ticks: borrelia burgdorferi where the spirochete causes the infection.
56
what are the symptoms of lyme disease?
fatigue, chills, fever, headache, myalgia, arthralgia, skin rash, lymphadenopathy, but can become worse leading to nervous system issues
57
what is the treatment of lyme disease?
antibiotics like doxycycline or amoxicillin, anti-inflammatory diet, probiotics, digestive enzymes, cat's claw
58
what is rocky mountain spotted fever?
infection caused by rickettsia rickettsii. symtoms include fever, headache an rash on ankles, wrist and forearms that spread to palms, soles, arms, legs and trunk
59
what is the treatment for rocky mountain spotted fever?
antibiotics: doxycycline
60
what is the treatment for black widow bite?
emergent care immediately to receive antivenin medication
61
does a brown recluse spider bite need antivenin?
No, supportive care is needed
62
How many epipens are prescribed to patients with anaphylaxis to bee stings or any allergen?
2 dosed at 0.3 mg for adults and 0.15 for children and dose can be repeated after 5-15 mins
63
what other natural treatments are effective for bee stings?
honey to help with wound healing, baking soda/ACV to neutralize the venom, wet aspirin tablets to reduce pain/swelling, aloe vera, calendula cream to heal wounds, lavender oil/tea tree oil, witch hazel to reduce pain, swelling
64
what are chiggers?
mite that have larva that bite humans causing itchy small bumps
65
what is the treatment for chiggers/fire ants?
baking soda, witch hazel, moxa, antihistamine cream
66
what diseases can mosquitos transmit?
west nile virus, dengue fever, malaria
67
68
what does dermatophytes (fungus) feed on?
keratin in skin, hair and nails
69
what lab is used to determine if someone has a fungal infection?
KOH wet mount
70
what colors show up under wood's lamp UV light for certain fungi?
tinea capitis- blue green
tinea versicolor- white yellow
pseudomonas- green
erythrasma- coral red
lint- white or dull yellow
71
what is tinea pedis?
athlete's foot. common in between toes due to excess moisture. symptoms include itching, burning, and stinging sensation.
72
what are the different types of tinea pedis?
hyperkeratotic (moccasin), interdigital, vesiculobullous
73
what is tinea cruris?
jock itch. fungal infection in groin. with red scaly rash that has raised borders. can spread to inner thighs, butt, or lower abdomen
74
what is tinea corporis?
aka ring worm. commonly affects the trunk, arms, and legs. itching is common.
75
what is tinea barbae/tinea facialis?
fungal infection in the beard/face area. can resemble folliculitis. symptoms include itching, pain, swelling. can have hair loss or breakage due to fungus eating keratin.
76
what is tinea capitis?
circular patches of hair loss with a scaly red or inflamed base. symptoms include itching. looks like alopecia
77
what is the treatment for tinea capitis?
oral antifungals, selenium sulfide shampoo, occasionally prednisone use.
78
what is tinea unguium/ onchomycosis?
discoloration of the nails turning yellow, brown or white. causes thickening and crumbling of nail. can lead to onchomycosis- separation of nail from nail bed.
79
what is the treatment for tinea unguium?
let nail grow out clean. treat with 2% fluconazole + 2% ibuprofen. OTC care vicks vapor rub. laser treatment for onchymycosis. and surgery to remove nail and tx nail bed.
80
what is an ID reaction?
a dermatophytid reaction which occurs distant from the primary infection site.
81
what is cutaneous cadidiasis?
yeast infection caused by candida albican.
82
how does diabetes cause someone to be predisposed to having greater risk of candida infections?
elevated blood sugar promote candida growth. poor circulation can impair immune function in the skin.
83
what are satellite lesions for cutaneous cadidiasis?
small pustular or papular lesions around main lesion
84
how to treat candida infection?
drying agents, nystatin, boric acid, limit sugar intake and alcohol, topical coconut oil with 3-5 drops oregano or tea tree oil. probiotics
85
what is tinea versicolor?
hypopigmented hyperpigmented or red macules on trunk or upper extremities. caused by malassezia furfur
86
what causes tinea versicolor to occur?
inhibition of the enzyme tryosinase due to azelaic acid that is produced by the M. furfur fungus.
87
what is the treatment of tinea versicolor?
use dandruff shampoo for body that contains selenium sulfide and ACV with 2% ketoconazole shampoo for body wash.
88
89
what are the HPV strains that cause common warts?
hpv 1, 2, 4, 7
90
what HPV strains cause plantar and palmar warts?
HPV 1, 2, 4 and are single painful papules covered by thick callus
91
what HPV strains cause flat warts?
HPV types 3 and 10. occassionally 26-29 and 41.
92
what are condyloma acuminatum?
genital warts. caused by HPV 6, 11 most common but can be by other strains.
93
what is the treatment for warts?
topical salicylic acid, cryotherapy, topical polyphenol E ointment for genital warts, homeopathy: Thuja (genitals), causticum, nitric acid, medorrhinum, 5 FU and glycolic acid compound cream
94
what is molluscum contagiosum?
clusters of pink dome shaped smooth waxy or pearly umbilicated papules caused by molluscum contagiosum virus. spread through direct contact.
95
what is mpox?
a virus that causes vesicles or pustules rash over body. spread through direct contact, respiratory droplets. is not a STI.
96
what vaccine can be given to prevent mpox?
MVA vaccine- 2 doses given 4 weeks apart
97
how is HSV 1 & 2 spread?
during active shedding of virus.
98
what triggers HSV viral load?
sunlight, stress, trauma, high arginine foods, illness, weed
99
what are the herpes virus types?
HSVI 1, 2, herpes simplex keratitis, herpetic whitlow, herpes encephalitis
100
what is herpes keratitis?
infection of the corneal epithelium by HSV leading to pain, tearing, sensitivity to light, and corneal ulcers
101
what is herpetic whitlow?
lesions on finger that become swollen, painful and red. common in healthcare workers who come in contact with HSV.
102
what homeopathic can be used for herpes virus?
natrum muriaticum best for oral herpes, rhus tox, sepia, nitric acid
103
what are the symptoms of measles?
fever, runny nose, cough, conjunctivitis, koplik spots with a rash that appears 3-5 days after sx start. rash starts on face than spreads to trunk/extremities
104
what is rubella?
caused by a RNA virus spread through respiratory droplets. symptoms include fever, conjunctivitis, lymphadenopathy, then leads to a rash that disappears within 3 days. less severe compared to measles
105
what is roseola infantum?
common viral infection in kids due to HHV-6
symptoms include high fever, cervical/posterior auricular lymphadenopathy, after fever goes away a rash appears on chest and abdomen
106
what is erythema infectiosum?
aka slapped cheek disease. caused by parvovirus B19. suppresses erythropoiesis, can lead to aplastc crisis for children with RBC disorders. symptoms include body rash on arms, legs and trunk reticular or lacy patterns
107
what is hand foot and mouth virus?
common in children spread through oral, oral-fecal route. will have prodrome flu like sx then rash on hands feet and mouth. caused by coxackievirus A16
108
what is varicella zoster?
chicken pox which is a human herpes virus 3. can be airborne or through direct contact. prodrome occurs in adults mainly. sx are itchiness, blister like lesions that appear in clusters.
109
what are the symptoms of herpes zoster?
painful, tender, itching, tingling, burning sensation on a particular area that has past chickenpox infection that is latent. vesicles arise in clusters like chicken pox but more painful. typically does not cross midline of body (unilateral)
110
what is the Hutchinson's sign?
shingle vesicles that pop up on the tip of the nose which can cause ocular disease.
111
112
what are the types of psoriasis?
chronic plaque with thick silvery white scales
guttate- red scaly small teardrop spots triggered by group A strep throat resolves on own in 3-4 months
pustular- tender pus filled blisters
erythrodermic- uncommon life threatening form of psoriasis causing red scaling over entire body
113
what is associated with psoriasis?
psoriatic arthritis which causes joint pain, stiffness and back pain
114
what is pityriasis rosea?
rash caused by possible viral infection but still unknown. signs include herald's patch on chest or back then smaller ones pop up with in days to weeks.
115
what is lichen planus?
plaque or papule like lesions that are purple, itchy, polygonal that can be on skin, in mouth, genitals, scalp or nails or esophagus.
kind of like an autoimmune condition where a virus, drug or allergen alters the epidermal self antigens increasing cytotoxic T cell activation.
116
what is hidradenitis suppurativa?
painful nodules and abscesses located in apocrine glands that can drain and cause thickening skin and scarring.
117
how do you treat HS?
90 mg of zinc gluconate and 30 mg of nicotinamide once a day for 3 mos. anti-inflammatory diet, no dairy, limit sugar intake, exercise, avoid shaving, deodorant, heat, humidity, topical and oral antibiotics.
118
what is perioral dermatitis?
small red papules or pustules around the mouth and spread to nose and eyes. common in women.
119
what is rosacea?
chronic skin condition that has facial redness, visible blood vessels and inflamed bumps or pustules.
120
what is the tx of rosacea ?
avoid triggers like extreme temps, sunlight, spicy foods, alcohol, exercise, stress, meds. gentle skin care, anti-inflammatory diet, support healthy gut microbiome, digestive enzymes, probiotics and acupuncture to increase blood flow to skin.
121
what are the forms of acne vulgaris?
comedomes (black and white heads) can be papules or pustules and cysts
122
what is the allergic triad?
allergic rhinitis, asthma, atopic dermatitis
123
what bacteria causes an increase risk of gut dysbiosis for eczema?
c. diff, e. coli, Bacteroides
124
what amino acid causes an increase itching sensation for skin conditions?
tryptophan
125
what is the most common contact dermatitis allergen?
nickel
126
what is lichen simplex chronicus?
thickened leathery skin (plaques) that itches due to chronic scratching, rubbing
127
what triggers lichen simplex chronicus?
can be due to nervous system dysfunction leading to an increase itch sensation.
128
what is seborrheic dermatitis?
dandruff in adults, cradle cap in infants. red flaky, and greasy patches on scalp or face that is itchy
129
what is a hemangioma of infancy?
nodular mass of dilated vessels that can be superficial or deep seated in the dermis/subcutaneous tissue. superficial hemangiomas are treated with timolol or surgery. deep hemangiomas are treated with surgery, propranolol, chemotherapy or will self resolve.
130
what are vascular birthmarks?
are lesions on face or neck that are flat and unilateral with color changes from red-blue
131
what are cherry angiomas?
benign vascular lesion of dilated or congested capillaries
132
what are spider angiomas?
flat dilated or broken blood vessels near skin surface look like spider webs. are on face, arms and upper back.
133
how do you treat spider angiomas?
radio or electrosurgery, pulse dye laser
134
what are venous lake lesions?
dilated venules that blanch with pressure. common on face, lips, ears
135
what is a pyogenic granuloma?
an oozing red small and bleeding hemangioma that occurs commonly due to minor trauma. Can be excised, laser treated, sclerotherapy, intralesional corticosteroid injections to treat if needed.
136
what is melasma?
light to brown hyperpigmentation that occurs in women due to hormonal fluctuations, thyroid dysfunction, hyperinsulinemia, pregnancy, anti seizure meds
137
what is a felon nail?
subcutaneous infection causing swelling in distal portion of fingernail. can be treated with antibiotics, I & D if abscess is present.
138
what is a onycholysis?
nail detachment at later or distal edge of nail, can have grayish white area in nail due to air entrapment, and nail can be yellow to brown in color with an odor.
139
what is onychogryphosis?
thickening of nail due to age, poor circulation, DM, lack of nutrients for nail health.
140
what is a subungual hematoma?
a hematoma that occurs under the nail bed due to trauma. Can be drained to release blood.
141
what is paronychia?
an inflammation of the nail fold caused by staph aureus infection. common on 2nd and 3rd nail. can have abscess or cellulitis
142
what is solar lentigo?
liver spots, senile freckles. common in elderly due to chronic sun exposure. will need to monitor to rule out skin cancer.
143
what is vitiligo?
an autoimmune skin condition that lacks melanocytes that form melanin or pigmentation of the skin.
144
what are seborrheic keratosis?
benign lesions that can be smooth or rough. Look like warts for rough. second most common benign skin lesion after nevi. can be greasy appearing or pasted on papule or plaque. smooth can have horn cysts in them.
145
what is dermatosis papulosa nigra?
common in black/brown people. papules that are brown/black spots round and slightly freckle like on face and neck
146
what are acrochordons?
skin tags! increase with obesity, insulin resistance, DM, metabolic syndrome.
147
what is a dermatofibroma?
benign fibrotic tumor with epidermal hyperpigmentation and thickening. common in young adults and women. due to trauma. firm on palpation. will have positive dimple sign when palpated.
148
what is the difference between dermatofibroma and dermatofibrosarcoma?
dermatofibrosarcoma is a malignant form of a dermatofibroma that grows slowly
149
what is a hypertrophic scar?
enlargement of a scar that occurs within the boundaries of the original scar
150
how to treat keloid/hypertrophic scar?
silicone therapy to increase hydration of stratum corneum
laser therapy
intralesional corticosteroid injection
cryotherapy
151
what is chondrodermatitis nodularis chronica helicus?
nodule on helix of ear that crusts and becomes dense
152
what is epidermal inclusion cyst?
cyst that forms in the stratified squamous epithelium epithelial layer. cyst is filled with trapped keratin
153
what is a pilar cyst?
a cyst that is in the stratified squamous epithelial layer that is thicker. filled with keratin, calcified, cholesterol. second most common cyst.
154
what is a sebaceous cyst?
rare cyst. plugged or blocked sebum gland within a hair follicle.
155
what is milia?
small epidermoid cyst formed from eccrine sweat ducts or pilosebaceous units due to staph aureus, beta hemolytic strep, H. influenza
156
what is a meibomian cyst?
chalazion tarsal cyst, mass in eyelid in the meibomian gland
157
what is a hordeolum?
stye. can be internal or external commonly caused by staph aureus
158
