Renal/Integumentary Flashcards
(168 cards)
1
Q
_____-Related Changes in the Renal System:
• Decreased kidney size – around age 30. You can actually lose up to 25% of the mass
• Decreased Renal Blood Flow (RBF) and Glomerular Filtration Rate (GFR)
o d/t renal vascular perfusion changes
• Decreased number of nephrons
• Decreased tubular transport response
• Decreased elimination of drugs
• Increased sclerotic glomerular capillaries
• Increased excretion of glucose
• Increased bladder symptoms
o Urgency, frequency, nocturia
A
Age
2
Q
this test is for a waste product that is continuously produced during normal muscle breakdown. What your kidneys do is filter that waste product from the blood into the urine where it is then excreted. This process allows for almost no reabsorption. So when you look at this test it tells you simply the amount of blood the kidneys can make creatinine-free each minute. As renal function declines, patient’s ability to clear creatinine will go down.
A
plasma creatinine concentration
3
Q
Normal creatinine value is ______ mg/dl
A
0.7 to 1.2
4
Q
Test used in glomerular nephritis
A
creatinine concentration
5
Q
a protein mainly used to assess kidney function. It also filters out of the blood by the glomeruli and is excreted out. Used when creatinine clearance could be misleading (cirrhosis, obese, malnourished, vegetarians) – individuals may not have the muscle mass to adequately assess their kidney function thru creatinine clearance.
A
Plasma Cystatin C Concentration
6
Q
plasma protein that is freely filtered at the glomerulus.
A
cystatin C
7
Q
two renal tests used to measure progressive renal dysfunction
A
creatinine + cystatin C
8
Q
waste product that kidneys move from blood out of body thru urine
end product of protein metabolism
varies as a result of altered protein intake and protein catabolism
A
blood urea nitrogen (BUN)
9
Q
test for hydration status (increases in dehydration and kidney failure)
A
BUN
10
Q
normal range for BUN: _____ mg/dL
A
10-20
11
Q
test: blood in the body continuously & hundreds of times throughout the day flow thru kidneys – they will push that liquid part of our body thru these tiny filters (nephrons) & the majority of the body’s fluid will be filtered thru nephrons and reabsorbed back into body. If not reabsorbed, it will then become urine
A
glomerular filtration rate (GFR)
12
Q
rate of blood flow through the kidneys
A
glomerular filtration rate (GFR)
13
Q
test that determines level of kidney function
A
glomerular filtration rate (GFR)
14
Q
normal pH of urine
A
5-6.5
15
Q
measures solute concentration of urine has a normal value of 1.016- 1.022
A
specific gravity
16
Q
measures RBC in urine (there should be none)
A
sediment
17
Q
measures accumulations of cellular precipitates in the urine
They are an indication of the type of disease the kidney is experiencing
A
casts
18
Q
renal infection (pyelonephritis) will result in ____ casts
A
WBC
19
Q
inflammation of the glomerulus (glomerulonephritis) will results in _____ casts
A
RBC
20
Q
urine ______ indicate inflammation, infection, or metabolic disorder
A
crystals
21
Q
urine test that shows if there is an infection
A
WBC
22
Q
urine \_\_\_\_\_\_\_\_\_ tests: • Glucose • Bilirubin • Urobilinogen • Leukocyte esterase • Nitrates • Ketones • Proteins • Hemoglobin and myoglobin
A
reagent strips
23
Q
test with flat plain film (one picture of abdomen AP [anterior posterior view])
->targets the kidney, ureter, and bladder (not that great of a diagnostic tool for urinary system – typically just use it when assessing for constipation)
A
x-ray “KUB”
24
Q
renal diagnostic test that uses iodine that contain a radiopaque dye that is injected into a vein to circulate throughout the kidney and then excrete in the urine. As it is excreted in the urine a rapid series of x-rays catches the dye as it is being excreted.
o This will give us a good idea of the urinary tract and if there are any underlying complications.
o The dye is nephrotoxic and hydration is recommended prior to the IVP
A
Intravenous Urography/Pyelography (IVP)
25
non-invasive, no exposure to radiation, test that allows visualization of the kidneys – measure kidneys, see shape/location, see if there’s kidney stones, tumors, cysts, abscess, etc. [often used in pediatrics for detection of causes of reflux etc]
ultrasound
26
minimally invasive test that is done under fluoroscopy- an x-ray done in “real time” (allows radiologist to see urinary tract & bladder)
-->will identify if there is any bladder backup to the kidneys [reflux] also if they have reflux and have had surgery, they may repeat to see if surgery was successful. Also if they are suspicious of a blockage in urethra, this test will identify that
o Shows how the lower urinary tract is functioning
o Child is usually catheterized, and the radiopaque material is passed via catheter to the bladder. And when the bladder is full the child is asked to urinate or may do so on his/her own. The fluoroscope pictures are being made as the bladder fills and the child voids
o Used to evaluate bladder size, if there is vesicoureteral reflux and what grade the reflux is
Voiding Cystourethrogram (VCUG)
27
Masses of crystals or other substances that occur in the kidney and cause obstruction
• Most are made of calcium crystals – calcium oxalate and calcium phosphate
**made of minerals & salts but calcium most common
Nephrolithiasis ("Kidney Stones")
28
CM of _____:
• VERY PAINFUL
• Nausea/vomiting
• Diaphoresis
• Pain radiating from flank to lower abdomen or groin
• Pain can come in waves w/fluctuating intensity.
• Pain can occur w/urination
Urine can be red, pink, or even brown in color
Nephrolithiasis ("Kidney Stones")
29
Patho of ________:
• Caused by inflammation of the urinary epithelium after invasion and colonization by some pathogen in the urinary tract
• There is a positive retrograde movement of bacteria into the urethra and bladder
• Most of the time, if bacteria enters the urinary tract, our body’s immune system can get rid of the bacteria on its own by protective mechanisms. If body’s natural immune system doesn’t protect us, the bacteria will enter thru urethra, lead to an inflammation of epithelium, and multiply.
• Leading pathogen: E-coli (85% of all UTIs)
Urinary Tract Infection (UTI)
30
Protective _______ ________:
• Bacteria is washed out of the urethra during micturition
• Low pH & high osmolality of urea, the presence of Tamm-Horsfall proteins, and secretions from the uroepithelium which all provide a bactericidal effect.
• The ureterovesical junction (UVJ) closes during bladder contraction preventing reflux of urine to the ureters and kidneys
• Length of the male urethra is protective
• Common pathogens
• Most common pathogens are Escherichia coli & Staphylococcus
Urinary Mechanisms
31
```
Causes of _____:
Mostly coliforms (e.coli, klebsiella, proteus, pseudomonas)
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Acute Cystitis (Bladder Infection)
32
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Risk Factors for _______:
Premature infant
female gender (including school aged girls)
sexually active women [can develop from sexual intercourse]
pregnant women
women recently treated with antibiotics
spermicide use
estrogen deficiency in women
persons with catheters
Diabetes Mellitus
bladder dysfunction
```
Acute Cystitis (Bladder Infection)
33
```
CM of _______:
Varies w/ age
Urinary urgency
burning
blood in urine
voiding small amounts
urinary frequency
foul urinary odor
pelvic discomfort
low-grade fever
adults
dysuria
low back pain
**May be asymptomatic especially during pregnancy or in the elderly. Symptoms different in children and older
sometimes suprapubic pain
**In the elderly they may manifest differently: lethargy, anorexia, confusion, anxiety
```
Acute Cystitis (Bladder Infection)
34
Evaluation of ____:
| • Urine dip or UA with microorganism count of 10,000 mls or more
Acute Cystitis (Bladder Infection)
35
Chronic bladder inflammation w/ acute cystitis-like symptoms of pelvic pain w/no evidence of bacteria in urine.
***Can be caused by autoimmune reaction, drug-induced, radiation, chemicals (spermicides, bubble baths, lubricants, etc.)
Interstitial Cystitis/Bladder Pain Syndrome [Noninfectious Cystitis]
36
Causes of _______:
Nonbacterial infection
noninfectious cystitis- radiation, chemical
interstitial cystitis- hypersensitivity
Hunner Ulcers- autoimmune derangement of the bladder mucosa with ulcers
scaring
decreased bladder capacity
Interstitial Cystitis/Bladder Pain Syndrome [Noninfectious Cystitis]
37
Acute infection of the ureter, renal pelvis, and/or renal parenchyma (most cases occur among women) in which bacteria has continued to travel past the bladder, thru ureters, and into the kidneys to wreak havoc
**Primary organism- E.Coli and other coliforms are the usual infectious agents (e.coli, klebsiella, proteus, pseudomonas
Acute Pyelonephritis (Kidney Infection)
38
Risk Factors for _______:
female gender
urinary tract blockage (like man w/large prostate)
weakened immune system
spinal cord or nerve damage around bladder
foreign bodies- catheter
”list goes on.”
Acute Pyelonephritis (Kidney Infection)
39
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Cause of ______:
ascending infection (from the lower urinary tract) or sepsis (blood born infection)
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Acute Pyelonephritis (Kidney Infection)
40
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CM of _______:
very sick
flank pain
fevers
chills
costovertebral tenderness
purulent urine
anorexia
dehydration
UTI symptoms [urgency, frequency, burning, blood in urine, foul-smelling urine, n/v]
```
Acute Pyelonephritis (Kidney Infection)
41
Evaluation for ______:
| UA ill show WBC casts- indicating pyelonephritis
Acute Pyelonephritis (Kidney Infection)
42
Chronic syndrome caused by an overactive detrusor muscle that contracts involuntarily even w/ a low volume of urine in bladder creating urgent need to void
***Symptom syndrome- urgency with/without urge incontinence, urinary frequency and nocturia
Overactive Bladder
43
Diagnosis of _____:
good medical hx
physical exam
negative urinalysis (may want to send off to lab to make sure urine doesn’t grow anything w/culture)
Overactive Bladder
44
sudden, intense urge to urinate followed by loss of urine (maybe urinary frequency & nocturia as well)
urge incontinence
45
urine leaks w/exerted pressure (coughing, sneezing, laughing, exercise)
stress incontinence
46
frequent or constant dribbling of urine because bladder doesn’t empty completely
overflow incontinence
47
physical or mental impairment that prevents making it to the toilet on time (dementia, bed-bound that requires assistance to bathroom).
functional incontinence
48
urine formation and excretion begins in fetus in the ___ month of gestation
3rd
49
the key to all stages of kidney development & maintenance of kidney function
Wilms Tumor 1 (WT1) gene
50
Urethral meatus is located on the ventral side or undersurface of the penis
hypospadias
51
rare malformation of penis but can also develop in famles as well.
o Males: Urethral opening is on the dorsal surface of the penis
o Females: Cleft along the ventral urethra usually extends to the bladder neck
o 2x as many boys are affected as girls
epispadias
52
absence of one or both kidneys in fetus
o If unilateral (occurs in 1 in 1000 live births) usually the left kidney is absent and the remaining kidney hypertrophies which can lead to a normal/healthy life
renal agenesis
53
kidneys are absent bilaterally (incompatible with uterine life and is a rare genetic disorder) resulting in low amniotic fluid
**more often in males
Associated with a group of facial anomalies:
• agenesis or hypoplasia
• wide set eyes,
• low set ears,
• receding chin,
• flattened nose with downward turned nasal tip
Potter Syndrome
54
Autosomal Dominant disorder (each child has 50% chance) that is a mutation of two genes:
• PKD1 on chromosome 16
• PKD2 on chromosome 4
Occurs in 1 in 1000 live births
• Cyst formation and obstruction, accompanied by destruction of renal parenchyma, interstitial fibrosis, and loss of functional nephrons
• Most common form, accounts for 90% of all polycystic disease
• Causes symptoms later in life around 30-40
• Affects both genders and all races
• Cysts will develop in clusters on kidneys, leading to hypertrophy & loss of function over a period of time
Polycystic Kidney Disease (PKD)
55
```
CM of ____:
HTN
flank pain
bloating
kidney stones
kidney failure
```
Polycystic Kidney Disease (PKD)
56
Autosomal Recessive disorder (both parents must carry the abnormal gene to pass on, each child will have 25% chance of getting disease, 50% carrier, 25% non-carrier)
that occurs due to gene mutation on chromosome 6 p
• Cystic changes of the kidney and liver are evident at birth
• Renal replacement therapy is typically needed and required during childhood or adolescence.
• Enlarged kidneys with cysts
• Systemic hypertension
• Liver problems
Polycystic Kidney Disease (PKD)
57
inflammation of tiny filters in kidneys
o Etiology: It is a renal disorder in which proliferation and inflammation of the glomeruli are secondary to an immune mechanism. There will be a sudden onset of hematuria with red blood cell casts and proteinuria
Acute Post Streptococcal Glomerulonephritis
58
Patho of ______:
The most common acute glomerulonephritis that occurs after a throat (i.e., pharyngitis) or skin infection (i.e., impetigo) with certain strains of group A α-hemolytic streptococci. This occurs because antigen-antibody complexes and complement are deposited in the glomerulus. Immune complexes then initiate inflammation and glomerular injury. This form primarily occurs in children 5 to 15 years of age.
[In English: Usually takes 1-2 weeks after recovering from either strep throat or impetigo to develop this. Immune response that occurs when body produces too many antibodies and extra settle in glomeruli, leading to inflammation]
Acute Post Streptococcal Glomerulonephritis
59
CM of ______:
• Pink or cola colored urine [from RBCs in urine],
• foamy urine d/t excess protein,
• HTN,
• Water retention,
• edema [face, hands, feet, abdomen], and,
• In severe cases- azotemia will be present [aka increase in BUN,Creatinine]
Acute Post Streptococcal Glomerulonephritis
60
o Etiology: Unknown
o Pathophysiology: IgA deposited in kidneys, trapped in glomeruli
o The most common form of glomerulonephritis in children and young adults and occurs more in males than females.
o It is characterized by deposition primarily of IgA and complement proteins in the glomerulus
o Most children recover completely. 20-40% may have recurrent symptoms or even renal failure
Glomerulonephritis – Immunoglobulin A (IgA) Nephropathy (Burger’s Disease)
61
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CM of ______:
• Hematuria (may or may not be visible – can be dark-brown cola looking)
• Proteinuria
• Urinating less
• Edema
```
Glomerulonephritis – Immunoglobulin A (IgA) Nephropathy (Burger’s Disease)
62
It is common to see recurrent gross hematuria with a concurrent URI (i.e., tonsillitis) or gastroenteritis in __________. Most children continue to have microscopic hematuria between the attacks of gross hematuria and have mild proteinuria. In severe cases, proteinuria, edema and HTN can occur and must be treated swiftly to prevent loss of kidney function
Glomerulonephritis – Immunoglobulin A (IgA) Nephropathy (Burger’s Disease)
63
Care is supportive for _______ and _________.
Glomerulonephritis – Immunoglobulin A (IgA) Nephropathy (Burger’s Disease)
Acute Post Streptococcal Glomerulonephritis
64
abnormal immune response in which the immune system makes IgA to protect the body from antigens & chose antigens (bacterial or viral)...typically preceded by infection...Antibodies attack blood ...majority occurs in people that have recently had an URI. It can also be associated w/other types of exposures such as meds, foods, insect bites.
Henoch-Schonlein Purpura (HSP)
65
CM of _______:
hematuria
proteinuria
HTN
can lead to renal failure
Rash (purpura-type) Reddish-purple spots that look like bruises on buttocks, legs, feet – can also appear on arms, face, trunk
Swollen/painful joints
GI symptoms – abdominal pain, n/v, blood in stools
In children:
kidney involvement is usually transient and kidney function returns to normal. Small % have long-term problems, even smaller % have kidney failure
In adults:
more likely to have chronic kidney disease that will eventually lead to kidney failure.
Henoch-Schonlein Purpura (HSP)
66
____ is a small vessel IgA mediated vasculitis
Henoch-Schonlein Purpura (HSP)
67
Henoch-Schonlein Purpura (HSP) often results in elevated _____ and _____.
BUN and creatinine
68
embryonal tumor of the kidney
o Most common kidney cancer in children (nearly all cases are diagnosed before age 10 but majority are diagnosed between birth and age 5)
o Affects 1 in 10,000 children
o Associated w/mutation of WT1 gene – also the CTNNB1 and AMER1 gene are also associated
o Arises from proliferation of abnormal renal stem cells
o Most common solid tumor of childhood
o Ranks 5th among most frequently occurring childhood cancers
o Both inherited and sporadic forms
• Wilms tumor suppresses genes WT1 and WT2 on chromosome 11
Nephroblastoma (Wilms Tumor)
69
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CM of _____:
Palpable abdominal mass
Abdominal Swelling
Abdominal Pain
Fever
hematuria
n/v
constipation
loss of appetite
High BP
```
Nephroblastoma (Wilms Tumor)
70
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CM of _____ in Children:
--Infants:
Vomiting
diarrhea
jaundice
fever
abdominal painp
oor growth
foul-swelling urine
bloating
weight loss
irritability
--Toddlers and young children:
Fever
frequency,
urgency
Enuresis or incontinence in a previously dry child
Abdominal, flank, or back pain, pubic bone pain
Foul-smelling urine and sometimes associated hematuria
Chills
Fatigue
```
UTI
71
Most common pathogen in UTI and pyelo in children
E.Coli
72
CM of ______ in Children:
Newborns: poor feeding, vomiting
Children under 2 – fever (not always), poor appetite, vomiting, diarrhea
Children over 2 – fever, appetite changes, stomach or low back pain, urinary urgency/frequency, pain w/urination. Previously potty-trained children may have accidents at night or day. Foul-smelling urine. Blood in urine.
Chills, fever
Flank or abdominal pain along with enlarged kidney(s) caused by edema
Pyelonephritis
73
Reflux of urine from the bladder, to the ureters and kidneys. Reflux encourages infected urine in the bladder to be swept up into the ureters and kidneys causing frequent pyelonephritis.
Vesicoureteral Reflux
74
Etiology of ____:
Congenital abnormalities, having parents/siblings with VUR, neural tube defects (spina bifida)
***Caused by a congenital abnormality in the valvular mechanism at the ureter bladder junction or ectopic insertion of the ureter into the bladder
Vesicoureteral Reflux
75
Diagnosis of ______:
* **Renal US (1st choice – non-invasive & will determine size/shape of kidneys – can not prove reflux is present but can show you the stretch of the kidneys that reflux can produce and will show you scarring that can be caused by the reflux)
- Voiding cystourethrogram (VCUG) – x-ray – catheter is placed and bladder is filled with liquid dye. X-rays are taken as the bladder fills & empties. Will identify any backwards flow of urine.
- intravenous pyelogram (IVP)
Vesicoureteral Reflux
76
atopic dermatitis is associated with:
increase in serum levels of IgE, interleukins and eosinophils
77
basal cell carcinoma starts as a ______
pearly/ivory nodule
78
most common type of skin cancer
basal cell carcinoma
79
multiple vesicular lesions around nares with yellow crust...most likely cause?
staph
80
aging causes _____ in the skin
decrease in cell proliferation
81
scabies looks like:
papules and vesicles that look like tunnels
82
psoriasis lesions arise from:
hyperproliferation of the skin
83
etiology of pityriasis rosea:
virus (likely herpes)
84
What will pityriasis rosea initially look like?
herald lesion then xmas tree pattern on trunk
85
greasy, scaling lesions in the nasolabial folds and sometimes behind the ears
seborrhic skin condition
86
clinical manifestations of this skin disorder include a slightly rough, pink or flesh-colored lesion in sun-exposed skin
actinic keratosis
87
actinic keratosis can develop into _______
squamos cell legion
88
antibodies found in Acute Post Streptococcal Glomerulonephritis (ASPNG)
IgG
89
seen in urine analysis in pyelonephritis
WBC
90
hormone that affects strength of pelvic muscles
estrogen
91
main problem with urge incontinence
relaces detressor muscle
92
typically see mixed incontinence in:
older adults
93
overflow incontinence in mean is usually due to:
(Benign Prostrate Hyperplasia) BPH
94
hemmorhagic ulcers in the bladder wall seen in interstitial cystitis
Hunner ulcers
95
```
Skin Changes with _____:
Thinner
Dryer
Less elasticity
Decreased melanocytes
Decreased SQ fat
Decreased vasculature
Decreased lymphatic drainage
Decreased # fibroblasts
Decreased cell proliferation
Decreased blood supply
Decreased Langerhans cells
Decreased pressure/touch receptors and free nerve endings
Decreased sensory perception
Decreased protective function
Changes in hair color & distributions
Changes in pigmentation
Shortened capillary loops
Atrophy of sebaceous, ecrine and apocrine glands
Compromised temperature regulation
Increased infections
Delayed wound healing
***90% geriatric persons have some kind of skin d/o
EX: keratosis, psoriasis, angiomas, liver spots and skin tags are common
Cancerous and precancerous lesions are common
```
Aging
96
Highly contagious childhood skin disorder that is transmitted by skin-to-skin contact and autoinoculation (little bumps on skin – when they rupture, the juice inside makes more bumps)
o Most common in children, can also occur in adults (esp. sexually active young adults – if found in genital area – considered an STI)
o Etiology: Poxvirus
Molluscum Contagiosum
97
CM of ______:
Waxy, pink globules seen on face/trunk/extremities
Small, raised, round & flesh colored bumps
Little indentation (dot) or umbilication at the top
May be itchy
May become inflamed
Clears in 6-9 months
Molluscum Contagiosum
98
most common and effective treatment option for Molluscum Contagiosum
Cantharidin
99
Three day measles (3-5 days) characterized by diffuse punctate macular rash that begins on the trunk and spreads to the arms and legs and a mild febrile state might be present
If contracted during first trimester of pregnancy it can cause severe teratogenic effects in the fetus.
Less aggressive
Look for in kids not vaccinated with MMR
Rubella (German Measles)
100
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CM of ______:
Enlarged and tender occipital and periauricular nodes Pinkish reddish Maculopapular rash that starts on face then spread to rest of body a few days later
low-grade fever
mild pink eye
headache
general discomfort
swollen lymph nodes
runny nose
cough
```
Rubella (German Measles)
101
Communicable viral disease-- Most contagious of all infectious diseases: it can remain infectious up to 2 hours in the air after an infected person leaves an area (infects very easily!)
Rubeola (Red Measles)
102
Rubeola etiology
Morbillivirus - single stranded RNA virus
103
Rubeola Route of Transmission
droplet/air
104
Rubeola Incubation Period
7-12 days
105
Rubella Etiology
Rubivirus – a positive strand of RNA virus
106
Rubella Transmission
direct/droplet
107
Rubella Incubation
: 14-21 days
108
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CM of _______:
High fever
Runny nose
Cough
Conjunctivitis
Photosensitivity
Kolpik spots (Pin point whites spot, surrounded by erythematous ring in the mouth)
1-3 day purple/reddish brown, macular and blotchy rash that begins along hairline and spread downward
```
Rubeola (6th Disease)
109
etiology of Roseola
HSV 6 or 7
110
transmission of Roseola
droplet
111
incubation period of Roseola
5-15 days
112
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CM of _____:
High fever (starts suddenly – when they are most contagious)
Pink, non-pruritis macular rash
Irritability
Swollen glands
Ear pain
Decreased appetite
```
Roseola
113
transmission of chicken pox
touch/droplet
114
incubation period of chicken pox
14 days
115
Reactivation of latent varicella virus that hides in the ganglia
Shingles
116
transmission of pityriasis rosea
unknown
117
incubation of pityriasis rosea
unknown
118
CM of _____:
URI symptoms
fever
headache
salmon-pink herald patch (2 in. raised patch) that is usually on the trunk
early lesions are macular and papular followed by expanding rose-colored oval lesions that are bilateral and symmetrically distributed on the trunk and upper extremities resembling drooping Christmas tree
multiple smaller pink spots that are dry and scaly
***typically lasts 2-3 months
Pityriasis Rosea
119
cold sores arising from the trigeminal nerve root with initial outbreak causing a flu-like prodrome w/ a burning and tingling sensation followed by vesicles and erythema as the virus replicates
• as the viral vesicles rupture ulcers form
• followed by crusting before healing
• Recurrence- the virus hides in the ganglia and will erupt again when the immune system is challenged
HSV Type 1
120
transmission of HSV Type 1
oral secretions
121
herpes on genitalia that arise from the sacral nerve root that cause cluster of blisters that will rupture & leak leaving area tender
HSV Type 2
122
transmission of HSV Type 2
contact
123
transmission of genital warts
direct contact
124
CM of ____:
| small, fleshy bumps, rough w/black centers (small clotted blood vessels) that resolve spontaneously
genital warts
125
Common benign papilloma caused by DNA containing papilloma viruses that causes an exaggeration of normal skin composition stratum corneum that becomes irregular and thickened
genital warts
126
etiology of impetigo
Staph
127
transmission of impetigo
Contact or touching articles/toys of infected individual
128
CM of ____:
Sores around the nose or mouth (red sores rupture & ooze, & ooze will dry)
Form yellowish brown crust
sores around mouth but can spread to fingers as well
Impetigo
129
etiology of Folliculitis, Furuncles, Carbuncles (all have to do w/hair follicles)
Staph
130
inflammation of the hair follicle (looks like small yellow pustules that are confined to hair follicle)
folliculitis
131
boils (more extensive, involved sebaceous glands)
furuncles
132
infected hair follicles (multiple furuncles that go deeper w/in layers of skin)
carbuncles
133
Fungal- Scaly, pruritic scalp w/bald areas; hair breaks easily
Tinea capitis (scalp)
134
Fungal- Circular, clearly circumscribed, mildly erythematous scaly patches with a slightly elevated ring-like border; some forms are dry & macular, & other forms are moist/vesicular
Tinea corporis (skin areas, excluding scalp, face, hands, feet, groin)
135
Fungal- Small erythematous and scaling vesicular patches w/a well-defined border that spreads over the inner and upper surfaces of the thighs; occurs w/heat & high humidity
Tinea cruris (groin, jock itch)
136
Fungal- Occurs between the toes & may spread to the soles of the feet, nails, & skin of toes; slight scaling, macerated painful skin, occasionally with fissures and vesiculation
Tinea pedis (athlete's foot)
137
Fungal- Dry, scaly, erythematous lesions, or moist vesicular lesions that begin w/clusters of intensely itching, clear vesicles; often associate w/fungal infection of the feet
Tinea manus (hand)
138
A superficial or deep inflammation of the nail that develops yellow-brown accumulations of brittle keratin over all or portions of the nail
Tinea unguium or onychomycosis (nails)
139
CM of _____:
• Itchy red scaly circular rash.
• Scalp - may not be red but may see circular patches of hair loss.
• Nails - thickening discolored nail that will crumble and fall off.
• Groin/feet - may just be red, itchy irritated skin
Fungal Infections of the Skin
140
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Risk Factors for ______:
warm moist environment
DM
antibiotics
immunosuppression
pregnancy
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Candidiasis
141
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Risk Factors for ______ :
Heat
Moisture
Occlusive clothing
Pregnancy
Systemic ATB therapy
DM
Sexual intercourse w/infected male
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Vaginal (vulvovaginitis)
142
Risk Factors for _______ Candidiasis:
Uncircumcised
Sexual intercourse w/ infected female
Penis (balanitis)
143
Risk Factors for _______ Candidiasis:
DM
Immunosuppressive therapy
Inhaled steroids
Mouth
144
Risk Factors for _______ Candidiasis:
Heat & Moisture
DM
Immunosuppressive therapy
Skinfolds
145
```
CM of _______:
Vaginal itching
white, watery, or creamy discharge
Red & swollen vaginal & labial membranes w/erosions
Lesions may spread to anus and groin
```
Vaginal Candidiasis
146
CM of _____:
| Pinpoint, red, tender papules & pustules on glans and shaft of penis
Penis (balanitis) Candidiasis
147
CM of ______:
Red, swollen, painful tongue & oral mucous membranes
Localized erosions & plaques appear w/chronic infection
Mouth Candidiasis
148
CM of ______:
| Pruritic red rash progressing to vesicles and papules that enlarge and rupture
Skinfold Candidiasis
149
CM of ______:
• Dry, itchy, scaly erythema (can show up anywhere)
• Creases of elbows/knees, face, hands, scalp, trunk
• Location very individualized
Atopic Dermatitis
150
Skin disorder that is a Type 1 hypersensitivity that increases IgE, eosinophils, & interleukins
Atopic Dermatitis
151
Allergic, Irritant Type 4 Hypersensitivity (cell-mediated) or Non-allergic reaction skin disorder
contact dermatitis
152
skin reaction due to chemicals, metals, or plants such as poison ivy, poison oak, sumac which is a delayed acquired hypersensitivity – Type 4 – to a specific antigen/allergen (***cell-mediated)
contact dermatitis
153
```
CM of ______:
Red skin
erythematous where irritant came in contact with skin, blisters (ooze & crust over)
swelling
burning
tenderness at site
may c/o itching
```
contact dermatitis
154
a papulosquamous inflammatory skin diseases whose etiology is unknown that is manifested by various degrees of greasy, scaling, erythema, in areas of high oil gland concentration of the face and scalp
o Common inflammatory skin disorder that mainly affects the scalp, causing scaly, itchy, red skin and stubborn dandruff
Seborrheic Dermatitis
155
seborrheic dermatitis of the scalp is known as ______
cradle cap
156
skin disorder with papules and plaques with overlying silvery scale that is an inflammatory inherited condition with immune system involvement (exacerbations and remissions)
o Lesions will be on the knees, elbows, lower back, scalp, nails
psoriasis
157
```
CM of ______:
red patches covered w/thick
silvery scales
Dry, cracked skin that is itchy
Nail changes (thickness, rigid)
swollen/stiff joints
```
psoriasis
158
CM of _____:
facial redness
swollen red papules
pustules
Rosacea
159
```
Risk Factors for ____:
women
fair skin
age
smoking
family hx
```
Rosacea
160
Disease of pilosebaceous unit triggered by increased production of androgen that arises when sludging of sebaceous oils and deposition of loose epithelial cells cause an obstruction of the follicular canal...associated with increase production of sex hormones, especially testosterone.
o Comedones and pustules distributed over the face, upper back, upper chest
Vulgaris Acne
161
Genetic; IgE mediated skin disorder most common in children that will improve with age in some persons
• Commonly found on the face, antecubital regions, behind the ears, wrists
• Thickening of the skin or lichenification occurs d/t scratching
Excema
162
Clinical manifestations of ______:
pruritic lesions
oozing
crusting
Eczema
163
skin disorder that is a Type 1 hypersensitivity caused by sunlight, chronic illness, or temp changes, drugs (antibiotics), foods (shellfish, peanuts), systemic disease (lupus) or physical agents (cold, heat)
o Most lesions (hives/welts) resolve spontaneously in <24 hours
o Antihistamines, corticosteroids and B-adrenergic agonists are treatment options
Urticaria (Hives)
164
Clinical Manifestations of _______:
red/skin-colored wheals
itchy painful swelling (angioedema)
Urticaria (Hives)
165
In glomerulonephritis, what damages the epithelial cells resulting in hematuria and proteinuria?
immune injury
166
Which cells of the inflammatory process are found in acute poststreptococcal glomerulonephritis?
immune complexes
167
When does an individual have their full complement of renal nephrons?
at birth
168
Which of the following reactivates with stress, sun exposure, or menses?
Herpes Simplex
