Skin Flashcards
(85 cards)
1
Q
Macule
Example- freckle
A
Flat discoloration, usually less than 1cm in diameter
2
Q
Patch
Ex- vitiligo, mongolian spot, measles rash, choasma.
A
Flat area of skin discoloration, larger than a macule (larger than 1 cm)
3
Q
Papule
Ex- raised nevus
A
Raised lesion, less than 1cm, may be the same ir different color than the surriunding skin
4
Q
Vesicle
Ex- varicella, blister, herpes zoster,
Contact dermatitis
A
Fluid filled, less than 1 cm
5
Q
Eccrine
A
Produces sweat from sweat glands
6
Q
Apocrine
A
Secretion from axillae, anogenital area occur with emotional and sexual stimulation
7
Q
Skin is (9)
A
8
Q
Inspect and palpate skin by looking at 8 things
A
Color Temp Moisture Texture Thickness Edema Movikity or turgor Vascularity or bruising
9
Q
If there are any lesions present note: (7)
A
Color Elevation Pattern or shape Size Location and distrubution on body Any exudate Use woods light to detect fluorescing
10
Q
Profile sign of nail
A
View index finger at its profile and note angle of nail base; it should be about 160 degrees
11
Q
Skin self examination A B C D E
A
Asymmetry Border Color Diameter Elevation and enlargement
12
Q
Annular
A
Circular, begins in center and spreads to the periphery
Example- ringworm, tinea corporis, tinea versicor, pityriasis
13
Q
Discrete
Ex- acrochordon, skin tag, or acne
A
Distinct, individual lesions that remain separate
14
Q
Confluent
Ex- hives
A
Lesions run together
15
Q
Gyrate
A
Twisted, coiled spiral, snakelike
16
Q
Linear
A
A scratch, streak, line, or stripe
17
Q
Zosteriform
A
Linear arrangement along a unilateral nerve route
18
Q
Grouped
Ex- vesicles of contact dermatitis
A
Clusters of lesions
19
Q
Target
Ex- erythema multiform
A
Iris or resembles iris of eye, concentric rings of color in lesions
20
Q
Polycyclic
Ex- lichen, planus, psoriasis
A
Annular lesions grow together
21
Q
Bulla
Ex- friction blister, burns, contact dermatitis
A
Larger than 1cm diameter usually single chambered; superficial in epidermis. Thinned wall and ruptures easily
22
Q
Tumor
A
Larger than a few centimeters in diameter, firm or soft. Deeper into dermis
23
Q
Wheal
Ex- mosquito bite, allergic reaction,
A
Superficial raised, transient, and erythematous; slightky irregular shape from edema
24
Q
Urticaria (hives)
A
Wheal to form extensive reaction, intensely pruritic.
25
Patch
Macules that are larger than 1cm
26
Plaque
| Ie- psoriasis
Papules coupled to form surface elevation wider than 1cm
27
Target
| Or Iris
Resembles iris of eye, concentric ring of color in lesion
28
When would you do a comprehensive assessment?
For an annual physical and/or new patient
29
Discuss three levels of priority
1st- Emergent- life threatening or immediate
2nd- next in urgency
3rd- important but can be addressed later
30
What is emergent?
Anything life threatening
31
What may be included in a routine periodic ohysical assessment? (8)
```
Dietary intake
Physical activity
Tobacco/alcohol/drug use
Sex
Counseling
Dentistry
Immunizations
Prophylactic medical approaches (ie- folic acid for a woman trying to get pregnant)
```
32
What are the four types of data
1-complete database
2- focused/problem centered data
3- follow up
4- emergency
33
Complete database
Whole history and physical
34
Focused/ problem cenetered data
Concerning one problem or system
35
Follow up
Status of problems alresdy addressed to see what changed
36
Emergency
Crucial info for swift diagnosis as the problem needs to be immediately addressed
37
Cue
Piece of information, sign, symptom, or lab. Can be object, action, personal.
38
When do we collect objective vs subjective data
Objective data is collected in the physical examination
Subjective is collected in the ROS
39
What is diagnotic reasoning?
Attending to cues, formulating hypotheses, gathering data relating to hypotheses, and evaluting each hypothesis to arrive at diagnoses
40
What are the components of evidence based decision makong
Utilize eveidence from research And evidence based theories, physical examination and assessment of patient, clinical expertise, and patient prefences/values.
41
Review of Systems
A technique used by healthcare providers for eliciting a medical history if patient. It is often structured as a component of an admission notes covering the organ systems eith the focus upon the subjective symptoms perceived by the patient
42
When does the pain scale get used in the HH?
In the HPI (oldcart)
43
What is the utility of quotes in the HH?
What person says us the reason for seeking care is recorded and enclosed in quotes to indicate pt exact words
44
Difference between signs and symptoms
Symptoms are subjective
And
Signs are objective
45
What is a genogram?
A pictorial display of a persons family relationship and medical history
46
Define open and closed ended questions
Open ended asks for narrative information and states the topic in general terms. Utilized when you start an interview, are introducing more questions, or a new topic is introduced. Closed is yes or no questions
47
Basal cell carcinoma
Most common form of skin cancer
Slow growing
Small,pink, or red papule with translucent top and overlying telangiectasia (broken blood vessels: occurs on sun exposed areas:face,ears, scalp, shoulders.
48
Describe squamous cell carcinoma
Erythematous scaly skin patches
Central ulcer eith surrounding erythema. Occurs on hands, head, bald scalp. Related to exposure to UV radiation. Grows rapidly, less common than basal cell ca
49
Describe malignant melanoma
Brown but may be tan, black, pink-red, purple, or mixed
50
You examine one lesion with a regular border ans one with a variation in color, it goes from red to white. Which is emergent?
The red and white is abnormal/emergent
51
What is seborrheic keratosis?
Appears dark, greasy, waxy, and stuck on old people generally. Most on the trunk/face/hands and on both unexposed and sun exposed areas. Nom cancerous
52
Patient has a bulls eye pattern, red, macular rash. What us a likely differential?
Lymes disease
53
Patient presents with a skin issue that has a rounded border with a central ulcer and depression. What is a good differential?
Basal Cell Carcinoma
54
You see an intertrigal rash with lesions, what would be the best class of antibiotics?
Antifungal- nystatin powder
55
An older person presents with flaky, silver skin PLAQUES. Differential?
Psoriasis
56
Demonstrate the simularities and differences between ulcerations, scars and fissures?
They are all breaks in continuity on the skins surface but an ulcer is a deep depression extending into dermis, a fissure is a linear crack in dermis, and a scar is what forms after a lesion like a fissure or ulcer is repaired made of collagen
57
Acutely infected lymph nodes are characterized by
Bilateral/ firm/enlarged/warm/tender/freely moveable
58
Describe lymph nodes in HIV
```
1 enlarged
2- firm
3- nontender
4- mobile
* occipital nodules are most commonly enlarged in HIV
```
59
Describe cancerous lymph nodes (4)
Hard, larger than infected UNILATERAL, FIXED
60
You examine enlarged POSTERIOR lymph nodes bilaterally. What is your differential?
Mono
61
You examine enlarged ANTERIOR lymph nodes bilaterally. What is your differential?
Strep
62
What is the best way to palpate lymph nodes?
Use gentle, circular motion of finger pads. Start at the preauricular lymph nodes in front of ear and then palpate the 10 groups in a routine order
63
What is the best way to inspect thyroid movement?
Have the patient take a sip of water and watch the tracheal midline
64
You have a patient with a hard, large, UNILATERAL, FIXED, supraclavicular lymph node. What are the risks here?
Not only is it cancerous but it is very likely metastatic given the fact its a supraclavicukar lymph node
65
What causes bells palsy?
A lower motor neuron viral lesion. It induces a rapid onset of cranial nerve 7 (facial) paralysis- often brought on by reactivation of HSV-1
66
You can easily palpate a pregnant womans thyroid gland. Is this a normal finding?
Yes
67
Describe the visual apperance of a person with parkinsons face
Mask like, immobile, flat, expressionless with elevated eyebrows, staring gaze, oily skin, and drooling
68
Someone reports a past diagnosis in their interview, is it objective or subjective?
Subjective
69
```
O
L
D
C
A
R
T
```
```
Onset
Location
Duration
Character
Alleviate/aggravation
Radiation
Treatment
```
70
```
P
Q
R
S
T
```
```
Provocative/palliative
Quality/quantity
Region/radiation
Severity
Timing
```
71
7 elements in patient interview
```
Cheif complaint
HPI
PMH
PSH
ROS(only need to do one)
Social history
Medications
Family history
```
72
HPI
```
Onset- when it starts
Location- midsternal
Duration- 2 weeks
Characteristics- sharp
Alleviating- rest, after eating/aggravated- exercise
Radiation- left shoulder
Time- lasts for 10 minutes
Severity- 2/10
```
73
CAGE
1-Do you ever feel uou have to CUT down on your drinking
2-ever feel ANNOYED by critism of drinking
3- guilty about drinking
4- eye opener
74
Cranial nerve 1
Olfactory
| Smell mint leaves/tobacco
75
Cranial nerve 2
Optic
| Visual acuity and funduscopic
76
Cranial nerve 3
Oculomotor
| Pupillary reaction
77
Cranial nerve IV
Trochlear
| Pupillary reaction
78
Cranial nerve 5
Trigeminal
| Clench teeth, open jaw, lip/chin test for light touch
79
Cranial nerve 6
Abducens
EOM
EYE MOVEMENT TO THE SIDE
80
Cranial nerve 7
Facial
| Raise eyebrows/frown/ show teeth/ smile/ puff cheeks
81
Cranial nerve 8
Acoustic
Whisper test
Weber/Rinne tests
82
Cranial nerve 9
Glossopharyngeal
Hoarseness
Tongue movement
83
Cranial nerve 10
Vagus
| Saying “ah” and note palate and uvula mive upward
84
Cranial nerve 11
Spinal accessory
| Shrug shoulders
85
Cranial nerve 12
Hypoglossal
| Inspect tongue for atrophy/ fasciculation
