Skin hair nails

Question 1

What are the layers of the skin (3)?

Answer 1

epidermis, dermis, subcutaneous tissue

Question 2

How many layers does the epidermis have?

Answer 2

Outer layer (Stratum Corneum) &
Inner Layer (stratum basale & stratum spinosum aka the malpighin layer)

Question 3

Keratin and melanin are found is which layer of the epidermis?

Answer 3

Inner Layer (stratum basale & stratum spinosum aka the malpighian layer)

Question 4

What does the dermis contain? (4)

Answer 4

sebaceous glands, sweat glands, hair follicles and most of the terminals of the cutaneous nerves

Question 5

Pallor may indicate?

Answer 5

anemia

Question 6

Define cyanosis?

Answer 6

A bluish hue indicative of; decreased O2 in the blood or decreased blood flow in response to a cold environment

Question 7

What causes Jaundice in the skin?

Answer 7

increased bilirubin

Question 8

describe vellus hair?

Answer 8

short, fine, inconspicuous and relatively unpigmented hair (think arms and legs)

Question 9

describe terminal hair?

Answer 9

coarser, thicker, conspicuous, pigmented (scalp hair, eyebrows)

Question 10

Name the parts of a nail (7)

Answer 10

nail plate, nail bed (pink color), lunula (whitish moon), nail root covered by the proximal nail fold, cuticle and lateral nail folds

Question 11

What is the angle between the proximal nail fold and the nail plate

Answer 11

< 180 degrees

Question 12

Name the two types of sweat glands and where are they found?

Answer 12

eccrine gland (widely distributed, opening up onto the skin surface). 
Apocrine gland (axillary and genitally regions)

Question 13

4 common areas of concern during a skin assessment?

Answer 13

Skin growths, rashes, hair loss and nail changes

Question 14

Growths include

Answer 14

lumps, sores, changes to the skin

Question 15

Causes of itching without rash?

Answer 15

dry skin, pregnancy, uremia, jaundice, lymphoma, leukemia, drug reactions, thyroid disease and rarely polycythemia vera.

Question 16

onycholysis

Answer 16

A painless separation of the nail from the nail bed starting distally, progressing proximally, freeing the nail from the nail bed.

Question 17

What are the causes of onychomycosis?

1 x 4, 1 x 7

Answer 17

trauma: excess manicuring, psoriasis, fungal infection, allergic reaction to nail cosmetics.
Systemic: diabetes, anemia, photosensitive drug reactions, syphilis, hyperthyroidism, peripheral ischemia and bronchiectasis

Question 18

Melanonychia

Answer 18

Increased pigmentation: If found in multiple nail beds caused by normal ethnic variation.
A thin, regular streak may be caused by a nevus.
A wide, irregular steak may be subungual melanoma.

Question 19

paronychia

Answer 19

An infection (staphylococcus aureus, streptococcus or candida) of the proximal and lateral nail folds. Nail folds may be red, swollen, painful. Causes: trauma (nail biting, manicuring, immersion, frequent immersion in H2O).

Question 20

Clubbing of fingers

Answer 20

Angle > 180 degrees, bulbous swelling. Attributed to congenital heart disease, interstitial lung disease, lung cancer.

Question 21

Habit tic deformity

Answer 21

Christmas tree appearance in nail plate from rubbing index finger and/or thumb bail plates (anxiety)

Question 22

onchomycosis

Answer 22

Nail thickening often caused by fungal infection: dermophyte trichophyton rubrum is one of the main causes.

Question 23

Terry Nails

Answer 23

Nail bed turns white, with a ground glass appearance, with a distal reddish brown band: liver disease, heart failure, diabetes.

Question 24

Transverse Linear depressions (beau Lines)

Answer 24

transverse depressions of the nail bed, usually bilateral. Caused by disruption of proximal nail growth by systemic illness, trauma or cold exposure (Raynaud).

Question 25

How quickly do fingernails grow?

Answer 25

1mm every 6 to 10 days

Question 26

Pitting

Answer 26

Depression dots in the nail plate caused by defective of the nail plate by the proximal nail matrix. Seen in association with psoriasis, atopic (eczema) or chemical dermatitis, sarcoidosis, Reiter’s syndrome (reactive arthritis) alopecia areata (patchy hair loss).

Question 27

Risk factors for pressure ulcers (6)

Answer 27

decreased mobility, sensation or blood flow (hypotension, microvascular disease, ) fecal or urinary incontinence and/or poor nutritional status

Question 28

What strength sunscreen is recommended?

Answer 28

at least 30 SPF, broad spectrum and water resistant for water exposure.

Question 29

The ABCD-EFG rule for mole screening (if more than 2 or more)

Answer 29

A = Asymmetry (One side of the mole compared to the other)
B = Border irregularity (ragged, notched or blurred)
C = Color variations (blue/black, white or red)
D = Diameter (> 6 mm)
E = Evolving and Elevation (changing rapidly in size, symptoms or morphology)
F = Firm to palpation
G = Growing progressively over several weeks

Question 30

Primary lesions (6)

Answer 30

Flat: macule (< 1cm), patch (> 1cm)
Raised, not fluid filled: papule (< 1cm), plaque (>1cm)
Raised, fluid filled: vesicle (< 1cm), Bulla (> 1cm)

Question 31

annular

Answer 31

ring -ike with central clearing

Question 32

nummular

Answer 32

coin-like with no central clearing

Question 33

telogen effluvium

Answer 33

scalp disorder: characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (the resting phase of the hair follicle). Typical hair loss is 125 hairs per day.

Question 34

Common examples of macules? (4)

Answer 34

Morbilliform drug reaction, tinea versicolor, nevi, melanoma

Question 35

Common examples of patches? (3)

Answer 35

seborrheic dermatitis, vitiligo, tinea cruris (jock itch)

Question 36

Common causes of papules? (4)

Answer 36

basal cell carcinoma, skin tags, molluscum contagiosum, guttate psoriasis

Question 37

Common causes of plaque? (5)

Answer 37

plaque psoriasis, atopic dermatitis, herald patch of pityriasis rosea, pityriasis rosea, nummular dermatitis

Question 38

Common causes of vesicles? (3)

Answer 38

herpes simplex, herpes zoster, rhus or allergic contact dermatitis (poison ivy)

Question 39

Common causes of bullae (blisters)? (5)

Answer 39

bullous fixed drug reaction, insect bites, friction, fragile skin, edema, burns

Question 40

What is a pustule?

Answer 40

a small, palpable collection of neutrophils or keratin that appear white (acne vulgaris, bacterial folliculitis).

Question 41

What is a furuncle?

Answer 41

Inflamed hair follicle (multiples are carbuncles). Deep infections are abscesses.

Question 42

What is a nodule?

Answer 42

Larger and deeper than a papule (dermatofibroma, keloid)

Question 43

Subcutaneous mass/cyst?

Answer 43

Encapsulated collections of fluid or semisolid tissue (epidermal inclusion cyst, pilar cysts, lipoma)

Question 44

Wheal

Answer 44

localized dermal edema that comes and goes (urticaria)

Question 45

burrow

Answer 45

small linear or serpiginous pathway in the epidermis caused by scabies mites.

Question 46

seborrheic keratosis

Answer 46

a common noncancerous skin growth, associated with aging, usually brown, black or light tan and look waxy, scaly and slightly raised, located on the head, neck, chest or back.

Question 47

solar lentigines

Answer 47

or sun spots: blemishes on the skin associated with aging and exposure to ultraviolet radiation from the sun, ranging in color from light brown to red or black, found in areas most often exposed to the sun, particularly the hands, face, shoulders, arms and forehead, and the scalp if bald.