skin, HEENT

Question 1

What is involved in the nail inspection?

Answer 1

Color of nail beds, length, symmetry, shape of nail plate surface, surface texture

Question 2

What could yellow nails indicate?

Answer 2

psoriasis, fungal infection, chronic respitory disease or tobacco use

Question 3

What could darkened nails indicate?

Answer 3

Trauma

Question 4

What could blue nails indicate?

Answer 4

acute cyanosis

Question 5

Deviation from smooth and slightly convex nails could be due to…

Answer 5

infection, chronic hypoxia, trauma, or genetic

Question 6

What could clubbing be due to?

Answer 6

chronic hypoxia

Question 7

What could convex nails be due to?

Answer 7

genetic problem

Question 8

What are spoon shaped nails called and what causes them?

Answer 8

Koilonychia, severe chronic iron deficiency anemia and hypothyroidism

Question 9

What is paronychia?

Answer 9

bacterial infection of tissue surrounding the nail

Question 10

What is onychomycosis?

Answer 10

fungal infection of nail bed

Question 11

What do you assess the hair for?

Answer 11

texture, quantity, distribution

Question 12

What is alopecia?

Answer 12

Hair loss could be local or universal

Question 13

What are the three skin layers?

Answer 13

epidermis, dermis, hypodermis

Question 14

Why do newborns have a red look to their skin?

Answer 14

very little subcutaneous fat

Question 15

What causes cyanosis?

Answer 15

Lack of oxygen in the periphery

Question 16

What is involved when you palpate for skin assessment?

Answer 16

Turgor, temperature, moisture, texture, mobility

Question 17

What is a macular lesion and examples?

Answer 17

essentially flat colored lesion: freckles, measles, drug rash

Question 18

What is a papular rash?

Answer 18

elevated above skin surface, firm or filled with solid materials, can also be fluid filled

Question 19

What is a maculopapular rash?

Answer 19

combination of papules and macular rash, red diffuse rash filled with fluid papules and crusts

Question 20

What is a rash with fluid filled lesions <1 cm in diameter that may be clustered or solitary?

Answer 20

vesicular

Question 21

What are two types of patch-like skin lesions?

Answer 21

psoriasis and vitaligo

Question 22

What is an elevated irregular accumulation of subcutaneous edema?

Answer 22

wheal, insect sting or drug reaction

Question 23

Where do nodules originate?

Answer 23

lower in dermis (elevated and firm)

Question 24

What are elevated encapsulated lesions in dermis or epidermis filled with fluid or semisolid materials?

Answer 24

cysts

Question 25

What is a excoriation lesion?

Answer 25

scratching

Question 26

What is a fissure lesion?

Answer 26

linear cracks

Question 27

What is an erosion lesion?

Answer 27

loss of part of the dermis, may follow rupture of a vesicle or bulla

Question 28

What is an ulcer?

Answer 28

loss of dermis, concave, varies in size

Question 29

What are common sites for pressure ulcers?

Answer 29

sacrum, hip socket, boney prominance of shoulders, heels, posterior region of head

Question 30

What are the characteristics of a stage 1 pressure ulcer?

Answer 30

localized skin intact, redness, non-blanching, discoloration for > 30 minutes after relief of pressure

Question 31

What are the characteristics of a stage II pressure ulcer?

Answer 31

partial thickness, loss of dermis, open and shallow, red & pink wound bed

Question 32

What are the characteristics of a stage III pressure ulcer?

Answer 32

Full thickness, deep crater, damage or necrosis to subcutaneous tissue, undermining may be present, bone/tendon not visible

Question 33

What are the characteristics of a stage IV pressure ulcer?

Answer 33

Full thickness skin loss to muscle/bone, extensive destruction, slough/ eschar present, underminig/ tunneling present, often requires full to heal

Question 34

What is an unstagable pressure ulcer?

Answer 34

involves full thickness skin loss, base of wound obscured by slough or eschar, commonly requires mechanical debridement

Question 35

What is involved in inspecting the external eye structures?

Answer 35

observe: conjuctiva for erythema or discharge, sclera for yellowing, peri-orbital region for edema, lids for symmetry or lid lag, under lower lid for conjuctiva sac, under upper lid for upper conjectiva

Question 36

Why may the lens may appear cloudy?

Answer 36

cataracts

Question 37

What is exopthamos?

Answer 37

Eyes appear to buldge as lids retract, usually due to hyperthyroidism

Question 38

What could an absence of the red reflex mean?

Answer 38

adults: cateracts neonates: retinobtruction or blastoma

Question 39

What is a strabismus?

Answer 39

misalignment of the eyes, can cause visual disturbance: esotropia: inward, exotropia: outward

Question 40

Where should the cone of light be for the internal ear exam?

Answer 40

4:00

Question 41

What is conductive hearing loss?

Answer 41

external or middle ear disorders, impairs sound to inner ear,

Question 42

what could cause conductive hearing loss?

Answer 42

foreign body, otis media, perforated eardrum, may be acute or chronic

Question 43

What is sensorineural hearing loss?

Answer 43

inner ear disorder, involves cochlear nerve and neuronal transmission to brain

Question 44

What can cause sensorineural hearing loss?

Answer 44

loud noise exposure, inner ear infection, trauma, aging, may be congenital

Question 45

Which should be longer in the Rinne test: bone or air conduction?

Answer 45

air conduction should be 2x longer

Question 46

Where do you put the tuning fork for the Rinne test?

Answer 46

first behind the ear on the mastoid bone and then put in front of the ear canal

Question 47

Where do you put the tuning fork for the Weber test?

Answer 47

on top of patient's head- ask then if they can hear it in one, both or neither side

Question 48

Where do you palpate for sinuses?

Answer 48

frontal and maxillary sinuses

Question 49

What could be abnormal findings when palpating the thyroid?

Answer 49

abnormal size, shape consistency, nodules or tenderness