UVR

Question 1

bands of UVR

Answer 1

UVA,B,C

Question 2

among three bands of UVR which has the longest wavelength

Answer 2

UVA

Question 3

UVA wavelength

Answer 3

320-400 nm

Question 4

UVB wavelength

Answer 4

290-320 nm

Question 5

UVC wavelength

Answer 5

<100-290 nm

Question 6

other name for UVA, B and C

Answer 6

A: long wave; near
B: middle wave
C: short wave, far

Question 7

Frequency: ranges from

Answer 7

1.65 x1015 to 7.5 x 1014

Question 8

Wavelength: shorter than –, longer than –

Answer 8

visible, x-ray

Question 9

use of UVA

Answer 9

blacklight

Question 10

use of UVB

Answer 10

skin erythema; sunburn

Question 11

UVC use

Answer 11

germicidal and bacterial purposes

Question 12

Method of transmission:

Answer 12

radiation via phototherapy
UV is not visible to us but we can feel it
Photochemical effect

Question 13

Possibilities:

Answer 13

Reflected, refracted, absorbed
Absorbed within 1-2mm (0.22) mm of human skin
80-90% absorbed in the dermis

Question 14

UV produces heat?

Answer 14

no

Question 15

UV is both –ing and –ing

Answer 15

UV is both ionizing and non-ionizing

Question 16

what can happen if wrong dosage is applied

Answer 16

Cutaneous malignant melanoma
Basal cell carcinoma
Squamous cell carcinoma

Question 17

Factors affecting penetration

Answer 17

Intensity => directly related
Wavelength => directly related
Power of radiation source => direct
Exposure duration => direct
Distance of radiation => inverse
Frequency => inverse
Size => inverse
Thickness => inverse
Pigmentation of skin => inverse

Question 18

equipment

Answer 18

Mercury arc

Fluorescent

Question 19

Mercury arc lamps:

Answer 19

Small
Emit radiation at constant intensity
Used for smaller areas
Types:
Hot quartz
Cold quartz

Question 20

Fluorescent lamps

Answer 20

Long
Emit higher-intensity radiation
Used for larger areas
Low pressure mercury discharge tubes with phosphor coating inside (theraktin)

Question 21

hot quartz

Answer 21

burner w argon gas and mercury

high pressure and temp

c erythema and pigmentation

applied >15 inches form area

no need for warm up

Question 22

cold quarts

Answer 22

cold quartz with mercury (ionized vapor)

dec pressure and temp

minimal erythema and no pigmentation

applied at close proximity

needs 5 min warm up

Question 23

physiological effects

Answer 23

erythema production
delayed pigmentation of skin
thickening of superficial layer of skin
vit d synthesis
bactericidal effect

Question 24

Erythema production

Answer 24

Vasodilation of vessels
Happens because of histamine and prostaglandin release
Exposure to UVB or UVA after drug sensitization
Practical application: proper dosage

Question 25

Delayed pigmentation of skin

Answer 25

Production and upward migration of melanin Oxidation of pre melanin Tanning = less penetration Practical app: examine skin phototype of patients

Question 26

Thickening of superficial layer of skin

Answer 26

Thickening of epidermis due to cell proliferation 72 hrs after exposure to UVR Practical app: progressive higher dose for thicker skin

Question 27

Vitamin D synthesis

Answer 27

Converts inactive provitamin D to become active vit D Activates inactive vit D Effective treatment for psoriasis Practical application: for psoriasis

Question 28

Bactericidal effect

Answer 28

UVC = bactericidal affect Promotes wound healing Desquamation => slough off dead skin cells Practical app: bactericidal effect in open wounds

Question 29

irradiance (I)

Answer 29

intensity or power density measured by uv sensor on device mw/cm2

Question 30

dose per treatment time (Dt) =

Answer 30

I X T

Question 31

cumulative dose (Dc) =

Answer 31

sum of all Dt

Question 32

Bunsen-roscoe law/reciprocity law

Answer 32

inverse relationship of irradiance and exposure time

Question 33

method based on skin color

Answer 33

fitzpatrick skin phototype method

Question 34

type 1

Answer 34

lighter white burns easily and never tans BBUVB initial: 20 BBUVB progression: 5 NBUVB initial: 130 NBUVB progression: 15

Question 35

type 2

Answer 35

darker white burns easily tans minimally BBUVB initial: 25 BBUVB progression: 10 NBUVB initial: 220 NBUVB progression: 25

Question 36

type 3

Answer 36

light brown burns moderately; tans gradually BBUVB initial: 30 BBUVB progression: 15 NBUVB initial: 260 NBUVB progression: 40

Question 37

type 4

Answer 37

moderate brown burns minimally; tans well BBUVB initial: 40 BBUVB progression: 20 NBUVB initial: 330 NBUVB progression: 45

Question 38

type 5

Answer 38

dark brown burns rarely; tans profusely BBUVB initial: 50 BBUVB progression: 25 NBUVB initial: 350 NBUVB progression: 60

Question 39

type 6

Answer 39

black never burns; intense tanning BBUVB initial: 60 BBUVB progression: 30 NBUVB initial: 400 NBUVB progression: 65

Question 40

frequency of fitzpatrick phototype method

Answer 40

3-5x/week

Question 41

minimal erythemal dose method levels

Answer 41

``` suberythemal minimal erythemal first degree second degree third degree ```

Question 42

SED

Answer 42

no erythema progression: 12.5% frequency: daily BSA: 100%

Question 43

MED

Answer 43

``` latency period: 6-12 hrs appearance: mild pink duration: <24 hrs dose: 1 progression: 25% frequency: daily; every other day BSA: 50-100% ```

Question 44

E1

Answer 44

``` latency period: 6 hrs appearance: definite pink; blanching duration: 2 days discomfort: slight soreness desquamation: powdery dose: 2.5 progression: 50% frequency: every other day BSA: <20% ```

Question 45

E2

Answer 45

``` latency period: 3 hrs appearance: very red; not blanching duration: 3-5 days edema: some discomfort: hot and painful desquamation: thin sheets dose: 5 progression: 75% frequency: 2x/week BSA: 4% ```

Question 46

E3

Answer 46

``` latency period: <2 hrs appearance: angry red duration: 7 days edema: blister discomfort: very painful desquamation: thick sheets dose: 10 progression: NA frequency: 1x/week BSA: <25 cm2 ```

Question 47

contraindications

Answer 47

``` Over eyes Skin cancer Pulmonary tuberculosis Cardiac kidney liver disease Systemic lupus erythematosus Fever Taking birth control pills ```

Question 48

Precautions

Answer 48

``` Photosensitivity or photo allergy Determine what type of allergic reaction Itchy, stop treatment Photosensitizing medications Psoralen: good agent Sulphonamides and tetracyclines - antibiotic Griseofulvin - antifungal Phenothiazine - tranquilizer Chlorothiazide - diuretic Recent x-ray No dose of UV should be done until effects of previous treatment have disappeared (3-6 months) ```

Question 49

adverse effects

Answer 49

``` Burn effects Premature aging of skin (actinic damage) Carcinogenesis UV overdose Counteracted with IRR for 20 mins every hour for 6-8 hours ```

Question 50

documentation

Answer 50

date, lamp used, distance, exact area, position, time, reaction obtained

Question 51

subacute and chronic psoriasis

Answer 51

``` Decreases DNA synthesis Lower proliferation of cells Narrow-band UVB MED or E1 Also for vitiligo PUVA (psoralen + UVA) Usually E1 is used E2 for heels and elbows ```

Question 52

Cystic acne/acne vulgaris

Answer 52

E1 for face, neck, chest | E2 for back and shoulders

Question 53

PUVA is used for

Answer 53

Eczema Urticaria Cutaneous t cell lymphoma Photosensitive disorders

Question 54

Non-infected wounds

Answer 54

Surgical incisions, ulcers Use UVC (can still use UVB) Granulation tissue (bright red color means healing well) => no treatment necessary If insisted by doc or pt: suberythema or MED, no progression applied Decubitus ulcers affecting epidermis/dermis Can use E1/E2 E1 for initial treatment Progress to E2 when pt reacts well Surrounding skin MED daily

Question 55

Infected wounds

Answer 55

Destroys and removes slough Strengthen growth of granulation tissue Thin yellowish slough => E2 daily and unprogressed Definite green and yellow slough => E3 daily and unprogressed Black slough => E3 daily Reassess when black is gone Surrounding skin => MED daily