1) H&P

Question 1

Spring conditions

Answer 1

• Atopic dermatitis

- Contact dermatitis

Question 2

Summer conditions

Answer 2

• Contact dermatitis
• Insect bites
• Photosensitivity
• Miliaria

Question 3

Fall conditions

Answer 3

• Ragweed dermatitis

- Contact dermatitis

Question 4

Winter conditions

Answer 4

• Chapping
• Xerostosis
• Pruritis

Question 5

Occupational hazards

Answer 5

• Chemicals
• Biological
• Physical
• Mechanical
• Psychological

Question 6

Common offending medications

Answer 6

• Antibiotics
• Antihistamines
• Fungicides
• Local anesthetics

Question 7

Poor arterial circulation may contribute significantly to dermatological manifestations including

Answer 7

• Arterial ulcers

Question 8

Bad venous circulation could cause various dermatoses including

Answer 8

• Venous stasis
• Hemosiderin deposition
• Edema
• Venous ulcers

Question 9

Characteristics of lesions to describe

Answer 9

• Size
• Shape
• Outline
• Border
• Color
• Texture
• Topography
• Contents

Question 10

Nail characteristics to look at

Answer 10

• Color of nail plate, bed, and lunula
• Thickness/texture
• Shape (longitudinal or transverse curvature)
• Attachment
• Surrounding structures
• Presence of pain

Question 11

The nail plate

Answer 11

• Formed by the matrix

- Active metabolic process and susceptible to local/metabolic disorders

Question 12

Anonychia

Answer 12

• Absence of nail

- One that has failed to develop

Question 13

Beau’s lines

Answer 13

• Horizontal depression across nail plate

- Caused by transient arrest of nail growth from MI, PE, high fever

Question 14

Blue nails

Answer 14

• Self evident

- Exposure to silver nitrate, antimalarial drugs, poor circulation, etc

Question 15

Brown nails

Answer 15

• Occurs in Addison’s, arsenic intoxication, melanoma, etc.

Question 16

Dystrophic nail

Answer 16

• Secondary to poor nutrition

Question 17

Gray nail

Answer 17

• Argyria (silver accumulation)

Question 18

Green nail

Answer 18

• PSeudomonas infection

Question 19

Hapalonychia

Answer 19

• Rubbery & pliable nail secondary to hyperhidrosis or endocrine disorders

Question 20

Hippocratic nails (clubbing)

Answer 20

• Excessive longitudinal curvature

- Seen in cardiac diseases, pulmonary disease, or GI diseases

Question 21

Koilonychia

Answer 21

• Plumber’s nail

- Long standing iron deficiency

Question 22

Leukonychia

Answer 22

• White spots or stria

Question 23

Lindsay’s nail

Answer 23

• Liver disease, azotemia

- Proximal nail is dull and white while distally is pink or brown with sharp demarcation

Question 24

Mee’s lines

Answer 24

• Single transverse white band

- Arsenic poisoning

Question 25

Melanonychia

Answer 25

• Pigmented longitudinal band

Question 26

Muehrcke’s nails

Answer 26

• Nephrotic syndrome

- Paired narrow horizontal white bands

Question 27

Onycholysis

Answer 27

• Separation from nail bed beginning distally and progressing proximally

Question 28

Onychomadesis

Answer 28

• Separation from nail bed beginning proximally and progressing distally

Question 29

Onychopuntata

Answer 29

• Pitting of the nails seen in psoriasis, lichen planus, and alopecia

Question 30

Onychoschizia

Answer 30

• Splitting or lamination of nail plate into layers

Question 31

Red lunula

Answer 31

• Associated with right-sided CHF

Question 32

Splinter hemorrhages

Answer 32

• Associated with subacute bacterial endocarditis and trichonosis

Question 33

Telangiectatic posterior nail fold

Answer 33

• Indicative of connective tissue disorder such as lupus & dermatomyositis