21 - 133 - SKIN MANIFESTATIONS OF INTERNAL ORGAN DISORDERS Flashcards
Nail changes associated with cardiovascular disease
clubbing and the Quincke pulsation
Quincke pulsation is indicative with what condition
aortic regurgitation
result from immune complex deposition and are painful, tender, and located distally on the digital tufts
Osler nodes
perivasculitis or necrotizing vasculitis without microabscess formation
nontender and located proximally on the palms and soles
Janeway lesions
vasculitis with microabscess formation
Frank sign (cutaneous finding of a diagonal earlobe crease) has been (controversially) associated with an increased risk of ____________
coronary artery disease
most common cardiac manifestation of SLE, occurring in approximately 25% of patients during the course of their disease
Pericarditis
Small vessel disease of the myocardium causing patchy fibrosis is a hallmark of __________
Systemic Sclerosis
can cause systolic or diastolic heart failure as well as arrhythmias and sudden death
characterized by increased distal fingertip mass and longitudinal and transverse nail plate curvature
Digital clubbing
angle between the nail plate and the proximal nailfold
Lovibond angle
Lovibond angle in digital clubbing
greater than 180 degrees
Lovibond angle in normal nail
less than 160 degrees
most common intrathoracic manifestation of sarcoidosis
Bilateral hilar adenopathy
most common pulmonary manifestation of rheumatoid arthritis and appears to correlate with high levels of rheumatoid factor
Interstitial lung disease (ILD)
Aquagenic wrinkling of the palms is associated with
cystic fibrosis
Blue discoloration of the lunulae can be seen in
Wilson disease
Koilonychia is associated with
hemochromatosis as well as iron deficiency anemia
Jaundice becomes evident when total serum bilirubin levels are above
3
In GVHD, the most commonly affected organs are
skin, liver, and GI tract
Kayser-Fleischer rings, which are brown or gray-green rings in the cornea is seen in what disorder
WILSON DISEASE
most common cause of pyoderma gangrenosum, responsible for 25% to 50% of cases
Inflammatory bowel disease (IBD)
characterized by a dull-white color proximally and a nonblanching red, pink, or brown color distally
Lindsay nails (half-and-half nails)
seen frequently in patients on dialysis and resolve with renal transplantation
They are characterized by a dull-white color proximally and a nonblanching red, pink, or brown color distally.
Quincke pulsation, which is flushing of the nail beds synchronous with the heart- beat, indicative of ____________ .
E. Aortic regurgitation
F. Mitral regurgitation
G. Aortic stenois
H. Mitral stenosis
Aortic regurgitation
Which of the following does not describe Osler nodes?
I. Result from immune complex deposition and are
J. Located distally on the digital tufts,
K. Non tender, non painful
L. Perivasculitis or necrotizing vasculitis without microabscess formation
Non tender, non painful
Small vessel disease of the myocardium causing patchy fibrosis is a hallmark of ___________ .
M. SLE
N. Ssc
O. Ehlers-Danlos Disease
P. Marfan Disease
Ssc
The following are skin findings in eosinophilic granulomatosis with polyangiitis (Churg-Strauss) except ____________ .
Q. Palpable purpura
R. Livedo reticularis
S. Pyoderma gangrenosum-like lesions
T. Urticarial lesions
Pyoderma gangrenosum-like lesions
Which of the following do not have a higher risk of ILD in DM?
U. Anti-MDA-5
V. Anti-tRNA synthetase enzymes
W. Anti-Jo-1
X. Anti-Mi-2
Anti-Mi-2
Jaundice becomes evident when total serum bilirubin levels are ________ mg/dL .
A. >1.5
B. >3
C. >5
D. >7
>3
This hereditary condition in which defective cellular copper transport leads to accumulation of copper in several organs—most commonly the ____________.
A. Lungs, liver, brain
B. Heart, lungs, liver
C. Kidney, heart, lungs
D. Liver, brain, cornea
D. Liver, brain, cornea
The most common organs involved in Kaposi sarcoma are ____________ .
A. Heart and brain
B. Vessels and kidneys
C. GIT and lungs
D. Eyes and GUT
C. GIT and lungs
_____________ are seen frequently in patients on dialysis and resolve with renal trans- plantation.
A. Yellow nails
B. Lindsay nails
C. Terry nails
D. Koilonychia
B. Lindsay nails
____________ manifests on the skin with patchy alopecia and characteristic nail changes.
A. Familial adenomatous polyposis
B. Gardner syndrome
C. Peutz-Jeghers
D. Cronkhite-Canada syndromes
D. Cronkhite-Canada syndromes
flushing of the nail beds synchronous with the heartbeat
Quincke pulsation
indicative of aortic regurgitation
It is often associated with the presence of antiphospholipid antibodies in patients with SLE
Libman-Sacks endocarditis
what do you call the sign characterized by a diagonal earlobe crease?
What condition is this associated?
Frank Sign
This has been (controversially) associated with an increased risk of** coronary artery disease**
deposits of immune complexes, fibrin, platelet thrombi, and mononuclear cells can build up on heart valves
Libman-Sacks endocarditis
- This condition can cause significant mitral or aortic insufficiency as well as serve as a source of emboli resulting in purpuric macules at acral sites.
Sarcoidosis is a multisystem granulomatous disease of unknown etiology most commonly affecting what organ?
**respiratory tract **(90%), skin (25%), and eyes
2 main pulmonary manifestations of systemic sclerosis
ILD and pulmonary arterial hypertension
In alcoholic cirrhosis, they are associated with the presence of esophageal varicosities and may be a predictive marker of future risk of esophageal bleeding
Spider angiomas
the skin can have a striking generalized metallic gray or bronze-brown color in this condition
hemochromatosis
In hemochromatosis, a mutation in this gene leads to increased intestinal iron absorption and subsequent iron overload
HFE gene
In the skin, acute GVHD most commonly presents with
nonspecific morbilliform eruption
an autoimmune disease associated with antimitochondrial antibodies typically affecting women 40 to 60 years of age in which intrahepatic bile ducts are destroyed, resulting in hyperbilirubinemia and cirrhosis
PRIMARY BILIARY CIRRHOSIS
- It is notable because of the constellation of** pruritus, jaundice, diffuse hyperpigmentation,** and xanthomas seen in the disease.
- The xanthomas are typically eruptive, planar, or occasionally tuberous.
- Pruritus is common and often severe, and it precedes the development of jaundice.
Polyarteritis nodosa can be associated with what hepatitis infection?
Hepatitis B
In this setting, medium-vessel vasculitis is thought to result from the formation of immune complexes containing hepatitis B surface antigen and immunoglobulin.
Gianotti-Crosti syndrome (papular acrodermatitis) is an eruption of monomorphic, flat-topped, erythematous papules on the face and limbs. It is most often seen in children as a result of what virus?
Epstein-Barr virus, but can be associated with HBV and, less often, HCV
Bruising of the skin around the umbilicus (Cullen sign) or the flanks (Grey Turner sign) are well-known features of what condition?
acute pancreatitis
variant of familial adenomatous polyposis with the addition of epidermoid cysts, fibromas, lipomas, desmoid tumors, pilomatricomas, and osteomas of the facial bones and skull
Gardner syndrome
characterized by small darkly pigmented macules on the lips, buccal mucosa, and digits
Peutz-Jeghers syndrome
- autosomal dominant condition consisting of many adenomatous polyps without extracolonic manifestations
- It leads to colorectal cancer with nearly 100% certainty starting at age 20 to 30 years.
Familial adenomatous polyposis
