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PathoPharm > 2.1 Disorders of Tissue Integrity and Function > Flashcards

2.1 Disorders of Tissue Integrity and Function Flashcards

1
Q

Define Rashes

A

temporary eruptions of the skin

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2
Q

Define lesion

A

A traumatic or pathologic loss of normal tissue continuity, structure, or function.

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3
Q

What are rashes associated with?

A

childhood diseases, heat, diaper irritation, or drug-induced reactions

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4
Q

The components of a rash are often referred to as the _____

A

lesions

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5
Q

Rashes can be described as:

A

blanched, erythematosus, hemmorhagic, pigmented or purpuric.

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6
Q

What can lead to lichenification?

A

repeated rubbing and scratching

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7
Q

what is lichenification?

A

a thickened, leathery, and rough skin characterized by prominent markings

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8
Q

What is excoriation?

A

a raw denuded area caused by breakage of the epidermis

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9
Q

What is the difference between primary lesions and secondary lesions?

A

Primary lesions arising previously from normal skin.

May develop as Secondary lesions resulting from other disease conditions.

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10
Q

Define blisters

A

vesicles or fluid-filled papules

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11
Q

What lesions are caused by friction?

A

blisters, calluses, & corns

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12
Q

How do blisters occur?

A

When there is a disruption of the intracellular junctions (between skin layers) results in accumulation of fluid between skin layers

Can also be caused by extreme temperature (burns, frostbite) or exposure to chemicals

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13
Q

Define calluses

A

hyperkeratotic plaques

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14
Q

How do calluses occur?

A

When hyperplasia of keratinized cells with increased adhesion resulting in hyperkeratosis and decreased skin shedding

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15
Q

What are corns also known as?

A

Helomas

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16
Q

Define corns

A

small, well-circumscribed thickening of keratinous skin

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17
Q

What is a heloma durum?

A

Associated with corns: central, hard core; occur on dry, flat surfaces of skin; usually painful

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18
Q

What is heloma molle?

A

Associated with corns: soft; more common between toes and stay moist, keeping the surrounding skin soft; usually not as painful

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19
Q

Define pruritus

A

defined as an unpleasant sensation of the skin that provokes the urge to scratch. Can be mild to severe.

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20
Q

What is the sensation of pruritus conducted by?

A

Type C neurons (small, mylenated) that transmit the signal to the brain

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21
Q

In pruritus, what is released by mast cells to activate itch receptors?

A

Histamine and tryptase

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22
Q

What can activate itch receptors?

A

Opioids and substance P

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23
Q

What can cause local activation of itch receptors?

A

Bradykinin and bile salts

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24
Q

Scratching is a ______ to pruritis.

A

spinal reflex

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25
Q

What are 2 concerns when scratching due to pruritis?

A
  • often not localized and does not relieve pruritus

- can result in skin damage from excessive scratching

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26
Q

What are 2 antipruritics that can be used to help alleviate itching?

A

diphenhydramine & hydrocortisone

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27
Q

Define xerosis

A

dry skin

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28
Q

what causes xerosis?

A

dehydration of sebaceous glands in the stratum corneum

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29
Q

In what population is xerosis most common in?

A

Older adults. due to again, there are decreased secretions to help moisturize skin

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30
Q

Xerosis can lead to ____

A

pruritis, intense itching which results in damage

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31
Q

What should we do to prevent pruritis and xerosis?

A
  • prevent friction
  • prevent exposure to pruritic agents (avoid things that have reactions to & things such as poison oak/ivy)
  • prevent drying of skin
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32
Q

How do pigmentary skin disorders arise?

A

malfunctioning in the melanocytes

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33
Q

If there is an absence of melanin production, this can result in

A

vitiligo and albinism

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34
Q

Define vitiligo

A

Melanocytes are not producing enough melanin which results in white patches on skin that are very localized area of skin. It is more common in dark pigmented people of all races; can occur in white people but not as often.

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35
Q

vitiligo can appear in any age but usually occurs some time after the age of, _______

A

20 years old

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36
Q

Etiology of vitiligo

A

unknown. Maybe related to genetics and autoimmunity.

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37
Q

Define albinism

A

A genetic disorder that is either complete or partial congenital absence of pigmentation in the skin, hair and eyes. Found in all races.

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38
Q

If there is an increase of melanin production, this can result in

A

mongolian spots & melasma

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39
Q

Define melasma

A

characterized by darkened facial macules. Common in all skin types but even more common in brown skinned people in Asia, Indian and south America.

Occurs in men but more common in women. Particularly during pregnancy or when taking contraceptives.

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40
Q

Define mongolian spots

A

Noticeable at birth and characterized as darkened skin as a result in increase melanin.

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41
Q

What are dermatomycoses?

A

Superficial fungal infections

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42
Q

What are the 2 types of dermatomycoses discussed?

A

Tinea & Candidal infections (yeast)

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43
Q

Define tinea pedis

A

“athletes foot” fungal infection of the feet.

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44
Q

Define tinea unguium

A

fungal infection of the fingernails and toenails, and the nail bed (onychomycosis)

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45
Q

Define tinea corporis

A

fungal infection of the arms, legs, and trunk

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46
Q

define tinea cruris

A

“jock itch” - fungal infection of the groin area

tip to help remember: “curtis” the jock has an itch

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47
Q

define tinea manuum

A

fungal infection of the hands and palm area

tip to help remember: a man (manuum) has bigger hands & palms

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48
Q

define tinea faciei

A

“face fungus”

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49
Q

define tinea capitis

A

fungal infection of the scalp and hair

tip to help remember: you wear a baseball cap (capitis) over your scalp and hair

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50
Q

define tinea barbae

A

fungal infestation of facial hair

tip to help remember: men grow facial hair and have to visit the barber (barbae)

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51
Q

define candidal infections

A

also known as “yeast infections” can occur on the skin and also oral and genital candiditis.

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52
Q

Primary topical antifungals

A

Azoles and non-azoles

53
Q

How does Clotrimazole work?

A

alters cell permeability resulting in death of fungal cells

54
Q

What is the prototype of topical antifungal

A

Clotrimazole

55
Q

pharmacokinetics of clotrimazole

A

since applied topically, it is not absorbed systemically

Should not be used for prolonged periods of times to avoid tissue damage and resistance

56
Q

Difference between primary bacterial infections and secondary bacterial infections?

A

Primary infection are superficial.

Secondary infections are deep cutaneous infections (more likely to see these cases)

57
Q

What are the 2 types of primary bacterial infections?

A

impetigo & ecthyma

58
Q

Define impetigo

A

A primary infection that appears as a small vesicle or pustule or as a large bulla on the face or elsewhere

59
Q

Define ecthyma

A

ulcerative form of impetigo

60
Q

List characteristics of secondary bacterial infections

A
  • infected ulcer
  • cellulitis
  • treated with targeted antibiotics based upon what the organism that is causing the infection
61
Q

What are the 3 viral infections discussed?

A
  1. Human papilllomavirus
  2. Herpes simplex virus
  3. Herpes zoster (“shingles”)
62
Q

Define human papillomas

A

HPV & causes verrucae (warts) which are common beign papillomas.

63
Q

Define herpes simplex virus

A

Type 1: spread by infected saliva. Causes oral herpes, canker sores, mouth sores
Type 2: genital herpes

64
Q

Define herpes zoster

A

“shingles”
caused by reactivation of latent varicella-zoster virus (chicken pox) within the sensory dorsal root ganglia

Occurs in people with older age, poor immune function, and those who have had chicken pox before 18 months of age.

65
Q

What does herpes zoster cause?

A

Postherpetic neuralgia which can be treated with anticonvulsants like gabapentin.

Basically the nerve body goes to the skin ending and produce noticeable blisters

66
Q

Is a shingle vaccine available?

A

YES QUEEN

67
Q

Define noninflammatory acne

A

Comedones which are plugs of materials that accumulate in sebaceous glands that open to the skin surface.

Comedones referred to as white heads and black heads

68
Q

Define inflammatory acne

A

Papules, pustules, and in severe cases, cysts

Believed to develop from the escape of sebum into the dermis and the irritating effects of the fatty acids contained in the sebum

69
Q

What are the 2 primary types of acne?

A

Acne vulgaris & acne conglobata

70
Q

Define acne vulgaris

A

chronic inflammatory disease of the pilosebaceous unit

71
Q

List the treatments for acne vulgaris

A

benzoyl peroxide (antimicrobial and comedolytic)

retinoids (increases cell turnover)

topical antibiotics (tetracycline, erythromycin, and clindamycin)

72
Q

What would be the antibiotic to treat moderate to severe acne vulgaris?

A

oral tetracycline

73
Q

What would be the antibiotic to treat severe acne vulgaris?

A

Isotretinoin

very effective but has many side effects. Patients have to be monitored very closely.

74
Q

define acne conglobata

A

comedones or cysts have multiple openings, large abscesses, and interconnecting sinuses.

Discharge is odoriferous, serous or mucoid, and purulent

75
Q

What type of people are affected by acne conglobata?

A

people with anemia with elevated WBC counts, sedimentation rates, and neutrophil counts

76
Q

What are some treatments for acne conglobata?

A

debridement, systemic corticosteroids, oral retinoids, and systemic antibiotics

77
Q

Define rosacea

A

chronic inflammatory process accompanied by vascular instability with leakage of fluid and inflammatory mediators into the dermis

78
Q

What is rosacea accompanied by?

A

GI symptoms (H. pylori)

79
Q

What is the treatments for rosacea?

A

Treated with acne meds. Topical metronidazole commonly used.

80
Q

What are the 4 types of Rosacea?

A

Erythematotelangiectatic
Papulopustular
Ocular
Phymatous

81
Q

Types of allergic and hypersensitivity dermatoses:

A

Contact dermatitis

82
Q

Define contact dermatitis

A

Results from cell-mediated, type IV hypersensitivity response

Irritant contact dermatitis is caused by chemicals that irritate the skin

May be treated with anipruritics (antihistamine or corticosteroid)

83
Q

Define contact dermatitis

A

Results from cell-mediated, type IV hypersensitivity response

Irritant contact dermatitis is caused by chemicals that irritate the skin

May be treated with antipruritics (antihistamine or corticosteroid)

84
Q

3 Types of allergic and hypersensitivity dermatoses:

A

Contact dermatitis
Atopic dermatitis
Nummular eczema

85
Q

Define contact dermatitis

A

Results from cell-mediated, type IV hypersensitivity response

Irritant contact dermatitis is caused by chemicals that irritate the skin

May be treated with antipruritics (antihistamine or corticosteroid)

86
Q

Define atopic dermatitis

A

“atopic eczema”
inflammatory skin disorder that is characterized by poorly defined erythema, edema, vesicles, and weeping at the acute stage

Lichenification in the chronic stage

Treatment is multifaceted and includes use of emollients and topic corticosteroids

87
Q

Define nummular eczema

A

coin-shaped papulovesicular patches involving the arms and legs

Lichenification and secondary bacterial infections are common

88
Q

Define nummular eczema

A

coin-shaped papulovesicular patches involving the arms and legs

Lichenification and secondary bacterial infections are common

89
Q

Define urticaria

A

“hives”

pale erythematous, blanchable, raised, itchy papules or plaques

90
Q

What does immunologic urticaria or “hives” result in?

A

IgE hypersensitivity response where there is a release of histamine which causes hyper-permeability of capillaries in outer layers of skin

91
Q

What does nonimmunologic urticaria or “hives” result in?

A

stress, temperature extremes, vibration.

Example: morphine and neuropeptides (associated with psychological hives)

92
Q

Where do angiodemas occur?

A

in DEEP layers

Can be life-threatening if obstructs airway

93
Q

What is a treatment for angiodemas?

A

antihistamines or leukotriene receptor blockers

94
Q

What are drug-induced skin eruptions?

A

Systemic drugs that cause generalized skin lesions

Topical drugs are usually responsible for localized contact dermatitis types of rashes

Can result in skin detachment

95
Q

3 Bullous skin lesions that caus drug-induced skin eruptions

A

Erythema multiforme minor
Stevens-johnson syndrome
Toxic epidermal necrolysis

96
Q

Define papulosquamous dermatoses

A

Skin disorders characterized by scaling papules and plaques

  • psoriasis
  • pityriasis rosea
  • lichens planus
97
Q

3 types of arthropod infestations

A
  1. scabies
  2. pediculosis
  3. Ticks
98
Q

3 types of arthropod infestations

A
  1. scabies
  2. pediculosis
  3. Ticks
99
Q

Define scabies

A

infestation of the skin by the human itch mite

treated with permethrin or malathion

100
Q

Define pediculosis

A

aka Lice - permethrin or malathion

101
Q

Rocky mountain spotted fever comes from ticks, what bacteria is it caused from? What is the treatment?

A

Rickettsia

Doxycycline

102
Q

What does permethrin or malathion treat?

A

Scabies and pediculosis

103
Q

What does doxycycline treat?

A

Rocky mountain spotted fever

Lyme disease

104
Q

Lyme disease comes from ticks, what bacteria is it caused from? What is the treatment?

A

Borrelia

Doxycycline

105
Q

Lyme disease comes from ticks, what bacteria is it caused from? What is the treatment?

A

Borrelia

Doxycycline

106
Q

Define UVC rays

A

short (100-289 nm)

do not pass earth’s atmosphere

107
Q

Define UVB rays

A

290 to 320 nm

responsible for nearly all skin effects of sunlight

108
Q

Define UVA rays

A

321 to 400 nm

can pass through window class, are more commonly referred to as sun tanning rays

109
Q

Define UVA rays

A

321 to 400 nm

can pass through window class, are more commonly referred to as sun tanning rays

110
Q

What are the acute effects of UV rays?

A

Short lived and reversible

  • erythema
  • pigmentation
  • injury to langerhans cells and keratinocytes
111
Q

What are chronic effects of UV rays?

A
  • Directly damaging skin cells
  • Accelerating the effect of aging on skin
  • Producing changes that predispose the development of skin cancer
112
Q

When a sunburn occurs, what layers of the skin are experiencing excessive UV radiation?

A

epidermal and dermal layers

113
Q

Sunburn is a result in what kind of reaction?

A

Erythematous inflammatory reaction

114
Q

What are the symptoms of severe sunburn?

A

inflammation, blistering, weakness, chills, fever, malaise, and pain

115
Q

Define photosensitive

A

exaggerated response to UV light when the drug is taken in combination with sun exposure

116
Q

Define pressure ulcers

A

ischemic lesions of the skin and underlying structures caused by unrelieved pressure

oxygen is not being delivered well to the tissue causing an ulcer

117
Q

What 4 factors contribute to the development of pressure ulcers?

A
  1. pressure
  2. shear force
  3. friction
  4. moisture
118
Q

4 ways to prevent pressure ulcers

A
  1. Identifying at-risk persons who need preventative measures and the specific factors placing them at risk
  2. Maintaining and improving tissue tolerance to prevent injury
  3. Protecting against the adverse effects of external mechanical forces (i.e. pressure, friction, and shear)
  4. Reducing the incidence of pressure ulcers through educational programs
119
Q

Define nevi

A

aka moles - benign tumors of the skin that predispose individual to cancer

120
Q

2 types of nevi

A

nevocellular nevi

dysplastic nevus

121
Q

dysplastic nevus has a great tendency to what?

A

transform into cancer cells

122
Q

3 major types of skin cancer

A
  1. Malignant melanoma
  2. basal cell carcinoma
  3. Squamous cell carcinomas
123
Q

Define malignant melanoma

A

rapidly progressing malignant tumor of the melanocytes

124
Q

Define Basal cell carcinoma

A

neoplasm of the nonkeratinizing cells of the basal layer of the epidermis

most common skin cancer in white-skinned people

125
Q

Define squamous cell carcinomas

A

second most frequently occurring malignant tumors of the outer epidermis

126
Q

4 types of melanomas

A
  1. superficial spreading
  2. nodular
  3. lentigo maligna
  4. acral lentiginous
127
Q

Define superficial spreading melanoma

A

characterized by raided-edge nevus with lateral growth

128
Q

Define nodular melanoma

A

26.45!!!!!!

PathoPharm (18 decks)

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