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Drug Action III > Acute Skin Disorders (Pathophysiology) - Block 1 > Flashcards

Acute Skin Disorders (Pathophysiology) - Block 1 Flashcards

1
Q

What is dermatitis?

A

Inflammation of the skin

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2
Q

What are the common skin inflammation?

A
  1. Erythema
  2. Lesions
  3. Itching
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3
Q

What are the types of dermatitis?

A
  1. Contact
  2. Seborrheic and exfoliative
  3. Urticaria
  4. Lichen planus
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4
Q

What is contat dermatitis?

A

Inflammation of the skin caused by contact with an irritant or allergen

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5
Q

What is the difference between allergic contact and irritant contact?

A

Allergic: Immune response to subsequent exposure (no sx first, but immune response on second)
Irritant: No allergen needed, but contact can damage or irritate the skin upon first exposure (80% of cases)

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6
Q

What are some of the causes of contact dermatitis?

A
  1. Type 4 hypersensitivity reaction (cell mediated immune reaction)
  2. Latex
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7
Q

How does sx differ between allergic and irritant contact derm?

A

Allergic: rash and bumps after 1-2 days after exposure
Irritant: Rash immediately, pruritus, erythema

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8
Q

What is seborrheic dermatitis?

A

Chronic skin inflammation with exacerbations and remissions

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9
Q

What is exfoliative dermatitis?

A

Widespread skin inflammation caused by preexisting skin disorders, drugs, cancer, or unknown causing increased skin turnover (erythema and scaling)

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10
Q

What is the cause of seborrheic dermatitis?

A

Linked to immunologic abnormalitites involving Malassezia (yeast)

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11
Q

Sx of seborrheic dermatitis?

A
  1. Lesions
  2. Covered with scales
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12
Q

Sx of exfoliative dermatitis?

A
  1. Erythematous
  2. Scaly
  3. Sloughing skin
  4. Local and systemic effects
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13
Q

What is urticaria?

A

Hives
(Acute, chronic, angioedema)

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14
Q

What are the triggers of urticaria?

A
  1. Drugs
  2. Allergens
  3. Water
  4. Emotional stimuli
  5. Physical stimuli
  6. Infection
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15
Q

What is the cause of urticaria?

A
  1. Released by immunoglobin E from mast cell in skin
  2. Activation of histamine receptors
  3. Extravasation of plasma into dermis
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16
Q

What are the sx of urticaria?

A
  1. Vascular reaction of skin
  2. Suddern eruption of pale wheals or papules that cause itching
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17
Q

What is lichen planus?

A

Inflammatory disorder of skin, mouth, nails, scalp, and mucous membranes.

Can also affect external genitals

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18
Q

Causes of lichen planus?

A

may be allergic or autoimmune response of body

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19
Q

Sx of lichen planus?

A
  1. Wickham striae
  2. Bumps
  3. Itching (nail and scalp)
  4. Lacy white patches
  5. Oral legions
  6. Genital
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20
Q

What is stevens johnson syndrome?

A

Rare disorder of skin and mucous membranes in which cell death causes epidermis to separate from dermis

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21
Q

What is the cause of stevens johnson?

A
  1. Delayed hypersensitive reaction
  2. Slow acetylators
22
Q

Sx of stevens johnson syndrome?

A
  1. FLu like sx
  2. Symmetric burning rash begins on face and upper part of torso
23
Q

What is TEN?

A

Inflammation of skin caused by poison resulting in necrosis and dissolution of tissue (with or without spots)

24
Q

What are the causes of TEN?

A
  1. Drug reaction
  2. immune-related cytotoxic reaction (keratinocyte apoptosis)
25
What are the sx of TEN?
1. Large blisters 2. Rupture 3. Skin shedding
26
What is acne vulgaris?
Formation of comedones, papules, pustules, nodules, or cysts when hair follicles and sebaceous glands become inflamed because of obstruction
27
Differentiate the types of acne?
**Inflamatory:** Closed comedones **Noninflammatory:** Comedones, blackheads, whiteheads **Combination**
28
What are the causes of acne?
1. Release of multiple inflammatory mediators into skin. 2. Follicular hyperproliferation and plugging of follicle. 3. Excess production of sebum. 4. Colonization of follicles by P. acnes.
29
What are the sx of acne?
1. Whiteheads 2. Blaxkheads 3. Papules, pustules 4. Nodules and cysts
30
What is rosacea?
Chronic rash distinct from acne
31
What are the causes of rosacea?
Increased blood flow to surface of skin
32
What are the sx of rosacea?
Telangiectasia: facial redness
33
What are the sources of burns?
1. Flame 2. Scaled 3. Chemical 4. Electrical 5. Lightning, electromagnetic, radiation, and ionizing radiation
34
What are the depths of burns?
1st, 2nd, 3rd (depth is due to duration of exposure and temperature)
35
What are first degree burns?
Superficial burn that only affects the outer layer of the epidermis **Sx:** Red, dry, no blisters
36
What are second degree burns?
Partial thickness: Involves the epidermis and dermis **Sx:** Blisters Full thickness: entire epidermis and dermis **Sx:** Painful, blisters and edema, waxy
37
What are third degree burns?
Extend into the sub-cutaneous tissue and may involve muscle and bone **Sx:** No pain, waxy
38
How do you measure the extent of a burn?
TBSA using rule of 9:
39
What are the characteristics of a critical burn?
1. >25% of body has second-degree burns. 2. >10% of body has third-degree burns. 3. Face, hands, or feet bear third-degree burns
40
What are the systemic complications of burns?
1. Hemodynamic instability 2. Respiratory failure 3. Hypermetabolic Response 4. Organ dysfunction 5. Sepsis
41
How can burns cause hemodynamic instability?
1. Injury to capillaries 2. Hypovolemic shock requiring therapeutic plasma exchange (TPE)
42
What is the zone of coagulation?
Area sustaining maximum damage from heat source where proteins become denatured and cell death is imminent
43
What is zone of stasis?
Surrounds coagulation area, where tissue is potentially salvageable
44
What is the zone of hyperemia?
Surrounds zone of stasis. Perfusion adequate due to patent blood vessels, and erythema occurs due to increased vascular permeability
45
How can burns cause respiratory failure?
1. Smoke inhalation and postburn lung injury 2. Signs of mucosal injury and airway obstruction 3. Pulmonary conditions
46
What is the hypermetabolic response?
Increased secretion of stress-related hormones to maintain homeostasis
47
What occurs during hypermetabolism?
1. Increased oxygen consumption. 2. Increased glucose use. 3. Protein (muscle) and fat wasting. 4. Hypermetabolic state peaks at ~7 to 17 days after the burn. 5. May require enteral and parenteral nutrition support
48
What is DRESS?
Drug Reaction with Eosinophilia and Systemic Symptoms: drug-induced hyper-sensitivity reaction
49
What are drugs that can lead to DRESS?
1. Anticonvulsants Culprit drugs can trigger viral reactivations: Reactivation of human herpes virus (HHV). Includ
50
What are the sx of DRESS?
**Liver:** elevated LFTs, hepatomegaly **Lungs:** cough, dyspnea, ARDs, resp failure **Heart:** Myocarditis

Drug Action III (23 decks)

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