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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
Q

What are the sx of TEN?

A
  1. Large blisters
  2. Rupture
  3. Skin shedding
26
Q

What is acne vulgaris?

A

Formation of comedones, papules, pustules, nodules, or cysts when hair follicles and sebaceous glands become inflamed because of obstruction

27
Q

Differentiate the types of acne?

A

Inflamatory: Closed comedones
Noninflammatory: Comedones, blackheads, whiteheads
Combination

28
Q

What are the causes of acne?

A
  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
Q

What are the sx of acne?

A
  1. Whiteheads
  2. Blaxkheads
  3. Papules, pustules
  4. Nodules and cysts
30
Q

What is rosacea?

A

Chronic rash distinct from acne

31
Q

What are the causes of rosacea?

A

Increased blood flow to surface of skin

32
Q

What are the sx of rosacea?

A

Telangiectasia: facial redness

33
Q

What are the sources of burns?

A
  1. Flame
  2. Scaled
  3. Chemical
  4. Electrical
  5. Lightning, electromagnetic, radiation, and ionizing radiation
34
Q

What are the depths of burns?

A

1st, 2nd, 3rd (depth is due to duration of exposure and temperature)

35
Q

What are first degree burns?

A

Superficial burn that only affects the outer layer of the epidermis
Sx: Red, dry, no blisters

36
Q

What are second degree burns?

A

Partial thickness: Involves the epidermis and dermis
Sx: Blisters

Full thickness: entire epidermis and dermis
Sx: Painful, blisters and edema, waxy

37
Q

What are third degree burns?

A

Extend into the sub-cutaneous tissue and may involve muscle and bone
Sx: No pain, waxy

38
Q

How do you measure the extent of a burn?

A

TBSA using rule of 9:

39
Q

What are the characteristics of a critical burn?

A
  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
Q

What are the systemic complications of burns?

A
  1. Hemodynamic instability
  2. Respiratory failure
  3. Hypermetabolic Response
  4. Organ dysfunction
  5. Sepsis
41
Q

How can burns cause hemodynamic instability?

A
  1. Injury to capillaries
  2. Hypovolemic shock requiring therapeutic plasma exchange (TPE)
42
Q

What is the zone of coagulation?

A

Area sustaining maximum damage from heat source where proteins become denatured and cell death is imminent

43
Q

What is zone of stasis?

A

Surrounds coagulation area, where tissue is potentially salvageable

44
Q

What is the zone of hyperemia?

A

Surrounds zone of stasis. Perfusion adequate due to patent blood vessels, and erythema occurs due to increased vascular permeability

45
Q

How can burns cause respiratory failure?

A
  1. Smoke inhalation and postburn lung injury
  2. Signs of mucosal injury and airway obstruction
  3. Pulmonary conditions
46
Q

What is the hypermetabolic response?

A

Increased secretion of stress-related hormones to maintain homeostasis

47
Q

What occurs during hypermetabolism?

A
  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
Q

What is DRESS?

A

Drug Reaction with Eosinophilia and Systemic Symptoms: drug-induced hyper-sensitivity reaction

49
Q

What are drugs that can lead to DRESS?

A
  1. Anticonvulsants

Culprit drugs can trigger viral reactivations: Reactivation of human herpes virus (HHV).
Includ

50
Q

What are the sx of DRESS?

A

Liver: elevated LFTs, hepatomegaly
Lungs: cough, dyspnea, ARDs, resp failure
Heart: Myocarditis

Drug Action III (23 decks)

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