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Copy > CCP S3 Integumentary > Flashcards

CCP S3 Integumentary Flashcards

1
Q
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macule

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2
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patch

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3
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papule

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4
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plaque

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5
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nodule

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6
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vesicle

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7
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pustule

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8
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bullae

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9
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petechiae

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10
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purpura

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11
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ecchymosis

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12
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scale

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13
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crust

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14
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fissure

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15
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erosion

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16
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ulceration

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17
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scar

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18
Q
A

excoriation

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19
Q

3 layers of the skin

A

hypodermis, dermis, and epidermis.

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20
Q

role of The skin

A
  1. serves as a barrier to the external environment (innate immune system)
  2. protects against external toxins and microbes (innate immune system)
  3. plays a role in fluid and electrolyte homeostasis and temperature homeostasis
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21
Q

define Primary skin lesions

A

lesions arising directly from the underlying disease process

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22
Q

define Secondary skin lesions

A

result from scratching, treatment, healing, or complicating infection

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23
Q

Nikolsky’s sign

A

Gentle rubbing of the skin results in sloughing of the top layer of the epidermis

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24
Q

Macule

A

Flat, circumscribed, pigmented area

<0.5 cm in diameter

25
Q

Patch

A

Flat, circumscribed, pigmented area

>0.5 cm in diameter

26
Q

Papule

A

Elevated, solid, palpable lesion of variable color

<0.5 cm in diameter

27
Q

plaque

A

Elevated, solid, palpable lesion of variable color

>0.5 cm in diameter

28
Q

Nodule

A

Solid, palpable, SC lesion

<0.5 cm in diameter

29
Q

Vesicle

A

Elevated, thin-walled, circumscribed, clear fluid-filled lesion

<0.5 cm in diameter

30
Q

Pustule

A

Elevated, circumscribed, purulent fluid-filled lesion

Any

31
Q

Bullae

A

Elevated, thin-walled, circumscribed, fluid-filled lesion

>0.5 cm in diameter

32
Q

Petechiae

A

Flat, erythematous or violaceous non-blanching lesion

<0.5 cm in diameter

33
Q

Purpura

A

Erythematous or violaceous non-blanching lesion; may be palpable

>0.5 cm in diameter

34
Q

Scale

A

Thickened area of epithelium

any size

35
Q

Crust

A

Dried area of plasma proteins

any size

36
Q

Fissures

A

Deep cracks in skin surfaces

any size

37
Q

Erosions

A

Disruption of surface epithelium

any size

38
Q

Ulcer

A

Deep erosion extending into dermis

any size

39
Q

Excoriation

A

Linear erosions typically secondary to scratching or rubbing

any size

40
Q

Hyperpigmentation

A

Increase in melanin-containing epidermal cells

any size

41
Q

Lichenification

A

Abnormally dense layer of keratinized epidermal cells

any size

42
Q

SJS vs TENS diagnosis

A

SJS/TENS are the same disease on a spectrum. differentiated by BSA affected

SJS = <10% of the BSA

TENS = >30% BSA

SJS–TENS overlap syndrome occurs when 10%-30% BSA is involved

43
Q

vesicles, blisters, peeling, and mucous membrane involvement w/ positive Nikolsi Sign with a flu-like prodrome

A

Stevens-Johnson Syndrome (SJS)

44
Q

one of the only interventions shown to improve outcomes in SJS/TEN

A

transfer to a tertiary burn center

45
Q

Therapeutic Considerations in SJS/TEN

A
  1. Discontinue offending agent.
  2. supportive care (crystalloid resuscitation, wound management, prevention of secondary infection)
  3. transfer to burn unit
  4. High-dose IVIG, plasmapheresis, or both may be indicated for patients with severe TEN or SJS
46
Q

Erythema, dark-red purpuric macules, target lesions, flaccid blisters, confluent erythema, sheet-like sloughing, and mucosal erosions affecting >30% BSA

A

Toxic Epidermal Necrolysis (TEN)

47
Q

risk factors for necrotizing soft tissue infection

A
  • IVDU
  • Recent surgery, childbirth, or other soft tissue wounds and trauma
  • Diabetic foot ulcers and decubitus ulcers
  • Wounds occuring in an aquatic environment
  • Varicella infection
  • Peripheral arterial disease
  • Diabetes
  • Cirrhosis
48
Q

most common pathogen identified in NSTI

A

Group A Streptococcus (GAS)

49
Q

type 2 NSTI

A

Monomicrobial (type II) necrotizing infection is most commonly caused by group A Streptococcus (GAS)(and other beta-hemolytic streptococci). It may occur in any age group and in individuals with no underlying comorbidities.

50
Q

type 1 NSTI

A

Polymicrobial (type I) necrotizing infection is caused by aerobic and anaerobic bacteria. It usually occurs in older adults and/or in individuals with underlying comorbidities including diabetes.

51
Q
A
52
Q

Skin Crepitus

A
  • skin that feels crackly when it is palpated
  • suggests that gas is present in the soft tissues.
  • This suggests necrotizing infection
53
Q

risk factors for cellulitis

A
  • Skin barrier disruption due to trauma
  • Skin inflammation (eczema, radiation therapy)
  • Edema due to impaired lymphatic drainage
  • Edema due to venous insufficiency
  • Obesity
  • Immunosuppression (diabetes, steroids or HIV)
  • Breaks in the skin between the toes
  • Preexisting skin infection (such as tinea pedis, impetigo, varicella)
54
Q

what is toxic shock syndrome?

A

bacteria produce superantigens that are able to activate large numbers of T lymphocytes, resulting in the massive release of inflammatory mediators, including interleukins, tumor necrosis factors, and interferon

55
Q

Diagnostic criteria for streptococcal toxic shock syndrome

A
  1. Presence of group A streptococcal infection
  2. Hypotension
  3. Two of the following:
    1. renal impairment
    2. liver abnormalities
    3. acute respiratory distress syndrome
    4. Coagulopathy
    5. necrotic soft tissue infection
    6. rash
56
Q

Clinical manifestations that suggest a necrotizing infection

A
  • signs of systemic toxicity, including abnormal vital signs,
  • severe pain or pain out of proportion to physical findings,
  • altered mental status,
  • rapidly advancing infection,
  • crepitus,
  • hemorrhage,
  • sloughing,
57
Q

common medication causes for SJS/TENS

A
  • sulfa drugs
  • nonsteroidal antiinflammatory drugs (NSAIDs),
  • penicillin,
  • aspirin,
  • barbiturates,
  • phenytoin,
  • carbamazepine,
  • allopurinol.
58
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59
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