Chap 6 and 7 Skin and lymphatic Flashcards
Which medication used for scabies is safe for children 2 months and older? a. Permethrin cream b. Lindane c. Crotamiton lotion and cream d. Ivermectin
Permethrin cream
The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? a. IgA b. IgE c. IgG d. IgM
IgG
The most common precancerous skin lesion found in Caucasians is: a. A skin tag b. Actinic keratosis c. A melanoma d. A basal cell lesion
Actinic keratosis
When staging a malignant melanoma using Clark’s levels, which level extends into the papillary dermis
Level I
Level II
Level III
Level IV
Level III
8. The “B” in the ABCDEs of assessing skin cancer represents: a. Biopsy b. Best practice c. Boundary d. Border irregularity
Border irregularity
Which of the following dermatological conditions results from reactivation of the dormant varicella virus?
D.
Herpes zoster
An older adult male presents with pain in his right chest wall for the past 48 hours. Upon examination, the nurse practitioner notices a vesicular eruption along the dermatome and identifies this as herpes zoster. The NP informs the gentleman that:
B.
Oral medications can dramatically reduce the duration and intensity of his symptoms
A 70-year-old white male comes to the clinic with a slightly raised, scaly, pink, and irregular lesion on his scalp. He is a farmer and works outside all day. You suspect actinic keratosis, but cannot rule out other lesions. What recommendation would you give him?
Perform a biopsy or refer to a dermatologist.
The immunofluorescent antibody (IFA) is a laboratory test used to diagnose which of the following disorders?
Herpes zoster
- A wound with drainage and foul odor should be cleansed with:
Normal saline
____ 6. A full thickness pressure ulcer is partially covered with eschar and the surrounding tissue is reddened. Which of the following is the most appropriate treatment for this condition?
Debride mechanically or chemically
In examining the skin of your nursing home patient, you note a “stained glass” brownish mark on the face. Which of the following lesions best describes a stained glass brownish mark?
Lentigo maligna
____ 8. Patients who have an underlying tinea infection to the cellulitis should also be treated with which one of the following?
An anti fungal medication
Identify the type of malignant melanoma that is associated with the Hutchinson’s sign of the cuticle of the finger.
Acral lentiginous
- A smooth round nodule with a pearly gray border and central induration best describes which skin lesion?
Basal cell carcinoma
Cellulitis is a deep skin infection involving the dermis and subcutaneous tissues. The nurse practitioner suspects cellulitis in a 70-year-old Asian diabetic male presenting with reddened edematous skin around his nares. Which statement below will the nurse practitioner use in her decision-making process for the differential diagnosis pertaining to reddened edematous skin?
B.
Facial cellulitis is more common in people >55
____ 12. An 82-year-old female has a “pimple” on his nose that occasionally bleeds and may have increased in size in the past year. The lesion is a 0.7-cm, dome-shaped, umbilicated papule with pearly translucence. There is also a hemorrhagic crust covering the central portion. Which of the following is the most likely diagnosis?
Basal cell carcinoma
Which of the following is generally not a first-line treatment for post herpetic neuralgia?
Which of the following is generally not a first-line treatment for post herpetic neuralgia?
A.
Intrathecal methylprednisolone
____ 14. A nursing home resident with a Stage 4 pressure ulcer that extends to the muscle layer and has significant undermining with heavy exudate should be treated with:
Calcium alginate dressings
____
____ 15. Which of the following descriptions accurately documents cellulitis?
Diffusely inflamed skin that is warm and tender to palpation
- Asymmetrical bi-color lesion with irregular border measuring 8 mm is found on the right lower arm of an adult patient. This assessment finding is consistent with:
A.
Melanoma
____ 17. Which of the following descriptions best illustrates assessment findings consistent with tinea capitis?
B.
Inflamed scaly dry patches with broken hairs
____ 18. A hyperkeratatotic nodule formed as the result of exposure of the foot to moisture from perspiration is called:
Soft corn
____ 19. A 64-year-old male presents with an exacerbation of psoriasis. His social history includes 50-year two packs a day of cigarettes and a six-pack a week of beer. He states he had a recent sore throat, which he attributes to minding his young grandson. He reports that until recently the pruritis was only minimal. His BMI is 37. Which of the following factors most likely contributed to the acute presentation of psoriasis?
____
B.
Smoking
____ 20. Treatment of complicated cellulitis of the lower extremity resulting from an anaerobe requires all of the following except:
Topical antifungal medication
Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a.
“You must be under a lot of stress lately.”
b.
“It is hereditary. Did your father experience this also?”
c.
“The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d.
“We’ll have to do some tests.”
Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a.
“You must be under a lot of stress lately.”
b.
“It is hereditary. Did your father experience this also?”
c.
“The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d.
“We’ll have to do some tests.”
Which of the following is “a linear crack extending from the epidermis to the dermis?” a. An ulcer b. A fissure c. Lichenification d. An excoriation
Which of the following is “a linear crack extending from the epidermis to the dermis?” a. An ulcer b. A fissure c. Lichenification d. An excoriation
A bulla is:
a.
A vesicle larger than 1 cm in diameter
b.
An elevated solid mass with a hard texture; the shape and borders can be regular or irregular
c.
A superficial elevated lesion filled with purulent fluid
d.
Thinning of the skin (epidermis and dermis) that appears white or translucent
A bulla is:
a.
A vesicle larger than 1 cm in diameter
b.
An elevated solid mass with a hard texture; the shape and borders can be regular or irregular
c.
A superficial elevated lesion filled with purulent fluid
d.
Thinning of the skin (epidermis and dermis) that appears white or translucent
An example of ecchymosis is: a. A hematoma b. A keloid c. A bruise d. A patch
An example of ecchymosis is: a. A hematoma b. A keloid c. A bruise d. A patch
When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? a. Spores b. Leukocytes c. Pseudohyphae d. Epithelial cells
When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? a. Spores b. Leukocytes c. Pseudohyphae d. Epithelial cells
. Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D? a. Vagistat vaginal cream b. Monistat combination pack c. Terazol vaginal cream d. Diflucan, 150 mg
. Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D? a. Vagistat vaginal cream b. Monistat combination pack c. Terazol vaginal cream d. Diflucan, 150 mg
Tinea unguium is also known as: a. Onychomycosis b. Tinea versicolor c. Tinea manuum d. Tinea corporis
Tinea unguium is also known as: a. Onychomycosis b. Tinea versicolor c. Tinea manuum d. Tinea corporis
____ 8. Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?
a. Bullous impetigo b. Staphylococcal scalded skin syndrome (SSSS) c. Nonbullous impetigo d. Ecthyma
=ecthyma
____ 9. Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?
a. Staphylococcal aureus b. Clostridium perfringens c. S. pyrogenes d. Streptococcus
b.
Clostridium perfringens
____ 10. When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?
a. A piece of hair or a thread b. Hyphae c. Leukocytes d. Spores
d.
Spores
Which statement regarding necrotizing fasciitis is true?
a. The hallmark of this infection is its slow and steady progression.
b. Once the border of the infection is “established,” it does not spread.
c. Loss of life or limb is a potential complication.
d. The lesion is most dangerous, because it is painless.
Loss of life or limb is a potential complication.
Which of the following statements about performing cryosurgery for actinic keratosis is true?
a. It is better to slightly overfreeze the area, so you only have to do it once.
b. Using liquid nitrogen, freeze each lesion for at least 30 seconds.
c. Every lesion should be biopsied after using liquid nitrogen.
d. The ‘freeze balls’ should be approximately one-and-a-half times as wide as they are deep.
The ‘freeze balls’ should be approximately one-and-a-half times as wide as they are deep.
Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?
a. Keratosis pilaris
b. Dennie’s sign
c. Keratoconus
d. Pityriasis alba
Dennie’s sign
When instructing your elderly client about treating her xerosis, what do you tell her?
a. A daily hot bath may help the associated pruritus.
b. Rub the skin briskly to make sure it is completely dry after bathing.
c. Only take short tepid showers.
d. Use a gel that is alcohol-based after bathing to soften the skin.
Only take short tepid showers.
Why do people of African descent have a lower incidence of non-melanoma skin cancer?
a. They have an increased number of melanocytes.
b. Their darker skin protects from ultraviolet radiation.
c. Their skin is thicker.
d. Their immune system is stronger.
b. Their darker skin protects from ultraviolet radiation.
Which scalp problem can be caused by a fever and certain drugs?
a. Telogen effluvium (TE)
b. Trichotillomania
c. Psoriasis
d. Alopecia areata
Telogen effluvium (TE)
Tori is on systemic antifungals for a bad tinea infection. You are aware that the antifungals may cause:
a. Renal failure
b. Skin discoloration
c. Breathing difficulties
d. Hepatotoxicity
Hepatotoxicity
- Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?
a. There are round, hypopigmented macules on his back.
b. Josh has red papules on his face.
c. There are crusted plaques in Josh’s groin area.
d. There are white streaks on his neck.
There are round, hypopigmented macules on his back.
Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation. There is some edema involved. You suspect:
a. Necrotizing fasciitis
b. Kaposi’s sarcoma
c. Cellulitis
d. A diabetic ulcer
Cellulitis
The most common precancerous skin lesion found in Caucasians is:
a. A skin tag
b. Actinic keratosis
c. A melanoma
d. A basal cell lesion
Actinic keratosis
Prevalence of psoriasis is highest in which group?
a. Scandinavians
b. African Americans
c. Asians
d. Native Americans
Scandinavians
Eighty percent of men have noticeable hair loss by what age?
a. 35
b. 50
c. 70
d. 85
85
The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
a. IgA
b. IgE
c. IgG
d. IgM
IgG
The “B” in the ABCDEs of assessing skin cancer represents:
a. Biopsy
b. Best practice
c. Boundary
d. Border irregularity
Border irregularity
Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?
a. Do not use lidocaine as it may potentiate bleeding.
b. Pinch the skin taut together.
c. Use gel foam to control bleeding.
d. This should be performed by a dermatologist only.
Use gel foam to control bleeding.
Harvey has a rubbery, smooth, round mass on his chest that is compressible and has a soft-to-very-firm texture. What do you diagnose this as?
a. A lipoma
b. A nevi
c. A skin tag
d. A possible adenoma
A lipoma
Jeffrey has atopic dermatitis. You are prescribing a low-dose topical corticosteroid for him. Which would be a good choice?
a. Betamethasone dipropionate 0.05%
b. Hydrocortisone base 2.5%
c. Halcinonide 0.1%
d. Desonide 0.05%
Hydrocortisone base 2.5%
Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?
a. Necrotizing fasciitis
b. Periorbital cellulitis
c. Erysipelas
d. “Flesh-eating” cellulitis
Erysipelas
Which is the most potent and irritating dose of tretinoin?
a. 0.05% liquid formulation
b. 0.1% cream
c. 1% foam
d. 0.02% cream
0.05% liquid formulation
Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?
a. Bullous impetigo
b. Staphylococcal scalded skin syndrome (SSSS)
c. Nonbullous impetigo
d. Ecthyma
Ecthyma
