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Systems Pathology II > Chapter 23 > Flashcards

Chapter 23 Flashcards

1
Q

What is a macule?

A

flat discoloration

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2
Q

What is a papule?

A

elevated dome

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3
Q

What is a plaque?

A

flat-topped elevation

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4
Q

What is a scale?

A

dry, horny, plate-like growth

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5
Q

What is a vesicle?

A

fluid-filled area (less than or equal to 5mm)

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6
Q

What is a bulla?

A

fluid-filled area (greater than 5mm)

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7
Q

What is a wheal?

A

raised area of edema

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8
Q

What is another name for a wheal?

A

hive

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9
Q

What are the seven macroscopic terms?

A 
macule
papule
plaque
scale
vesicle
bulla
wheal
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10
Q

What the four microscopic terms?

A

acantolysis
acanthosis
hyperkeratosis
spongiosis

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11
Q

What is acantholysis?

A

loss of keratinocyte adhesion

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12
Q

What is acanthosis?

A

epidermal hyperplasia

general

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13
Q

What is hyperkeratosis?

A

hyperplasia of the stratum corneum

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14
Q

What is spongiosis?

A

intracellular epidermal edema

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15
Q

Intracellular epidermal edema is most likely to be seen in which of the following acute inflammatory dermatoses?

a. poison ivy
b. acne
c. urticaria
d. erythema multiform

A

a. poison ivy
(it is a type IV hypersensitivity reaction that causes allergic contact dermatitis - a subcategory of eczema which presents with spongiosis)

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16
Q

What are the four types of acute inflammatory dermatoses?

A

urticaria
acute eczematous dermatitis
erythema multiform
acne

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17
Q

What macroscopic term can be associated with urticaria?

A

wheals

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18
Q

What macroscopic term can be associated with acute eczematous dermatitis?

A

vesicles

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19
Q

What macroscopic term can be associated with erythema multiform?

A

macule

possible vescile/bulla

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20
Q

What macroscopic term can be associated with acne?

A

papule

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21
Q

Urticaria is most commonly due to …

A 
allergic reaction 
(type I hypersensitivity)
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22
Q

What are the two types of urticaria involving IgE?

A

IgE-Dependent

IgE-Independent

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23
Q

What causes IgE-Dependent urticaria?

A

common allergens

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24
Q

What causes IgE-Independent urticaria?

A

adverse drug reactions (opiates, antibiotics)

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25
Q

What is the common age in which urticaria can occur?

A

20-40 (young adulthood)

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26
Q

How long does a case of urticaria last?

A

most develop and fade in a few hours

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27
Q

What are the two other subcategories of urticaria?

A 
pressure urticaria (chronic idiopathic urticaria) 
hereditary angioedema
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28
Q

What is the term for pressure urticaria as seen with writing on the skin?

A

dermatographia

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29
Q

What is hereditary angioedema?

A

excessive complement activation that leads to dermal edema

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30
Q

What is the deficiency in hereditary angioedema?

A

inherited C1 esterase inhibitor deficiency

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31
Q

What can lead to or trigger hereditary angioedema?

A 
trauma 
menstruation 
physical stress 
viral infections 
ADR to various meds
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32
Q

What are characteristics of acute eczematous dermatitis?

A

red, vesicles, oozing, crusts

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33
Q

What is characteristic of chronic eczema?

A

scaling plaque

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34
Q

As time goes on, what are the symptoms/signs of eczema?

A

starts out itchy with spongiosis and as time progresses it becomes painful with hyperkeratosis

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35
Q

What are the types of hypersensitivities that are seen in patients with eczema?

A 
type I (atopic dermatitis) 
type IV (allergic contact dermatitis) 
itchy (trauma over time - can progress to chronic)
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36
Q

What is the most common form of eczema?

A

allergic contact dermatitis

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37
Q

What immunological response is involved with allergic contact dermatitis?

A

CD4 + T cells sensitization

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38
Q

What is the pattern of distribution of allergic contact dermatitis?

A

limited to contact site

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39
Q

What are the two types of eczema?

A

allergic contact dermatitis

atopic dermatitis

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40
Q

What is characteristic about atopic dermatitis?

A

family history (genetic risk), childhood onset, and atopic triad

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41
Q

What is atopic triad?

A

dermatitis, asthma, rhinitis

42
Q

What is the prognosis of atopic dermatitis?

A

generally improves with age

43
Q

What is the pattern of distribution for eczema in infants, children, and adults?

A

infant: face primarily along with arms and legs
children: large joints and moving off of face
adult: large joints

44
Q

What is characteristic of the skin lesion that present in erythema multiform?

A

targetoid appearance (red macule with pale eroded center)

45
Q

What is the difference between erythema multiform and erythema migrans?

A

erythema migrans has a red center with a white ring followed by a red ring (bull’s eye in appearance)

46
Q

Erythema multiform can mimic what other skin condition?

A

ringworm

47
Q

What type of hypersensitivity is erythema multiform?

A

type IV

48
Q

What does erythema multiform attack?

A

the junction of the epidermis and dermis

49
Q

Which form of erythema multiform is more mild and is post infection?

A

erythema multiform minor

50
Q

Which form of erythema multiform is aggressive and drug-related?

A

erythema multiform major

51
Q

What are characteristics of erythema multiforom major?

A

sloughing of epidermis, fluid loss, infection

52
Q

What are the two kinds of erythema multiform major?

A

Stevens-Johnson syndrome (<30% epidermal sloughing)

Toxic Epidermal Necrolysis ( equal or >30% epidermal sloughing) - risk for hypovolemic shock

53
Q

Which form of acne is more common?

A

acne vulgaris

54
Q

Which form of acne is more severe?

A

cystic acne

55
Q

What are the two presentations of acne vulgaris?

A

pustule (whitehead)

comedones (blackhead)

56
Q

What are the two factors that contribute to the cause of acne?

A

genetics (sebum) and propionibacterium acnes (most common bacteria)

57
Q

When does acne most commonly occur in males?

A

adolescence

58
Q

When does acne most commonly occur in females?

A

adulthood

59
Q

What is characteristic of cystic acne?

A

larger skin lesions filled with pus/edema, pronounced inflammation, and likely to produce scarring

60
Q

Where is baby acne most commonly seen?

A

cheeks, nose, and forehead

61
Q

When is baby acne most common?

A

around 2 months

62
Q

What causes baby acne?

A

idiopathic, possibly from hormonal fluctuations

63
Q

What is a characteristic sign of baby acne?

A

milium

64
Q

What is milium?

A

keratin-filled cysts (white)

65
Q

What are the kinds of chronic inflammatory dermatoses?

A

psoriasis
lichen planus
lichen simplex chronicus

66
Q

What immunological response is involved with psoriasis?

A

CD8+ T cells

67
Q

What macroscopic terms is associated with psoriasis?

A

scale

plaque

68
Q

What autoimmune skin condition deals with epidermal hyperplasia?

A

psoriasis

69
Q

What is the characteristic sign of psoriasis?

A

well demarcated lesions with pink-to-salmon color plaques covered by a flaky silver-white scale

70
Q

Where is psoriasis commonly located?

A

elbows, knees, scalp, lumbosacral region, glans penis, intergluteal cleft

71
Q

What are the treatments for psoriasis?

A

methotrexate, cyclosporine, and phototherapy (UVB)

72
Q

What does UVB do to help psoriasis?

A

slows the growth of hyperplasia

73
Q

What are the possible characteristic signs of psoriasis?

A

Auspitz sign
Koebner phenomenon
oncholysis

74
Q

What is Auspitz sign?

A

microbleeds from flaking and scratching

75
Q

What is Koebner phenomenon?

A

plaque formation on site of prior trauma 1-2 weeks after skin injury (from pressure)

76
Q

What is oncholysis?

A

detachment of nail (seen in roughly 1/3 of psoriasis patients)

77
Q

In what percentage of patients does psoriatic arthritis occur?

A

5-30%

78
Q

What deformity is seen in patients with psoriatic arthritis?

A

pencil in cup deformity

79
Q

Which is more common in patients with psoriasis:

psoriatic arthritis or dactylitis?

A

dactylitis (occurs in about 35% of psoriasis patients)

80
Q

Where is the pencil in cup deformity usually found?

A

common in DIP and PIP joints

81
Q

What is dactylitis?

A

combination from inflammation of joints and surrounding tissues
(also commonly referred to as sausage digits)

82
Q

What autoimmune skin condition has T cells at the dermoepidermal junction?

A

lichen planus

83
Q

What are the risks of causing/contributing to lichen planus?

A

various meds, dyes, arsenic, HCV infection, and other conditions

84
Q

What age range does lichen planus usually effect?

A

middle-aged adults

85
Q

What pattern of distribution is most commonly seen with lichen planus?

A

symmetrical on extremities

86
Q

What are the 6 P’s for lichen planus?

A 
pruritic (itchy) 
purple 
polygonal 
planar 
papules 
plaque (can become scaly when chronic)
87
Q

What is a characteristic sign of lichen planus?

A

Wichkam’s striae

88
Q

What is Wickham’s striae?

A

white reticular changes most commonly (70%) seen in oral mucosa

89
Q

What causes lichen simplex chronicus?

A

chronic rubbing and scratching (occupational, OCD, anxiety/depression)

90
Q

What is involved with lichen simplex chronicus?

A

epidermal hyperplasia and dermal scarring

91
Q

What is acanthosis nigricans?

A

asymptomatic hyperpigmentation of skin

92
Q

What is the appearance of acanthosis nigricans?

A

dark and velvety appearance

93
Q

Where acanthosis nigricans typically found?

A

body folds/creases, axillae, groin, neck

94
Q

What are possible risks for acanthosis nigricans?

A

diabetes, obesity, genetics, and cancer (possible paraneoplastic syndrome)

95
Q

What are the three types of infectious dermatoses?

A

bacterial, fungal, and viral infections

96
Q

What is the most common bacteria to cause impetigo?

A

staph. aureus

97
Q

What is the appearance of impetigo?

A

red rash with “honey-colored crust”

98
Q

Who does impetigo most commonly affect?

A

children, adolescent athletes

99
Q

True or False

Impetigo is itchy and non-painful.

A

True

100
Q

What is a dermal abscess?

A

deeper skin infection (puncture wound or burn injury)

101
Q

What is the bacteria that causes dermal abscesses?

A

Psuedomonas aeruginosa

Systems Pathology II (2 decks)

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