Chapter 24: Med Surg Flashcards

1
Q

UVA light

A

responsible for tanning, elastic tissue damage and actinic skin damage

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2
Q

UVB light

A

responsible for sunburn, major developer of skin cancer

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3
Q

tanning

A

skin’s response to injury and increased melanin

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4
Q

chemical sunscreen

A

light creams and lotions designed to absorb or filter UV light, resulting in diminished UV light penetration

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5
Q

physical sunscreen

A

thick and opaque heavy creams that reflect UV radiation

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6
Q

PABA

A

blocks UVB rays

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7
Q

Parsol

A

blocks UVA

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8
Q

benzophenones

A

block both UVB and UVA

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9
Q

what was treated with radiation 30 years ago?

A

acne and hirtuism causing increased carcinoma in present middle aged patients

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10
Q

Vitamin A

A

essential for epithelial cell structure and normal wound healing

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11
Q

Vitamin B

A

essential for complex metabolic functions; deficiencies can cause erythema

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12
Q

Vitamin C

A

essential for connective tissue and normal wound healing; absence can cause scurvy or petechiae

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13
Q

Vitamin D

A

essential for bones

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14
Q

Unsaturated fatty acids

A

essential for cellular and subcellular membranes in tissue metabolism

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15
Q

biotin

A

water-soluble B complex prevents rashes and alopecia; e.g. liver, cauliflower, salmon, carrots, bananas

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16
Q

acanthosis nigricans

A

velvety dark skin of neck and body folds

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17
Q

ABCDE

A

cornerstone rule of self-skin examination; asymmetry, border, color, diameter >6 mm, and evolution

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18
Q

risk factors for developing skin cancer

A

fair skin (blonde or red hair and green or blue eyes), chronic sun exposure, family history, chemicals

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19
Q

nonmelanoma cancer

A

do not develop from melanocytes, instead develop in epidermis on sun exposed areas (face, head, neck, back of hands, and arms)

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20
Q

actinic keratosis

A

flat or elevated hyperkeratotic papules and plaques on sun exposed portions of body; greatly effect the elderly, most common of all precancerous lesions

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21
Q

basal cell carcinoma

A

well defined, locally invasive, epidermal basal cells, most common and least deadly and almost never spread beyond skin; some mistaken for melanoma because of curled borders and opaque appearance

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22
Q

squamous cell carcinoma

A

keratinizing cells, sun exposed or previously damaged skin, scaly appearance, less common but more aggressive, has potential to metastasize, biopsy should ALWAYS be performed when suspected

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23
Q

malignant melanoma

A

most deadly skin cancer and can metastasize to any organ

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24
Q

where does malignant melanoma frequently occur for women?

A

lower legs and back

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25
Q

where does malignant melanoma frequently occur for men?

A

trunk, head, and neck

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26
Q

cutenaeous melanoma

A

when melanoma begins in the skin

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27
Q

all suspected melanoma should be biopsied how?

A

excisional biopsy

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28
Q

what is the most important prognostic factor?

A

tumor thickness at time of diagnosis

29
Q

Breslow measurement

A

depth of tumor in millimeters

30
Q

Clark level

A

depth of invasion of the tumor; the higher the number, the deeper the tumor

31
Q

dysplastic nevi

A

atypical moles at increased risk for melanoma, >5 mm across, irregular borders, and various colors

32
Q

impetigo

A

associated with poor hygiene and very contagious; thick, honey crusts surrounded by erythema; tx: penicillin

33
Q

folliculitis

A

small pustule at hair follicle opening with erythema and some crusting; tx: antistaphylococcal soap and usually cures w/o scarring

34
Q

furuncle

A

deep infection with staphylococci around hair follicle, tender, draining pus and painful; tx: incision and drainage, warm compress

35
Q

carbuncle

A

multiple furuncles, heal slowly with scarring tx same as furuncle

36
Q

cellulitis

A

inflammation of subq tissue, hot and tender, edema; tx: moist heat, immobilization and elevation

37
Q

erysipelas

A

superficial cellulitis primary involving dermis, red and hot plaque that is painful, most common on face and extremities; tx: penicillin and usually hospitilize

38
Q

herpes simplex

A

transmission from respiratory droplets or virus containing fluid (saliva or cervical secretions), painful at first and usually recurrent in same spot; tx: moist compress, Acyclovir but no vaccine available for HSV1 & 2

39
Q

herpes zoster

A

activation of the varicella-zoster virus, linear distribution of vesicles, painful; tx: Acyclovir within 72 hours to prevent postherpetic neuralgia

40
Q

Verruca vulgaris

A

caused by HPV, spontaneous disappearance within 1-2 yrs, greater in youth and immunosuppressed, circumscribed flesh colored papule and painful; tx: surgery, liquid nitrogen therapy

41
Q

plantar warts

A

caused by HPV, grows inward, painful when pressure applied, cone shaped with black dots (thrombosed vessels) present when wart is removed

42
Q

candidiasis

A

present in warm, moist areas, white, painful, papular, erythmatous rash; tx: antifungals, keep area clean and dry, powder

43
Q

tinea corporis

A

ringworm, angular, scaly appearance; tx: cool compress and antifungal

44
Q

tinea cruris

A

jock itch, well-defined scaly plaque in groin area and does not affect mucous membranes; tx: topical antifungal cream

45
Q

tinea pedis

A

athlete’s foot, interdigital scaling and maceration; tx: topical antifungal cream, gel, spray, powder

46
Q

tinea unguium

A

affects the toenails and sometimes nails, scaliness, brittle, thickened; tx: antifungal

47
Q

bedbugs

A

wheal surrounded by vivid flare, severe puritis, often grouped in threes; tx: antihistamines or topical corticosteroids

48
Q

pediculosis

A

head lice, parasites that suck blood and leave excretement and eggs on skin and hair, lesions are red and noninflammatory; tx: Benzene-hexachloride or pyrethrins

49
Q

scabies

A

mite penetrates and deposits eggs and allergic reaction occurs, transmission via direct contact, rarely seen in dark skined people, severe itching especially at night

50
Q

allergic contact dermatitis

A

delayed hypersensitivity, sensitization after one or more exposures, appearance of lesions 2-7 days after contact with allergen, manifested by red papules and plaques, pruritic

51
Q

urticaria

A

allergic phenomenon, erythema and edema in upper dermis, occurs spontaneously, raised multiple wheals

52
Q

drug reaction

A

can occur as late as 14 days after cessation of drug

53
Q

atropic dermatitis

A

genetically influenced, chronic, relapsing disease, most severe in childhood, acute- bright erythema, extreme itching, subacute- scaly, light red plaques, chronic- lichenification

54
Q

acne vulgaris

A

inflammatory disorder of sebacceous glands, noninflammatory lesions, open comedones (blackheads) and closed comedones (white heads)

55
Q

nevi

A

moles, grouping of normal cells derived from melanocyte-like precursor cells

56
Q

psoriasis

A

autoimmune chronic dermatitis, excessive turnover of epidermal cells, develops before age 40, silvery scaling plaques on reddened skin

57
Q

seborrheic keratoses

A

benign, familial, usually occur after 40 years of age, irregularly round or oval, well defined, increase in pigmentation over time

58
Q

acrochordons

A

skin tags, common after midlife, small and skin colored, soft, pedunculated papules

59
Q

lipoma

A

benign tumor of adipose tissue, encapsulated, rubbery, compressible

60
Q

lentigo

A

increased number of normal melanocytes in basal layer of epidermis related to sun exposure and aging, hyperpigmented, brown to black macule or patch on sun exposed areas

61
Q

total-body skin irradiation

A

body is bombarded with high energy electrons, treatment for cutaneous T-cell lymphoma, lengthy and causes premature aging of skin

62
Q

curettage

A

removal and scooping away of tissue using an instrument with a circular cutting edge attached to a handle

63
Q

excision

A

considered when cut to be made involdes the dermis

64
Q

Moh’s surgery

A

microscopically controlled removal of a cutaneous malignancy, sections the surgical speciment horizontally,removed in thin layers, preserves normal tissues, produces smallest wound possible, and complete removal of the cancer before surgical closure

65
Q

face-lift

A

repositions the lower 2/3 of the face and neck

66
Q

free graft

A

provides blood supply to the grafted skin

67
Q

reconstructive microsurgery

A

circulation is immediately established in the free flap by anastomosis of the blood vessels from the skin flap to the vessels in the recipient site

68
Q

skin flap

A

moving a section of skin and subq from one part of the body to another without terminating the vascular attachment (pedicle), used for wounds with poor vasulcar bed or over cartilage and bone

69
Q

soft tissue expansion

A

resurfaces a defect, removes a disfiguring mark or a preliminary step in breast reconstruction; subq tissue expander placed under skin, expand with saline, repeated until skin reaches size of repair, old incision is then opened, expander removed, and soft tissue used for advancement flap