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Dermatology - Chapters > Chapter 3 - Principles of Diagnosis > Flashcards

Chapter 3 - Principles of Diagnosis Flashcards

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Dermatology Board Prep flashcards
1
Q

steps in dermatologic diagnosis (5)

A
  • history
  • physical - identify the morphology of basic lesion
  • consider clinicopathologic correlations
  • configuration or distribution of lesions
  • laboratory tests
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2
Q

the most important part of the physical examination is __

A

inspection

Dermatology is a visual specialty and diagnosis rests heavily on skin inspection

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3
Q

Skin disorders are divided into 2 broad categories:

A

rashes and growths

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4
Q

a discrete lesion resulting from proliferation of one or more of the skin’s components

A

growth

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5
Q

an inflammatory process that usually is more widespread than a growth

A

rash

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6
Q

for a rash, important diagnostic information can be obtained by noting ___

A

the arrangement of distributed

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7
Q

the initial history can be abbreviated by asking 3 general questions:

A

how long?
does it itch?
how have you treated it?

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8
Q

most common symptom for skin disorders is ___

A

itching

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9
Q

__ can cause all types of skin rash

A

Drugs

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10
Q

in patients with a generalized maculopapular eruption, the two most common causes are __

A

drugs and viruses

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11
Q

chronic skin ulcer from persistent herpes simplex infection is a sign of ___

A

immunosuppression - AIDS

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12
Q

__ is the leading cause of workers disability

A

Industrial dermatiis

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13
Q

A complete “skin exposure history” is required whenever ____ is suspected

A

contact dermatitis

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14
Q

what are the 3 essential requirements needed for the Physical exam?

A

undressed patient, clothed in an examining gown
adequate illumination - natural light or bright overhead lighting
an examining provider prepared to see what is there

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15
Q

-

A

lesions that may accompany the presenting complaint

unrelated but important incidental findings

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16
Q

what type of lighting can be used to detect subtle elevations?

A

side lighting

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17
Q

what is used to accentuate pigmentary alternations in the skin, like vitiligo?

A

woods light

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18
Q

an illuminated handheld magnifying device intended to help the clinican to diagnose melanoma clinically

A

dermatoscope

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19
Q

why should you palpate the skin as well? (2)

A
  • to assess the texture consistency and tenderness of the skin lesion
  • to reassure patients that we are not afraid to tough their skin lesions
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20
Q

the most important task in the physical examination is to _____

A

characterize the morphology of the basic lesion

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21
Q

scale, lichenification, vesciles, bullae, pustules and crusts are all ___ alterations

A

epidermal

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22
Q

erythema, purpura, and induration reflect changes in the __

A

dermis

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23
Q

epidermal growths results from ___ of keratinocytes

A

hyperplasia

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24
Q

__ accumulates hen the rate of stratum corneum production exceeds the rate of shedding

A

scale

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25
Q

excessive accumulation of keratin

A

hyperkeratosis

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26
Q

malignant epidermal growths usually feel ____

A

indurated

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27
Q

term designate thickening of the dermis

A

indurated

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28
Q

what are examples of hyperpigmented macules that results from increased melanin production

A

freckles

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29
Q

__ and __ are examples of growths characterized by increased numbers of melanin-producing cells

A

nevi and melanomas

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30
Q

dermal and subcutaneous growths result from ___ proliferative processes in the dermis or subcutaneous fat, most are fully appreciated by palpation

A

focal

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31
Q

a ___ is often required for the diagnosis of a dermal nodule

A

skin biopsy

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32
Q

thickened skin with accentuated skin markings

A

lichenification

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33
Q

__ is the hallmark of chronic dermatitis

A

lichenification

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34
Q

scaling eruptions are the result of thickened stratum ___

A

corneum

35
Q

fish skin

A

ichthyosis

36
Q

white or light tan and flakes off rather easily

A

scale

37
Q

dried serum and debris on the skin surface and is usually darker, most often yellow or brown, it is adherent and a weeping base is revealed

A

crust

38
Q

__ are usually associated with vesicles, bullae, pustules and malignant growths

A

crusts

39
Q

__ occur when fluid accumulates within or beneath the epidermis, occur either intraepidermally or subepidermally

A

vesicles and bullae

40
Q

__ blisters are tense and less easily broken

A

subepidermal blister

41
Q

__ blisters are flaccid and easily ruptured

A

intraepidermal blister

42
Q

hypopigmentary changes are accentuated with _____ examination

A

woods light

43
Q

t/f erythema is blanchable

A

true, the increased blood in the skin is contained within dilated blood vessels

44
Q

t/f purpura is blanchable

A

false, blood has extravasated from disrupted blood vessels into the dermis so not blanchable

45
Q

test for blanchability is ___ - simply applying pressure with a finger or glass slide and observing color changes

A

diascopy

46
Q

__ rashes are subdivided into generalized, localized and specialized types

A

erythematous

47
Q

a special type of blanchable, transient, erythematous lesion of the skin

A

wheal / hive

48
Q

purpuric rashes are subdivided into __ and ___ categories

A

macular and papular

49
Q

flat and nonpalpable

A

macular purpura

50
Q

elevated and palpable

A

papular purpura

51
Q

what type of purpura occur in 2 settings: conditions associated with increased capillary fragility and bleeding disorders

A

macular purpura

52
Q

disruption and necrosis of the blood vessel caused by inflammatory reaction are called __

A

necrotizing vasculitis (papular purpura)

53
Q

idiopathic disorder of increased collagen deposition

A

scleroderma

54
Q

totally devoid of epidermis and some or all of the dermal tissue is missing, may extend down to the bone

A

ulcer

55
Q

__ processes can result in ulcerations that do not heal, for this reason, all chronic ulcers should be biopsied

A

malignant

56
Q

loss of hair

A

alopecia

57
Q

to determine whether alopecia is scarring or non scarring, look for the presence or absence of __

A

follicular openings

58
Q

inflammation and scaling in the nail bed result in separation of the nail plate from the bed

A

onycholysis

59
Q

what are the 4 types of configurations of a rash

A

linear
grouped
annular
geographic

60
Q

a flat skin lesion recognizable because its color is different from that of the surrounding normal skin

A

macule

61
Q

a macule with some surface change, either slight scale or fine wrinkling

A

patch

62
Q

small elevated skin lesions less than 0.5 cm in diameter

A

papules

63
Q

an elevated plateau like lesion greater than 0.5 cm in diameter but without substantial depth

A

plaque

64
Q

elevated, marble like lesions more than 0.5 cm in both diameter and depth

A

nodules

65
Q

blisters filled with clear fluid, less than 0.5 cm

A

vesicle

66
Q

blister filled with clear fluid, great than 0.5 cm

A

bullae

67
Q

vesicles filled with cloudy or purulent fluid

A

pustules

68
Q

liquid debris that has dried on the surface of the skin

A

crust

69
Q

__ results from breakage of vesicles, pustules, or bullae

A

crust

70
Q

visibly thickened stratum corneum, dry and usually whitish

A

scale

71
Q

visible and palpable thickening of the skin with accentuated skin markings

A

epidermal thickening - lichenification

72
Q

dermal thickening resulting in the skin that feels thicker and firmer than normal

A

induration

induration is in the DERMIS

73
Q

a thin, linear tear in the epidermis

A

fissure

74
Q

wider but is limited in depth, confined to the epidermis

A

erosion

75
Q

defect devoid of epidermis as well as part of all of the dermis

A

ulcer

76
Q

loss of skin tissue

A

atrophy

77
Q

a papule or plaque of dermal edema, central pallor and irregular borders

A

wheal

78
Q

superficial blood vessels enlarged sufficiently to be clinically visible

A

telangiectasia

79
Q

serpiginous tunnel or streak is caused by a ___ organism

A

burrowing – scabies

80
Q

noninflammatory lesions of acne that result from keratin impaction in the outlet of the pilosebaceous canal

A

acne - comedo

81
Q

contact dermatitis from poison ivy will demonstrate a ____ configuration

A

linear

82
Q

herpes simplex will demonstrate a ___ configuration

A

grouped

83
Q

tinea corporis will demonstrate a ___ configuration

A

annular scaling patch

84
Q

when morphology and configuration (or distribution) appear to conflict, who wins??

A

morphology

Dermatology - Chapters (18 decks)

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