clinical examination Flashcards
what is a good examination technique
- Distribution - which areas are affected
- Configuration - how lesions are arranged
- morphology - what the lesion looks like
- Examination beyond the skin eg hair, nails, mouth, joints
what is onycholysis
separation of the nail plate from bed
what is hypertrichosis
general excess growth of hair
what is hirsute
excess growth of hair in the male pattern
what is purpura
extravasation of blood, will not blanche and may be raised
what is petechia
1-2mm area of flat purpura
what is erythema
vascular dilation, blanches on pressure
what is macule and patch
macule = localised flat colour change> 1cm patch = localised flat colour change > 1cm
what is a papule and a nodule
Papule = localised elevated area< 0.5cm Nodule = localised elevated area > 0.5cm
what is a plaque
raised edge and flatter surface > 1cm
what is a fluid filled raised lesion
vesicle < 0.5cm
bulla > 0.5 cm
what is a wheal
compressible dermal swelling
what is a scale
accumulated fragments of keratin layer
what is a crust
dried exudate eg serum
what is a lichened surface feature
thickened with increased surface markings
what is a fissure
linear split in epidermis
what is erosion and and ulcer
erosion = superficial break in epidermis ulcer = deeper break in dermis
what do you consider when looking at morphology of a lump
A asymmetry B boarder C colour D diameter E elevation
what investigations should be done if you suspect a skin infection
- bacterial infection = swab for bacteriology
- viral infection = swab for virology
- fungal infection = scraping for mycology
- infestations = scraping for mycology
what investigations should be done for a tumour or rash diagnoses
biopsy for pathology
what investigations should be done for an allergy
- immediate allergy = prick tests and IgE levels
- delayed allergy = patch test
what are the many choices of technique for a skin biopsy
- punch (usually 4mm in diameter)
- shave = remove lesion at skin level
- curettage = scrapes off lesion
- ellipse = incisional (takes off a small bit) or Excisional (takes the whole thing off)
what investagation is needed for patients that have a skin disease caused by sunlight
phototesting - light testing
