Clinical Reasoning (F1)

Question 1

LO’s

Answer 1

1. Apply the principles of clinical reasoning in formulating a differential diagnosis between the different presentations of skin disease.
2. Apply the principles of clinical reasoning in formulating a differential diagnosis between the different presentations of rash.
3. Describe the biopsychosocial impact of living with skin disease.

Question 2

Actinic Keratosis

Answer 2

• A rough, scaly patch on your skin.
• Usually first appears in people over 40.
• Can eventually become skin cancer.
• Due to sun exposure.

Question 3

Basal Cell Carcinoma

Answer 3

• The most common type of skin cancer.
• Appears as a painless raised area of skin.
• Individuals with a basal-cell carcinoma typically present with a shiny, pearly skin nodule.
• However, superficial basal-cell cancer can present as a red patch similar to eczema.

Question 4

Melonoma

Answer 4

• Develops from the pigment-containing cells known as melanocytes.
• Melanomas typically occur in the skin, but may rarely occur in the mouth, intestines, or eye.
• Brown mark.
• The primary cause of melanoma is ultraviolet light (UV) exposure in those with low levels of skin pigment.
• Melanoma is the most dangerous type of skin cancer.

Question 5

Squamous Cell Carcinoma

Answer 5

• A number of different types of cancer that result from squamous (very thin flattened) cells.
• Compose most of the epidermis.
• Most common in areas exposed to the sun.
• Wart like, dark, red.

Question 6

In the biopsychosocial model what does each category mean related to eczema and psoriasis?

Answer 6

• Biological (just the symptoms): Itchy, sleeplessness, movement restricted, dry skin, redness.
• Psychological (things you feel): Irritable, depression, isolate, anxiety, embarrasment,stigma, stress (have to keep on top of it) and low self esteem.
• Social (other people): Not able to form friends, low self esteem, time investment, can’t exercise/work, money issues and pressure to have clear skin.

Question 7

What is sensitivity in a screening test?

Answer 7

• People who test positive, and actually have the disease. Tests have to be extra sensitive to make sure everone who actually has the disease is screened for.
• If a test has 97% sensitivity, 97% of people with cancer will be picked up. If the test was done in people with cancer only, 97% of them will be picked up. The screen will pick up loads of people who don’t have cancer.

Question 8

What is specificity in a diagnostic test?

Answer 8

The ability of the test to correctly identify those without the disease (true negative rate). If a test has 98% specificity, 98% of people who tested negative don’t have the disease.