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Dermatology Intro > Dermatology 1 > Flashcards

Dermatology 1 Flashcards

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Dermatology Board Prep flashcards
1
Q

What is Dermatology?

A

the study of the integument (skin, hair, nails, and mucus membranes)

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2
Q

What are the 8 functions of the skin?

A
  1. protects against microbial and foreign substances and minor physical trauma
  2. mechanical barrier against fluid loss
  3. regulates body temp
  4. provides sensory perception
  5. produce vitamin D form precursors in skin
  6. contributes to BP regulation
  7. Excretion of metabolites
  8. expression of emotions
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3
Q

Epidermis

A

thin, outermost portion of the skin, avascular- 5 layers

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4
Q

Stratum Corneum

A

contains cornified cell- tightly packed dead squamous cells, contains keratin

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5
Q

How long does it take to replace the stratum corneum?

A

3-4 weeks

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6
Q

What is keratin?

A

the warterproofing protein

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7
Q

Is there keratin or a granular layer in mucus membranes?

A

No

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8
Q

Stratum lucidum

A

Lucid layer (2nd from top)

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9
Q

Stratum granulosum

A

granular layer, with granular cells (3rd from the top)

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10
Q

Stratum spinosum

A

spinous layer- prickle or spinous cells, also has dermotomes, which attach the cells

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11
Q

Stratum Basale

A

Basal layer contains the keratinocytes and melanocytes

only layer that has mitosis occuring

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12
Q

Melanocytes

A

in contact with granulocytes, packages granularly

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13
Q

basement membrane

A

connects the epidermis to the dermis

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14
Q

Dermis

A

Richly vascular, provides nutrition for the epidermis by means of penetrating papillae

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15
Q

What 5 structures are located in the dermis?

A
  1. connective tissue (elastin, collagen, reticulin fibers)
  2. sebaceous glands
  3. blood vessels
  4. sensory nerve fibers
  5. autonomic motor neurons
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16
Q

What do the AMN innervate?

A

blood vessels, sweat glands, and pilo erection

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17
Q

Hypodermis

A

AKA subcutaneous layer
loose connective tissue filled with fatty cells
sweat glands
deeper hair follicles

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18
Q

Eccrine sweat glands

A 
distributed over most of the body
open directly to the surface of the skin
regulate body temp through water secretion
primary stimulus= heat
regulated via the hypothal.
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19
Q

Apocrine sweat glands

A

inactive until puberty
larger and deeper and Ecc
found in the axillae, anogenital region, aerola, nipple, eyelids and external ear
secretion is stimulated by emotional stress (odorless white fluid)

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20
Q

What causes the odor?

A

bacterial decomposition

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21
Q

sebaceous glands

A

stimulated by sex hormones
secrete lipid rich sebum to keep skin an hair lubricated (continuos outflow) via the follicle
None on palms or soles

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22
Q

Hair follicles

A

invagination of epidermal cells into the dermis
consists of a root, shaft, and follicle
nutrients provided by the papilla

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23
Q

Melanin
carotene
oxyhemoglobin
deoxyhemoglobin

A

brown
golden-yellow/ orange- seen on palms, soles
bright red
dark blue

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24
Q

What light is best for skin inspection? second best?

A
  1. natural light

2. combo of incandescent and fluorescent

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25
Q

Acrocyanosis

A

blueness in palms and soles of feet

common*

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26
Q

peripheral cyanosis

A

blueness in arms and legs

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27
Q

central cyanosis

A

blueness in tongue and mouth

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28
Q

vellus hair

A

short, fine, soft, inconspicuous nonpigmented

all over the body

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29
Q

terminal hair

A

conspicuous, thicker course, usually pigmented from melanocytes

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30
Q

Life cycle of hair

A
  1. anagen growth- 80-90% of hair
  2. catagen atrophy-5%
  3. telogen rest- 10-15%
  4. shed
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31
Q

Trickogram

A

pluck 50 hairs to diagnose alopecia

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32
Q

How many mm per day does scalp hair grow?

A

0.33 mm/day

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33
Q

how long does it take for a fingernail to grow back? toenail?

A

grows 0.1 mm/day
3 mo for finger
6 mo for toe

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34
Q

Changing levels of androgens in adolescents stimulate?

A

increased terminal hairs on the face
appearance of axillary hair
increased truncal and body hair (males> females)

35
Q

other skin changes in teens?

A
  1. apocrine glands enlarge and become active causing axillary sweating and body odor
  2. sebaceous glands increase sebum production causing oily skin and acne
36
Q

Name 6 elderly skin changes?

A
  1. decreased turgor (wrinkles)
  2. decreased vascularity of the dermis
  3. skin thins and is more fragile
  4. furrowing and thickening of the skin (sun)
  5. nails loose luster and yellow
  6. hair thins and looses pigment (d/t decrease functioning melanocytes)
37
Q

Primary skin lesion

A

lesions that occur as the initial spontaneous manifestation of an underlying pathologic process

38
Q

Secondary skin lesion

A

lesion that results from a later evolution of or external trauma to a primary lesion
(from scratching or infection)

39
Q

Diagnostics for skin lesions: (5)

A
  1. fungal scrapings with KOH prep
  2. fungal culture
  3. Tzanck smear (neonatal herpes)
  4. scabies preparation
  5. Allergy skin testing (patch or prick)
40
Q

Macule

A

flat, circumscribed lesion, less than 1 cm in diameter, distinguished by coloration
examples: freckles, flat moles, petechiae measles

41
Q

patch

A

flat, irregular in shape, macule that is > 1 cm in diameter

examples: vitiligo, congenital melanocytic nevus, port wine marks

42
Q

Papule

A

elevates, palpable firm, circumscribed, less than 1 cm in diameter
brown, red, pink, tan, or bluish red in color
examples: warts, malignant melonoma, lichen planus, pigmented nevi

43
Q

Plaque

A

elevated, flat topped, firm, rough superficial plaque > 1 cm

examples- psoriasis, suborrheic and actinic keratosis

44
Q

wheal

A

elevated and irregular-shaped area of skin edema, solid transient and changing, variable diameter: pale pink and lighter in the center
examples- urticaria and insect bites

45
Q

Nodule

A

elevated, firm, circumscribed, palpable, deeper in the dermis than papule
1-2 cm
ex- lipomas, kaposi’s sarcoma

46
Q

Tumor

A

elevated, solid, may or may not be demarcated

greater than 2 cm, may or may not vary from skin color

47
Q

Vesicle

A

elevated, circumscribed, superficial, filler with serious fluid, < 1 cm diameter
examples- blister, varicella, eczema, hepes zoster

48
Q

bulla

A

vesicle >1 cm

ex- blister, pemphigus vulgaris

49
Q

pustule

A

elevated, superficial, like a vesicle, but filled w/ puss

ex- imetigo, acne, folliculitis

50
Q

cyst

A

encaspsulated, elevated, filled with liquid or semisolid material
ex- epidermoid cyst

51
Q

scale (2)

A

heaped-up keratinized cells, flakey exfoliation,

ex- psoriasis, exfoliative dermatitis

52
Q

crust (2)

A

dried serum, blood, purulent exudate, varies in color

ex- scab, impetigo, eczema

53
Q

Lichenification (2)

A
  • rough, thickened epidermis, accentuated skin markings caused by rubbing or irritation
  • involves flexor surfaces
  • ex chronic dermatitis
54
Q

scar (2)

A

thick to thin fibris tissue replacing injured dermis
pink red or white
ex- healed wound or surgical excision

55
Q

Keloid (2)

A

irregularly shaped, elevated progressively growing scar, grows beyond boundaries of the scar caused by excessive collagen formation during healing (from ear piercing or burn)

56
Q

excoriation (2)

A

loss of epidermis, linear or hollowed out crusted area, dermis is exposed
ex- abrasion, scratch

57
Q

Fissure (2)

A

linear crack or break from epidermis to the dermis
small, deep, red
ex- athletes foot, cheilosis

58
Q

Erosion (2)

A

loss of all or part of the dermis, depressed, moist, glistening, follows rupture of bulla
ex- pemphigus vulgaris

59
Q

Ulcer (2)

A

loss of epidermis and dermis, concave, varies in size, exudative, red or reddish blue
ex- stasis or radiation ulcers

60
Q

Atrophy (2)

A

thinning of skin surface and loss of skin markings- skin is translucent and paperlike
ex- striae, aged skin

61
Q

Ecchymoses

A

red-purple nonblanchable discoloriazation of variable size

causes- vascular wall destruction, trauma, vasculitis (aka bruise)

62
Q

capillary hemangioma

A

(nevus flammeus) red irregular macular patches

cause- dilation of dermal capillaries

63
Q

Telangiectasia

A

fine. irregular line caused by dilation of the capillaries

64
Q

venus star

A

bluish spider, linear or irregularly shaped; does not blanch with pressure caused by increased pressure in superficial veins

65
Q

spider angioma

A

red central body with radiating spiderlike legs that blanch with pressure to the central body caused by liver disease, vit b def. and idiopathic

66
Q

Prednisolone

A

double bond between C1-C2 and has increased anti-inflammatory properties

67
Q

MOA of steroid

A

penetrates cell membrane, attaches to receptors in cytoplasm, which reacts with DNA synthesis resulting in modified RNA protein synthesis

68
Q

Effects of steroids?

A 
anti- inflammatory
immunosuppression
vasoconstriction 
anti-mitotic
mineralcorticoid activity 
glucocorticoid activity
antimetabolic effects
69
Q

Drying agents for weepy dermatitis

A 
Water is the best
aluminum salts
colloidal oatmeal (aveeno)
shake lotions
powder
70
Q

what should you not use antipuritis with?

A

“canes”

71
Q

What does SPF protect against?

A

UBV

72
Q

Topical Abx

A 
bacitracin
noemycin (most potential for sensitivity/ allergy)  
polymyxin
sulfa preparations
bactroban
73
Q

common size of tubes

A

15, 30, 45,60, 120, 480 grams

74
Q

ointments cover how much more than creams?

A

5-10%

75
Q

do children or adults absorb more?

A

children 3X more than adults

76
Q

1 lb = ___ oz = ____ grams

A

16, 454

77
Q

30 grams=

A

1 oz

78
Q

shave biopsy

A

partial thickness

use scalpel or scissors and nitrate sticks to stop bleeding

79
Q

punch biopsy

A

full thickness
remove a small piece of the mature lesion
no normal tissue

80
Q

elliptical excision biopsy

A

includes borders of normal skin

usually for mole excision

81
Q

curettage

A

for benign cutaneous lesions (wart)

82
Q

electrodessication

A

dehydrates and destroys the cells

83
Q

electroangulation

A

produces more destruction, boils tissue and coagulates the lesions, good for vascular lesions (usually do a biopsy first to determine what you have)

84
Q

cryosurgery

A

(liquid nitrogen)- application of cold to the skin, used for warts

Dermatology Intro (3 decks)

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