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advanced health ass. > exam 1 > Flashcards

exam 1 Flashcards

1
Q

3 ways to describe a rash

A

color, morphology, size

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2
Q

3 morphology of primay lesion

A

fluid filled vs solid
color
scale or no scale

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3
Q

distrubution of a rash can either be ____ or ____

A

diffuse (all over) or localized

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4
Q

describe symmetrical distrubution

A

bilateral in the same area of the boday

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5
Q

acral sites on the body are where?

A

palms, soles of feet, no and ears

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6
Q

with a blister, a lesion that is <1cm

A

vesicle

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7
Q

with a blister, a lesion that is >1cm

A

bullae

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8
Q

what is Nikolsky sign?

A

when skin sloughs off when pressed aginst it

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9
Q

Dyshidrotic eczema
* Herpes simplex
* Impetigo
* Varicella/zoster
* Tinea pedis
* Scabies
* Contact dermatitis
* Hand foot and mouth
* Polymorphic light eruption
* Grover’s disease
* Arthropod assaults
* Erythema multiforme
* Dermatitis herpetiformis
* Id reaction

are all examples of

A

Vesicles (≤1 cm)

fluid filled lesions

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10
Q
  • Bullous impetigo
  • Bullous tinea
  • Trauma/thermal
  • Bullous erythema multiforme
  • Staph scalded skin
  • Stephens Johnson Syndrome
  • Toxic epidermal necrolysis
  • Autoimmune blistering disease
  • Bullous drug eruption
  • Lichen planus
  • Porphyria cutanea tarda
  • Diabetic bullae

are all examples of

A

Bullae (≥1 cm
fluid filled lesions

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11
Q
A

algorithm

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12
Q
A

moph. prime. lesion

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13
Q

(same size and shape)
usually solitary papules and dome-shaped

A

Monomorphic
(inflammatory lesions)

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14
Q

(varied size and shape),
multiple, often confluent, flat-topped

A

Polymorphic
(vascular reaction)

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15
Q

*Petechiae
*Coagulation disorders
*Leukocytoclastic vasculitis
*Henoch-Schonlein purpura
*Ecchymoses
*Meningococcemia
*Rocky Mountain Spotted
Fever
*Vascular ulcers

are all examples of

A

Purpuric/non-blanchable
(polymorphic/vasculr)

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16
Q

*Kawasaki disease
*Staph scalded skin
*Toxic shock syndrome
*Red man syndrome
*Angioedema
*Autoimmune blistering
diseases
*Erythema multiforme
*Erythema nodosum
*Drug eruption
*Urticarial vasculitis

A

Persistent/blanching
(polymorphic/vasculr)

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17
Q

*Rosacea
*Urticaria

are all exaples of

A

Transient
(polymorphic/vasculr)

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18
Q

*Furuncles
*Carbuncles
*Epidermoid cysts
*Cellulitis
*Erythema nodosum
*Acne vulgaris
*Mycosis fungoides

are all examples of

A

Nodules
Monomorphic
Inflammatory Lesions

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19
Q

Macules and papules
*Arthropod assaults
*Spider and cherry angiomas
*Scabies
*Acne
*Keratosis pilaris
*Candidiasis
*Pyogenic granulomas
*Granuloma annulare
*Viral exanthems
*Early psoriasis lesions
*Pityriasis rosea (w/o scale)
*Secondary syphilis (the
‘great imitator’)
*Pityriasis lichenoides
*Grover’s disease

are all examples of

A

Monomorphic
Inflammatory Lesions

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20
Q

red scaly lesion with epitheial disruption

A

Eczematous

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21
Q

red scaly lesion with no epitheial disruption

A

Papulosquamous

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22
Q

Atopic dermatitis
* Irritant contact dermatitis
* Allergic contact dermatitis
* Dyshidrotic eczema
* Nummular eczema
* Stasis dermatitis
* Scabies
* Secondary lesions (DH, tinea, etc.)
* Seborrheic dermatitis
* Polymorphic light eruption
* Lichen planus
* Eczematous reaction patterns
* Cutaneous T cell lymphoma
* Xerotic eczema
* Exfoliative erythroderma

are all examples of

A

Eczematous
Epithelial Disruption

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23
Q
  • Psoriasis
  • Tinea
  • Lupus erythematosus
  • Discoid lupus
    erythematosus
  • Cutaneous T cell
    lymphoma (mycosis
    fungoides)
  • Pityriasis rubra pilaris
  • Lichen planus
  • Darier’s disease
  • Exfoliative erythroderma

are all examples of

A

Prominent plaques
Papulosquamous
No Epithelial Disruption

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24
Q
  • Pityriasis rosea
  • Keratosis pilaris
  • Seborrheic dermatitis
  • Tinea
  • Lichen planus
  • Secondary syphilis
  • Guttate psoriasis
  • Pityriasis lichenoides
    (PLC or PLEVA)

are all examples of

A

Papules
Papulosquamous
No Epithelial Disruption

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25
Q

are flat or slightly elevated with a central core, circumscribed, painful lesions with a smooth, hard surface

A

Corns

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26
Q

A superficial area of hyperkeratosis is called a

A

callus

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27
Q

They may be flat, raised, dome-shaped, smooth, rough, or hairy. Their color ranges from pink, tan, gray, blue, and shades of brown, to black.

A

nevi (moles)

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28
Q

There is a strong association between _______ and the number of nevi.

A

sun exposure

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29
Q

Atypical nevi tend to occur on heavily sun damaged skin, classically ______ in men and on the ____ in women

A

upper back
legs

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30
Q

areas of hyperpigmentation on the face and neck that are associated with pregnancy or hormonal variation

A

melasma

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31
Q

Alterations in color in dark-skinned persons are best seen in what 7 areas

A

the sclera
conjunctiva
buccal mucosa
tongue
lips
nail beds
palms.

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32
Q

Sharp, oval, or circular; depigmented halo around nevus; may undergo many morphologic changes; usually disappears and halo repigments (may take years)

A

Halo nevus

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33
Q

occurence for Halo nevus

A

Usually on back in young adult

Usually benign; biopsy indicated because same process can occur around melanoma

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34
Q

occurence for Intradermal nevus

A

Cells limited to dermis

No indication for removal other than cosmetic

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35
Q

occurence for Junction nevus

A

Nevus cells lining dermoepidermal junction

Should be removed if exposed to repeated trauma

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36
Q

occurence for Compound nevus

A

Nevus cells in dermis and lining dermoepidermal junction

Should be removed if exposed to repeated trauma

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37
Q

occurence for Blue nevus

A

Nevus cells in dermis

Typically benign, but should be removed if changes occur

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38
Q

Dome-shaped; raised; flesh to black color; may be pedunculated or hair bearing

A

Intradermal nevus

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39
Q

Flat or slightly elevated; dark brown

A

Junction nevus

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40
Q

Slightly elevated brownish papule; indistinct border

A

Compound nevus

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41
Q

May be present at birth; may cover large area; hair growth may occur after several years

A

Congenital nevus

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42
Q

Normal Nevus color

A

Uniformly tan or brown; all nevi on one person tend to look alike

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43
Q

Normal Nevus shape

A

Round or oval with a clearly defined border that separates the nevus from surrounding skin

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44
Q

Normal Nevus surface

A

Begins as flat, smooth spot on skin; becomes raised; forms a smooth bump

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45
Q

Normal Nevus size

A

Usually less than 6 mm (size of a pencil eraser)

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46
Q

Normal Nevus number

A

Typical adult has 10–40 nevi scattered over the body

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47
Q

Normal Nevus location

A

Usually above the waist on sun-exposed surfaces of the body; scalp, breast, and buttocks rarely have normal nevi

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48
Q

Atypical Nevus color

A

Mixture of tan, brown, black, and red/pink; nevi on one person often do not look alike

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49
Q

Atypical Nevus shape

A

Irregular borders may include notches; may fade into surrounding skin and include a flat portion level with skin

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50
Q

Atypical Nevus surface

A

May be smooth, slightly scaly, or have a rough, irregular, “pebbly” appearance

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51
Q

Atypical Nevus size

A

Often larger than 6 mm and sometimes larger than 10 mm

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52
Q

Atypical Nevus number

A

Many persons do not have increased number; however, persons severely affected may have more than 100 nevi

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53
Q

Bleeding into the skin results in ecchymoses (i.e., bruising); pinpoint bleeding from capillaries is called

(smaller than 0.5 cm in diameter)

A

petechiae

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54
Q

atypical nevus location

A

May occur anywhere on the body, but most commonly on back; may also appear below the waist and on scalp, breast, and buttocks

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55
Q

Bleeding into the skin results in ecchymoses (i.e., bruising); pinpoint bleeding from capillaries is called

larger than 0.5 cm in diameter)

A

purpura

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56
Q

lesion that occur as initial spontaneous manifestations of a pathologic process

A

primary

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57
Q

that result from later evolution of or external trauma to a primary lesion

A

secondary

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58
Q

Clostridium gas gangrene smells like

A

rotten apples

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59
Q

Proteus infection smell like

A

mousy

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60
Q

Pseudomonas infection (especially burns) smell like

A

grapelike

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61
Q

Tuberculous lymphadenitis (scrofula) smells like

A

stale beer

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62
Q

Anaerobic infection; scurvy smells like

A

putrid

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63
Q

Phenylketonuria smells like

A

mousy/ musty

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64
Q

A flat, circumscribed area that is a change in the color of the skin; less than 1 cm in diameter

A

Macule

Freckles, flat nevi, petechiae

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65
Q

An elevated, firm, circumscribed area; less than 1 cm in diameter

A

papule

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66
Q

A flat, nonpalpable, irregularly shaped macule greater than 1 cm in diameter

A

patch

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67
Q

Elevated, firm, and rough lesion with flat top surface greater than 1 cm in diameter

A

plaque

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68
Q
A
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69
Q

Elevated, irregular-shaped area of cutaneous edema; solid, transient, variable diameter

A

wheal

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70
Q

Elevated, firm, circumscribed lesion; deeper in dermis than a papule; 1–2 cm in diameter

A

nodule

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71
Q

Elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter

A

tumor

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72
Q

Elevated, circumscribed, superficial, not into dermis; filled with serous fluid; less than 1 cm in diameter

A

vesicle

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73
Q

Vesicle greater than 1 cm in diameter

A

bulla

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74
Q

Elevated, superficial lesion; similar to a vesicle but filled with purulent fluid**

A

pustule

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75
Q

Elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material

A

cyst

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76
Q

Fine, irregular, red lines produced by capillary dilation

A

Telangiectasia

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77
Q

Heaped-up, keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size

A

scale

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78
Q

Rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation; often involves flexor surface of extremity

A

Lichenification

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79
Q

Irregularly shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing

A

keloid

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80
Q

Loss of the epidermis; linear hollowed-out, crusted area

A

Excoriation

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81
Q

Linear crack or break from the epidermis to the dermis; may be moist or dry

A

fissure

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82
Q

Loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla

A

erosion

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83
Q

Loss of epidermis and dermis; concave; varies in size

A

ulcer

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84
Q

Dried serum, blood, or purulent exudates; slightly elevated; size varies; brown, red, black, tan, or straw-colored

A

crust

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85
Q

Thinning of skin surface and loss of skin markings; skin translucent and paper-like

A

Atrophy

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86
Q

lesion arrangement that Following a nerve or segment of the body

A

Zosteriform (dermatomal)

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87
Q

lesion arrangement that is Interlocking or coalesced circles (formed by enlargement of annular lesions)

A

Polycyclic

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88
Q

lesion arrangement Pink macules with purple central papules

A

Iris/target lesion

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89
Q

lesion arrangement Snakelike or wavy line track

A

Serpiginous

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90
Q

lesion arrangement Netlike or lacy

A

Reticulate

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91
Q

lesion arrangement Measles-like: maculopapular lesions that become confluent on the face and body

A

Morbilliform

92
Q

lesion border Well demarcated or defined, able to draw a line around it with confidence

A

Discrete

93
Q

lesion border Poorly defined, have borders that merge into normal skin or outlying ill-defined papules

A

Indistinct

94
Q

lesion border Margin of lesion shows greater activity than center

A

active

95
Q

lesion border Nonsmooth or notched margin

A

Irregular

96
Q

lesion border Center of lesion depressed compared with the edge

A

Border raised above

97
Q

lesion boarder Expanding at margins

A

Advancing

98
Q

Associated Changes Within Lesions
An erythematous border surrounds lighter skin

A

centeral clearing

99
Q

Associated Changes Within Lesions
Peeling or sloughing of skin

A

Desquamation

100
Q

Associated Changes Within Lesions
Hypertrophic stratum corneum

A

Keratotic

101
Q

Associated Changes Within Lesions
Central umbilication or dimpling

A

Punctation

102
Q

Associated Changes Within Lesions
Dilated blood vessels within lesion blanch completely, may be markers of systemic disease

A

Telangiectasias

103
Q

type of arrangement

A

linear

104
Q

lesion arrangement ** Round, active margins with central clearing**

A

annular

105
Q

10 physical exam charachteristics of skin lesions

A

Size (measure all dimensions)
Shape
Color
Blanching
Texture
Elevation or depression
Attachment at base
Exudates
Configuration
Location and distribution

106
Q

11 red flags in skin assessment

A
  • Fever
  • Ill appearance
  • Extreme of age (young or old)
  • Purpura or petichiae
  • Generalized or musculoskeletal pain
  • Immunocompromised
  • Lymphadenopathy
  • Commonly offending drugs
  • Nonhealing chronic lesion
  • Chronic, irregular, and evolving lesion greater than 6 mm
  • Oral lesions
106
Q

Most common inflammatory skin disorder

can be caused by
Irritant contact dermatitis
Allergic contact dermatitis
Atopic dermatitis

Can be more severe in Black/Hispanic population- papular and lichenification (article) can be present
A

Eczematous dermatitis

106
Q

Deep-seated infection of the pilosebaceous unit
Staph aureus most common organism

Acute onset of tender red nodule with center filled with pus.

A

Furuncle (boil)

107
Q

Inflammation and infection of the hair follicle and surrounding dermis

A

Folliculitis

107
Q

Characterisitic Findings
itching
primary lesions: erythema, papules, vesicles
secondary lesions
excoriations in acute stage from scratiching
lichenification in chronic forms

A

dermatitis

107
Q

what is this an example of

A

lichification

107
Q

Group of noncandidal fungal infections that involve the stratum corneum, nails, or hair;

A

tinea

Tinea Corpus
Tine Cruris
Tine Capitus
Tinea Pedis

107
Q

Chronic and recurrent disease of keratinocyte proliferation; salmon or silvery pink scaling on extensor surfaces

A

Psoriasis

107
Q

Nonspecific reaction pattern associated with obesity, certain endocrine syndromes or malignancies, or as an inherited disorder

A

Acanthosis nigricans

108
Q

Most common form of skin cancer

usually in elderly but getting younger
head & neck area
rarely metastasizes
pearly nodule with telangictasia
Rolled borders

A

basal cell carcinoma

109
Q

precancerous lesions

A

Actinic keratosis

110
Q

Squamous CellCarcinoma causes

A

sun, burns, chronic inflammatory disease and scars,
aging

111
Q

Scaly pink/red patch
Scaling
crusting
Central ulceration/erosion

Lips mouth and ears
Papule that bleeds, scale, sore that won’t heal
can metastasize

A

squamous cell carcinoma

112
Q

Upper back & legs
Horizontal growth
papule to plaque to nodule
variation in color
irregular border
asymmetry
>6 mm

A

malignent melanoma

113
Q

Neoplasm of the endothelium and epithelial layer of the skin causing painless, flat or raised purple, red, or brown patch/nodules

Commonly associated with human immunodeficiency virus (HIV) infection

A

Kaposi sarcoma

114
Q

A superficial benign neoplasm of epidermal cells that presents as a papule or plaque with a characteristic “pasted-on” appearance. These lesions are usually acquired later in life (middle age and beyond) and tend to grow slowly.

A

Seborrheic Keratosis ( not malignant)

115
Q

Causes yellow greasy scales and erythema on the scalp- may be related to stress, fatigue, yeast

A

Seborrheic dermatitis ( dandruff)

116
Q

Growth of terminal hair in women in the male distribution pattern on the face, body, and pubic areas

A

Hirsutism

117
Q

Inflammation of the paronychium

A

Paronychia

118
Q

Fungal infection of the nail

A

**Onychomycosis
**

119
Q

Loosening of the nail plate from the nail bed that begins at the distal groove

A

Onycholysis

120
Q

Central depression of the nail with lateral elevation of the nail plate- what are these associated with?

A

Koilonychia (spoon nails)

** iron deficiency anemia, syphilis, fungal dermatoses, hemochromatosis, and hypothyroidism**

121
Q

Whitening of the proximal half to three-quarters of the nail bed- associated with liver disease, chf, dm and aging

A

White banding (Terry nails)

122
Q

Benign dermatosis that usually arises in the third trimester of a first pregnancy

A

Polymorphic eruption of pregnancy

123
Q

Caused by blocked sweat ducts and trapped sweat beneath the skin

A

Miliaria rubra (prickly heat)

124
Q

Common, contagious superficial skin infection

Most common bacteria is staphylococcus aureus, not usually MRSA.

Can be treated with topical or oral treatment.

A

Impetigo

125
Q

Measles virus infects by invasion of the respiratory epithelium

A

Measles (rubeola)

126
Q

Occurs on the lower legs in some patients with venous insufficiency

A

Stasis dermatitis

127
Q

Atypical squamous cells confined to the upper layers of epidermis

A

Actinic keratosis

128
Q

Eczema in black skin:

A

thicker cohesion:
papular and lichenified areas
sometimes soft ivory in color but commonly dark brown

129
Q

Keloids: a higher tendency to scar in _____ especially in darker skin

A

darker skin

130
Q

-refers to nodes that are abnormal either in size, consistency, or number

can be localized or general

A

Lymphadenopathy

131
Q

Generalized if lymph nodes are enlarged in __or more noncontiguous areas I.e. inguinal and occipital

localized if only one area is involved.

A

2

132
Q

hard node suggests ____

A

malignancy

133
Q

Warm and tender nodes may be related to ____

A

inflammation/infection

134
Q

2 things to examine for Enlarged node-

A

examine regions they drain and nodes elsewhere in the chain

Examine spleen

135
Q

enlarged Submandibular & submental nodes

A

dental problems

136
Q

enlarged nodes in Preauricular

A

same side conjunctivitis
lymphoma

137
Q

enlarged Occipital nodes

A

common in childhood infections

138
Q

enlarged Inguinal nodes

A

STDs
Leg and foot infections
Pelvic malignancy

139
Q

enlarged Axillary nodes

A

hand and arm infections
lymphoma
breast cancer

140
Q

enlarged nodes

A

Lymphadenopathy

141
Q

inflamed & enlarged nodes

A

Lymphadenitis:

142
Q

Inflammation of one or more lymphatic vessels
nodes Draining into area

A

Lymphangitis:

143
Q

excess accumulation of lymph fluid

A

Lymphedema

144
Q

Congenital malformation of nodes

(transilluminates; hemangiomas do not)

A

Lymphangioma

145
Q

Wavelike motion when nodes are palpated

A

Fluctuant:

146
Q

Nodes feel connected and move as unit

A

matted

147
Q

lymphadenopathy in >2 extrainguinal sites for 3 months
Kaposi’s sarcoma
CMV infection; TB

A

HIV infection

148
Q

9 red flags with headaches

A

Stiff neck/fever
Abrupt onset of severe pain
Neurological deficit (AMS)
Progressively worsening headache
Vomiting
New onset in persons 50 years or older
worst headache of life
ice pick (lancinating) pain
unrelenting w/ treatment

149
Q

headache that : not directly related to a specific cause**

A

Primary:

150
Q

headaches that have an underlying cause
Cerebrovascular, menningeal irritation, facial or cervical disfunction

A

secondary

151
Q

elongated head
prominent nose and lower jaw
heavy eyebrow ridge
coarse facial features

A

Acromegaly

152
Q

congenitally small skull

A

Microcephaly:

153
Q

acorn shaped head due to skull enlargement

A

Paget’s disease

154
Q

acromegaly, Cushings syndrome, Grave’s disease, hypothyroidism
are all examples of

A

Endocrine facies:

155
Q

Cushing’s syndrome facial 4 charachteristics

A

moon face
telangiectasis
hirsutism
paper thin and erythematous skin

156
Q

small non-tender nodes that feel like BBs under the skin

A

Shotty—

157
Q

exopthalmos, periorbital swelling, upper lid retraction
fine, moist skin
fine hair
staring or startled expression
goiter

A

Grave’s Disease

158
Q

ptosis
periorbital swelling
thickening of nose and lips
prominent tongue
dull facial expression

A

Hypothyroidism

159
Q

Paralysis of upper and lower parts of face
lax eyelid
flat nasolabial fold
drooping corner of mouth

A

Facial Palsy (Bell’s Palsy)

160
Q

is the most common cause of bilateral or unilateral enlargement of the parotid gland in children.

A

Mumps

161
Q

premature suture union, while brain continues to grow

A

Craniosyostosis: premature suture

162
Q

birth trauma
bleeding into periosteum
bound by suture lines
on palpation, firm at first, later becomes softer and fluctuant
generally resolves in 2 weeks to 3 months

A

Cephalohematoma

163
Q

subcutaneous edema
common form of birth trauma
on palpation, feels soft with poorly defined margins
resolves in days

A

Caput succedaneum

164
Q

sutures are palpable til __ months of age

A

6

165
Q

fontanels
closed by 2 years of age
diamond shaped
4-5 cm

A

anterior

166
Q

fontanels
closed by 2 months of age
triangular shpaed
0.5 to 1 cm

A

posterior

167
Q

mouth breathing
allergic shiners

A

Perennial Allergic Rhinitis

168
Q

are tiny, bright ruby-red to dark blue/black, round papules that may become brown with time. They occur in virtually everyone older than 30 years and increase numerically with age

A

Cherry angiomas

169
Q
  • Itching is typically present.

often report allergy history (allergic rhinitis, asthma).

  • For irritant or allergic contact, exposure history is important.

*

A

Eczematous Dermatitis

170
Q

Acute phase characterized by erythematous, pruritic, weeping vesicles

  • Subacute eczema characterized by erythema and scaling
  • Chronic stage characterized by thick, lichenified, pruritic plaques
A

Eczematous Dermatitis

171
Q

Self-limiting inflammation of unknown cause.
Sudden onset with occurrence of a primary (herald) oval or round plaque.

  • Herald lesion is often missed.
  • Eruption occurs 1–3 weeks later and lasts for several weeks.
  • Pruritus may be present with the generalized eruption.
  • Often occurs in young adults during the spring time.
A

Pityriasis Rosea

172
Q

Pain, itching, or burning of the dermatome area usually precedes eruption by 4–5 days.

  • After eruption resolves, there may be persistent pain called postherpetic neuralgia.
A

Herpes Zoster (Shingles)

173
Q

Single dermatome that consists of red, swollen plaques or vesicles that become filled with purulent fluid (Fig. 9.53)

  • Does not cross midline
  • Can still occur in immunized patients
  • Disseminated lesions in immunosuppressed or older adults
A

Herpes Zoster (Shingles)

174
Q
  • Persistent sore or lesion that has not healed
  • May have crusting
  • May itch
A

basal cell

175
Q
  • Pink growth with a slightly elevated rolled border and a crusted indentation in the center; as the growth slowly enlarges, tiny blood vessels may develop on the surface.
  • Scar-like area that is white, yellow, or waxy and often has poorly defined borders; the skin appears shiny and taut.
A

basal cell

176
Q

(thin-walled, contains clear lymph fluid)

A
  • Cystic hygroma
177
Q

(tends to feel spongy; appears reddish blue, with color depending on size and extent of blood vessel involvement; Valsalva maneuver may enlarge the mass)

A
  • Hemangioma
178
Q

Objective Data

  • Red streaks in the skin after the course of the lymphatic collecting duct
  • Appears as a tracing of rather fine lines streaking up the extremity
  • Sometimes indurated and palpable to gentle touch
A

Acute Lymphangitis

179
Q

Subjective Data

  • Enlarged lymph node
  • Pain, malaise, possibly fever
  • Minor trauma to the skin distal to the area of
A

Acute Lymphangitis

180
Q

Infection and inflammation of a lymph node; may affect a single or localized group of nodes

A

Acute Suppurative Lymphadenitis

181
Q

Subjective Data

  • Enlarged lymph nodes
  • Pain from enlarged lymph nodes
A

Acute Suppurative Lymphadenitis

182
Q

Objective Data

  • Involved node usually firm and tender
  • Overlying tissue edematous; skin appears erythematous, usually within 72 hours
  • When abscess formation is extensive, nodes fluctuant
  • Mycobacterial adenitis characterized by an inflammation without warmth that may or may not be slightly tender
A

Acute Suppurative Lymphadenitis

183
Q

Subjective Data

  • Painless cystic masses
  • Usually manifest during the first year of life and often enlarged after an upper respiratory infection
  • Asymptomatic when in the posterior triangle of the neck, but if found anteriorly, may cause airway or swallowing problems
A

Congenital malformation of dilated lymphatics

184
Q

Objective Data

  • Soft, non-tender, and easily compressible spongy fluid-containing mass without discrete margins
  • Most present at birth and apparent early in life, usually in the neck or axilla, less commonly in the chest or extremities
  • May be large enough to distort face and neck
  • Diagnosis through physical examination and imaging studies (ultrasound, computed tomography, or magnetic resonance imaging), which show a thin-walled, multiloculated cystic mass
A

Congenital malformation of dilated lymphatics

185
Q

Massive accumulation of lymphedema throughout the body; the most common cause of secondary lymphedema worldwide

A

Lymphatic Filariasis (Elephantiasis)

186
Q

Subjective Data

  • Swelling of limb or body area
  • Travel to infected areas: Asia, Africa, the Western Pacific, India, Philippines
  • Many patients are asymptomatic, but some may develop fever with lymphangitis and lymphadenitis, chronic pulmonary infection, and progressive lymphedema
A

Lymphatic Filariasis (Elephantiasis)

187
Q

Objective Data

  • Lymphedema of the entire arm or leg; the genital regions (vulva, scrotum, breasts)
  • Diagnosis can be made by identification of microfilariae microscopically in blood
A

Lymphatic Filariasis (Elephantiasis)

188
Q

Malignant neoplasm of the lymphatic system and the reticuloendothelial tissues

A

Non-Hodgkin Lymphoma

189
Q

Subjective Data

  • Painless enlarged lymph node(s)
  • Fever, weight loss, night sweats, abdominal pain, or fullness
  • Family history
A

Non-Hodgkin Lymphoma

190
Q

Objective Data

  • Nodes may be localized in the posterior cervical triangle or may become matted, crossing into the anterior triangle.
  • Nodes usually well defined and solid
A

Non-Hodgkin Lymphoma

191
Q

Malignant lymphoma

A

Hodgkin Lymphoma

192
Q

Objective Data

  • Clinical presentation variable
  • Most commonly, painless enlargement of the cervical lymph nodes, often in the posterior triangle, that is generally asymmetric and progressive (Fig. 10.24)
  • Nodes sometimes matted and firm, almost rubbery
  • Usually asymmetric; may occasionally be enlarged in similar patterns on both sides of the body
  • Nodal size may fluctuate
A

Hodgkin Lymphoma

193
Q

Subjective Data

  • Painless enlarged lymph nodes
  • May have abdominal pain, sometimes fever
  • May have history of infectious mononucleosis
A

Hodgkin Lymphoma

194
Q

Infectious mononucleosis

A

Epstein-Barr Virus Mononucleosis

195
Q

Subjective Data

  • Malaise, fatigue, acute or prolonged (longer than 1 week) fever, headache, sore throat, nausea, abdominal pain, and myalgia
  • Prodromal period may last 1–2 weeks
A

Epstein-Barr Virus Mononucleosis

196
Q

Objective Data

  • Generalized lymphadenopathy most commonly in the anterior and posterior cervical nodes and the submandibular lymph nodes and less commonly in the axillary and inguinal lymph nodes
  • Epitrochlear lymphadenopathy is particularly suggestive of infectious mononucleosis
  • Hepatomegaly; symptomatic hepatitis or jaundice is uncommon, but elevated liver enzymes are common.
  • Splenomegaly to 2–3 cm below the costal margin is typical; massive enlargement is uncommon
  • Moderate to severe pharyngitis with tonsillar enlargement, occasionally with exudates
  • Petechiae at the junction of the hard and soft palate frequently seen
  • Diagnosis with mononucleosis spot test
A

Epstein-Barr Virus Mononucleosis

197
Q

Subjective Data

  • No significant symptoms
  • History of eating raw or rare meat or uncooked eggs
  • History of direct contact with cat feces, cleaning the litter box, gardening in feces-contaminated soil
A

Toxoplasmosis

Zoonosis, caused by the parasite Toxoplasma gondii

198
Q

Objective Data

  • Single node, chronically enlarged and non-tender
  • Node is usually in the posterior cervical chain
A

Toxoplasmosis

199
Q

Subjective Data

  • Fever—usually high grade and persistent over 3–4 days
  • Sometimes associated with a mild respiratory illness and lymphadenopathy
A

Roseola Infantum (HHV-6)

Infection by human herpes virus 6

200
Q

Objective Data

  • Adenopathy, discrete and not tender, involves the occipital and postauricular chains and may last for some time
  • When the fever diminishes, a morbilliform fine maculopapular rash occurs, spreading from the trunk to the extremities; the child begins feeling much better
A

Roseola Infantum (HHV-6)

Infection by human herpes virus 6

201
Q

Subjective Data

  • Burning, itching lesions
  • May report enlarged lymph nodes
A

Herpes Simplex (HSV)

Infection by human herpes virus 1 (HSV-1) or human herpes virus 2 (HSV-2)

202
Q

Objective Data

  • Discrete labial and gingival vesicles or ulcers
  • May have enlargement of the anterior cervical and submandibular nodes
  • These nodes tend to be somewhat firm, quite discrete, movable, and tender; the frequency of this condition and the symptoms are generally sufficient to establish the diagnosis; a viral culture can be obtained if necessary
A

Herpes Simplex (HSV)

Infection by human herpes virus 1 (HSV-1) or human herpes virus 2 (HSV-2)

203
Q

Subjective Data

  • Enlarged lymph nodes
  • Initial symptoms include severe fatigue, malaise, weakness, persistent unexplained weight loss, fevers, arthralgias, and persistent diarrhea
A

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)

Viral infection that attacks the body’s immune system

204
Q

Objective Data

  • Generalized lymphadenopathy
  • In children there may be a prolonged clinical latent period, but initial signs may include neurodevelopmental problems with loss of developmental milestones
  • Progressive infection characterized by decreasing CD4+ T-lymphocyte count and increasing viral load level
A

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)

Viral infection that attacks the body’s immune system

205
Q

Subjective Data

  • Slow-growing painless lumps, either in front of ear or under jaw
  • Difficulty opening the mouth
  • Tongue numbness or weakness
A

Salivary Gland Tumor

Tumor in any of the salivary glands, but most commonly in the parotid

206
Q

Objective Data

  • Benign tumors usually smooth, malignant often irregular
  • Facial weakness, fixation of the lump, sensory loss, and ulceration
A

salivary gland tumor

Tumor in any of the salivary glands, but most commonly in the parotid

207
Q

Subjective Data

  • Weight gain, constipation, fatigue, and cold intolerance (Table 11.1)

Objective Data

  • Normal-size thyroid, no goiter, or nodule(s)
A

Hypothyroidism

208
Q

Subjective Data

  • Weight loss
  • Tachycardia
  • Diarrhea
  • Heat intolerance
A

Hyperthyroidism

209
Q

Objective Data

  • Normal-size thyroid, goiter, or nodule(s)
  • Fine hair
  • Brittle nails
  • Exophthalmos
  • Tachycardia
A

Hyperthyroidism

210
Q

In hyperthyroidism

______ intolerance
weight _____
______ emotional state
______ hair
____ skin
______ nails
_____ eyes
______ neck
________ cardiac
_______ GI
_____ menstrual
_____ neuromuscular

A

heat intoleranece
weight loss
Nervous, easily irritated, highly energetic
Fine, with hair loss; failure to hold a permanent wave
Warm, fine, hyperpigmentation at pressure points
Thin, with tendency to break; may show onycholysis
Bilateral or unilateral exopthalmos, lid retraction, double vision
Goiter, change in shirt neck size, pain over the thyroid
Tachycardia, dysrhythmia, palpitations
Increased frequency of bowel movements; diarrhea rare
Scant flow, amenorrhea
Increasing weakness, especially of proximal muscles

211
Q

In hypothyroidism

______ intolerance
weight _____
______ emotional state
______ hair
____ skin
______ nails
_____ eyes
______ neck
________ cardiac
_______ GI
_____ menstrual
_____ neuromuscular

A

cold intolerance
weight gain
Lethargic, complacent, disinterested
hair Coarse, with tendency to break
skin Coarse, scaling, dry
Thick fingernails
Puffiness in periorbital region
No goiter
no cardiac changes
constipation
Menorrhagia
Lethargic, but good muscular strength

212
Q

subjective data

    • Cognitive impairment, slowed mentation, poor concentration, decreased short-term memory, social withdrawal, psychomotor retardation, depressed mood, and apathy
  • Constipation
  • Muscle pains
  • Hearing problems, deafness
A

Myxedema

Skin and tissue disorder usually due to severe prolonged hypothyroidism

213
Q

Objective Data

  • Coarse thick skin, thickening nose, swollen lips, puffiness around eyes
  • Slow speech
  • Mental dullness, lethargy, mental problems
  • Weight gain
  • Thin brittle hair, with bald patches
A

Myxedema

214
Q

Subjective Data

  • Palpitations
  • Heat intolerance
  • Weight loss
  • Fatigue
  • Increased appetite
  • Tachycardia
A

Graves Disease

Overactive thyroid caused by autoimmune antibodies to thyroid-stimulating hormone receptor

215
Q

Objective Data

  • Diffuse thyroid enlargement; most commonly with prominent eyes (exophthalmos)
A

Graves Disease

Overactive thyroid caused by autoimmune antibodies to thyroid-stimulating hormone receptor

216
Q

Subjective Data

  • Weight gain
  • Nausea
  • Fatigue

Objective Data

  • Enlarged nontender smooth thyroid
A

Hashimoto Disease

Underactive thyroid caused by autoimmune antibodies against thyroid gland

217
Q

pain begins unilaterally but may become generalized and may lateralize to the opposite side and/or radiate to the face or neck.

typical onset at approximately age 6 years through adolescence.

Black people and those of Hispanic descent more affected

A

migraine

218
Q

pain occurs in episodic clusters of attacks.

A

cluster headaches

219
Q

mild to moderate nonthrobbing pressure or squeezing pain that can occur anywhere in the head or neck. The pain often starts slowly as a dull and aching discomfort that progresses to holocranial pain and pressure.

A

tenision headache

advanced health ass. (4 decks)

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