Exam V -- Skin

Question 1

Describe risk factors for pressure injury

Answer 1

-Prolonged immobilization
-moisture
-neurologic disorders
-fractures
-impaired perfusion/ischemia
-malnutrition/dehydration

Question 2

Differentiate light skin vs dark skin assessment of pressure ulcer injury

Answer 2

Lighter skin: erythema/redness
Darker skin: purple/blue/violet skin, non-blanchable, induration, taut/shiny skin, pain assessment

Question 3

Describe altered scarring by name and description

Answer 3

Keloids: ‘clawing’ scars outside of original border
Hypertrophic: fibrous scar within original border

Question 4

Compare allergic to irritant dermatitis

Answer 4

Allergic/atopic: type 1/type 4 hypersensitivity response, genetic mutation, common in younger children in crevices
Irritant/contact: older adults, response to chemical exposure

Question 5

Describe Steven’s Johnson Syndrome

Answer 5

Form of erythema multiforme: T cell immunologic reaction to drugs
-Bulls eye lesions on skin, mucous membranes

Question 6

Differentiate between virus and bacterial skin pathophysiology

Answer 6

Bacterial: impetigo (staph/strep_, furuncles/carbuncles, folliculitis/cellulitis,
Viral: HSV, shingles, chickenpox, warts (HPV)

Question 7

List benign vs cancerous/malignant alterations of skin

Answer 7

Benign:
-Nevi
-Actinic keratosis
-Seborrheic keratosis

Malignant:
-Basil cell carcinoma
-Melanoma
-Squamous cell carcinoma

Question 8

Identify tinea fungal infections by location: scalp, hand, foot, corporis, cruris, unguium

Answer 8

Capitis (scalp), manus (hand), pedis (foot), corporis (ringworm) cruris (Crotch), unguium

Question 9

Explain the pathophysiology of shingles, relationship to chicken pox, and the clinical manifestations

Answer 9

OG chicken pox (varicella-zoster) infection –> virus latent in trigeminal/dorsal root ganglia –> present as shingles (herpes zoster) along thoracic dermatome

Question 10

What is the” Rule of Nines”?

Answer 10

The body is split into segments of 9%: head/neck, chest/back, abdomen/lower back, each leg.
Used for estimating size of burns.

Question 11

Describe the clinical presentation/ pattern of scabies

Answer 11

Infestation –> 3-5 weeks later: burrows/papules/vesicles
-in crooks/crannies
-intense pruritis–worse at night
-secondary infections (crusting) common

Question 11

Describe the etiology/pathophysiology and clinical presentation of impetigo

Answer 11

PATHO:
-skin lesion r/t opportunistic staph or strep on skin

CM:
-honey crusted lesions around face/nose/mouth, common in children

Question 11

Explain the pathophysiology of acne vulgaris vs acne rosacea

Answer 11

Vulgaris: Inflammation of pilosebaceous follicles, can be inflammatory (cystic) or non-inflammatory
Rosacea: chronic vasodilation results in lesions–adults (triggered by sun, alcohol, hormones)

Question 12

Explain the pathophysiology of atopic dermatitis and its’ clinical manifestations

Answer 12

AKA eczema
PATHO: IgE mediated reaction–associated with filaggrin gene mutation/deficiency
MANIFESTATIONS: redness, edema, scaling, pruritis

Question 13

Differentiate between virus and bacterial pediatric skin pathophysiology (name bacterial vs viral infections)

Answer 13

Bacterial: impetigo, SSSS—breach in skin barrier –> infection
Viral: Molluscum, rubella, rubeola, roseola, small pox, chicken pox viral infection of cells –> more systemic

Question 14

Rubella patho, S/S

Answer 14

PATHO: RNA respiratory virus
s/s: maculopapular rash that moves from trunk –> extremities “3 day measles”

Question 15

What infection leads to ‘Kopliks’ spots? What are they?

Answer 15

-Rubeola–classic measles
-white spots on buccal mucosa