FMS-Derm Flashcards
(145 cards)
0
Q
What accounts for approximately 20% of the body’s weight?
A
skin
1
Q
What is the largest organ of the body?
A
skin
2
Q
What is the primary function of the skin?
A
protect the body against:
- microorg. 3. loss of body fluids
- UV radiation 4. stress of mechanical forces
3
Q
T/F: The skin regulates body temperature.
A
TRUE
4
Q
The skin is involved in the production of which vitamin?
A
Vitamin D
5
Q
What are some genetic & environmental factors that affect the integumentary system?
A
- skin becomes thinner, drier, wrinkled, & demonstrates changes in pigmentation
- shortening & decreasing in number of capillary loops
- fewer melanocytes & Langerhans cells
- atrophy of sebaceous, eccrine, & apocrine glands
- changes in hair color
- fewer hair follicles & growth of thinner hair
6
Q
flat circumscribed area of altered color that is <1cm
A
macule
7
Q
raised, solid lesion <5mm-1cm
A
papule
8
Q
flat, pigmented lesion >5mm-1cm
A
patch
9
Q
> 5mm flat-topped, raised leesion
A
plaque
10
Q
transient swelling due to dermal edema
A
Wheal
11
Q
solid, round circumscribed elevation of 1-2cm
A
nodule
12
Q
elevated, solid lesion that may be clearly demarcated, deeper in the dermis & >2cm
A
tumor
13
Q
<1cm papule containing clear fluid
A
vesicle
14
Q
large (>5mm-1cm), circumscribed , fluid-containing elevation
A
Bulla
15
Q
papule containing purulent fluid
A
pustule
16
Q
encapsulated nodule containing fluid, cells, or keratin
A
cyst
17
Q
small, dilated superficial blood vessels
A
telangiectasia
18
Q
thick stratum corneum due to increased proliferation or keratincytes
A
scale
19
Q
focal area of thickened skin with accentuation of skin lines due to rubbing/scratching
A
lichenification
20
Q
irregular, elevated, enlarging scar caused by excessive collagen formation during healing, following surgery or other skin trauma
A
keloid
21
Q
thin to thick fibrous tissue healed dermal layer or deeper, healed wound or surgical incision
A
scar
22
Q
shallow abrasion, linear hallowed-out, crusted area
A
excoriation
23
Q
linear, split in epidermis &/or crack in dermis (can be moist or dry)
A
fissure
24
partial loss of epidermis, heals without scarring
erosion
25
loss of epidermis & dermis, surface excudate &/or crusting often present; heals with scarring
ulcer
26
thinning of skin surface & loss of skin markings
atrophy
27
What are pressure ulcers a result of?
any unrelieved pressure on the skin
- pressure
- shearing forces
- friction
- moisture
28
What are some risk factors of pressure ulcers?
1. immobilization
2. incontinence
3. debilitation
29
You are a PA doing rounds & you notice one of your elderly patients that has limited movement has not changed positions for sometime. What should you be worried about this patient developing?
pressure ulcers
30
T/F: chronic diseases accompanied by anemia, edema, renal failure, malnutrition, sepsis, & urinary or fecal incontinence puts patients at risk for pressure ulcers.
TRUE
32
T/F Coarse bed sheet used for turning patients over do not present any risk of causing pressure ulcers.
FALSE (they do!!! It produces a shearing force)
33
T/F Epinephrine infusion is a risk factor for pressure ulcers in the critically ill patient.
FALSE! (Norepinephrine infusion is a risk factor)
34
IDENTIFY THE RISK FACTORS OF PRESSURE ULCERS IN A CRITICAL ILL PATIENT:
An 76 year old elderly woman was admitted to the hospital for 2 months for treatment of her anemia, renal insufficiency, fecal incontinence, and severe burn from spilling boiling water on her while cooking for her family on Sunday morning.
Pressure ulcer risk factors for the critically ill
1. Age greater than 60 years
2. Anemia
3. Renal insufficiency
4. fecal incontinence
3. length of hospital stay
35
T/F Individuals with darkly pigmented skin are at higher risk for pressure ulcers than white pigmented skin.
OF COURSE THEY ARE!!!!!!! ALWAYS ALWAYS ALWAYS.
| ***early signs of skin damage may not be clearly visible in DARK PIGMENTED PEOPLE
36
Non-blanchable erythema of intact skin is what stage of a pressure ulcer?
stage 1
37
Partial thickness skin loss involving epidermis or dermis is in what stage of a pressure ulcer?
stage 2
38
Full thickness skin loss involving damage or loss of subcutaneous tissue is what stage of a pressure ulcer?
stage 3
39
Full thickness skin loss involving damage or loss of subcutaneous tissue is what stage of a pressure ulcer?
stage 4
40
A patient was just checked into the ER with a pressure ulcer covered with eschar. What stage of a pressure ulcer would u describe this as?
UNSTAGEABLE!!!!!!! - the wound is cover by eschar - dead or decaying tissue
41
What are elevated, rounded, firm, and has claw like margins that extend beyond the original site of injury due to excessive collagen formation during dermal connective tissue repaid?
Keloids
42
Which type collagen is increased during the development of a Keloid?
Type III
43
Who are Keloids most commonly found in?
darkly pigment skin types and pt's with burn scars
44
Pruritis is the most common symptom of what disorders?
primary skin disorders
45
What is itch carried by?
specific unmyelinated C-nerve fibers
46
What is itch triggered by?
a number of itch medicators-
1. Histamine
2. Seratonin
3. Prostaglandins
4. Brandykinins
5. Neuropeptides
6. Acetylcholine
47
Chronic itching leads to persistent scratching. What can result because of this?
Infections and Scarring
48
What are the treatments for chronic itching?
treated with antihistamines, minor tranquilizers, and topical steroids.
49
What can modulate the itch response?
CNS
50
T/F Pain stimuli at lower intensities can induce itching.
true
51
What is the most common inflammatory disorders?
Dermatiti or eczema
52
There are various types of dermatitis. What are the general characteristics of dermatitis?
pruritis, lesions with indistinct borders, and epidermal changes including erythema, papules, and scales
****KNOW THIS - see the name - be able to describe it! :)
53
What type of reaction is allergic contact dermatitis caused by?
hypersensitivity type 4 reaction
54
In allergic contact dermatitis an allergen comes into contact with the skin, binds to ______ to form _______.
binds to carrier protein to form sensitizing antigen
55
In contact dermatitis an allergen comes into contact with the skin, binds to the carrier protein to form sensitizing antigen. What processes the antigen? What becomes sensitized to the antigen?
Langerhans cells process the antigen, carry to T cells to become sensitized to antigen.
56
What are the manifestations of allergic contact dermatitis?
1. Erythema
2. Swelling
3. Pruritis
4. Vesicular Lesions
57
Type 1 hypersensitivity inludes activation of mast cells, eosinophils, T-lymphocytes, other inflammatory cells. What inflammatory disorder is a type 1 hypersensitive disorder?
Atopic dermatitis
58
What are the manifestations of Atopic dermatitis?
red, weeping crusts and chronic inflammation, lichenification
59
T/F Irritatnt contact dermatitis is an immunological inflammatory reaction
FALSE!!! it is a non-immunologic inflammation.
60
A patient comes into the ER with signs of chemical irritation from acids or prolonged exposure a substance causing irritation. What would you, a PA, diagnose this patient with?
IRRITANT CONTACT DERMATITIS!!!!!!!
61
What is the treatment of irritant contact dermatitis?
Removal of the stimulus
62
What occurs in the leg as a result of venous stasis, edema, and vascular trauma?
Stasis dermatitis
63
A patient comes into Mississippi College PA clinic and describes a history of erythema, followed by pruritus, then scaling, petechiae, and then finally today she is showing an ulcer on her legs after coronary artery bypass graft surgery. What would be the diagnosis of this patient?
Stasis Dermatitis
64
Heather comes into Enterprise Medical Clinic with red rash covering her checks and nose including her nasolabial folds. This diagnosis will develop into scaly, white, or yellowish plaques.
Seborrheic dermatitis.
65
T-cell immune mediated skin disease that is scaly, thick, silvery, elevated lesions, usually on scalp, elbows, knees caused by a high rate of mitosis in the basal cell layer. This describes what disorder?
Psoriasis - a papulosquamous disorder
66
Is Psoriasis chronic?
Yes
67
Is Psoriasis a relapsing, proliferative skin disorder?
yes
68
T/F Psoriasis is thinking of the dermis.
FALSE!! Shows evidence of dermal and epidermal thickening
69
What is the epidermal turnover in psoriasis?
26-30 days to 3-4 days
70
Why do the dermis and epidermis thicken and form the thick scaly lesions in psoriasis?
the cellos do not have time to mature or keratinize. Epidermis turn over goes from 26-30 days to 3-4 days instead.
71
A patient comes into the family practice clinic in Enterprise, MS complaining of having a big circular, 3-4 cm demarcated salmon pink colored lesion on her chest approximately 3 weeks ago. Shorty after a lot of smaller similar lesions appeared across her body. What would you diagnose this patient with?
Pityriasis rosea - HERALDS PATCH!!!
72
Pityriasis rose usually occurs during what months?
winter
73
T/F Pityriasis rosea is a chronic inflammatory papulosquamous disorder.
false!!!!!! benign, self limiting, inflammatory disorder
74
What is thought to be the cause of Pityriasis rosea?
Herpes like virus
75
Nonscaling violet colored, 2-4mm lesion, found on the patients wrists, ankles, lower legs, and genitalia.
Lichen planus - Papulosquamous disorder
76
T/F Lichen planus is a benign, inflammatory disorder of the skin and mucous membranes.
True
77
What is thought to be the origin of lichen planus?
Unknown origin, BUT T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells are involved
78
A papulosquamous disorder causing inflammation of the pilosebaceous follicle?
Acne vulgaris
79
Inflammation of the skin that develops in adulthood. Erythematotelengiectatic, papulopustular, phymatous, and ocular lesions.
Acne Rosacea
80
What is associated with chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun?
Acne Rosacea
81
inflammatory, autoimmune disease with cutaneous manifestations, though to be an altered immune response to an unknown antigen or response to UV wavelengths with the development of self-reactive T and B cells, decreased number of regulatory T cells and increased proinflammatory cytokines
Lupus erythematosus
Autoantibodies and immune complexes causes tissue damage
82
What is restricted to the skin, photosensitivity, butterfly pattern over the nose and cheeks, subtype of SLE
discoid lupus erythematosus
83
diseases that have different causes and clinical courses but share the common characteristic of vesicles, or blister, formation
vesiculobullous disorders
| Pemphigus and Erythema multiforme
84
blister or bubble, rare, chronic blister-forming disease of the skin and oral mucous membranes, blisters form in deep or superficial epidermis
pemphigus
85
autoimmune disease caused by circulating IgG autoantibodies, the antibodies and complement act against the cell surface adhesion molecule, desmoglein in the suprabasal layer of the epidermis
pemphigus
86
loss of intracellular connections
acantholysis
87
type of pemphigus that is severe
pemphigus vulgaris
88
type of pemphigus that is on the face and chest, milder form
pemphigus foliaceus
89
type of pemphigus that is variant of pemphigus foliaceous associated with SLE
pemphigus erythematosus
90
more benign disease than pemphigus vulgaris, bound IgG and blistering of the subepidermal skin layer, subepidermal blistering and eosinophils distinguish pemphigoid from pemphigus
bullous pemphigold
91
acute recurring disorder of skin and mucous membranes, associated with allergic or toxic reactions to drugs or microorganisms
erythema multiforme
92
caused by immune complexes formed and deposited around the dermal blood vessels, basement membranes and keratinocytes, "bull's eye" or target lesion
erythema multiforme
93
surrounded by rings of alternating edema and inflammation
erythematous regions
94
bullous lesions from erosions and crusts when they rupture, affects the mouth, air passages, esophagus, urethra and conjuctivae
erythema multiforme
95
what are the severe forms of erythema multiforme?
stevens-johnson sydrome and toxic epidermal necrolysis
96
infection of hair follicles, staph is the common causes
folliculitis
97
"boils" are an inflammation of the hair follicles, develop from preceding folliculitis; spread through follicular wall into the surrounding dermis, staph is the most common causative organism
furuncles
98
collection of infected hair follicles, erythematous, painful, swollen mass that drains through many openings, abscesses may develop, chills, fever, malaise
carbuncles
99
infection of the dermis and subcutaneous tissue, staph or strep are the common cause
cellulitis
100
an acute superficial infection of the upper dermis (a superficial form of cellulitis) and strep is the most common cause
erysipelas
101
a superficial lesion of the skin, caused by coagulase-positive staph or strep
impetigo
102
8 types, DNA virus
Herpes simplex virus
103
usually causes infection of the cornea, mouth and labia, contact with infected saliva, "cold sore" or "fever blister" the most commmon manifestation
HSV-1
104
HSV-1 infection of the cornea
herpes keratitis
105
HSV-1 infection of the mouth
gingivostomatitis
106
HSV-1 infection of the labia
labialis
107
gential infections, skin to skin mucous membrane contact during viral shedding, vertical transmission from mother to neonate is associated with significant neonatal morbidity and mortality
HSV-2
108
An initial infection from varicella zoster can be followed years later by ________ _______.
Herpes zoster
109
What virus causes these symptoms? Pain and paresthesia localized to the affected dermatome (cutaneous area innervated by a single spinal nerve) followed by vesicular eruptions along a facial, cervical, or thoracic lumbar dermatome
Herpes zoster
110
Warts are benign lesions caused by _______ and are diagnosed by ______.
human papilloma virus
| visualization
111
Highly-contagious, sexually transmitted venereal warts that present as cauliflower type lesions in moist areas- along the glans of the penis, vulva and anus
Condylomata acuminata
112
Primary cause of cervical cancer
oncogenic HPV
113
Fungi causing superficial skin lesions are called
dermatophytes
114
Fungal disorders called mycoses caused by dermatophytes are called
tinea
115
Which fungal infection affects the scalp?
Tinea captitis
116
Which fungal infection affects the feet?
Tinea pedis
117
Which fungal infection causes "ringworm"?
Tinea corporis
118
Which fungal infection causes jock itch?
Tinea cruris
119
Which fungal infections affect the nails?
Tinea ungium or onychomycosis
120
Candidiasis is a fungal infection caused by_________ ______ that is normally found where?
Candida albicans
| skin, GI tract, and vagina
121
What could cause Candida albicans to change from a commensal organism to a pathogen?
```
local environment of moisture and warmth
systemic administration of antibiotics
pregnancy
diabetes mellitus
Cushing's disease
debilitated states
younger than 6 months of age
immunosuppresion
neoplastic diseases
```
122
Results from immune complexes in the small blood vessels that develops from drugs, bacterial infections, viral infections or allergens
Cutaneous vasculitis
123
How do the lesions of Cutaneous vasculitis present?
palpable purpura progressing to hemorrhagic bullae with necrosis and ulceration
124
Due to type 1 hypersensitivity reactions to allergens; histamine release causes endothelial cells of the skin to contract and causes leakage of fluid from the vessels
Urticaria (hives)
125
What is the treatment of urticaria?
antihistamines and steroids
126
Sclerosis of the skin that can progress to internal organs- associated with several antibodies
Scleroderma
127
How do the lesions caused by scleroderma present themselves?
Lesions exhibit massive deposits of collagen with inflammation, vascular changes, and capillary dilation
128
How does the skin present when scleroderma is present?
skin is hard, hypo pigmented, taut, and tightly connected to underlying tissue
129
How does scleroderma affect the facial skin?
Facial skin becomes very tight
| Mouth may not open completely
130
What are some of the side effects of scleroderma?
Facial skin becomes very tight
Fingers become tapered and flexed
Nails and fingertips can be lost from atrophy
Mouth may not open completely
131
50% of patients with scleroderma die within ___ years.
five years
132
Lyme disease and Rocky Mountain Fever can be caused by what insect?
tick
133
Malaria, yellow fever, dengue fever, filariasis, and St. Louis encephalitis may be caused by which insect?
mosquitoes
134
Bites from flies may cause what?
Painful bites
| Urticaria and mild bleeding
135
What are four types of benign tumors found on the skin?
Seborrheic Keratosis, Keratoacanthoma, Actinic Keratosis, Nevi (moles)
136
Four different types of malignancies found on the skin.
Basal Cell Carcinoma, Squamous Cell Carcinoma, Malignant Melanoma, Kaposi Sarcoma
137
What is a skin injury due to exposure to extreme cold?
Frostbite
138
Which area of the hot hiker man's body might be affected after reaching the summit of Everest?
Fingers, toes, ears, nose, cheeks
139
The burning reaction the hot hiker man felt on areas of his body affected by frostbite were caused by what occurring in his hot body?
Alternating cycles of vasoconstriction and vasodilation.
140
In this hair loss disease, there is no loss of hair on the frontal hairline.
Female-pattern alopecia
141
Disease caused by genetic predisposition response to androgens
male-pattern alopecia
142
Autoimmune T-cell–mediated inflammatory disease against hair follicles that results in baldness
Alopecia Areata
143
Abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women
Hirsutism
144
Acute or chronic infection of the cuticle
Paronychia
145
Fungal or dermatophyte infection of the nail plate
Onychomycosis
