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AANP Class - Leik, Sarah Michell, MedMastery, & Other > Integumentary > Flashcards

Integumentary Flashcards

1
Q

Lichenification

A

Skin becomes hardened and leathery that’s caused by chronic inflammation and scratching

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2
Q

Excoriation

A

Scratch or abrasion of the skin, commonly seen in conditions with pruritis

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3
Q

Fissure

A

Linear cleavage, sharp walls, or crack through the epidermis, smaller than a laceration caused by irritants, dryness, or fungal infections

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4
Q

Purpura

A

flat, non-blanchable, confluent, purple-colored irregularly shaped lesions on skin ranging 2-20 mm in size

A 52-year-old woman states, “these purple splotches appeared on my arms and legs following a round of chemotherapy.”

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5
Q

Wheal

A

clustered, smooth, slightly raised circumscribed, pruritic skin-colored lesions of various sizes up to 2 cm surrounded by an area of erythema

An 18-year-old states, “this itchy rash appeared all over my body a few hours after starting my antibiotic”

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6
Q

Linear

A

streaks such as noted in photodermatitis, with vesicular lesions forming, typically a number of hours after exposure to plant oil (urushiol) contained in poison ivy, poison oak, poison sumac

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7
Q

Crusting

A

Formation of an outer layer or coating on the skin that occurs when bodily exudates (e.g., pus or blood) dry up, e.g., impetigo

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8
Q

Macule

A

Single, flat, non-palpable area of discoloration, irregularly shaped, and 0.5 cm at the widest diameter (< 1 cm wide), same texture as rest of skin

A 50-year-old man says I have had that spot on my cheek for years. Freckles, sunspots.

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9
Q

Papule

A

Single, uniformly colored, slightly raised, solid irregularly shaped with defined borders

A 45-year-old woman states, that thing on my shoulder hasn’t’ changed in years. Solid pimple, acrochordon (skin tag), molluscum contagiosum

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10
Q

Scattered

A

generalized over body without a specific pattern or distribution, as seen in viral exanthem such as rubella

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11
Q

Confluent / Coalescent

A

multiple lesions blending together, such as the plaques seen in severe psoriasis vulgaris

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12
Q

Annular

A

“bull’s eye” lesion often seen with central clearing
- Lyme’s disease
- Steven-Johnsons
- epidermal necrolysis / TEN

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13
Q

Potency

A

Low potency on face
Medium potency on Arms/Legs/Trunk
High potency on hands and feet

*lichen sclerosis is the only area that we can put high potency topical steroids is clobetazol

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14
Q

Psoriasis vulgaris
tx

A

Medium potency topical corticosteroid

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15
Q

Scabies (scabies mites)
tx

A

Permethrin Lotion

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16
Q

Verruca Vulgaris (warts)
Tx

A

Imiquimod Cream
Skin Cancer, Actinic Keratosis, Warts, HPV

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17
Q

Tinea Pedis
tx

A

Topical Ketoconazole

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18
Q

Rosacea
Tx

A

Topical Metronidazole

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19
Q

Phytodermatitis
- poison ivy, poison oak, poison sumac
Systemic Treatment

A

Systemic corticosteroid is preferred when greater or equal to 20% is affected prescribe:
- prednisone PO for 5-7 days
- reduce dose of prednisone 50% for another 5-7 days

20
Q

Phytodermatitis
- poison ivy, poison oak, poison sumac
Topical Treatment

A

Mid or High potency topical corticosteroids on body
- triamcinolone (0.1% Kenalog, Aristocort) or
- clobestasol (0.5% Temovate)

Low-potency corticosteroids on face
- desinode (Desowen)

21
Q

Phytodermatitis
- poison ivy, poison oak, poison sumac
Adjunctive Treatment

A
  • cool compress
  • calamine lotion
  • colloidal oatmeal bath
  • OTC analgesics
  • Oral antihistamines (pruritus)
22
Q

Impetigo (honey crusted exudate)
Nonbullous (no blisters)
Causes
Tx

A

Causes
- Staphylococcus aureus
- Streptococcus pyogenes

Tx: MUPIROCIN OINTMENT
Improvement: 3-5 days

Pregnancy B: do not use if breastfeeding

23
Q

Cellulitis
What is it?
Causes?
Tx

A

Infection of dermis and subcutaneous fat with s/s/ of heat, redness, discomfort

Cause
- Streptococcus pyogenes (most common)
- Staphylococcus aureus
- MRSA
- MSSA

Tx: systemic antimicrobial therapy

24
Q

Erysipelas (superficial form of cellulitis )
How does it present?

A

More red with sharply demarcated borders compared to cellulitis

25
Q

Abscess
Moderate Tx

A

1) Incision and Drainage + Culture and Sensitivity

2) Empiric Tx - Orals
TMP/SMX or Doxycycline

3) Culture and Sensitivity Results - Orals
MRSA tx is TMP/SMX or Doxycycline
MSSA tx is dicloxacillin or cephalexin

26
Q

Cellulitis / Erysipelas / Bullous Impetigo
Mild Treatments

A

Orals (5-7 days)
- penicillin VK
- cephalexin
- dicloxacillin
- clindamycin

27
Q

Cellulitis / Erysipelas / Bullous Impetigo
Moderate Treatments

A

IVs
Penicillin
Ceftriaxone
Cefazolin
Clindamycin

28
Q

Cyst

A

single, firm, smooth, raised, dome-shaped fluid filled, flesh colored encapsulated lesion of 1.5 cm in diameter

A 28-year-old woman states, “a smelly liquid leaks out of this when I push on the area.”

29
Q

Abscess
Mild Tx

A

Incision and Drainage
Warm Compress

30
Q

Shingles, Herpes Simplex Type 1 and Type 2`
Tx
Warning

A

Antivirals (topical and PO)
- drugs end in -cyclovir
- acyclovir (Zovirax) and valacyclovir (Valtrex)

Warning: AKI, thus we hydrate

**Must start of within 48 hours of onset to be effective (maybe 72 hours)

31
Q

Seborrhoeic dermatitis, tinea corpus (ringworm), vaginal infections
Tx
Warning

A

Antifungals
- triazoles or - azole
- fluconazole (Diflucan)

Warning: teratogenic

*spontaneous abortion and heart defects in fetus (1st trimester)
*liver toxicity - do not prescribe with current liver issues

32
Q

Selenium Sulfide (Selsun Blue)
What do I treat?

A

Anti-fungal and anti-infective (slows growth of yeast) shampoo that relieves itchy, flaking, redness

Tinea Versicolor, Tinea Capitus, common dandruff of scalp

33
Q

Pinworms aka Enterobiasis
Tx
Other Interventions

A

MeBENDAZOLE / Vermax
AlBENDAZOLE / Albenza
*think I’m bending over for pinworms

  • give one dose now, then another dose 2 weeks later
  • highly contagious must treat everyone in the home
  • daily showers, laundering
34
Q

Terbinafine / Lamisil
What do I treat?
How long should I prescribe?
What do I assess before prescribing?

A
  • treats tinea capitis & onychomycosis (nail fungus)
  • 2 to 4 week tx for tinea capitus
  • 6 to 12 week tx for onychomcosis
  • assess liver before prescribing
35
Q

Griseofulvin
What do I treat?
How long should I prescribe?
What do I assess before prescribing?

A
  • treats tinea capitis
  • 6 to 8 weeks
  • take with a fatty meal
36
Q

Premetherin (Nix)
What do I treat?
How do I treat it?

A
  • treats lice with 1% lotion, reapply in one week if you see lice
  • treats scabies (mites) with 5% cream, reapply in two weeks if you see mites
37
Q

Acne Tx

A

1) Benzoyl Peroxide / Benzagel (see if the patient used OTC salicylic acid before this)

Other options:
2) tretinoin (Retin-A)…topical retinoids b/c it unclogs pores
3) oral antibiotics - tetracycline
4) refer to derm for accutane

do not prescribe accutane / isotretinoin, refer to derm = birth defects = birth control

38
Q

Class III medium- to high-potency corticosteroids

A

amcinonide 0.1%
betamethasone dipropionate 0.05%
fluticasone propionate 0.005%
triamcinolone acetonide 0.5%

39
Q

Class IV medium-potency corticosteroids
Class V medium-potency corticosteroids

A

betamethasone valerate 0.1%
desoximetasone 0.05%
Fluocinolone acetonide 0.025%
fluticasone propionate 0.05%
hydrocortisone butyrate 0.1%
hydrocortisone probutate 0.1%
hydrocortisone valerate 0.2%
mometasone furoate 0.1%
triamcinolone acetonide 0.025%
triamcinolone acetonide 0.1%

40
Q

Class VI low-potency corticosteroids

A

alclometasone dipropionate 0.05%
desonide 0.05%
fluocinolone 0.01%
hydrocortisone butyrate 0.1%

41
Q

Class VII least-potent corticosteroids

A

hydrocortisone 1% and 2.5%

42
Q

Class II high-potency corticosteroids

A

amcinonide 0.1%
augmented betamethasone dipropionate 0.05% betamethasone dipropionate 0.05%
desoximetasone
diflorasone diacetate 0.05%
fluocinonide 0.05%
halcinonide 0.1%

43
Q

Class I superpotent corticosteroids

A

clobetasol propionate 0.05%
augmented betamethasone dipropionate 0.05%
diflorasone diacetate 0.05%
fluocinonide 0.1%
halobetasol propionate 0.05%

44
Q

Acanthosis Nicricans
patient population
s/s

A
  • diabetes, metabolic syndrome, obesity, GI cancers
  • diffuse thickening of the skin located behind the neck and on axilla
45
Q

Xantheasma

A

raised yellow colored soft plaques located under eyebrow and upper/lower lids of eye
- sign of hyperlipidemia

46
Q

Plane Xanthomas

A

raised yellow colored soft plaques
- sign of hypercholesterolemia

AANP Class - Leik, Sarah Michell, MedMastery, & Other (20 decks)

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