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Boards Study Set > Integumentary > Flashcards

Integumentary Flashcards

1
Q

What is the first line treatment for Rocky Mountain spotted fever?

A

Doxycycline

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2
Q

Patient’s present with abrupt onset of high fever, chills, severe headache, nausea, and vomiting, photophobia, myalgia, and arthralgia, followed by rash that erupts 2 to 5 days after fever onset. The rash consist of small red spots that start to erupt on the wrist and ankles sometimes the palms and souls it rapidly progresses towards the trunk until it becomes generalized.

A

Rocky Mountain spotted fever

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3
Q

An expanding red rash with central clearing that resembles a target, which usually appears within 7 to 14 days after a deer tick bite. The rash feels hot to the touch and has a rough texture.

A

Erythema Migrans (Early Lyme Disease)

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4
Q

Symptoms of sudden onset of sore throat, cough, fever, headache, stiff neck, photo phobia, and changes in level of consciousness. In some cases there’s a abrupt onset of petechial to hemorrhagic rashes in the axle, flanks wrist and ankles. Hypertension and shock are common.

A

Meningococcemia (Meningitis)

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5
Q

What prophylaxis should be given as soon as possible after exposure to meningitis?

A

Rifampin (twice a day for 2 days) and ceftriaxine 250 mg IM (one dose)

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6
Q

Located on the ophthalmic branch of the trigeminal nerve CN5 presents with sudden eruption of multiple vascular lesions, which rupture into shallow ulcers with crust located on one side of the scalp and forehead, and the sides and tip of the nose. The eyelid on the same side as swollen and red patients complain of photophobia eye, pain, and blurred vision, more common in elderly patients.

A

Shingles infection of the trigeminal nerve (herpes zoster opthalmicus)

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7
Q

Dark colored moles, with an even texture, variegated colors and a regular borders with a diameter of 6 mm or larger.

A

Melanoma

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8
Q

Most common in African-Americans and Asians, dark brown to black lesions are located on the nailbeds subungual Palmer and planter surfaces and rarely the mucus membranes look like longitudinal brown black bands on the nailbeds.

A

Actual Lentiginous Melanoma

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9
Q

Most common type of skin cancer in the United States looks like a pearly or waxy skin lesion with an atrophic or ulcer rated center that does not heal. The lesion could be white light, pink, brown, or flash colored. It may bleed easily with mild trauma, more common and fair skin individuals with long-term daily sun exposure.

A

Basal cell carcinoma

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10
Q

Dry round, and red colored lesions with a rough texture that do not heal slow growing. Most common locations are some exposed areas such as the cheeks nose, face, neck, arms, and back, mostly found in fair skin older to elderly adults.

A

Actinic keratosis

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11
Q

Flat non-palpable lesion less than one centimeter in diameter

A

Macule
Example: freckles, lentigo or lentigines

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12
Q

Flat non-palpable lesion less than one centimeter in diameter

A

Macule
Example: freckles, lentigo or lentigines

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13
Q

Palpable solid lesion, less than or equal to 0.5 cm in diameter

A

Papule
Example: Navi (moles), acne, small cherry angiomas

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14
Q

Flattened elevated lesion with variable shape greater than one centimeter and diameter

A

Plaque
Psoriatic lesions

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15
Q

Elevated superficial blister filled with serious fluid and greater than 1 cm in size

A

Bulla
Impetigo, second-degree burn with blisters, Stephen Johnson syndrome lesions

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16
Q

Elevated superficial skin lesion less than 1 cm in diameter, filled with serous fluid

A

Vesicle
Herpetic lesions

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17
Q

Elevated superficial skin lesion, less than 1 cm and diameter, filled with purulent fluid

A

Pustule
Example: Acne

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18
Q

Thickening of the epidermis with exaggeration of normal skin lines due to chronic itching

A

Lichenification
Example: eczema

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19
Q

Flaking skin

A

Scale
Example: psoriasis

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20
Q

Dried expedite may be serous exudate

A

Crust
Example: impetigo

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21
Q

Honey colored crust, fragile bullae, priritic

A

Impetigo

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22
Q

Koplik’s spots are small white round spots on a red base on the buccal mucosa by the rear molars and appear two to three days before onset of symptoms

A

Measles

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23
Q

Very pruritic especially at night; serpiginous rash on interdigital webs, waist, axilla, penis

A

Scabies

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24
Q

Sandpaper rush would sore throat (strep throat).

A

Scarlet fever

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25
Q

Hypo pigmented round oval macular rashes most lesions on upper shoulders/back not pruritic.

A

Tinea versicolor

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26
Q

Christmas tree pattern rash(on cleavage lines); Herald patch, largest lesion appears initially

A

Pityriasis rosacea

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27
Q

Smooth papules 2 to 5 mm in size that are dome shaped with central umbilication with a white plug

A

Molluscum contagiosum

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28
Q

Red target like lesions that grow in size some central clearing early stage of Lyme disease

A

Erythema migrans

29
Q

Purple to dark, red, painful skin lesions all over her body, acute onset, high fever, headache, level of consciousness changes, rifampin prophylaxis for close contacts

A

Meningococcemia

30
Q

Red spot like rashes that first break out on the hand, palm wrist, and foot so ankle, acute onset, high fever, severe headache, myalgias

A

Rocky mountain spotted fever (Rickettsia Rickettsii from a tick bite)

31
Q

Hi area become swollen, tender, and red; blister appears within 24 Hours center of lesion may form a purple to black escar which becomes an ulcer when it is sloughed off

A

Brown recluse spider bite

32
Q

Soft or like fleshy growths in the trunk that are located mostly on the back. Skin lesions look like they are pasted on the skin. Lesions on the same person can range in color from light tan to black. They start to appear during middle age or later, and become more numerous as a patient gets older, they are painless.

A

Seborrheic Keratoses

33
Q

Raised and yellow colored soft plaques that are usually located under the brow or upper and or lower lids of the eyes on the nasal side.

A

Xanthelasma
If the patient is younger than 40 years of age rollout, hyperlipidemia

34
Q

Bilateral brown to tan colored stains, located on the upper cheeks malar area (cheeks, and nose) forehead, and chin, and some women who have been or are pregnant or on oral contraceptive pills (estrogen)

A

Melasma (mask of pregnancy)

35
Q

Loss of epidermal melanocytes. White patches of skin (hypopigmentation) With irregular shapes that gradually develop, coalesce, and spread overtime.

A

Vitiligo

36
Q

Benign, small and smooth round papules that are a bright cherry red color size ranges from 1 to 4 mm. They always Blanche with pressure and more common and middle-aged to older patients.

A

Cherry Angioma

37
Q

Soft fatty cystic , tumors that are usually painless and are located in the subcutaneous layer of the skin. Most located on the neck, trunk and arms. They are the most common type of benign soft tissue tumor. They are round or oval shape and measure 1 to 10 cm or more, feel smooth with a discreet edge.

A

Lipoma

38
Q

Round macules papules in colors ranging from light tan to dark brown. Distinct or slightly irregular borders, concentrated on the trunk and lower extremities.

A

Nevi (moles)

39
Q

Patient complains of pruritic erythematous plaques covered with fine silvery white skills along with pitted fingernails and toenails. These are distributed in the scalp, elbows, knees, sacrum, and intergluteal folds. Partially resolving plaques are pink colored with minimal scaling.

A

Psoriasis

40
Q

What is the gold standard for diagnosing actinic keratosis?

A

Referral to dermatologist for biopsy

41
Q

Patient complains of multiple hypopigmented round macules on the chest shoulders and/or back that appear after skin becomes tan from sun exposure

A

Tinea versicolor

42
Q

Acute skin infection of the deep dermis and underlying tissue usually caused by gram-positive bacteria. There are two forms purulent and non-purulent.

A

Cellulitis

43
Q

Person complains of acute onset of diffused pink to red colored skin that is poorly demarcated with advancing margins. The lesions feel warm to the touch and may become abscessed, or maybe fluctuate (pointing) or draining pus. Infection may spread to the lymph node chains, which appears like red streaks radiating from the infected area.

A

Cellulitis

44
Q

Reddish to purple colored lesion that increases rapidly in size may have bullae. Infected areas appear indurated with complaints of severe pain on affected side.

A

Necrotizing fasciitis (flesh eating bacteria)

45
Q

Infection of hair follicles may involve several follicles small 1 mm round lesions filled with pus with erythema.

A

Folliculitis

46
Q

An infected hair follicle that feels with pus abscess may have started out as folliculitis that worsened looks like a round red bump and his hot and tendered to the touch when it is fluctuate it can rupture and drain pure green color discharge.

A

Furuncles (Boils)

47
Q

Several boils that coalesce to form a large bowl or abscess. Sometimes they may form several heads. They’re usually treated with systemic antibiotics.

A

Carbuncles

48
Q

Sudden onset of one large, hot and indurated red skin lesion that has clear demarcated margins. Usually located on the lower legs, the shins or the cheeks. Accompanied by fever and chills.

A

Erysipelas

49
Q

Chronic and recurrent inflammatory disorder of the apocrine glands that results and painful nodules abscesses and pustules in locations such as the axilla, mammary area, perianal area, and groin.

A

Hidradenitis Suppurativa

50
Q

Patient complains of recurrent episodes of painful, large, dark, red nodules abscesses and pustules ruptured lesions, drain pure lint, green color discharge and pain resolves when the abscess drains and heels which takes 10 to 30 days. History of recurrent episodes on the same areas in the axle results and sinus tracks, keloids, and multiple scars.

A

Hidradenitis Suppurariva

51
Q

Acute onset of itchy, pink red lesions, which evolve into vesiculopustules that rupture after rupture, red weeping shallow ulcers appear when serious fluid dries up it looks like lesions covered with honey colored crust.

A

Impetigo

52
Q

College student who resides in a dormitory presents with sudden onset of sore throat, cough, fever, headache, stiff neck, photophobia, and changes in level consciousness. May also have an abrupt onset of petechial to hemorrhagic rashes in the axillae, flanks, wrist, and ankles. Hypotension and shock is common.

A

Meningococcemia (meningitis)

53
Q

An individual who lives in a recently visited the north eastern region of the United States, presents with an expanding red rash with central clearing that resembles a target, located on the beltline, axillary area, behind the knees, and groin area. The Bullseye rash appears 7 to 14 days after a deer tick bite. Thrash is hot to touch and has a rough texture. The lesion spontaneously resolves within a few weeks.

A

Early lyme disease

54
Q

Prodrome of fever, pharyngitis and malaise that is followed within 24 hours by the eruption of pruritic vesicular lesions in different stages of development over a period of four days. The rashes start on the head and face and quickly spread to the trunk and extremities. It takes one to two weeks for the crust to fall off and the skin to heal.

A

Chickenpox/Varicella

55
Q

Elderly or older adult reports acute onset of groups of papules and vesicles on a red base that rupture and become crusted. Crusted lesions follow a dermatomal pattern on one side of the body, pain which can be quite severe last 2 to 4 weeks.

A

Shingles

56
Q

Patient complaints of an acute onset of extremely painful, red bumps and small blisters on the side of the finger, the cuticle area, or on the terminal phalanx of one or more fingers may have recurrent outbreaks. This is a viral skin infection of the fingers called spy herpes simplex type one or two virus infection and results from direct contact with either a cold sore or genital herpes lesions.

A

Herpetic Whitlow

57
Q

Patient complains of acute onset of a painful and red swollen area around the nail on a finger that eventually becomes abscessed. The most common locations are index finger and thumb. Reports a history of picking a hangnail, biting off hangnail or trimming the cuticle during a manicure.

A

Paronychia

58
Q

Patient complains of oval lesions with fine skills that follow skin lines, cleavage lines of the trunk or a Christmas tree pattern. Salmon, pink color and white people may be pruritic.
Harold patch: this is the first legion to appear, and his largest size appears two weeks before full breakout. It is a single round oval shape in about 2 to 5 cm in diameter.

A

Pityriasis Rosacea

59
Q

Patient complains of pruritic rashes, located in the interdigital webs of the hands, axillae, breast, buttock folds, waist, scrotum, and penis. Itching that is worse at night time and interferes with sleep. Other family members may have the same symptoms.

A

Scabies

60
Q

School-age child with an asymptomatic Skelly patch that gradually enlarges. The hairs inside the patch break off easily by the roots looks like black dots, causing patchy alopecia.

A

Tinea Capitis (ringworm of the scalp)

61
Q

Light skin adult to older patient with Celtic background, Irish Scottish English complains of chronic and small acne like papules around the nose, mouth and chin. Taelangiectasias maybe present on the nasal area and sheets. Patient blushes easily usually is blonde or red haired and has light colored eyes. May have ocular symptoms such as red eyes dry eyes or chronic blepharitis.

A

Rosacea (acne rosacea)

62
Q

Dome shaped papules 2 to 5 mm diameter with central umbilical (white plug) caused by skin infection with the poxvirus. Spread by skin skin, direct contact and more common in children.

A

Molluscum contagiosum

63
Q

When is closed within 24 hours by suturing or applying tissue glue or butterfly strips so that the edges of the wound are well approximated. Causes the least amount of scarring what type of wound healing is this?

A

Primary healing (Primary closure)

64
Q

Wound is left open with formation of granulation tissue and scarring. Wound heals from the bottom of the wound up. Wound edges are not well proximated. Causes more scarring. What kind of wound healing is this?

A

Secondary intention

65
Q

Wounds with heavy contamination or poor vascularity (crash injuries ) Our best left open to heal by secondary intention (granulation ) and wound contraction. Then the wound edges are approximated and 3 to 4 days. This type of wound produces the most scar tissue. What kind of wound healing is this?

A

Tertiary intention (delayed primary closure)

66
Q

All of the following pharmacologic agents are indicated for the treatment of plaque psoriasis, except
A. Topical corticosteroids.
B. Vitamin D analogs
C. Ultraviolet light therapy.
D. Oral antibiotics.

A

Oral antibiotics

67
Q

A 70-year-old male presents to the clinic with a three day history of redness to the face, fever, and chills. Upon examination, the nurse practitioner notes, a large hot, indurated, and demarcated red skin lesion on his cheek. The patient states he has tenderness to the phase, but denies ocular pain, what diagnosis is most likely?
A. Rosacea.
B. Chagas disease.
C. Intertrigo.
D. Erysipelas

A

D. Erysipelas
This is a subtype of cellulitis involving the upper dermis and superficial lymphatics. It is distinguished by well demarcated borders, marked erythema, and warmth. It occurs commonly on the face.

68
Q

An 18-year-old female patient is being followed up for acne by the nurse practitioner. During the facial exam papules and pustules are noted mostly on the forehead and the chin areas. The patient has been using over-the-counter, topical anabiotic, gels, and medicated soap daily for six months without much improvement. The nurse practitioner will recommend:
A. Isotretinoin (Accutane)
B. Tetracycline (Sumycin)
C. Clindamycin topical solution (Cleocin T)
D. Minoxidil (Rogaine)

A

B. Tetracycline (Sumycin)
First line treatment for acne vulgaris includes over-the-counter medicated soap, and water with topical antibiotic gels. The next step in treatment would be the initiation of oral tetracycline.

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