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FNP: Systems Review > Integumentary > Flashcards

Integumentary Flashcards

1
Q
  • An expanding red rash with central clearing that resembles a target.
  • Has a “Bulls-Eye” appearance that usually appears with 7 to 14 days after a deer tick bite (ranges from 3 to 30 days).
  • Accompanied by “flu-like” symptoms
  • Rash feels hot to touch with a rough texture
  • The rash/lesions spontaneously resolve in a few weeks.
  • This is more common in NorthEastern regions of the U.S
A
  • Erythema Migrans (Early Lime Disease)
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2
Q
  • Where are the common sites/locations of “Early Lime Disease/Erythema Migrans” ?
A
  • Belt Line/Waist
  • Axillary area
  • Behind the knees
  • Groin area
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3
Q
  • Numerous round, dry, red-colored lesions with a rough texture.
  • Most often found on elderly, fair-skinned adults, with light-colored eyes.
  • It is a PRECANCEROUS lesion of “squamous cell carcinoma.
  • Patients with early childhood history of severe sunburn are at higher risk for squamous cell carcinoma, basal cell carcinoma, and melanoma.
A
  • Actinic Keratosis
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4
Q
  • Common sites for Actinic Keratosis include:
A
  • Sun exposed areas such as:
  • Cheeks
  • Nose
  • Face
  • Neck
  • Arms
  • Back
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5
Q
  • This is most common type of melanoma in African Americans and Asians.
  • It is a subtype of melanoma
  • Dark brown to black lesions are located on the nailbeds (subungal), palmar, and plantar surfaces.
  • Subungal melanomas look like longitudinal brown to black bands on the nailbeds.
A
  • Acral Lentiginous Melanoma
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6
Q
  • This rash looks like small red spots (petechiae) and starts to erupt on both the hands and palms, feet and soles, rapidly progressing toward the trunk, until it become generalized.
  • The rashes appear on the 3rd day after the onset of a high fever (103 to 105 degree) accompanied by a severe headache and myalgia, conjunctival injection, nausea and vomiting, and arthralgia.
A
  • Rocky Mountain Spotted Fever
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7
Q
  • The highest incidence of Rocky Mountain Spotted Fever occur where?
A
  • Southeastern and South central areas

* During the spring and early summer seasons.

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8
Q
  • How is meningococcemia spread?
A
  • Aerosol droplet
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9
Q
  • Risk factors of Melanoma include:
A
  • Family history
  • Extensive/Intensive sunlight exposure
  • Blistering sunburn in childhood
  • Tanning beds
  • High Nevi/Nevus count or Atypical Nevi/Nevus
  • Fair skinned and Light Eyes
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10
Q

Which drugs are associated with Steven Johnson Syndrome?

A
  • Penicillin
  • Sulfas
  • Barbiturates
  • Phenytoin (Dilantin)
  • ** HIV patients have a 40-fold increased risk of SJS due to Bactrim, compared with the general population.***
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11
Q
  • A bacterial infections of the sebaceous glands of the axilla (or groin) by “Staphyllococcus Aerus” (which is gram-positive) that frequently becomes chronic.
  • It is marked by flare ups and resolutions.
  • Usually both axillae are involved.
  • The chronic infections usually leaves sinus tracks and scars.
A
  • Hidradenitis Suppurativa
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12
Q
  • Treatment for Hidradenitis Suppurativa includes:
A
  • Augmentin (Amoxicillin/Clavulanate) p.o BID x 10days, or…
  • Dicloxacillin p.o TID x 10 days.
  • Use antibacterial soap on axillae and groin areas.
  • Avoid underarm deodorant during acute phase
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13
Q
  • Acute superficial skin infection caused by gram-positive bacteria such as strep pyogenes or S. Aureus.
  • VERY CONTAGIOUS
  • Maculopapular lesions with yellow serous fluid and HONEY COLORED crusts
  • More common in children and teens
A
  • Impetigo/Pyoderma
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14
Q
  • Treatment for Impetigo includes:
A
  • Keflex (Cephalexin) QID or Dicloxacillin QID x 10 days

* PCN allergy: Macrolide (Azithromycin 250mg x 5 days), or clindamycin x 10 days.

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15
Q
  • 1st line pharmacological treatment for Rocky Mountain Spotted Fever is?
A
  • Doxycycline (a tetracycline)
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16
Q
  • Acute local bacterial infection of the proximal or lateral nail folds (cuticle) that resolves after abscess drainage.
  • Most common locations are index finger and thumb.
  • Usually reports a history of a hang nail.
A
  • Paronychia
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17
Q
  • The causative agents of Paronychia include:
A
  • Staph Aureus
  • Sreptococci
  • Pseudomonas
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18
Q
  • Oval lesions, with fine scales that follow skin lines (cleavage lines) of the trunk or a “Christmas Tree” pattern.
  • Salmon-pink color in Caucasians/Whites.
  • A “HERALDS PATCH” is the 1st lesion to appear and the largest in size. (it appears 2 weeks before full breakout).
  • It is self-limited and the cause is unknown.
A
  • Pityriasis Rosea
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19
Q
  • Tinea Pedis is known as
A
  • Athletes Foot
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20
Q
  • Ring-like pruritic rashes with collarette of fine scales that slowly enlarge with some central clearing.
A
  • Tinea Corporis (Ringworm of the body)
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21
Q
  • Peri-anal and groin area area pruritic red rashes with fine scales.
  • May be mistaken for candida infection (beefy, bright red rashes with satellite lesions)
A
  • Tinea Cruris (Jock Itch)
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22
Q
  • Inflammation and infection of the sebaceous glands.
  • Found mostly on the face, shoulders, chest, and back.
  • Highest incidence during puberty and adolescence.
  • Has multifactorial causes: High androgen levels, bacterial infections, and/or genetic influences.
A
  • Acne Vulgaris (Common Acne)
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23
Q
  • Mild Acne Vulgaris such as blackheads, small papules, and small pustules are treated with:
A
  • Topical Retin-A 0.25% (a topical isotretinoin)
  • Benzoyl peroxide with erythromycin
  • Clindamycin topical cream
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24
Q
  • Treatment for Moderate Acne Vulgaris includes:
A
  • Same as mild acne, but switch antibiotics to Tetracyclines.
  • Topical Retin-A (Retonic Acid 0.25%)
  • Benzamycin (Benzoyl peroxide with erythromycin)
  • Tetracycline
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25
Q
  • The most common type in America is “Black Dot”
  • African American children are at a higher risk.
  • Spread by close contact and/or fomites.
  • Scaly patch in the scalp that gradually enlarges.
A
  • Tinea Capitis (Ringworm of the Scalp)
26
Q
  • Koplik spots = small white round spots on a red base on the buccal mucosa by the rear molars.
  • These represent
27
Q
  • Very pruritic, especially at night.

* Serpenginous rash on interdigital webs, waist, axilla, and penis.

28
Q
  • Hypopigmented round to oval macular rashes.
  • Most lesions on upper shoulders/back.
  • Non-pruritic
A

Tinea versicolor

29
Q
  • Smooth papules that are dome-shaped with central umbilication, with a cheesy-white plug
A
  • Molluscum Contagiosum
30
Q
  • These are known as 2nd degree burns.
  • Red-colored skin with blisters/bullae (Painful)
  • Usually from hot water or oil scalds, or fire
A
  • Partial Thickness Burns
31
Q
  • Treatment for “Partial Thickness” or “2nd Degree” burns include:
A
  • Mild soap and water, or…
  • Normal saline to cleanse broken skin
  • NEVER HYDROGEN PEROXIDE OR FULL STRENGTH BETADINE*
32
Q
  • In the “Rule of Nines” body surface area, what is the percentage for the arms and head?
A
  • Each arm is 9%

* The head is 9%

33
Q
  • When the entire skin layer, subcutaneous area, and soft tissue fascia is destroyed.
  • Must rule out airway and breathing compromise 1st.
  • Also known as 3rd degree burns
A
  • Full Thickness Burns
34
Q
  • In the “Rule of Nines”, each leg, the anterior trunk, and the posterior trunk are considered
35
Q
  • Chronic inherited skin disorder marked by extremely pruritic rashes that are located on the hands, flexural folds, and neck.
  • Rashes are exacerbated by stress and environmental factors.
  • Associated with a history of asthma, allergic rhinitis, and multiple allergies
A
  • Atopic Dermatitis (ECZEMA)
36
Q
  • What is the GOLD standard lab for Varicella infections:
A
  • Viral Culture, polymerase chain reaction (PCR) for ZDV
37
Q
  • The preferred antibiotic for human, cat, or dog bites is:
A
  • Augmentin (Amoxicillin/Clavulanate) p.o x 10 days
38
Q
  • A skin infection, involving the “upper dermis and superficial lymphatics” that is usually caused by “Group A Strep.
  • Acute onset of one large “HOT & INDURATED” red skin lesion that has clear demarcated margins.
  • Usually located in lower legs or the cheeks.
  • Accompanied by fever and chills (systemic symptoms)
A
  • Erysipelas (A sub-type of cellulitis)
39
Q
  • A skin infection involving the “DEEP DERMIS” and underlying tissue.
  • Usually caused by a Gram-positive bacteria
  • Point of entry is usually through breaks in skin, by insect bites, abrasions, and surgical wounds.
  • Has 2 forms: Purulent and Non-purulent.
  • Patient may be barefoot
A
  • Acute Cellulitis
40
Q
  • Infected follicles that are filled with pus.

* Red-round bump that is hot and tender to touch.

A
  • Furnicles/Boils
41
Q
  • Pruritic erythematous plaques covered with fine silvery white scales, along with pitted fingernails and toenails.
  • Plaques are distributed in the scalp, elbows, knees, sacrum, and intergluteal folds.
42
Q
  • Nail becomes yellowed, thickened, and opaque with debris.
  • Nail may separate from nail-bed.
  • Great toe is the most common location.
  • Commonly a FUNGAL INFECTION
A
  • Onychomycosis
43
Q
  • Treatment for Onychomycosis is
A
  • Oral Fluconazole 150mg - 300mg weekly
  • Get baseline LFTs
  • Watch for hepatotoxicity and drug-drug interactions
44
Q
  • Inflammatory skin reaction due to contact with an irritating external substance.
  • Acute onset of one to multiple bright red pruritic lesions that evolve into bullous or vesicular lesions.
  • Lesions are easily ruptured, leaving moist, painful areas.
  • Lesions are UNILATERAL/ASYMMETRICAL in shape.
  • The shape of the lesion may follow a pattern
A
  • Contact Dermatitis
45
Q
  • Treatment for “ATOPIC DERMATITIS” includes:
A
  • Topical Steroids (1st line treatment)

* Hydrocortisone 1% to 2.5%

46
Q
  • Treatment for “CONTACT DERMATITIS” includes:
A
  • Removal from offending agent
  • Calamine lotion
  • Topical Steroids
47
Q
  • Treatment for MRSA Cellulitis includes:
A
  • Batrim DS daily x 10 days, or…
  • Doxycyline BID x 10 days
  • Follow up in 48 hours*
48
Q
  • Treatment for Non-MRSA Cellulitis includes:
A
  • Dicloxacillin Q.I.D x 10 days, or..
  • Cephalexin (Keflex) QID x 10 days
  • Cefadroxil (Duricef) QID x 10 days
  • **Follow up in 48 hours***
49
Q
  • Sudden onset of groups of small vesicles on a red base that become crusted.
  • Mainly found in Elderly patients
  • Crusted lesions follow a dermatomal pattern on one side of the body.
  • Can be very painful
  • CONTAGIOUS WITH THE ONSET OF RASHES UNTIL ALL LESIONS HAVE CRUSTED OVER.
A
  • Herpes Zoster (SHINGLES)
50
Q
  • Treatment for Herpes Zoster includes:
A
  • Antivirals (Acyclovir 5 per day, or Valacyclovir BID x 10 days)
  • Most effective when started within 48 to 72 hours of when rash appears.
51
Q
  • Treatment for Shingles related Post-Herpetic Neuralgia includes:
A
  • Tricyclic Antidepressant (Amitriptylline/Elavil)
  • Gabapentin/Neurontin
  • Pregablin/Lyrica
  • Capsaicin cream
52
Q
  • Viral skin infection of the fingers.
  • Caused by HERPES SIMPLEX VIRUS (1 or 2)
  • It is from direct contact with either a cold sore or genital herpes lesion.
  • Acute onset of extremely painful red bumps and small blisters on sides of fingers or cuticles or terminal phalanx
A
  • Herpetic Whitlow
53
Q
  • Treatment for Herpetic Whitlow includes:
A
  • Self Limiting (Analgesics and NSAIDs)
54
Q
  • Chronic skin inflammatory disorder that has relapsing.
  • Commonly seen in Irish, Scottish, or English decent people.
  • Chronic small acne like papules and pustules around the nose, mouth, and chin.
  • THERE IS NO CURE
A
  • Rosacea (Acne Rosacea)
55
Q
  • Treatment for Rosacea includes:
A
  • Metronidazole Gel
56
Q
  • What precautions should females use when using Isotretinoin (Accutane)
A
  • Use 2 forms of birth control
57
Q
  • What is the preferred treatment for Psoriasis?
A
  • Topical Steroids
  • Topical Retinoids (Tazorotene)
  • Tar preparations
58
Q
  • Flattened elevated lesions with variable shape that is >1cm in diameter.
  • An example is Psoriatic lesions
59
Q
  • Elevated superficial blister filled with serous fluid and > 1cm in size.
  • An example is Impetigo, 2nd degree burns with blisters, and Steven Johnson Syndrome
60
Q
  • Pinpoint areas of bleeding remain in the skin when a plaque is removed.
  • Associated with Psoriasis
A
  • Auspitz Sign

FNP: Systems Review (10 decks)

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