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NURS 2501 > Integumentary immune disorders > Flashcards

Integumentary immune disorders Flashcards

1
Q

Erythematous papules and plaques covered with silvery scales - chronic - remissions and exacerbation are common

A

Psoriasis

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2
Q

Coal Tar Agents - Estar , PsoriGel

A

topical; for mild - moderate psoriasis; suppresses DNA synthesis, decreasing mitonic activity ; may stain clothing, skin and hair

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3
Q

Estar, PsoriGel - SE

A
  1. skin irritation - burning
  2. photosensitivity
  3. staining effect
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4
Q

Anthrolin (AnthraDerm, Lasan)

A

for moderate psoriasis; inhibits DNA synthesis thus suppressing proliferation of the epidermal cells. may stain clothing, hair and skin.

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5
Q

Anthrolin - SE

A
  1. erythema (redness) to normal skin; burn - cover medicated lesions ; wash off with mineral oil after 2 hrs
  2. inflamed eyes
  3. staining effect
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6
Q

Tazarotene (Tazaac, Avage) - vitamin A derivative

A

for mild-moderate psoriasis; reduces epidermal inflammation ; photosensitivity can occur ; X pregnancy - 2 forms of contraception used during treatment

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7
Q

Calcipotriene (Dovonexsynthetic Vitamin D)

A

for mild to moderate plaque psoriasis; burning, stinging and erythema may occur ; excess use may increase Ca levels

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8
Q
  1. Coal Tar Agents
  2. Anthrolin
  3. Tazarotene
  4. Calcipotriene
A

Topical agents - psoriasis

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9
Q

Retinoid; severe psoriasis; inhibits keratin formation and skin inflammation; pregnancy X ( pregnancy delayed up to 3 years after tx); avoid alcohol - convert med to toxic metabolite ; take with food ; derivative of vitamin A

A

Acitretin (Soriatane)

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10
Q

Folate Analog Metabolic Inhibitor; Inhibits rapid cell proliferation; block folic acid metabolism which interferes with DNA synthesis; can cause hepatotoxic and nephrotoxic problems - regular evaluation ; causes immunosuppresion - risk for lymphoma - evaluate WBCs

A

Methotrexate (Folate) - psoriasis, psoriatic arthritis, lupus , scleroderma

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11
Q

Calcineurin Inhibitor Immunosuppressant; suppresses immune response; used when other meds produced poor outcome ; causes general immune suppression; tablets or liquid (dilute); no grapefruit juice; SE: hypertension, nephrotoxicity

A

Cyclosporin A (Neoral, Sandiimmune)

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12
Q

Antimetabolite; off label use; antineoplastic ; causes myelosupression - especially neutropenia; nausea, vomiting, diarrhea, stomatitis ; wash hands and wear gloves when handling

A

Hydroxyurea (Hydrea)

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13
Q

Tumor Necrosis Factor Blocker; reduces levels of cytokines that cause joint destruction and inflammation; used to treat psoriatic arthritis - administered subcut - site irritation, headache and infection

A

Etanercept (Enbrel)

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14
Q

ingestion of Psoralen (photosensitizing drug) 2 hours before exposure UVA light; 2-3 hours per week; exposure gradually increased until tanning occurs; dark glasses during treatment and for the rest of the day following treatment; SE: cataracts, premature aging of the skin , skin cancer

A

PUVA - Psoralen and Ultraviolet A therapy

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15
Q

used when condition becomes more widespread; potency and distance constant; exposure time gradually increased; monitor for burning and tenderness; can be used in combination with topical treatment; SE: premature aging of the skin, skin cancer, actinic keratosis

A

Ultraviolet Light B (UVB) therapy

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16
Q

Abnormal, aggressive growth of epidermal cells - reach skin surface in 4-5 days vs usual 28-30 days; autoimmune reaction? - overstimulation of immune system - overproduction of skin cells & plaque formation

A

Psoriasis - pathophysiology

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17
Q

skin condition in which small, red, and scaly teardrop-shaped spots appear on the arms, legs, and middle of the body

A

Psoriasis - guttate

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18
Q

red, skin patches covered by silvery, white scales ; MOST COMMON

A

Psoriasis vulgaris

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19
Q

Pustular plaques, may be accompanied by fever & leukocytosis; MOST SEVERE FORM

A

Pustular psoriasis

20
Q

Generalized erythema & scales - increases blood flow to skin - vasodilation can lead to dehydration from evaporation & fluid loss

A

Exfoliative psoriasis

21
Q

Psoriasis - tx goals

A

Decrease inflammation & removal of scales

22
Q

Teratogen

A

is a drug or other substance capable of interfering with the development of an embryo fetus that may lead to birth defects or developmental malformations.

23
Q 
Methotrexate - Folate 
Hydroxyurea - Hydrea
Cyclosporin A - Neoral
Acitretin - Soriatane 
Etanercept - Enbrel
A

Systemic and biological agents - psoriasis - suppress immune system slowing epidermal cellular division

24
Q

PUVA - teach !!!

A

Observe for generalized redness with edema and tenderness - if present treatment must be interrupted until they subside ; wear dark glasses during treatment and for the remainder of the day

25
Q

Steroids - Prednisone - SE

A
  1. Infection
  2. Cushing’s Syndrome
  3. Diabetes
  4. Osteoporosis
26
Q

premalignant (can progress to squamous); small papule or macule; can disappear without treatment or reappear after treatment ; common in elderly or sun-damaged skin.

A

Actinic Keratosis

27
Q

cancer of the epidermis; invades and can metastasize - firm nodular lesion topped with crust

A

Squamous cell carcinoma

28
Q

cells of inner dermal layer; mets are rare; MOST COMMON type of skin cancer - pearly papule with central crater and rolled waxy borders

A

Basal cell carcinoma

29
Q

life-threatening; easy metastasis; MOST LETHAL type of skin cancer - irregularly shaped, pigmented papule or plaque

A

Melanoma

30
Q

Skin cancer - ABCD

A

Asymmetry of shape
Border irregularity
Color variation within one lesion
Diameter greater than 6 mm (pencil eraser)

31
Q

Lupus erythematosus - types

A
  1. DLE - discoid lupus erythematosus -affects only skin

2. SLE - systemic lupus erythematosus

32
Q

SLE + Scleroderma

A

chronic inflammatory autoimmune disorder of connective tissue

33
Q

SLE - S/s

A
  1. Butterfly rash - dry, scaly, raised - face
  2. Oral and nasal lesions
  3. Arthritic changes
  4. Pericarditis
  5. Pleural effusion
  6. Renal chronic disease - lupus nephritis leading cause of death
  7. Fever + fatigue
34
Q

Scleroderma - S/s

A
  1. Raynaud’s phenomenon
  2. Skin thick + hard
  3. Smooth + shiny
  4. Loss of elasticity/ movement
  5. CREST syndrome ‘
  6. GI/Renal
35
Q

CREST syndrome

A
  • Scleroderma
  • Calcinosis - calcium deposits in the tissue
  • Raynaud’s phenomenon - spasm of blood vessels in response to cold or stress
  • Esophageal dysmotility - acid reflux and decrease in mobility of esophagus
  • Sclerodactyly - thickening and tightening of skin on hands and fingers
  • Telangiectasia - capillary dilation that causes spider-like hemangiomas
36
Q

SLE - pathophysiology

A

autoimmune process - antinuclear antibodies primarily affect the DNA within the cell nuclei - immune complexes form in the serum and organ tissue - inflammation + damage - invade organs directly or cause vasculitis (deprives organs of arterial blood and oxygen).

37
Q

Scleroderma/ systemic sclerosis

A

lymphokines stimulate procollagen - insoluble collagen deposits - inflammatory response - edema - fibrotic changes of skin and eventually organs

38
Q

SLE and Scleroderma - DX

A
  1. Skin biopsy
    • ANA - antinuclear antibody
  3. Pancytopenia
  4. Inflammatory markers - CRP + ESR
    * No definitive dx
39
Q

Target organs for lupus

A
  1. Skin
  2. Joints
  3. Kidneys
  4. Heart + vessels (vasculitis)
  5. Lungs
  6. CNS
40
Q

Hydroxychloroquine (Plaquenil )

A

antimalarial agent; eye exams needed Q 6 mo (toxic to retina) ; Tx - SLE

41
Q

SLE - Tx

A
  1. NSAIDS
  2. Skin - topical steroids
  3. IV steroids for flare ups + p.o. for maintenance
  4. Antimalarial
  5. Immunosuppresive + cytotoxic meds - methotrexate + cytoxin
  6. Plasmapheresis
42
Q

Lupus - helpful organizations

A

Arthritis foundation

as progresses - Kidney foundation

43
Q

Lupus - sign of flare-up

A

Fever

44
Q

Penicillamine (Cuprimine)

A

Antirheumatic Agent; decrease pain + join swelling

45
Q

Minocycline (Minocin)

A

Anti-infective ; thought to decrease collagen thickening

NURS 2501 (11 decks)

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