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Medical Conditions II > Integumentary System > Flashcards

Integumentary System Flashcards

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USMLE® Step 1 flashcards
1
Q

Macule

A
  • flat, circumscribed area that is a change in the color of skin
  • less than 1 cm diameter
  • -ex. freckles, mole, measles
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2
Q

Patch

A
  • flat, nonpalpable irregular-shaped macule
  • larger than 1 cm diameter
  • -ex. port-wine stains, cafe au lait spots
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3
Q

Papule

A
  • elevated, firm circumscribed area
  • less than 1 cm

-ex. wart, elevated mole

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4
Q

PLaque

A
  • elevated, firm rough lesion with flat top

- greater than 1 cm

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5
Q

Wheal

A
  • elevated, irregular-shaped area of cutaneous edema
  • solid transient,
  • variable diameter

ex. insect bites, allergic reactions

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6
Q

Nodule

A

elevated, firm circumscribed lesion

  • deeper in dermis thatn papule
  • 1-2 cm

-ex. lipoma

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7
Q

vesicle

A

elevated, circumscribed superficial (not into dermis)

  • filled with serous fluid
  • less than 1 cm

-ex. chicken pox

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8
Q

Bulla

A
  • vesicle greater than 1 cm in diameter

- ex. blister

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9
Q

Erosion

A
  • loss of part of epidermis
  • depressed, moist, glistening
  • can follow rupture of vesicle or bulla
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10
Q

Pustule

A
  • elevated superficial lesion
  • similar to vesicle
  • filled with purulent fluid

-ex. acne

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11
Q

Cyst

A
  • elevated, circumscribed, encapsulated lesion
  • in dermis or subQ
  • filled with liquid or semisolid material

ex. sebaceous cyst

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12
Q

Scale

A
  • heaped up, karatinized cells
  • flaky skin, irregular
  • thick/thin, dry/oily, variation in size

-(ex. eczema)

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13
Q

Lichenification

A
  • rough, thickened epidermis
  • secondary to persistent rubbing, itching or skin irritation
  • involves flexor surface of extremity

-Ex. chronic dermatitis

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14
Q

Plaque

A

patch of raised cells (scale)

  • usually silvery in appearance
  • ex. psoriasis
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15
Q

Telangiectasia

A

Fine, irregular red lines produced by capillary dilation

-ex. rosacea, spider veins

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16
Q

Excoriation

A
  • loss of epidermis
  • linear, hollowed-out
  • crusted area

-ex. abrasion/scratch

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17
Q

Fissure

A
  • linear crack/break from epidermis to dermis
  • moist or dry
  • ex. athlete’s foot
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18
Q

Scar

A

-thin/thick fibrous tissue that replaces normal skin following injury or laceration to dermis

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19
Q

Keloid

A
  • irregular-shaped, elevated, progressively enlarging scar
  • grows beyond boundries of wound
  • cause by excessive collagen formation
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20
Q

Tumor

A
  • elevated, solid lesion
  • may be clearly demarcated
  • deeper in dermis
  • greater than 2 cm
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21
Q

Types of Skin Cancer

A

-basal cell carcinoma (doesn’t go deeper or metastasize, spread wider)
-squamous cell carcinoma (spreads deeper)
-malignant melanoma (spreads)
kaposi sarcoma

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22
Q

Prognosis of melanoma based on:

A
  • depth of lesion

- >0.76 mm=prognosis is worse

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23
Q

Benign Characteristics

A
  • <6 mm
  • uniform color
  • distinct borders
  • symmetric
  • seldom bleed/ulcerate
  • soft to firm consistency
  • slow rate of growth/change
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24
Q

Malignant Characteristics

A
  • > 6mm
  • multiple shades, varied pigmentation
  • irregular, blurred borders
  • asymmetric
  • often bleed/ulcerate
  • firm to hard consistency
  • slow/rapid growth or change
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25
Q

Basal Cell Carcinoma

A
  • contained in epidermis
  • does not invade blood or lymph vessels
  • grows out not deeper
  • face, head, ears, neck, back of hands
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26
Q

Squamous Cell Carcinoma

A
  • precursed by actinic keratosis
  • can present as flat red area, indurated plaque/nodule
  • can metastasize
  • face, head, ears, neck, back of hands
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27
Q

ABCDE

A
  • Asymmetrical
  • Borders irregularly, poorly circumscribed
  • Color variation, black/blue/multiple
  • Diameter >6mm
  • Evolving/Elevation, changing
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28
Q

Risk Factors skin cancer (HARMM)

A
  • History of skin cancer
  • Age >50
  • Regular dermatologist absent
  • Mole changing
  • Male gender
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29
Q

Pruritis

A
  • itching
  • local/general
  • primary skin condition or systemic condition
30
Q

Mechanisms of Pruritis

5

A 
1-histamine release
2-wheal formation
3-activation of nerve fibers
4-activation of lymphocytes
5-pain
31
Q

Management

A
  • antihistamines
  • tranquilizers
  • skin emollients
  • increasing environmental humidity
  • topical steroids
32
Q

Eczema/dermatitis

A
  • inflammatory disorder of skin caused by endog/exogenous agents
  • erythema, vesicles, scales and pruritis
33
Q

Atopic Dermatitis

A
  • most common eczma
  • chronic skin disorder with scaly itching rashes
  • have family history of allergic conditions like asthma/hay fever
34
Q

Eczema Most common in:

A
  • infants

- usually clear by age 36

35
Q

Sx of Atopic Dermatitis

A
  • skin redness, inflammation around blisters
  • rash
  • kids under 2: cheeks, elbows, knees
  • more/less pigment than other skin
  • inner elbows, behind knees common
  • spread to neck, hands, feet, eyelids, behind knees
  • raw areas, ear discharge, bleeding
36
Q

Atopic Dermatitis Intervention

A

-avoid agg factors
-topical anti inflammatory meds
-lubrication
-antibiotics for infections
-cold compress for acute irritation
-wet dressings
-

37
Q

Eczema Prognosis/Complications

A
  • chronic, avoid irritants
  • not contagious
  • 2* bacterial infections of skin
  • permanent scar formation
38
Q

Papulosquamous disorders

A
  • characterized papules, scales, plaques, erythema
  • psoriasis, acne vulgaris, systemic lupus erythematosis
  • pityriasis rosea, lichen planus, acne rosacea, lupus erythematosus
39
Q

Psoriasis

A
  • chronic, relapsing, proliferative skin disorder of unknown cause
  • agg by mechanical injury, chemical injury, virus infections, prescription drug use, psych stress, drinking, smoking, pregnancy, emotional stress
  • flare-ups in winter with lack of sunlight
40
Q

Psoriasis Pathophys

A
  • skin turnover decreased from 26-30 days to 3-4 days
  • increased T cell lymphocytes
  • may be autoimmune disorder
41
Q

Psoriasis Common on:

A

-scalp, chest, nails, elbows, knees, groin, skin folds, lower back, buttocks

42
Q

Psoriasis Msk Complaints

A
  • itching

- may develop into psoriatic arthritis

43
Q

Psoriatic Arthritis Locations

A

-fingers, toes, SIJ

44
Q

Post-Rest Gel

A
  • stiffness in mornings
  • time it takes to feel good in morning
  • RA 2-3 hours
  • Psoriatic Arthritis 30 min-2 hours
45
Q

Psoriasis Treatment

A
  • topical preps
  • UV light (sunlight)
  • Anti-metabolic meds (slow cell proliferation)
  • immunosuppressants
  • most are progressive
46
Q

Lupus Erythematosus Hallmark Sign

A

butterfly rash

malar rash

47
Q

SSc

A
  • Systemic Sclerosis

- chronic disease that results in differing degrees of skin thickening

48
Q

Polymyositis/Dermatomyositis

A
  • inflammatory myopathy from autoimmune reaction causing muscle breakdown
  • inflam and deterioration of muscle & skin
49
Q

DM/PM

A

Dermatomyositis/Polymyositis

50
Q

DM/PM S/Sx

A
  • joint swelling
  • raynaud’s phenomenon
  • abnormal cardiopulm exam
  • weakness in Mm
  • skin reddening
  • heliotrope rash
  • high CPK levels
  • gottron’s sign
51
Q

Heliotrope rash

A

-red discoloration of eyelids in dermatomyositis, usually associated with periorbital edema

52
Q

Elevated CPK due to

A
  • muscle break down

- can cause kidney failure

53
Q

DM/PM Diagnostic tests

A
  • CPK levels
  • electromyogram
  • myscle biopsy
  • positive ANA titer
54
Q

Gottron’s Sign

A
  • pink patches/papules on knuckles

- in dermatomyositis

55
Q

DM/PM Management

A
  • immunosuppressants
  • immunolomodulating agents
  • bed rest
  • positioning
  • diet
  • prevent contractures
  • avoid sun
56
Q

Calcinosis

A
  • deposition of calcium deposits in soft tissue
  • in DM/PM
  • Treatment: surgery, calcium channel blockers
57
Q

Vesiculobullous Disorders

A

characterized by blister or vesicle formation

-(pemphigus, erythema multiform, infections)

58
Q

Pemphigus

A

-Autoimmune blistering disease

59
Q

erythema multiform

A

-reaction to drugs or microorganism leading to inflammation of skin and mucous membranes

60
Q

Infections causing Vesiculobullous Disorders

A
  • folliculitis
  • cellulitis
  • impetigo
61
Q

Folliculitis

A

-bacterial infection of hair follicle

62
Q

Cellulitis

A
  • infection of dermis and subq tissue
  • usually bacterial
  • thin water exudate spreads thru interstitial spaces
  • treat with antibiotics
63
Q

Impetigo

A
  • superficial lesion caused by staphylococcus or streptococcus
  • most common bacterial skin infection in infants and young children
  • erythematous vesicles, straw colored fluid, honey crust
64
Q

Viral Infections

A

-herpes simplex

65
Q

Wart

A
  • benign lesion by virus
  • named by location and appearance
  • TYPES: plantar warts, flat warts, filiform, digital warts, mosaic, genital
66
Q

Wart: S/Sx

A
  • small, hard, flat, raised skin lesion/bump

- lighter/darker than other skin

67
Q

wart treatment

A
  • go away spontaneously w/n 2 years

- freeze/cut off

68
Q

Fungal infections

A
  • tinea (based on location)

- candidiasis (yeast like infection

69
Q

Tinea Corporis

A
  • ring worm

- transmission thru contact

70
Q

Tinea Pedis

A
  • athlete’s foot
  • erythema, skin peeling, pruritis
  • strong odor
  • point of entry for bacterai
71
Q

Signs and Symptoms of Skin Disorders

A
  • pruritis
  • urticaria
  • rash
  • blisters
  • xeroderma (dry skin)
  • unusual spots, moles, nodules, cysts
  • edema/swelling
  • change in appearance of nails
  • changes in pigmentation, turgor, texture
72
Q

Skin with aging

A
  1. vascular changes (thermoregulation/wound healing)
  2. loss of collagen (skin integrity)
  3. decreased wound healing

Medical Conditions II (34 decks)

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