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Dermatology > Intro To Derm > Flashcards

Intro To Derm Flashcards

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Dermatology Board Prep flashcards
1
Q

Average adult surface area

A

3000 in2

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2
Q

Varies in thickness from ___ to ___

A

.5 to 3 mm

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3
Q

Functions

A
  1. Protect against infection, desiccation, harmful light rays
  2. Maintain body temperature
  3. Receives stimuli from environment
  4. Stores chemical compounds
  5. Excretes waste products
  6. Synthesizes vit. D
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4
Q

Epidermis

A

4 layers (except 5 layers in soles and palms)

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5
Q

Deepest layers of the Epidermis

A

2 deepest layers- Stratum basale and Stratum spinosum

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6
Q

What forms during the process of degeneration?

A

Keratin (a waterproofing protein)

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7
Q

Outermost layer of the epidermis is?

A

Stratum corneum- 25-30 rows of flat dead cells that are filled with keratin and are shed and replaced continuously

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8
Q

Complete turnover of epidermis occurs?

A

28-30 days

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9
Q

Epidermal cells

A

Keratinocytes

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10
Q

Keratinocytes are bound by what?

A

intracellular junctions called desmosomes (vital for skin integrity)

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11
Q

Which two cells serve as protective functions in the epidermis?

A

Melanocytes and Langerhans cells

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12
Q

The dermis contains…

A

blood vessels, nerves, glands, and hair follicles

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13
Q

Upper layer of dermis

A

loose connective tissue

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14
Q

Deeper layer of dermis

A

netlike collagenous fibers that branch through subcutaneous tissue and attach to underlying bones and muscles

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15
Q

What are appendages of the skin?

A

Structures that develop from embryonic epidermis including hair, glands, and nails

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16
Q

Hair that’s soft and covers the body

A

vellus

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17
Q

Coarse hairs that develop at puberty, plus hairs of scalp and eyebrows

A

terminal hairs

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18
Q

External portion (outside the skin)

A

hair shaft

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19
Q

Internal portion (inside the skin)

A

hair root

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20
Q

Surrounding the root

A

Hair follicle (epidermis dipping down into the dermis to surround the root)

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21
Q

What are associated with the hair follicle?

A

Sebaceous glands, arrector pili muscles, and root hair plexuses *sometimes apocrine sweat gland

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22
Q

Color is a combination of what?

A

3 pigments (brown, black, theo melanin)

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23
Q

Graying?

A

Loss of pigment

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24
Q

Sebaceous glands

A

secrete sebum, at the hair follicle which protects the hair and skin from becoming too dry

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25
Q

Two types of sweat(sudoriferous) glands

A

Apocrine and Eccrine

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26
Q

Which glands begin at puberty?

A

Apocrine sweat glands located in axilla, pubic region, and breast areolae

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27
Q

Eccrine glands

A

Distributed throughout the skin

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28
Q

Parts of the nail

A

free edge, nail body, nail root, lunula (white area), cuticle (epidermis around the nail), nail bed (epidermis under the nail)

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29
Q

Skin color?

A

determined by melanin and carotene and by blood in the capillaries of the dermis

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30
Q

All races have…

A

same number of melanocytes but the amount of melanin produced varies

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31
Q

Increased melanin production is caused by

A

UV radiation increasing enzymatic activity

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32
Q

Carotene

A

pigment found in people of central and east Asian descent, adds yellowish hue to their skin

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33
Q

Epidermal ridges

A

genetically determined, unique for each individual, does not change throughout life except to enlarge, increase friction

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34
Q

Lines of cleavage/Langer’s lines/ skin tension lines

A

Collagenous fibers in dermis tend to run more in one direction, predominant direction is called Langer’s lines etc. (an incision made across the lines of cleavage ends to heal with broad, thick scar)

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35
Q

HPI

A

History of present illness

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36
Q

Dermatology HPI

A

taken before the physical exam is done, this is an exception. Doing the physical exam at the same time as taking the history can be more productive

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37
Q

Questions to ask when taking a Derm HPI

A
  1. Are your symptoms limited to the skin, or are you acutely ill (fever, cough) or chronically ill (fatigue, weight loss)
  2. When did the problem start?
  3. Where did the problem start?
  4. What symptoms are with it (Itch, hurt, bleed, ooze)
  5. How has it changed? (shape, color, spread)
  6. Does anything make it better or worse? (heat, cold, foods, excercise)
  7. What previous treatments have you tried?
38
Q

Two things to do when performing a general examination of the skin

A
  1. Inspection
  2. Palpation
    - consistency
    - tenderness
    - blanching/non-blanching
39
Q

What is evaluated with overall inspection/palpation of the skin

A

color, moisture, temperature, texture, mobility, and turgor

40
Q

Tools to use in an examination

A

magnifying glass and/or oblique lighting, alcohol pads, gloves, ruler, wood’s lamp (UV light)

41
Q

What do you need to have in your documentation?

A

1/ type of lesion

  1. shapes of individual lesions
  2. pattern and distribution of multiple lesions
  3. color
  4. consistency
  5. anatomic component/location
42
Q

Macule

A

any change in skin color that is not palpable (not raised or depressed)

43
Q

Patch

A

similar to macule, but often quite large, OR barely raised plaque

44
Q

Flat Lesions

A

macule, patch

45
Q

Papule

A

elevated, superficial, solid lesion, <0.5 cm

46
Q

Plaque

A

a plateau-like elevation, usually well defined

47
Q

Nodule

A

solid, larger and often starting at a deeper level than a papule

48
Q

Wheals

A

pink papules or plaques that change or disappear within hours

49
Q

Comedones

A

dilated and plugged hair follicles

50
Q

Horn

A

conical mass

51
Q

Scar

A

proliferation of fibrous tissue that replaces normal collagen after a wound that breaches the dermis

52
Q

Raised Lesions

A

papule, plaque, nodule, wheals, comedones, horn, scar

53
Q

Cyst

A

encapsulated cavity containing fluid or semisolid material

54
Q

Vesicle

A

clear fluid filled cavity, <0.5 cm, often thinned roofed

55
Q

Bulla (Blister)

A

clear fluid filled cavity, >0.5 cm. often thinned roofed

56
Q

Pustule

A

cavity is filled with purulent exudate

57
Q

Abscess

A

accumulation of purulent material deep in the dermis or subcutaneous tissue, often fluctuant

58
Q

Fluid filled lesions

A

cyst, vesicle, bulla (blister), pustule, abscess

59
Q

Erosion

A

loss of a portion of the epidermis, usually moist, won’t scar

60
Q

Ulcer

A

loss of epidermis and part of the dermis, heals with scarring

61
Q

Atrophy

A

diminution of epidermal cells resulting in thinning, glossy, transparent, and wrinkled appearance

62
Q

Poikiloderma

A

pigmentary changes often associated with atrophy

63
Q

Striae

A

linear depressions that occur from rapid stretching of the skin

64
Q

Sclerosis

A

a diffuse, slightly depressed, hardened area of skin

65
Q

Depressed lesions

A

erosion, ulcer, atrophy, poikiloderma, striae, sclerosis

66
Q

Scale

A

flakes of skin

67
Q

Crust

A

develop when serum, blood, or purulent exudate dries on the skin surface

68
Q

Excoriations

A

surface excavations that result from scratching

69
Q

Lichenification

A

thickening of the epidermis and some changes in the dermis may be due to continual rubbing of the skin

70
Q

Lesions with surface changes

A

scale, crust, excoriations, lichenification

71
Q

Purpura

A

reddish-purple lesion that is non-blanchable, indicating blood having left the vessels and moving through other tissues

72
Q

Petechiae

A

pinpoint purpura

73
Q

Ecchymosis

A

large purpura; bruise

74
Q

Telangiectasia

A

Persistent dilations of small capillaries. May or may not be blanchable

75
Q

Angioma

A

benign tumor with blood vessels; some types blanch others don’t

76
Q

Vascular lesions

A

purpura, petechiae, ecchymosis, telangiectasia, angioma

77
Q

Types of lesions

A
  1. Annular- ring shaped; the edge differs from the center
  2. Round-also called nummular or discoid; coined-shaped
  3. Arcuate-are shaped
  4. Linear- resembling a straight line
  5. Reticular- net like
  6. Targetoid- also called iris; has three distinct zones
78
Q

Patterns and Distributions of Lesions

A
  1. Grouped- clustered together
  2. Scattered- irregularly distributed
  3. Dermatomal- Lying in the distribution of a single spinal nerve root
  4. Sun exposed- also called photo distribution; occurs in areas usually not covered by clothing
  5. Sun protected- occurs in areas usually covered by clothing
  6. Acral- occurs on distal locations, such as hands and feet
  7. Truncal- occurs on central body
  8. Extensor- extensor surfaces of knees, elbows, and other joints
  9. Flexor- flexor surfaces of knees, elbows, and other joints
  10. Intertriginous- occurring in the skin folds
  11. Localized- confined to single location
  12. Generalized- widespread
79
Q

Gram Stain

A

bacterial infection; guides antibiotic selection, purple gram positive, pink gram negative
*does not substitute for a culture

80
Q

Tzanck smear

A

viral infections; placed on slide allowed to air dry and stained; GIANT multi-nucleated cells; does not indicate which virus
*does not replace a culture

81
Q

KOH prep

A

fungal infection; scraped from skin and placed on slide, potassium hydroxide is added; septated tube like= dermatophyte
spaghetti and meatballs= candidal infection

82
Q

Direct examination of pathogen

A

sample is scraped from skin and placed on slide with a drop of mineral oil
ex. scabies, mites

83
Q

Cultures

A

all types of pathogens; bacterial cultures can show a sensitivity to antibiotic, fungal cultures are slow and less reliable; different tubes

84
Q

Biopsy

A

punch, elliptical (wedge excision), saucerization (scoop), shave

85
Q

What is done if a definitive diagnosis is needed?

A

biopsy

86
Q

Used if the lesion is very large or very small

A

punch biopsy

87
Q

Which biopsy is used if you suspect melanoma?

A

elliptical excisional biopsies

88
Q

Which biopsy is used if basal or squamous cell carcinoma is suspected?

A

Saucerization biopsies

89
Q

Which biopsy is used for lesions limited to the epidermis?

A

Shave biopsies (not used if there is potential for metastasis)

90
Q

Patch test

A

testing what you are allergic to by touch

91
Q

Prick test

A

testing what you are allergic to that you don’t touch

92
Q

RAST test

A

same thing as prick test but uses blood serum; not as sensitive or reliable. Used if pt. does not have clear skin

Dermatology (5 decks)

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