Lecture 2: General Appearance and Skin Exam

Question 1

What is Unsteady Gait?

Answer 1

• Lack of coordination; abnormal posture during ambulation
• gait influenced by pain
• muscle/nervous system abnormalities

Question 2

What can cause Unsteady Gait?

Answer 2

• inflammatory joint disease, joint/bone infection, muscle/tendon disease, trauma, congenital disease, footwear

Question 3

What is Parkinsonian Gait?

Answer 3

• Trunk, head, neck forward and knee flexed
• wide base, small shuffling step
• tend to fall forward and increase speed (festination)

Question 4

What is the ABCDE of skin lesion screeing?

Answer 4

A - asymmetry (visually split in half and compare)
B - borders
C - color (important in determine metastatic potential)
D - diameter (concerned if > 6 cm)
E - evolution (change in morphology, size, symptoms)

Question 5

Hair Assessment (Hirsutism, Virilization, Alopecia)

Answer 5

Hirsutism - excessive hairiness, especially in women

Virilization - secondary male sex traits in females

• most common cause: polycystic ovarian syndrome
• excessive terminal hair growth

Alopecia - balding, loss of hair

Question 6

What is the most common area for basal/squamous cell carcinomas?

Answer 6

the face

Question 7

What is Palatal petechiae?

Answer 7

“Hand-Foot-Mouth” Disease

• caused by multiple enteroviruses

Question 8

What are common sites for psoriasis and atopic dermatitis?

Answer 8

psoriasis - elbows

atopic dermatitis - anticubital fossae

Question 9

What is a common site for dermatitis, scabies, and lichen planus?

Answer 9

flexor wrists

lichen planus - recurrent, pruritic, inflammatory eruption (small, discrete polygonal, flat-topped papules that may coalesce into rough scaly plaques

Question 10

What are the major things to look for during fingernail inspection?

Answer 10

1. onycholysis (distal nail plate detached from nail bed)
2. fungal growth
   - clubbing (> 180 degrees), vert/horizontal defects, color change, splinter hemorrhages

Question 11

What are the 6 F’s that contribute to increased abdominal girth?

Answer 11

Fluid, Flatus, Feces, Fetus, Fat, Fatal Tumor

Question 12

Where are over 40% of melanomas in women found?

Answer 12

on anterior/medial surfaces of legs

Question 13

What are signs of vascular disease in feet?

Answer 13

pallor and decreased temperature

Question 14

Common Practices for Draping (3)

Answer 14

1. respect patients privacy
2. expose only what is needed to be exposed
3. communicate what you are doing before you do it through explanation and patient consent

Question 15

What should lower legs be evaluated for?

Answer 15

edema, stasis dermatitis, ulcers

Question 16

What should the abdomen be evaluated for?

Answer 16

• examine body folds of obese patients for evidence of candida infection or intertrigo
• examine inguinal area for lymphadenopathy and fungal infection

Question 17

Where are 40% of melanomas in men located

Answer 17

upper central back