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NUNP531 Applied Pathophysiology > MIDTERM- Derm > Flashcards

MIDTERM- Derm Flashcards

1
Q

Define macule

A

Flat, circumscribed, area that is change in color of skin (i.e., freckles, flat moles (nevi)

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2
Q

Define papule

A

Raised/ elevated firm, circumscribed area less than 1 cm in diameter (wart, elevated moles, lichen planus, insect bite)

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3
Q

Define patch

A

Flat, non palpable, irregular area that is change in skin color more than 1 cm in diameter (i.e., vitiligo, port wine, Mongolian spots)

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4
Q

Define plaque

A

Raised/ elevated, firm, rough lesion with flat top greater than 1 cm diameter (psoriasis, seborrheic and acitinic keratoses)

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5
Q

Define wheal

A

Elevated, irregular shaped area of cutaneous edema; solid, transient, variable diameter (insect bites, uticaria, allergic reaction)

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6
Q

Define nodule

A

Elevated, firm, circumscribed lesion; deeper in dermis than papule, 1-2 cm in diameter (i.e., lipoma, erythema nodosum)

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7
Q

Define tumour

A

Elevated, solid lesion. May be clearly demarcated. Deeper in dermis. More than 2 cm diameter (neoplasm, benign tumor, lipoma, hemangioma)

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8
Q

Define vesicle

A

Elevated, circumscribed, superficial; does not extend into dermis. Filled with serous fluid; less than 1 cm diameter (varicella, shingles, hsv)

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9
Q

Define bulla

A

Vesicles more than 1 cm in diameter (blister, pemphigus vulgaris)

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10
Q

Define pustule

A

Elevated, superficial, similar to vesicle but filled with purulent fluid (impetigo, acne)

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11
Q

Define cyst

A

Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous layer; filled with liquid or semisolid material (sebaceous cyst; cystic acne

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12
Q

Define telangiectasia

A

Fine (0.5-1mm) irregular red lines produced by capillary dilation; can be assoc with acne rosacea, venous HTN, sclerosis, or developmental abnormalities

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13
Q

Define crust

A

Dried exudate on surface (blood/ serum/ pus combo) i.e., scab

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14
Q

Define erosion

A

Loss of part of epidermis; superficial; depressed, moist, glistening, follows rupture of vesicle or bulla or chemical injury

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15
Q

Define ulcer

A

Deeper- loss of epidermis and dermis- concave, varies in size (pressure and stasis ulcer

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16
Q

Define comedone

A

Small, flesh colored white/ dark bumps that give skin a rough texture. Clogged hair follicle with keratin + oil. Typical of acne

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17
Q

Define milia

A

Tiny white bumps that are clogged eccrine sweat glands; keratin filled little cysts just under epidermis. Found in babies. In adults, usually around eyes, nose, groin. Harder texture than comedone.

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18
Q

Define scale

A

Heaped up, keratinized cells; flaky skin; irregular shape, thick or thin, dry or oily, variation in size (i.e., flaking of skin with seborrheic dermatitis; can follow medication reaction; dry skin)

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19
Q

Define lichenification

A

Roughened, thickened epidermis secondary to persistent rubbing, itching, or skin irritation. Often involves flexor surface of extremity. i.e., chronic dermatitis

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20
Q

Define keloid

A

Irregular shaped, elevated, progressively enlarging scar; grows beyond boundaries of wound, caused by excessive collagen formation during healing (i.e., keloid)

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21
Q

Define scar

A

Thin to thick fibrous tissue that replaces normal skin following injury/ laceration to dermis

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22
Q

Define excoriation

A

Loss of epidermis- linear, hollowed out, crusted area (i.e., abrasion, scabies)

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23
Q

Define fissure

A

Linear crack or break from epidermis to dermis. Moist or dy. i.e., athletes foot, anal fissure, dermatitis, cracks at corner of mouth

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24
Q

Define petechiae

A

Non blanchable punctuate foci of hemorrage (i.e., platelet abnoramlties, thrombocytopenia, vasculitis, infection (RMSV, meningococcemia)

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25
Q

Define prurpura

A

Larger area of hemorrage; may be palpable. Half mark of leukocystoclastic vasculitis. May indicate coagulopathy. Large areas of purpura can be called ecymosis (bruise)

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26
Q

Define burrow

A

Thread like linear or serpiginous (wavy/ serpent like) tunnel in epidermis. Typically caused by parasite (i.e., scabies)

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27
Q

Describe 7 skin functions

A

Protection, secretion, absorption, excretion, filtration, diffusion, sensory reception

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28
Q

What is a myocses

A

Disease caused by fungal infection

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29
Q

What is a dermatophyte

A

Fungi requiring keratin for growth, causing superficial infection of skin, hair, nails

ID with potassium hydroxide stain

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30
Q

How are bacteria classified

A

environment (aerobic vs anerobic), shape (cocci- round; bacilli- rod; spirrila- spiral), gram stain (positive- retains dye due to cell wall peptidoglycans- purple blue; negative- thin wall- pink or red)

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31
Q

What are 2 pathogens commonly causing skin infection

A

Staphyllococcal aureus (cellulitis, folliculitis, impetigo)
Streptococci (group A- impetigo; group B- cellulitis; pyogenes- impetigo)

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32
Q

What is a common virus causing skin infection

A

HPV (DS DNA) (condylmata accuminat, cold sores, verruca vulgaris)
Varicella (shingles)
Poxvirus (molluscum contagiosum)

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33
Q

What are common parasites causing skin infection

A

lice (pediculosis), scabies (mite), bed bugs

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34
Q

Name 3 skin conditions that can progress to cancer

A

Bowens disease (SCC in situ- epidermis only)
Keratocanthoma (often progresses to SCC)
Acitinic keratosis (early lesion of SCC and BCC- epidermal lesions of atypical keratinocytes at basal layer of skin)

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35
Q

Name 3 types of skin cancer and where they originate

A

SCC (basal layer of keratinocytes of epidermis)
BCC (dermis)
Melanoma (melanocytes)

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36
Q

Name 3 skin conditions with autoimmune causes

A

Possible answers include acnea rosacea, dermatitis, lichen planus, pemphigus, psoriasis, uticaria, vitiligo, alopecia (androgenica or areata)

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37
Q

What is pediculosis?

A

Lice

38
Q

S&S of pediculosis?

A

Pruritus, often see ova/ nits attached to hair shaft 1 inch from head. May be located in hair, eyelashes, pubic region. May see red macule, papule, or wheal with hemorragic puncture site

39
Q

Tx pediculosis?

A

Topical pediculicides (repeat in 1 week, as does not kill eggs)

40
Q

What are the distinguishing signs of lichen planus?

A

flat, shiny, pruritic purple papules and patches; wickmans striae (white reticulated lacy pattern)

41
Q

Who gets lichen planus?

A

30-60 year olds, rarely children. Risk factors- family history, thiazides, beta blockers, ACEis, sulfonylureas

42
Q

What is the time course for lichen planus

A

Lesions are self limiting and average duration is 6-18 months

43
Q

What is the cause of lichen planus

A

Acute, idiopathic skin eruption; thought to be benign autoimmune inflammatory disorder of skin. May involve T cell response to damaged keratinocytes

44
Q

Tx for lichen planus?

A

Corticosteroids, antihistamines, retinoids, derm referall if refractory or mucosal involvement

45
Q

What is steven johnsons syndrome

A

separation of basement membrane of skin; toxic epidermal necrolysis; skin peels off >10% of body

46
Q

What is Nikolosky’s sign

A

skin peels off in sheets (stick arm on thumb, drag, and skin peels off) (SJS)

47
Q

How does SJS progress

A

Abrupt red/ tender/ painful rash on trunk extends over hours to days onto face, limbs (rarely affecting scalp, palms, soles); max extent reaches by 4 days. Macules or purpuric spots and flaccid blisters.

48
Q

What does a typical shingles lesion look like

A

Localized to dermatome; red swollen plaques with vesicles that rupture then form crusts

49
Q

What virus causes shingles

A

Reactivated varicella zoster

50
Q

Name the distinguishing feature/ characteristic for: acne vulgaris

A

comedones

51
Q

Name the distinguishing feature/ characteristic for: allergic contact dermatitis

A

type 4 hypersensitivity, environmental allergen, intense itching, vesicles, distribution of exposure

52
Q

Name the distinguishing feature/ characteristic for: irritant dermatitis

A

erythematous scales

53
Q

Name the distinguishing feature/ characteristic for: atopic dermatitis (eczema)

A

dry skin and severe pruritus

54
Q

Name the distinguishing feature/ characteristic for: Bowens disease

A

red scaly patch on skin in sun exposed area

55
Q

Name the distinguishing feature/ characteristic for: Candidiasis

A

white scale

56
Q

Name the distinguishing feature/ characteristic for: Cellulitis

A

dermis and subcutaneous tissue, redness, warmth, pain; indistinct border

57
Q

Name the distinguishing feature/ characteristic for: condylmata accuminata

A

cauliflower warts on genitals

58
Q

Name the distinguishing feature/ characteristic for: dematophytes

A

papules, plaques with round edge, white scale. may be pruritic

59
Q

Name the distinguishing feature/ characteristic for: erythema multiform

A

many morphologies, iris center, appear suddenly in symmetric or crop pattern on palms, soles, forearm, legs.

60
Q

Name the distinguishing feature/ characteristic for: folliculitis

A

dome shaped pustules; inflammation of hair follicle

61
Q

Name the distinguishing feature/ characteristic for: furuncles

A

deep, red, painful, fluctuant, walled off collection of pus

62
Q

Name the distinguishing feature/ characteristic for: carbuncles

A

deep, red, painful, nodules that are interconnected aggregates of infected abscessed follicles

63
Q

Name the distinguishing feature/ characteristic for: HSV

A

papules then vesicles (on lips)

64
Q

Name the distinguishing feature/ characteristic for: herpes zoster

A

vesicles, dermatomes, crust

65
Q

Name the distinguishing feature/ characteristic for: impetigo

A

skin infection, bullous or non bullous, firmly adherent honey yellow crust, satellite lesions

66
Q

Name the distinguishing feature/ characteristic for: lichen planus

A

flat, shiny, purple, pruritic papule or plaque; wickmans striae (white lacy reticulated pattern)

67
Q

Name the distinguishing feature/ characteristic for: molluscum contagiosum

A

umbilicated

68
Q

Name the distinguishing feature/ characteristic for: onychomycosis

A

yellow/ white nail plate, elevated, brittle, thick

69
Q

Name the distinguishing feature/ characteristic for: pediculosis

A

eggs 1 cm from hair shaft, pinpoint macule or wheal, pruritus in hair

70
Q

Name the distinguishing feature/ characteristic for: pemphigus

A

bullae 1-3 cm rupture easily, IgG destruction of cell to cell adhesion in dermal layer

71
Q

Name the distinguishing feature/ characteristic for: pityriasis rosea

A

herald patch (salmon pink lesion 3-10 cm), secondary lesion (collarette/ pine tree)`

72
Q

Name the distinguishing feature/ characteristic for: pityriasis versicolor

A

colors vary spot to spot

73
Q

Name the distinguishing feature/ characteristic for: psoriasis

A

pruritic, well demarcated, erythematous plaques with silver scale

74
Q

Name the distinguishing feature/ characteristic for: scabies

A

burrows

75
Q

Name the distinguishing feature/ characteristic for: seborrheic dermatitis

A

red greasy scaling rash that is patches and plaques; stuck on

76
Q

Name the distinguishing feature/ characteristic for: seborrheic keratosis

A

stick on, smashed, keratin cysts or horns

77
Q

What are we suspicious of in the event of sudden appearance of many seborrheic keratoses?

A

internal malignancy

78
Q

Name the distinguishing feature/ characteristic for: uticaria

A

acute- type 1- histamine release
Edema, erythema, 2-3 cm

79
Q

Name the distinguishing feature/ characteristic for: verruca vulgairs

A

dome shape, hyperkeratotic, black dot (thrombosed capillaries)

80
Q

Name the distinguishing feature/ characteristic for: vitiligo

A

white macules coalesce into patches

81
Q

Name the distinguishing feature/ characteristic for: keratoacanthoma

A

dull red crateriform nodules, volcano like shape with central keratotic plug or depression

82
Q

Name the distinguishing feature/ characteristic for: SCC

A

pink, pearly white, smooth, teleangiectasia, raised border

83
Q

Name the distinguishing feature/ characteristic for: BCC

A

dull red, scale over central cavity, lower lip

84
Q

Name the distinguishing feature/ characteristic for: acitinic keratosis

A

sun exposed skin, rough feeling usually detected by pt

85
Q

Name the distinguishing feature/ characteristic for: melanoms

A

asymmetry, border, color, diameter, evolving
Small mole increases in size, changes in color, becomes ulcerated, bleeds easily. do not biopsy urgent derm referal

86
Q

Name the distinguishing feature/ characteristic for: alopecia androgenica

A

male pattern baldness (temples to top)

87
Q

Name the distinguishing feature/ characteristic for: alopecia areata

A

patchy hair loss 1-4 cm

88
Q

Name the distinguishing feature/ characteristic for: lyme

A

bulls eye red and white alternating rings

89
Q

Name the distinguishing feature/ characteristic for: rocky mountain spotted fever

A

petechial rash involving palms and soles, fever, malaise

90
Q

Name the distinguishing feature/ characteristic for: erythema nodosum

A

tender nodules look like bruises

91
Q

Name the distinguishing feature/ characteristic for: SJS/ TENs

A

nikolskys sign, separation of basement membrane

92
Q

You see a rash on your patients palms and recall the acronym MRS TECK that helps you think of causative conditions

A

Meningiococcal/ measles, RMSF, syphilis, tens, sjs, endocarditis, coxsackie, kawasacki

NUNP531 Applied Pathophysiology (24 decks)

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