MIDTERMS: Integumentary System

Question 1

What are common locations for accidental bruises?

Answer 1

Shin, lower arms, forehead, hips, elbows, and ankles.

Question 2

What are common locations for inflicted bruises?

Answer 2

Under chins, upper arms, upper anterior thighs, trunks, genitalia, buttocks, face, ears, and neck.

Question 3

What characteristics indicate bruises that are likely inflicted rather than accidental?

Answer 3

: Bruises in uncommon locations, bruising away from bony prominences, multiple bruises in clusters, and patterned injuries.

Question 3

What are signs of suspicious burns?

Answer 3

Burns that appear older than the history suggests, existence of other injuries, symmetrically distributed burns, and burns localized to the perineum.

Question 3

What are common signs and symptoms of skin conditions?

Answer 3

Pruritus, urticaria, rash, blisters, xerosis, unusual spots, moles, nodules, cysts, edema, and changes in nails and skin pigmentation.

Question 4

What are primary skin lesions classified by morphology?

Answer 4

Flat: Macule (<1 cm), Patch (>1 cm)
Fluid-filled: Vesicle (<1 cm), Bull (>1 cm)
Elevated: Plaque (>1 cm), Nodule (<1 cm), Papule (>1 cm)
Irregular elevated: Wheal
Pustule: Contains pus and varies in size
Cyst: Papule/nodule with fluid/viscous material
Vegetation: Elevated and irregular lesion
Scales: Thin plates of dried cornified epithelium
Lichenification: Dry plaque with skin furrows
Crusts: Dried serum, blood, pus, or sebum on a ruptured vesicular/pustular lesion

Question 4

What is dermatitis (eczema)?

Answer 4

Skin inflammation characterized by redness, itchiness, rash, and blisters, with types including contact/allergic, actinic, and atopic dermatitis.

Question 5

What are the stages of dermatitis?

Answer 5

Acute: Red, oozing, crusting rash with pruritic vesicles
Subacute: Erythematous skin, scaling, scattered plaques
Chronic: Thickened skin, increased skin markings, fibrotic papules, pigmentation changes

Question 5

What is stasis dermatitis?

Answer 5

A condition characterized by dry, thin skin and shallow ulcers in the lower legs due to venous insufficiency, often seen in individuals with a history of varicose veins or deep vein thrombosis.

Question 6

What is rosacea?

Answer 6

A chronic facial disorder in middle-aged and older people with fair skin, marked by erythema, telangiectasia, and potential inflammatory papules, often triggered by sun exposure and humidity.

Question 6

What are common bacterial skin conditions?

Answer 6

Impetigo and cellulitis.

Question 7

What is impetigo?

Answer 7

A bacterial infection commonly caused by staphylococci or streptococci, characterized by small macules that develop into vesicles and pustules, leading to thick yellow crusts.

Question 8

What are the key features of cellulitis?

Answer 8

Inflammation from bacterial infection with symptoms including hyperthermia, local abscess/ulcer, tenderness, chills, fever, malaise, warmth, edema, erythema, and pain.

Question 8

What are common viral skin conditions?

Answer 8

Warts and herpes simplex virus type 1 (HSV1).

Question 9

What is HSV1 and its common manifestations?

Answer 9

HSV1 causes cold sores or fever blisters, presenting as itching, soreness, and vesicular eruptions usually around the lips or skin near the mouth.

Question 10

What virus causes genital herpes?

Answer 10

HSV-2 (Herpes Simplex Virus Type 2)

Question 11

What are the common symptoms of herpes zoster (shingles)?

Answer 11

Rash, vesicles, severe pain, burning or shooting pain, tingling, fever, chills, malaise, and postherpetic neuralgia.

Question 11

How is syphilis primarily transmitted?

Answer 11

By direct contact with a syphilis sore during vaginal, anal, or oral sex.

Question 11

What are the two stages of syphilis?

Answer 11

Primary stage (chancre with lymphadenopathy) and Secondary stage (neurologic symptoms and rash).

Question 12

What is seborrheic keratosis?

Answer 12

A benign tumor characterized by proliferation of basal cells, appearing as yellowish to brown, greasy, velvety, warty lesions.

Question 13

What is actinic keratosis and its potential risk?

Answer 13

Flat, round, irregular lesions on sun-exposed areas that can lead to squamous cell carcinoma.

Question 14

Describe basal cell carcinoma.

Answer 14

A malignant tumor of the bottom layer of the epidermis, usually on sun-exposed areas, presenting as a translucent nodule with a depressed center.

Question 15

What are the characteristics of squamous cell carcinoma?

Answer 15

Red hard nodules on sun-exposed areas, may ulcerate or crust, and does not typically metastasize.

Question 16

What is clubbing and what conditions can cause it?

Answer 16

Clubbing is chronic oxygen deprivation, often seen in COPD, congenital heart defects, or can occur acutely with pulmonary abscesses or malignancy.

Question 17

What is koilonychia?

Answer 17

Also known as “spoon nails,” associated with iron deficiency anemia, chemical irritants, or local injury.

Question 18

When should a medical referral be considered for skin conditions?

Answer 18

For unusual spots or changes in lesions, skin rashes in individuals with no history, and changes in nail beds with associated symptoms.

Question 18

What are Beau’s lines?

Answer 18

: Transverse grooves or ridges on the nail plate due to interrupted nail production, associated with trauma, illness, or chemotherapy.

Question 18

What do Terry’s nails indicate?

Answer 18

Liver pathology, malnutrition, diabetes, hyperthyroidism, or idiopathic causes.

Question 19

What does nail pitting indicate?

Answer 19

Conditions such as psoriasis, chronic infections, or other skin diseases.

Question 19

A 55-year-old woman presents with a new, irregular brown spot on her arm that has been changing in size and color. She has a history of excessive sun exposure.
Q: What skin condition should be suspected?

Answer 19

Malignant Melanoma

Question 19

: A 28-year-old female presents with painful blisters and a rash that has developed on her lower back and left side. She reports experiencing severe burning pain in the affected area.
Q: What condition is most likely diagnosed in this patient?

Answer 19

Herpes Zoster (Shingles)

Question 19

What is malignant melanoma?

Answer 19

The most serious skin cancer formed from melanocytes, associated with high intensity of sunlight exposure, capable of metastasizing.

Question 19

A 75-year-old female comes in with numerous yellowish, raised lesions on her face and trunk. They have a greasy appearance and are asymptomatic.
Q: What is the likely diagnosis?

Answer 19

Seborrheic Keratosis

Question 19

: A 35-year-old male reports a painless sore on his genital area that has not healed for several weeks. On examination, a single ulcerated lesion with indurated edges is noted.
Q: What is the most likely diagnosis?

Answer 19

Primary Syphilis (Chancre)

Question 20

A 60-year-old man presents with a red, scaly patch on his face that has been growing over several months. The lesion is firm and has a slightly raised border.
Q: What condition might this patient have?

Answer 20

Squamous Cell Carcinoma

Question 21

A 50-year-old female presents with thickened nails and separation of the nail plate from the nail bed, following a history of fungal infections.
Q: What is this condition called?

Answer 21

Onycholysis

Question 22

A 45-year-old man presents with flat, round lesions on his scalp and hands that are covered with dry, scaly patches. He frequently works outdoors.
Q: What skin condition does this presentation suggest?

Answer 22

Actinic Keratosis

Question 23

A 30-year-old male has developed white spots on his nails after experiencing a significant illness. He also reports that some nails have transverse grooves.
Q: What might these findings indicate?

Answer 23

Beau’s Lines due to recent illness or trauma

Question 23

Which assessments are commonly performed during a skin examination?

Answer 23

Inspection, palpation, assessment of texture, color, temperature, and turgor of the skin.

Question 24

: A 60-year-old man presents with multiple lesions on his skin that are brownish and appear to be growing. He is HIV positive and has a history of skin lesions.
Q: What condition should be suspected?

Answer 24

Kaposi’s Sarcoma

Question 24

A 22-year-old female presents with spoon-shaped nails and fatigue. Laboratory tests show low iron levels.
Q: What is the likely underlying condition?

Answer 24

Koilonychia due to iron deficiency anemia

Question 25

When examining a wound, what characteristics should be documented?

Answer 25

Size, depth, shape, color, odor, drainage, and the presence of granulation tissue.

Question 26

What is the significance of assessing nail bed changes during an examination?

Answer 26

Nail changes can indicate systemic conditions such as anemia, infection, or nutritional deficiencies.