Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology > Petechiae, Purpura, and Vasculitis > Flashcards

Petechiae, Purpura, and Vasculitis Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

What is purpura?

A

red/purple lesions dur to extravasation of blood into skin/mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is diascopy?

A

use of glass slide to apply pressure to lesion to determine erythema:
- secondary to vasodilation (blanchable w/ pressure)
- erythrocyte extravasation (retains red color)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What may non-blanchable erythema indicate?

A

underlying issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some causes of purpura?

A
  • hyper/hypo-coaguable states
  • vascular dysfunction
  • extravascular issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 types of purpura and how are they differentiated?

A
  • petechiae = small lesions < 3mm = pin-point dots
  • ecchymoses = large lesions > 5mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 different morphologies of purpura?

A

palpable, macular/flat, retiform, non-retiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does palpable purpura indicate?

A

vascular inflammation (vasculitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does macular purpura indicate?

A

non-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is retiform purpura and what does it indicate?

A

angulated w/ sharp edges

arterial occlusion in disseminated intravascular coagulation (DIC) or arterial inflammation (medium vessel vasculitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is non-retiform purpura and what does it indicate?

A

indistinct non-angulated edges = blood leakage due to trauma, weakened connective tissue, hypo-coagulable state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Etiology of Scurvy

A

Vitamin C deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pathophysiology of Scurvy

A

Vitamin C reqauired for normal collagen structure = no Vit. C = skin and vessel fragility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical presentation of Scurvy

A
  • perifollicular purpura
  • large ecchymoses on lower legs
  • intramuscular and periosteal hemorrhage
  • keratotic plugging of hair follicles
  • hemorrhagic gingivitis (in those w/ poor oral hygiene)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnosis of Scurvy

A

History = indicative in dietary history

PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Solar Purpura?

A

senile purpura = common in geriatric population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pathophysiology of Solar Purpura

A

weakened collagen and connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Etiology of Solar Purpura

A

Chronic UV damage = degrades collagen and elastin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is purpura fulminans?

A

petechiae and large retiform ecchymotic patches on upper and lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can presence of petechial or purpuric lesions in a patient with meningitis indicate?

A

sepsis and DIC (disseminated intravascular coagulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Etiology of DIC (disseminated intravascular coagulation)

A

unregulated intravascular clotting due to depletion of clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What lab workup would a patient with DIC show in terms of PT/PTT

A

elevated clotting time bc platelet count is low (takes more time to clot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment for DIC?

A

treat underlying condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common tick-borne infection in the USA?

A

Rocky Mountain Spotted Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Etiology for Rocky Mountain Spotted Fever

A

Rickettsia rickettsii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical presentation for Rocky Mountain Spotted Fever

A

petechial rash after several day since onset of fever

starts as faint macules on wrists/ankes → becomes petechial on trunk, extremities, palms/soles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Diagnosis of Rocky Mountain Spotted Fever

A

Hx of hiking/traveling where these ticks are present; fever onset days before petechial rash

PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are important history items to include when clinically evaluating purpura

A
  • FMHx of bleeding/thrombotic disorders
  • use of drugs/meds affecting platelet function/coagulation
  • medical conditions that may result in altered coagulation
28
Q

Lab order to evaluate purpura

A

CBC with differential PT/PTT = assess platelet function/coagulation states

29
Q

What can cause petechiae?

A
  • impaired platelet function
  • DIC, infection
  • ↑ intravascular venous pressure
  • thrombocytopenia
  • inflammatory skin diseases
30
Q

What can cause ecchymoses?

A
  • external trauma
  • DIC, infection
  • coagulation defects
  • skin weakness/fragility
  • “pinch purpura” of systemic amyloidosis
31
Q

What causes palpable purpura?

A

inflammation of cutaneous vessels

32
Q

What causes vessel inflammation?

A

vessel wall damage + extravasation of erythrocytes

33
Q

What is vasculitis?

A

inflammation of small cutaneous vessels

can occur as a primary process or secondary to an underlying disease

34
Q

What is palpable purpura the hallmark lesion for?

A

leukocytoclastic vasculitis (small vessel vasculitis)

35
Q

What is the clinical morphology of vasculitis?

A

correlates w/ size of affected vessel

36
Q

What do small vessel vasculitis indicate?

A

palpable purpura

urticarial lesions = rare case

37
Q

What do small-medium vessels vasculitis indicate?

A

subcutaneous nodules, retiform (reticulated) purpura

ulceration/necrosis may be present

38
Q

What do large vessel vasculitis indicate?

A

claudication (lower leg cramps); ulceration; necrosis

39
Q

What is systemic vasculitis?

A

involving vessels in other organs

40
Q

What are lab test used to evaluate suspected vasculitis and how do they do that?

A
  • Urinalysis = detects renal involvement
  • ANA = (+) antinuclear Ab test detecting connective tissue disorder
  • ANCA = indicates ANCA-associated or drug-incuded vasculitis
  • Complement = low serum complement levels = urticarial vasculitis
  • ESR = systemic vasculitides and sedimentation rates
41
Q

What is Henoch-Schonlein Purpura (HSP)?

A

most common form of systemic vasculitis in kids

AKA: IgA vasculitis

42
Q

What is HSP (Henoch-Schonlein Purpura) characterized by?

A
  • palpable purpura (vasculitis)
  • arthritis
  • abd pain
  • potential kidney disease
43
Q

Epidemiology of HSP (Henoch- Schonlein Purpura)

A
  • childhood disease (3-15 yo)
  • peak at winter
44
Q

Diagnosis of HSP (Henoch-Schonlein Purpura).

A

Clinical presentation (Hx and PE)

+/- skin biopsy

45
Q

Skin biopsy result with HSP (Henoch-Schonlein Purpura)

A
  • IgA immune complexes deposit in vessel walls
  • leukocytoclastic vasculitis in postcapillary venules
46
Q

DDx for HSP (Henoch-Schonlein Purpura)?

A

strep infection

r/o w/ ASO or throat culture

47
Q

Prognosis of HSP (Henoch-Schonlein Purpura)

A
  • kids typically completely recover
  • can worsen into progressive renal disease (more common in adults)
48
Q

How can you determine systemic involvement with HSP (Henoch-Schonlein Purpura)?

A
  • renal = UA, BUN/Cr (creatine)
  • GI = stool guaiac
  • HSP may be secondary to an underlying malignancy
49
Q

Treatment for HSP (Henoch-Schonlein Purpura)

A

supportive; prednisone

50
Q

What historical information is always associated with leukocytoclastic vasculitis (LCV)?

A

IV medication/drug use

51
Q

Clinical presentation of Leukocytoclastic Vasculitis?

A
  • palpable purpura!!!
  • palpable hemorrhagic papules coalescing (form together) into plaques
  • bilateral presentation on lower extremities
52
Q

Diagnosis of Leukocytoclastic Vasculitis?

A

Clincial = Hx and PE

skin biopsy

53
Q

Treatment of leukocytoclastic vasculitis.

A

stop IV drug use; determine systemic involvement and treat that

54
Q

What is polyarteritis nodosa?

A
  • affects medium arteries
  • systemic disorder of necrotizing vasculitis
55
Q

What is polyarteritis nodosa (PAN) characterized by?

A

painful subQ nodules (can ulcerate)

may present w/ livedo reticularis

56
Q

Etiology of polyarteritis nodosa?

A

unknown; may affect any organ: skin, peripheral nerves, kidneys, joints, GI

57
Q

What viruses can be associated with polyarteritis nodosa?

A

HepB, HepC, HIV, Parvo-B19

58
Q

Clinical presentation of polyarteritis nodosa?

A
  • parasthesias
  • ↓ sensation and reflexes
  • fever
59
Q

Diagnosis of polyarteritis nodosa?

A

Clincial = Hx and PE

Skin biopsy = skin nodules w/ medium-size artery inflammation

renal involvement

60
Q

What is mononeuritis multiplex?

A

peripheral neuropathy of 2 or more nerves in PNS

**nerve next to affected artery can be damaged during inflammatory process **

tingling, numbness, pain and paralysis

61
Q

What is the 2 different types of polyarteritis nodosa diseases?

A

cutaneous and systemic

62
Q

What are the characteristics of cutaneous polyarteritis nodosa?

A
  • skin involvement +/- polyneuropathy
  • arthralgias, myalgias
  • fever
  • common w/ kids (s/p strep infection)
  • chronic but benign course
63
Q

What are the characteristics of systemic polyarteritis nodosa?

A
  • neuro involvement = mononeuritis multiplex, stroke
  • renal = HTN
  • may affect: joint, heart, GI, liver
  • orchitis in HepB patients
64
Q

Prognosis of polyarteritis nodosa?

A

chronic (mos-yrs) – exacerbation/remissions

65
Q

Treatment of polyarteritis nodosa?

A
  • wound care of ulcers
  • systemic corticosteroids (not systemic PAN)
  • systemic PAN = refer to consults; adjunctive therapy
  • treat underlying conditions (ie: HepB)
66
Q

What may petechia/purpura indicate in a septic patient?

A

DIC (disseminated intravascular coagulation) disease

Dermatology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions