PHAM EXAM 10 Flashcards
1
Q
3 layers of skin
A
epidermis
dermis
subQ
2
Q
outermost layer; 5% thickness
five layers
A
epidermis
3
Q
outermost strongest layer of epidermis
large amt of keratin
forms barrier that repels bacteria and foreign matter
thickest in high-stress areas–soles an palms
A
stratum corneum
4
Q
deepest layer of epidermis
supplies new cells to epidermis
A
stratum basale
5
Q
middle layers of epidermis
A
stratum spinosum, granulosum, lucidum
6
Q
secretes the dark pigment melanin
helps protect the skin from UV rays
A
melanocytes
7
Q
second layer; 95% thickness
foundation for hair and nails
nerve endings, oil glands, sweat glands, blood vessels here
A
dermis
8
Q
third layer; composed of adipose tissue
cushions, insulates, provides source of energy
is not considered when measuring skin layers
A
SUBQ
9
Q
Supplied by stratum basale
Deepest epidermal layer
Old cells damaged or lost by normal wear
A
skin cells
10
Q
Takes ? weeks for new cell to reach skin surface
A
3
11
Q
Pigment determined by amount of
A
melanin
12
Q
Protects skin from ultraviolet in sunlight
A
melanin
13
Q
Causes of Skin Disorders
A
Infectious
Inflammatory
Neoplastic
14
Q
examples of infectious skin disorders
A
bacterial
fungal
parasitic
viral
15
Q
bacterial infections
A
boils
impetigo
infected hair follicles
16
Q
fungal infections
A
ringworm
athletes foot
jock itch
nail infection
17
Q
parasitic infections
A
ticks
mites
lice
18
Q
viral infections
A
cold sores fever blisters chicken pox warts shingles measles german measles
19
Q
injury & exposure to the sun
combo of overactive glands, increased hormone production, and/or infection such as acne and rosacea
A
inflammatory
20
Q
inflammatory skin disorders
A
disorders with:
itching, cracking, and discomfort such as:
atopic dermatitis, contact dermatitis, seborrheic dermatitis, stasis dermatitis, and psoriasis
21
Q
neoplastic skin disorders
A
skin cancers: squamous cell carcinoma, basal cell carcinoma, and malignant melanoma
22
Q
benign neoplasms include
A
keratosis & keratocanthoma
23
Q
May be reflective of disease processes occurring elsewhere in the body
A
dermatologic sx and symptoms
24
Q
dermatologic sx and symptoms include:
A
abnormalities in skin color, sizes, character of surface lesions, skin and moisture
25
hormones influence glandular activity, calcium homeostasis, and skin health
endocrine system
26
the skin and muscles are important for proper body movement and expression
muscular system
27
helps fight diseases and infections of the skin
lymphatic system
28
proper nutrition is important for healthy skin
digestine system
29
emotions affect skin coloration.
the skin is a sensory organ
nervous sytem
30
the blood carries oxygen and carbon dioxide, factors that influence skin health and coloration
cardiovascular system
31
the lungs provide oxygen to all cells in the body
respiratory system
32
the bones are a strong storage site for calcium, an important mineral connected with Vit. D function
skeletal system
33
the skin covers external genitalia
sex hormones influence skin health
reproductive system
34
Bacterial infections occur when there is
a break in the skin's defenses
35
Two most common: bacterial skin infections
staph and streptococcus
36
Many bacterial skin infections are mild and self-limiting and can be treated with?
topical antibiotics
37
Serious skin infections are deep or systemic require what kind of tx?
oral or parental antibiotics
38
Occur in warm, moist areas of skin
fungal skin infections
39
tinea pedis
athletes foot
40
tinea cruris
jock itch
41
tinea capitits
ring worm of scalp
42
tinea ungium
nails
43
all of the tines are treated with?
topical antifungals
44
Fungal infections of skin and mucous membranes of immunocompromised patients are serious and are treated with?
oral or parenteral antifungal
45
childhood viral skin infections
varicella (chickenpox)
rubeola (measles)
rubella (german measles)
46
adult viral infections
```
herpes zoster (shingles)
herpes simplex (cold sores and genital lesions)
```
47
pharmacotherapy for viral infections
topical or oral antiviral therapy with acyclovir (Zovirax)
48
what causes scabies?
mites (sarcoptes scabiei)
49
what do scabies do?
the female burrows into skin & lays eggs
50
scabies cause intense _____.
itching
51
common areas for scabies
```
fingers,
extremities,
trunk,
axillary and
gluteal folds,
pubic area
```
52
scabies is spread by?
contact with upholstery and linens
53
Infest areas with hair
Transmitted by infected clothing or personal contact
lice (pediculus)
54
lice Lay eggs and leave debris called ____.
nits
55
kill mites
scabicides
56
kill lice
pediculicides
57
tx of choice for lice and scabies is ?
permethrin (Nix)
58
mechanism of action for Nix
Kills head and crab lice and mites and eradicate their ova
59
what type of drug is Nix
cream or lotion
60
1% lotion of Nix is approved for
lice
61
5% lotion of Nix is approved for?
mites
62
sx of Nix
few systemic effects
```
Local reactions include pruritus,
rash,
transient tingling,
burning,
stinging,
erythema, and
edema
```
63
Common problem among general public
Associated with light-skinned complexion and lack of sun protection
sunburn
64
Dangers of skin exposure
eye injury
cataracts
skin cancer
65
Affect only the outer layers of the epidermis
minor, first-degree burns
66
Signs and symptoms of sunburn include:
```
Erythema,
intense pain,
nausea,
vomiting
Chills,
edema, and
headache
```
67
The best treatment for sunburn is
prevention
68
Absorb the spectrum of UV light
Include those that contain benzophenone for protection against UVA rays
chemical sunscreens
69
Cinnamates, p-aminobenzoic acid (PABA) work against UVB rays
chemical sunscreens
70
Such as zinc oxide, talc, and titanium dioxide
Reflect or scatter light
Prevent the penetration of both UVA and UVB rays
physical sunscreens
71
is another sunscreen product that is being used
parsol
72
Treatment for sunburn consists of:
| Addressing symptoms with soothing lotions, rest, & prevention of ______.
dehydration
73
Topical anesthetics for minor burns include
benzocaine (Solarcaine)
dibucaine (Nupercainal)
lidocaine (Xylocaine)
tetracaine HCl (Pontocaine)
74
is a popular natural therapy for minor skin irritations and burns
aloe vera
75
Affects 80% of adolescents
acne vulgaris
76
Also found in over-30 population
acne tardive
77
overproduction of sebum by oil glands
seborrhea
78
Abnormal formation of keratin that blocks oil glands
causes acne vulgaris
79
Stimulate sebum production
androgens
80
Most common OTC benzoyl peroxide
benzalin
| triaz
81
Progressive disorder
Onset between 30 and 50 years of age
Characteristic symptoms:
Small papules without pus
Flushed face around nose and cheeks
Soft tissues of nose may swell—rhinophyma
rosacea
82
Soft tissues of nose may swell—
rhinophyma
83
Rosacea Exacerbation
Sunlight, stress, increased temperature
Agents that dilate facial blood vessels
84
Dries and sheds outer layer of epidermis
Keratolytic—
85
ex of keratolytic
benzoyl peroxide
86
Reduce oil production and clogged pores
| Do not use if patient is pregnant
retinoids
87
common reaction to retinoids is?
sensitivity to sunlight
88
Pharmacotherapy of Acne and Rosacea
```
benzoyl peroxide
retinoids
antibiotics
estrogen
antiprotozoals
```
89
Decreases comedone formation and increases extrusion of comedones
tretinoin (Retin-A)
90
Primary use of tertian (retin-a)
early treatment and control of mild to moderate acne vulgaris
91
AE of retinoids
```
Very high doses can cause bone pain,
fever,
headache,
nausea,
vomiting,
rash,
stomatitis,
pruritus,
sweating, and
ocular disorders
```
92
Inflammatory skin disorder—pain, redness, and pruritus
dermatitis
93
Chronic dermatitis; genetic predisposition
atopic dermatitis or eczema
94
hypersensitivity response dermatitis
contact dermatitis
95
type of dermatitis Seen in newborns and teenagers after puberty
seborrheic dermatitis
96
type of dermatitis that is a Sign of poor venous circulation
stasis dermatitis
97
most effective tx of dermatitis
topical glucocorticoids
98
Relieve local inflammation and itching
topical glucocorticoids
99
Adverse effects with long-term use of topical glucocorticoids
Irritation,
redness,
thinning of skin
100
Available in creams, lotions, solutions, gels, pads
topical glucocorticoids
101
Chronic skin disorder
psoriasis
102
sx of psoriasis
Red patches of skin covered with flaky, silver-colored scales (plaques)
103
etiology of psoriasis
May be genetic immune reaction
104
Causes extremely fast skin-turnover rate
Plaques are shed rapidly
Underlying skin is inflamed and irritated
psoriasis
105
goal of pharmacotherapy for psoriasis
reduce erythema, plaques, and scales to improve appearance
106
is there a cure for psoriasis
NO
107
Topical Therapies for Psoriasis
Topical corticosteroids
Topical immunomodulators (TIMs)
Retinoid-like compounds
108
Suppress immune system
Topical immunomodulators (TIMs)
109
When topical drugs fail for psoriasis
methotrexate
cyclosporine
biologic thearapies
110
immunosuppressive agent, for severe conditions.
Cyclosporine (Sandimmune, Neoral)
111
biologic therapies for psoriasis:
alefacept
| adalimumab
112
what to do before assessing pt with scabicides or pediculicide
don gloves
113
Assess patient's ? for evidence of lice, nits, or scabies
hair & skin
114
what other areas to assess?
axilla, neckline, hairline, groin, beltline areas
115
For severe cases of sunburn, assess for
fever, chills, weakness, shock
116
may cause hypersensitivity reaction in sunburns
Topical benzocaine (Solarcaine)
117
Do trial application on small area of skin
topical benzocaine
118
Have patient undress so you can examine extent of
acne
119
Assess anterior and posterior ____ for acne.
thorax
120
Drug Therapy for Acne-related Disorders
isotretinoin (acutane)
121
acutane is Contraindicated with
history of depression,
suicidal ideation,
pregnancy
122
what should you Obtain in all female patients of childbearing years
pregnancy test
123
filled with aqueous humor
Anterior cavity
124
Aqueous humor originates from ____ _____ in posterior chamber
ciliary body
125
aqueous humor Flows through the ___ into anterior chamber
pupil
126
Occurs when there is increased intraocular pressure
Leads to optic nerve damage and visual-field loss
glaucoma
127
glaucoma is the leading cause of ?
preventable blindness
128
glaucoma Can be secondary to certain conditions such as?
```
Eye trauma,
diabetes,
inflammation
Hemorrhage,
tumor,
cataracts
```
129
long term use of what meds can cause glaucoma?
glucocorticoids
antihypertensives
antihistamines
antidepressants
130
what medical condition cause cause glaucoma?
HTN
131
Migraine headaches
Severe nearsightedness or farsightedness
Normal aging
risk factors for glaucoma
132
both types of glaucoma result from?
build up of aqueous humor
133
what can cause the build up of aqueous humor
excessive production
blockage of outflow
134
Measures intraocular pressure (IOP)
tonometry
135
Goal of glaucoma is to prevent damage to optic nerve by ?
lowering IOP
136
when does Treatment begin for glucoma:
when IOP is between 21-30mmHg
When signs of optic nerve damage or visual-field changes are present
137
Drugs used for glaucoma decrease what?
Decrease IOP by increasing outflow of aqueous humor, or
Decrease formation of aqueous humor
138
Dilate trabecular meshwork
Increase aqueous humor outflow
Prostaglandins
139
Decrease production of aqueous humor
beta-adrenergic blockers
&
Alpha2-adrenergic agonists
&
Carbonic anhydrase inhibitors
140
AE of beta-adrenergic blockers
bronchoconstriction,
dysrhythmias,
hypotension
141
Dilate pupil to increase outflow
May also cause increased IOP, increased BP and HR
Rarely used for glaucoma
Nonselective sympathomimetics (mydriatics)
142
Constrict pupil to allow more room for outflow
Cholinergic agonists (miotics)
143
Reduce formation of aqueous humor
Osmotic diuretics
144
believed to reduce IOP by increasing outflow of aqueous humor
latanoprost (Xalatan)
145
primary use for latanoprost (Xalatan)
to treat open-angle glaucoma
146
AE of latanoprost (Xalatan)
conjunctival edema, tearing
147
other AE of latanoprost (Xalatan)
Dryness, burning, pain, irritation
Itching, sensation of foreign body in eye
Photophobia and/or visual disturbances
Eyelashes on treated eye may grow thicker and/or darker
Changes in pigmentation of iris of treated eye and periocular skin
148
Reduces formation of aqueous humor
timolol (Timoptic, Timoptic XE)
149
primary use of timolol (Timoptic, Timoptic XE)
to reduce elevated intraocular pressure in chronic open-angle glaucoma
150
AE of timolol (Timoptic, Timoptic XE)
local burning and stinging upon instillation
151
With use of beta blockers, teach patient how to ?
check pulse and blood pressure
152
Dilate pupil to allow better visualization
Cause photophobia, can increase IOP, can cause CNS effects
Mydriatics
153
Cause both dilation and relaxation of ciliary muscle
Cause severe blurred vision, loss of near vision, angle-closure glaucoma attacks
Cycloplegics
154
Drugs for Irritation and Dryness
Vasoconstrictors
Cycloplegics
Mydriatics
Lubricant drugs
155
Actions of Drugs for Irritation and Dryness
Lubricate eye's surface
Penetrate specific area of eye
156
Two major sensory functions of the ear
Hearing
Equilibrium and balance
157
Associated with water (swimmer's ear)
External otitis
158
Associated with upper respiratory infections, allergies, auditory tube irritation
otitis media
159
inflammation of mastoid sinus
Mastoiditis
160
what can mastoiditis lead to if untreated?
hearing loss
161
what type of antibiotics for external ear?
topical (ear drops)
162
for middle and inner ear infections; also for extensive outer ear infections
systemic
163
used when inflammation present of the ear
Topical corticosteroids
164
Many otic medications contraindicated in presence of ?
perforated eardrum
