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Dermatology > PHYSICAL EXAMINATION OF THE SKIN, HAIR AND NAILS > Flashcards

PHYSICAL EXAMINATION OF THE SKIN, HAIR AND NAILS Flashcards

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Dermatology Board Prep flashcards
1
Q

Derm Specific History what to ask
Onset:

A

Abrupt or gradual onset?

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2
Q

Derm Specific History what to ask
Location:

A

Where lesions first noted and where they are now.

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3
Q

Derm Specific History what to ask
Location:

A

Where lesions first noted and where they are now.

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4
Q

Derm Specific History what to ask
Duration:

A

Recurrences, remissions, exacerbations

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5
Q

Derm Specific History what to ask
Evolution:

A

Has it spread? Gotten itchier? More painful?

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6
Q

Derm Specific History what to ask
Character:

A

Pruritus/pain, bleeding, non-healing, wounds

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7
Q

Derm Specific History what to ask
Aggravating/Alleviating:

A

UV exposure, heat/cold, exposures (chemicals,medications, cosmetics, perfumes, plants, metals)

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8
Q

Derm Specific History what to ask
Temporal:

A

Constant, intermittent, worst at night, climate change.

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9
Q

Derm Specific History what to ask
Severity:

A

Severity of pain or pruritus (0/10 works for both).

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10
Q

Derm Specific History what to ask
Pertinent Derm Questions:

A

Previous occurrence(s), any close contacts with similar symptoms, new/change in hygiene products

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11
Q

Overall Skin Inspection algorithm
(CUTSHP)

A

Color (rule out potentially actue issues)
Uniform Appearance
Thickness
Symmetry (unilateral vs. bilateral presentation)
Hygiene (some conditions have predisposing hygienic concerns)
Presence of any lesions

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12
Q

Definition of what?
(a)Rated as I-VI on the scale
(b)Quasi-objective metric of amount of melanin pigment in the skin

A

Fitzpatrick Scale

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13
Q

_____ resistance is largely determined by melanocyte activity and melanocytic pigmentation of the skin.

A

UVR

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14
Q

What is the umbrella term used in dermatology for any observed skin change or finding

A

Lesions

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15
Q

Size of lesion is measured on what dimensions and in what measurement scale?

A

1)Length
2)Width
3)Depth is covered by noting elevation or depression
Always in mm or cm!

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16
Q

Lesion Shapes:
Ring shape with central clearing

A

Annular (Ring shaped)

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17
Q

Lesion Shapes:
a)Coin-shaped; solid circle or oval
b)Uniform appearance from the edges to the center

A

Round (nummular)

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18
Q

Lesion Shapes:
Often a result of incomplete formation of an annular lesion

A

Arcuate (arc-shaped)

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19
Q

Lesion Shapes:
Multiple different shapes located closely together (grab-bag)

A

Multiform:

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20
Q

Lesion Shapes:
Formed from coalescing circles, rings, or incomplete rings

A

Polycyclic:

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21
Q

Lesion Shapes:
Target-like, with a center darker than the periphery

A

Targetoid

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22
Q

Lesion Shapes:
Dot-like, typically around 1 mm

A

Punctate

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23
Q

Lesion Shapes:
a)With a central depression of the surface.
b)Also known as “delled”.

A

Umbilicated

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24
Q

Lesion Shapes:
a)Resembling a straight line
b)Ex: Poison Ivy or scratch marks

A

Linear

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25
Q

Lesion Shapes:
a)Serpentine or snake-like
b)Ex: Lymphadenitis

A

Serpiginous

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26
Q

What is the most important additional feature of a lesion other than primary morphology(Shape)

A

Lesion Color

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27
Q

The most common types of color on the skin are:

A

1) Variations in brown
2) Hyperpigmentation
3) Hypopigmentation
4) Variations in red (erythema)

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28
Q

What part of the lesion inspection can be referred to as either ‘borders’ or ‘margins’?

A

Demarcation (Borders)

29
Q

What level of demarcation?
1) Borders are clearly defined and have a definitive ‘stop’ point
2) AKA ‘Discrete’ or well defined’

A

Well demarcated

30
Q

What level of demarcation?
1)Tight borders on a round lesion
2)Clear “beginning & end”

A

Circumscribed

31
Q

What level of demarcation?
1) Borders are indistinct and lack a definitive start/stop point
2) AKA ‘indistinct’ or ‘confluent’

A

Not well-demarcated

32
Q

Border/Margins definition
1) Expanding at margins
2) Ex: Cellulitis, erysipelas, necrotizing fasciitis, etc.

A

Advancing

33
Q

Border/Margins definition
1) AKA ‘central clearing
2) Similar to annular or arcuate except the border is being considered vice the shape.

A

Border raised above center

34
Q

This defines what?
Protein-rich fluid containing cellular elements extruded from blood vessels secondary to inflammation or injury

A

Exudate

35
Q

This defines what?
Thick, yellow to green discharge typically associated with infection.

A

Purulent

36
Q

This defines what?
Dried Crust discharge

A

Serum

37
Q

Location and Distribution Terms:
Unilateral & lying in the distribution of a single spinal afferent nerve root

A

Dermatomal/Zosteriform

38
Q

Location and Distribution Terms:
Lying along the distribution of a lymph vessel; implies infectious agent spreading from an acral (distal) site

A

Lymphangitic

39
Q

Location and Distribution Terms:
Occurring in distal locations, such as on the hands, feet, wrists, ankles, ears, or penis.

A

Distal (Acral)

40
Q

Location and Distribution Terms:
Occurring on the trunk or central body.

A

Truncal

41
Q

Location and Distribution Terms:
Occurring in areas usually not covered by clothing: face, dorsal hands

A

Sun Exposed (AKA Photo-distributed)

42
Q

Location and Distribution Terms:
Occurring in areas usually covered by one or more layers of clothing

A

Sun Protected

43
Q

Location and Distribution Terms:
Occurring over the dorsal extremities, (extensor muscles, knees, or elbows)

A

Extensor

44
Q

Location and Distribution Terms:
Overlying the flexor muscles of the extremities (antecubital & popliteal fossae)

A

Flexor

45
Q

Location and Distribution Terms:
Occurring in the skin folds, where 2 skin surfaces are in contact: (axillae,inguinal folds, inner thighs, inframammary skin)

A

Intertriginous (Latin inter, “between”’ trigo, “rubbing”)

46
Q

Location and Distribution Terms:
1) Favoring the hair-bearing locations of the skin
2) Scalp, eyebrows, beard, central chest, axillae, genitals, nasolabial and postauricular creases.

A

Seborrheic

47
Q

Location and Distribution Terms:
Confined to a single body location.

A

Localized

48
Q

Location and Distribution Terms:
Widespread

A

Generalized

49
Q

What type of lesion?
Flat, circumscribed area of color change less than 1 cm in diameter.

A

Macule

50
Q

What type of lesion?
A flat, non-palpable, irregularly shaped macule greater than 1 cm in diameter.

A

Patch

51
Q

What type of lesion?
An elevated, firm, circumscribed area less than 1 cm in diameter.

A

Papule

52
Q

What type of lesion?
An elevated firm, rough, lesion with flat top greater than 1 cm in diameter.

A

Plaque

53
Q

What type of lesion?
Elevated, circumscribed, superficial fluid-filled (clear/serous). Less than 1 cm.

A

Vesicle

54
Q

What type of lesion?
Elevated, superficial lesion. Similar to a vesicle but filled with purulent fluid

A

Pustule

55
Q

What type of lesion?
Vesicle greater than 1 cm

A

Bulla

56
Q

What type of lesion?
An elevated, irregularly-shaped area of cutaneous edema. Solid, transient and variable diameter.

A

Wheal (Hive)

57
Q

What type of lesion?
Elevated, firm, circumscribed lesion; deeper in the dermis than a papule. 1-2cm in diameter.

A

Nodule

58
Q

What type of lesion?
Elevated and solid lesion; may or may not be clearly demarcated; deep in dermis. Greater than 2 cm.

A

Tumor (Mass)

59
Q

What type of lesion?
Encapsulated lesion in the dermis or hypodermis; filled with liquid or semi-solid material.

A

Cyst

60
Q

What type of lesion?
Fine, irregular, red line produced by capillary dilation

A

Telangiectasia

61
Q

Secondary Skin Lesions
Typically categorized in what three ways:

A

1) Accumulation of material
2) Change in skin integrity or thickness
3) Loss of layers or skin breakdown

62
Q

What is this?
Irregularly shaped, elevated scar that grows beyond the boundaries of the initial injury or wound.

A

Keloid

63
Q

What is this?
Overgrowth of scar tissue that remains confined to the site of initial injury. May be raised or flat.

A

Hypertrophic Scar

64
Q

What is this?
Thinning of the skin and loss of skin markings. Skin can turn translucent and paper-like.

A

Atrophy

65
Q

What type of skin loss?
Loss of part of epidermis (not dermis)
a) Does not bleed
b) Heals without scarring
c) Follows rupture of a vesicle or bulla
d) Examples
-(1 Varicella
-(2 Variola after rupture

A

Erosion

66
Q

What type of skin loss?
Loss of epidermis and dermis
a) Concave
b) May bleed
c) Heals with scarring

A

Ulcer

67
Q

Loss of epidermis
a) Linear, hollowed-out crusted area
b) Due to mechanical trauma (scratching)

A

Excoriation

68
Q

Linear crack in skin continuity from epidermis to dermis
a) Can be moist or dry
b) Examples
-(1 Athlete’s foot
-(2 Intertrigo
-(3 Angular chelitis

A

Fissure

69
Q

True/False
Dermatoglyphics (fingerprint lines) are preserved over the surface in warts

A

FALSE
Dermatoglyphics (fingerprint lines) are preserved over the surface in Corns and callus

Dermatology (28 decks)

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