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Advanced Health Assessment > Skin > Flashcards

Skin Flashcards

1
Q

Macule

Example- freckle

A

Flat discoloration, usually less than 1cm in diameter

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2
Q

Patch

Ex- vitiligo, mongolian spot, measles rash, choasma.

A

Flat area of skin discoloration, larger than a macule (larger than 1 cm)

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3
Q

Papule

Ex- raised nevus

A

Raised lesion, less than 1cm, may be the same ir different color than the surriunding skin

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4
Q

Vesicle
Ex- varicella, blister, herpes zoster,
Contact dermatitis

A

Fluid filled, less than 1 cm

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5
Q

Eccrine

A

Produces sweat from sweat glands

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6
Q

Apocrine

A

Secretion from axillae, anogenital area occur with emotional and sexual stimulation

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7
Q

Skin is (9)

A
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8
Q

Inspect and palpate skin by looking at 8 things

A 
Color
Temp
Moisture
Texture
Thickness
Edema 
Movikity or turgor 
Vascularity or bruising
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9
Q

If there are any lesions present note: (7)

A 
Color
Elevation
Pattern or shape 
Size
Location and distrubution on body 
Any exudate 
Use woods light to detect fluorescing
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10
Q

Profile sign of nail

A

View index finger at its profile and note angle of nail base; it should be about 160 degrees

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11
Q 
Skin self examination 
A
B
C
D
E
A 
Asymmetry 
Border 
Color 
Diameter 
Elevation and enlargement
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12
Q

Annular

A

Circular, begins in center and spreads to the periphery

Example- ringworm, tinea corporis, tinea versicor, pityriasis

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13
Q

Discrete

Ex- acrochordon, skin tag, or acne

A

Distinct, individual lesions that remain separate

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14
Q

Confluent

Ex- hives

A

Lesions run together

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15
Q

Gyrate

A

Twisted, coiled spiral, snakelike

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16
Q

Linear

A

A scratch, streak, line, or stripe

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17
Q

Zosteriform

A

Linear arrangement along a unilateral nerve route

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18
Q

Grouped

Ex- vesicles of contact dermatitis

A

Clusters of lesions

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19
Q

Target

Ex- erythema multiform

A

Iris or resembles iris of eye, concentric rings of color in lesions

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20
Q

Polycyclic

Ex- lichen, planus, psoriasis

A

Annular lesions grow together

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21
Q

Bulla

Ex- friction blister, burns, contact dermatitis

A

Larger than 1cm diameter usually single chambered; superficial in epidermis. Thinned wall and ruptures easily

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22
Q

Tumor

A

Larger than a few centimeters in diameter, firm or soft. Deeper into dermis

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23
Q

Wheal

Ex- mosquito bite, allergic reaction,

A

Superficial raised, transient, and erythematous; slightky irregular shape from edema

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24
Q

Urticaria (hives)

A

Wheal to form extensive reaction, intensely pruritic.

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25
Q

Patch

A

Macules that are larger than 1cm

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26
Q

Plaque

Ie- psoriasis

A

Papules coupled to form surface elevation wider than 1cm

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27
Q

Target

Or Iris

A

Resembles iris of eye, concentric ring of color in lesion

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28
Q

When would you do a comprehensive assessment?

A

For an annual physical and/or new patient

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29
Q

Discuss three levels of priority

A

1st- Emergent- life threatening or immediate
2nd- next in urgency
3rd- important but can be addressed later

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30
Q

What is emergent?

A

Anything life threatening

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31
Q

What may be included in a routine periodic ohysical assessment? (8)

A 
Dietary intake 
Physical activity 
Tobacco/alcohol/drug use 
Sex 
Counseling
Dentistry 
Immunizations 
Prophylactic medical approaches (ie- folic acid for a woman trying to get pregnant)
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32
Q

What are the four types of data

A

1-complete database
2- focused/problem centered data
3- follow up
4- emergency

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33
Q

Complete database

A

Whole history and physical

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34
Q

Focused/ problem cenetered data

A

Concerning one problem or system

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35
Q

Follow up

A

Status of problems alresdy addressed to see what changed

36
Q

Emergency

A

Crucial info for swift diagnosis as the problem needs to be immediately addressed

37
Q

Cue

A

Piece of information, sign, symptom, or lab. Can be object, action, personal.

38
Q

When do we collect objective vs subjective data

A

Objective data is collected in the physical examination

Subjective is collected in the ROS

39
Q

What is diagnotic reasoning?

A

Attending to cues, formulating hypotheses, gathering data relating to hypotheses, and evaluting each hypothesis to arrive at diagnoses

40
Q

What are the components of evidence based decision makong

A

Utilize eveidence from research And evidence based theories, physical examination and assessment of patient, clinical expertise, and patient prefences/values.

41
Q

Review of Systems

A

A technique used by healthcare providers for eliciting a medical history if patient. It is often structured as a component of an admission notes covering the organ systems eith the focus upon the subjective symptoms perceived by the patient

42
Q

When does the pain scale get used in the HH?

A

In the HPI (oldcart)

43
Q

What is the utility of quotes in the HH?

A

What person says us the reason for seeking care is recorded and enclosed in quotes to indicate pt exact words

44
Q

Difference between signs and symptoms

A

Symptoms are subjective
And
Signs are objective

45
Q

What is a genogram?

A

A pictorial display of a persons family relationship and medical history

46
Q

Define open and closed ended questions

A

Open ended asks for narrative information and states the topic in general terms. Utilized when you start an interview, are introducing more questions, or a new topic is introduced. Closed is yes or no questions

47
Q

Basal cell carcinoma

A

Most common form of skin cancer
Slow growing
Small,pink, or red papule with translucent top and overlying telangiectasia (broken blood vessels: occurs on sun exposed areas:face,ears, scalp, shoulders.

48
Q

Describe squamous cell carcinoma

A

Erythematous scaly skin patches
Central ulcer eith surrounding erythema. Occurs on hands, head, bald scalp. Related to exposure to UV radiation. Grows rapidly, less common than basal cell ca

49
Q

Describe malignant melanoma

A

Brown but may be tan, black, pink-red, purple, or mixed

50
Q

You examine one lesion with a regular border ans one with a variation in color, it goes from red to white. Which is emergent?

A

The red and white is abnormal/emergent

51
Q

What is seborrheic keratosis?

A

Appears dark, greasy, waxy, and stuck on old people generally. Most on the trunk/face/hands and on both unexposed and sun exposed areas. Nom cancerous

52
Q

Patient has a bulls eye pattern, red, macular rash. What us a likely differential?

A

Lymes disease

53
Q

Patient presents with a skin issue that has a rounded border with a central ulcer and depression. What is a good differential?

A

Basal Cell Carcinoma

54
Q

You see an intertrigal rash with lesions, what would be the best class of antibiotics?

A

Antifungal- nystatin powder

55
Q

An older person presents with flaky, silver skin PLAQUES. Differential?

56
Q

Demonstrate the simularities and differences between ulcerations, scars and fissures?

A

They are all breaks in continuity on the skins surface but an ulcer is a deep depression extending into dermis, a fissure is a linear crack in dermis, and a scar is what forms after a lesion like a fissure or ulcer is repaired made of collagen

57
Q

Acutely infected lymph nodes are characterized by

A

Bilateral/ firm/enlarged/warm/tender/freely moveable

58
Q

Describe lymph nodes in HIV

A 
1 enlarged 
2- firm 
3- nontender 
4- mobile 
 * occipital nodules are most commonly enlarged in HIV
59
Q

Describe cancerous lymph nodes (4)

A

Hard, larger than infected UNILATERAL, FIXED

60
Q

You examine enlarged POSTERIOR lymph nodes bilaterally. What is your differential?

61
Q

You examine enlarged ANTERIOR lymph nodes bilaterally. What is your differential?

62
Q

What is the best way to palpate lymph nodes?

A

Use gentle, circular motion of finger pads. Start at the preauricular lymph nodes in front of ear and then palpate the 10 groups in a routine order

63
Q

What is the best way to inspect thyroid movement?

A

Have the patient take a sip of water and watch the tracheal midline

64
Q

You have a patient with a hard, large, UNILATERAL, FIXED, supraclavicular lymph node. What are the risks here?

A

Not only is it cancerous but it is very likely metastatic given the fact its a supraclavicukar lymph node

65
Q

What causes bells palsy?

A

A lower motor neuron viral lesion. It induces a rapid onset of cranial nerve 7 (facial) paralysis- often brought on by reactivation of HSV-1

66
Q

You can easily palpate a pregnant womans thyroid gland. Is this a normal finding?

67
Q

Describe the visual apperance of a person with parkinsons face

A

Mask like, immobile, flat, expressionless with elevated eyebrows, staring gaze, oily skin, and drooling

68
Q

Someone reports a past diagnosis in their interview, is it objective or subjective?

A

Subjective

69
Q 
O
L
D
C
A
R
T
A 
Onset
Location
Duration
Character 
Alleviate/aggravation 
Radiation
Treatment
70
Q 
P
Q
R
S
T
A 
Provocative/palliative 
Quality/quantity 
Region/radiation 
Severity 
Timing
71
Q

7 elements in patient interview

A 
Cheif complaint 
HPI
PMH
PSH
ROS(only need to do one) 
Social history 
Medications
Family history
72
Q

HPI

A 
Onset- when it starts
Location- midsternal 
Duration- 2 weeks
Characteristics- sharp
Alleviating- rest, after eating/aggravated- exercise 
Radiation- left shoulder 
Time- lasts for 10 minutes
Severity- 2/10
73
Q

CAGE

A

1-Do you ever feel uou have to CUT down on your drinking
2-ever feel ANNOYED by critism of drinking
3- guilty about drinking
4- eye opener

74
Q

Cranial nerve 1

A

Olfactory

Smell mint leaves/tobacco

75
Q

Cranial nerve 2

A

Optic

Visual acuity and funduscopic

76
Q

Cranial nerve 3

A

Oculomotor

Pupillary reaction

77
Q

Cranial nerve IV

A

Trochlear

Pupillary reaction

78
Q

Cranial nerve 5

A

Trigeminal

Clench teeth, open jaw, lip/chin test for light touch

79
Q

Cranial nerve 6

A

Abducens
EOM
EYE MOVEMENT TO THE SIDE

80
Q

Cranial nerve 7

A

Facial

Raise eyebrows/frown/ show teeth/ smile/ puff cheeks

81
Q

Cranial nerve 8

A

Acoustic
Whisper test
Weber/Rinne tests

82
Q

Cranial nerve 9

A

Glossopharyngeal
Hoarseness
Tongue movement

83
Q

Cranial nerve 10

A

Vagus

Saying “ah” and note palate and uvula mive upward

84
Q

Cranial nerve 11

A

Spinal accessory

Shrug shoulders

85
Q

Cranial nerve 12

A

Hypoglossal

Inspect tongue for atrophy/ fasciculation

Advanced Health Assessment (4 decks)

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