Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacy Year 3 > Skin > Flashcards

Skin Flashcards

1
Q

What is the main function of the epidermis?

A

Replace damaged cells to maintain the skins protective features

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

How does the epidermis protect the skin?

A

Produces keratinocytes and pushes them up through 4 layers of the epidermis until the cells are shed.
This takes 28 days

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

What does the epidermis consist of?

A

Keratinocytes, melanocytes and Langerhans cells

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

How many layers does the epidermis have? Name them

A 
4 layers:
Stratum basale
Stratum spinosum
Stratum granulosum
Stratum corneum (top part)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the stratum basale

A

Single layer of keratinocytes
Cells divide continually and push old cells up
Melanocytes produce melanin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the function of the stratum spinosum

A

Anchors cells together by interlocking cytoplasmic processes

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

Describe the processes in the stratum granulosum

What does it contain?

A

Cells undergo enzyme induced destruction, losing nuclei and cytoplasmic organelles
Keratin is laid down

Contains lipid rich secretions - skin water sealant

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

Describe the stratum corneum

A

Layer contains dead cells flattened and filled with densely packed keratin
Cells are shed from skin

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

Describe the dermis

A

Located below the epidermis
Provides strength to skin, contains collagen and fibroblasts
Gives skin elasticity for strength
Has specialised structures e.g. sweat glands

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

What are the 7 skin functions

A 
Production of vitamin D
Sensory organ for touch, pain and temperature
Controls body temperature 
Weak insulator 
Barrier protection
Immune response
Healing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the function of skin in the production of vitamin D

A

7 dehydroxycholesterol produces vitamin D3 in the presence of sunlight

D3 is converted to calcidol in the liver and the hydroxylated to calcitrol in the kidney to produce active D3

Vitamin D increases plasma calcium levels by stimulating the intestinal epithelium to produce carriers for transport

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

What does a lack of vitamin D lead to?

A

Inadequate calcium absorption and deposition in the bones.

Causes rickets in children and osteomalacia in adults

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

Describe the function of skin as a sensory organ for touch, pain and temperature

A

Contains receptors which detect information from the skin surface and relay back to the CNS via sensory neurones

Mechanoreceptors can detect light touch and deep pressure on the skin surface

Thermoreceptors detect warmth and cold

Nocicereceptors respond to pain stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the function of skin in controlling body temperature

A

Capillaries in the skin control body temperature by altering blood circulation

Vasodilation causes capillaries to open and increase blood flow - causes heat loss at skin surface

Sweat glands in the skin secrete water and salt when internal body temp goes above normal

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

Describe the function of skin as a weak insulator

A

Mitochondria oxidise brown fat to produce more heat than ATP

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

Describe the function of skin as barrier protection

A

Protects from bacteria, toxins, dehydration, UV radiation, mechanical damage and trauma

Outer epidermal layer has keratinocytes which push up old dying cells - gives a waterproof layer

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

Describe the function of skin in an immune response

A

Produces new skin to replace old and damaged skin

Epidermis is first line defence barrier

Langerhans cells in the epidermis ingest foreign particles to be presented to the immune system

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

What are the 4 stages of healing? And briefly describe what happens in each.

A
  1. Haemostasis - clot formation
  2. Inflammatory processes - cleans wound to prepare for healing
  3. Proliferative phase - dermal repair and epidermal regeneration
  4. Maturation phase - scar formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the process of haemostasis in skin healing

A

Platelets in the blood recognise exposed collagen, platelets become sticking, releasing thromboxane A2

Platelets aggregate with collagen, forming a temporary plug

Activated platelets release serotonin which decreases blood supply to the wound

Damaged tissue releases thromboplastin which with calcium produces fibrin

Fibrin combines with the aggregate - traps RBCs to produce a clot

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

Describe the inflammatory process in skin healing

A

Langerhans cells are activated and release inflammatory mediators

Bradykinin increases pain at the site

Leukotrienes increase blood flow and warm the skin

Increased vascular permeability allows WBCs to reach

Plasma movement makes wound look swollen

Neutrophils digest bacteria and particles

Monocytes move to the wound

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

Describe the proliferative phase in skin healing

A

Macrophages release angiogenic growth factors for new blood vessels - in wound with low oxygen, it bring oxygen and nutrients

Chemicals attract granulation tissue to produce new connective tissue

Platelet derived growth factors and macrophages activate fibroblasts which grow and divide to produce a collagen network to provide strength

Myofibroblasts contract edges of the wound to close it. Cells move until the meet and then contact inhibition stops them moving

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

Describe the maturation phase in skin healing

A

Collagen is realigned to improve strength, the strands pull the wound inwards

Extra blood vessels close

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

What happens when a skin injury only affects the epidermis?

A

Keratinocytes in the stratum basale break from the basement membrane

Cells move till they meet each other, contact inhibitor stops cells moving

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

Give examples of intrinsic patient factors affecting wound healing

A 
Nutrition 
Skin perfusion
Age
Weight
Co-morbidity incl. medication
Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How does nutrition affect wound healing?
Protein is needed for antibodies, leukocytes, collagen and fibroblasts Vitamin A, B, C, E, Zn and Fe are also needed
26
How does skin perfusion affect wound healing?
Wound need oxygen and nutrients, compromised blood supply can delay wound healing
27
How does age affect wound healing?
Younger people are more likely to have better perfusion, nutrition and less co-morbidities
28
How does weight affect wound healing?
In obesity, collagen structure may be altered and may decrease tissue perfusion
29
How do co-morbidities (incl. medication) affect wound healing?
Hypoglycaemia affects leukocyte phagocytosis Anaemia, ischaemia, jaundice and malignancy Some cytotoxic drugs and PGEIs precept healing due to antagonism of growth factors Vasoconstrictors e.g. nicotine and cocaine cause tissue hypoxia
30
How does smoking affect wound healing?
Impairs wound contraction, decreases oxygen and causes platelet aggregation
31
Give examples of extrinsic wound factors affecting wound healing
``` Moist wound Temperature Oxygenation pH Infection Clean surface ```
32
How does moisture affect wound healing?
Wounds ned to be moist to allow epithlialisation Moisture allows growth factors and enzymes to diffuse But too moist encourages bacterial and fungal infections
33
How does temperature affect wound healing?
Wounds heal quicker at body temperature
34
How does oxygenation affect wound healing?
Less oxygen needed at granulation phase | More oxygen needed at epithelialisation
35
How does pH affect wound healing?
Decreased oxygen = increased lactic acid = decreased pH | Oxygen dissociated from Hb - this decreases tissue oxygenation
36
How does infection affect wound healing?
Delays wound healing, chronic wounds are colonised with bacteria. Infection shows when bacterial cells outweigh the body's immune response
37
How does a clean surface affect wound healing?
Foreign matter increases inflammatory phase and delays healing
38
What is the most common type of psoriasis?
Chronic plaque psoriasis
39
Which parts of the body does psoriasis commonly affect?
Scalp | Outside surfaces of the limbs - skin & elbows and lower back
40
What are the biological abnormalities of psoriasis?
Abnormal differentiation of keratinocytes - they don't mature in the same way as normal ones Infiltration of dermis and epidermis with activated T cells and neutrophils Stimulation of cutaneous vasculature, leading to new blood vessel formation in psoriatic plaques
41
What other parts of the body can chronic plaque psoriasis affect?
``` Flexures Intertriginous areas (axillae, groin, perineum and under the breasts) ```
42
Describe the appearance of guttate psoriasis
Widespread small scaly lesions
43
Describe the appearance of pustular psoriasis
Yellow-brown pustules on palms or soles of the feet
44
What kind of psoriasis requires hospital administration?
Pustular
45
Describe erythrodermic psoriasis
Psoriasis that becomes inflamed Scaling of skin Skin feels hot but patient feels cold Usually use to systemic or potent topical steroids so stop them
46
What kind of psoriasis appears on the nail?
Show as small pits, omycholysis and "oil spots" or "salmon patches"
47
Give examples of precipitating/exacerbating factors for psoriasis
``` Trauma Infection Hormonal events Sunlight Drugs Alcohol intake Cigarette smoking Psychological stress ```
48
What is classed as severe psoriasis?
Disease affecting >15-20% of body surface area (but this doesn't factor in small areas or in sensitive or visible areas)
49
What is used to treat mild psoriasis?
Topical treatments
50
What is used to treat moderate to severe psoriasis?
Phototherapy, photochemotherapy or systemic drug treatment
51
How do emollients treat psoriasis?
Restore pliability of the skin and reduce shedding of skin scales. They reduce itching (pruritus) and help to prevent painful cracking and bleeding
52
Give examples of vitamin D analogues
Calcipotriol Tacalcitol Calcitriol
53
How do vitamin D analogues treat psoriasis?
Inhibit keratinocytes and differentiation | Anti-inflammatory activity
54
What makes calcitriol suitable for use on sensitive skin?
It is less irritating
55
Which areas of skin are mild topical steroids suitable for in psoriasis?
Face, flexures or genitalia
56
On which kind of psoriatic skin would potent steroids used for?
Recalcitrant lesions on trunk/limbs
57
How much skin can be covered by one FTU of a topical steroid?
2 palms worth of skin
58
Which topical corticosteroid should not be used in psoriasis?
Clobetasone butyrate 0.05%
59
What is Tazarotene?
Topically active retinoid
60
How does tazarotene treat psoriasis? How can its side effect be avoided?
Normalises keratinocyte differentiation and has anti-proliferative and anti-inflammatory effects Use with a topical corticosteroid to minimise irritation
61
How does coal tar treat psoriasis?
Keratolytic with anti-inflammatory effects
62
What is dithranol?
Yellow irritating powder that causes inflammation, blistering and stains
63
What are the counselling points for psoriasis treatment?
Psoriasis can't be cured but it can be controlled Psoriasis is not infectious Doesn't develop into skin cancer Can't spread to new areas through topical treatment
64
What is involved in the management of atopic eczema in primary care?
Identify and avoid triggers Care plan tailored to disease severity Referral when conventional measures are ineffective
65
Give examples of tigger factors for eczema
Irritation Psychological stress Food hypersensitivity Allergens
66
How do emollients treat eczema?
Restore/maintain or restore suppleness and pliability of the skin, they reduce corticosteroid requirements and improve cosmetic appearance Form an oily layer over the skin that prevents water evaporation. Water trapped causes swelling of corneocytes which closes intercellular gaps
67
When should an emollient be applied with using with a steroid?
At least half an hour before any topical corticosteroid to avoid dilution or spread of the steroid
68
What is the purpose of humectants in emollients? Give examples of commonly used ones
They rehydrate dry and flaky skin | Urea, glycerin, PEG and lactic acid
69
What are the properties that colloidal oatmeal adds to an emollient? Give an example of a product with colloidal oatmeal
Soothing and anti-pruritic properties Aveeno cream
70
What property do lauromacrogols add to emollients? Give examples of products with lauromacrogols
Balneum plus and E45 Itch
71
How do topical corticosteroids treat asthma?
Inhibit the production and action of inflammatory mediators, this reduced inflammation and itch
72
Give an example of a mild corticosteroid. What kind of skin would it be used for?
Hydrocortisone Thin skin
73
Give an example of a moderate corticosteroid What is it used for and for how long?
Clobetasone butyrate Used for mild-moderate eczema for 1-2 weeks
74
Give an example of a potent corticosteroid What is it used for?
Mometasone furoate Moderate-severe eczema and for areas where there is thicker skin
75
What should infants <1 y/o with eczema be treated with
Mild potency preparations e.g. hydrocortisone ointment 1%
76
What can be given OTC in community pharmacies for eczema?
Hydrocortisone 1% for mild-moderate atopic eczema but shouldn't be used for >1 week without medical advice Clobetasone butyrate 0.05% for short term use and for >12 y/o
77
What are the counselling points for eczema patients using corticosteroids?
Don't use as an emollient Make sure they know the difference between potency and concentration One FTU for 2 palms worth of skin
78
When would antibiotics be needed in the treatment of eczema? Give examples of the antibiotics used
Moderate-severe bacterial infection with S.aureus | Treat with oral antibiotics - flucloxacillin and erythromycin for a short period of time
79
How can sedating antihistamines be used in ecemza treatment? | Give examples
If taken at night they may help to reduce itching Promethazine and alimethazine
80
When would topical immunomodulators be used in the treatment of eczema?
When there is a risk of serious side effects with topical corticosteroids or when eczema isn't controlled with corticosteroids
81
Give examples of topical immunomodulators and the types of eczema they treat. How do they work?
Pimecrolimus for mild - moderate eczema Tacrolimus for moderate - severe eczema They are both inhibitors of calcineurin phosphatase, an enzyme involved in the activation of T cells
82
Give examples of immunosuppressants used to treat severe atopic eczema
Ciclosporin Axathioprine Methotrezate
83
What needs to be measured before a patient is started on azathioprine?
Thiopurine methyltransferase enzyme activity
84
What is phototherapy and how does it work?
Controlled exposure to UV light, UVA or UVB Involves immunosuppression
85
What kind of eczema is wet wrapping used for? Describe the process
Extensive and severe eczema in young children A layer of emollient or mild corticosteroid is applied and covered with a wet cotton tubular bandage, then a dry one. Can go to bed with it on.
86
What kind of counselling points should eczema patients be given?
Recognition of flares Management of flares according to care plan Importance of starting treatment for flares as soon as signs and symptoms appear and continue for ~48 hours after they subside
87
What is isotretinoin used for?
Severe acne unresponsive to topical treatments and oral antibiotics
88
How does isotretinoin work?
Reduces skin sebum excretion by ~90% after 6 weeks Decreases hyperkeratinisation - interferes with comedogensis Anti-inflammatory
89
What are the risks associated with isotretinoin use?
``` Teratogenic Depression, anxiety, suicidal ideation Impaired night vision Dry skin and mucous membranes Joint pains Makes skin sensitive (need UV protection) ```
90
What is psoralens used for? When should it be taken? How does psoralens work?
Psoriasis Take 2 hours before UVA exposure, 3 times a week for 5-6 weeks Disrupts DNA synthesis inhibiting basal cell proliferation Slows basal cell growth to normal
91
What are the ADRs associated with psoralens use?
Teratogenic Premature skin ageing Skin pigmentation Cataract formation
92
How does acitretin work? | Why would it be considered to be better than isotretinoin?
Decreases hyperkeratinisation - normalises skin cell proliferation and differentiation Longer half life than isotretinoin
93
What are the risks associated with acitretin use?
Hyperlipidaemia | Hepatoxicity
94
How does methotrexate work?
Folic acid antagonist Blocks DNA synthesis - slows down basal cell proliferation in psoriasis Enzyme inhibition leads to increased adenosine which inhibits neutrophil chemotaxis and cytokine secretion
95
What are the risks associated with methotrexate use?
``` Liver cirrhosis (LFTs monthly) Blood disorders (FBC weekly then monthly) GI symptoms (5mg folic acid) Alopecia Infection risk ```
96
How does ciclosporin work?
Blocks calcineurin dependent factor Interleukin 2 (IL2) is blocked Blocks proliferation of T cells and cytosines Blocks proliferation of keratinocytes
97
What are the risks associated with ciclosporin use?
Nephrotoxicity Hypertension Teratogenic Infections
98
Give examples of biologics used in complex dermatology therapy
``` Etanercept Infliximab Adalimumab Usterkinumab Secukinumab ```
99
What are the risks associated with biologics?
Increased risk of infections CVD risk Worsening of neurological disease Lymphoma
100
Which biologic are given as an IV infusion? | How often is it given?
Infliximab | 0, 2, 6 then 8 weekly
101
Which biologics are given as a sub cut injection? | How often are they given?
Ethanercept - twice weekly injection Adalimumab - every 2 weeks Ustekinumab - 0, 4 then every 12 weeks Secukinumab - weekly for 4 weeks, then every 4 weeks

Pharmacy Year 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions