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Pathology > Skin and Sensory (Final) > Flashcards

Skin and Sensory (Final) Flashcards

1
Q

Contact Dermatitis

A

• acute inflammatory reaction triggered by direct exposure to an irritant or allergen-producing substance; not contagious or life threatening
• varies in severity depending on substance, are affected, exposure extent, and individual sensitivity
• usually resolves in 2-4 weeks

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2
Q

Irritant Contact Dermatitis

A

doesn’t involve the immune system but triggers the inflammatory response

produces a similar reaction to a burn

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3
Q

Irritant Contact Dermatitis Causes

A

chemicals
plants
body fluids
rubber gloves
soaps

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4
Q

Irritant Contact Dermatitis Manifestations

A

erythema
edema
pain
pruritus
vesicles

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5
Q

Allergic Contact Dermatitis

A

sensitization occurs on first exposure and subsequent exposures produce type IV cell-mediated hypersensitivity

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6
Q

Allergic Contact Dermatitis Causes

A

metals
chemicals
adhesives
cosmetics
plants

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7
Q

Allergic Contact Dermatitis Manifestations

A

appear 24-48 hrs after exposure

pruritus
erythema
edema
small vesicles

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8
Q

Atopic Dermatitis (Eczema)

A

chronic inflammatory condition with an inherited tendency; may be accompanied by asthma and allergic rhinitis

most common in infants and usually resolves by early adulthood; characterized by remissions and exacerbations

exact cause unknown but may result from immune system malfunction (similar to hypersensitivity reactions ie IgE elevation)

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9
Q

Atopic Dermatitis Complications

A

secondary bacterial skin infections
neurodermatitis (permanent scarring and discoloration from chronic scratching)
eye problems (conjunctivitis)

may affect any area but pattern exhibited tends to be age specific

YOUNG CHILDREN: FACE, SCALP, HANDS, FEET
OLDER CHILDREN/ADULTS: KNEES AND ELBOWS

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10
Q

Atopic Dermatitis Manifestations

A

may be worsened by environmental factors like food allergens, airborne allergens, Staphylococcus aureus colonizations on skin, topical products, sweating, and rough fabrics

red to brownish-gray skin patches
pruritus, which may be severe especially at night
vesicles
thickened (lichenified), cracked or scaly skin
irritated, sensitive skin from scratching

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11
Q

Urticaria (Hives)

A

raised erythematous skin lesions (welts)

occurs when histamine release is initiated by these substances or conditions

usually short lived and harmless

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12
Q

Urticaria Causes

A

Type I hypersensitivity reaction often triggered by food (shellfish, nuts) and medicine (antibiotics)

emotional stress
excessive perspiration
diseases (autoimmune, leukemia)
infections (mono)

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13
Q

Urticaria Manifestations

A

welts that blanch and pruritus
diffuse welts may grow large, spread and fuse together
can impair breathing if around face and progress to anaphylaxis and shock

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14
Q

Psoriasis

A

common chronic inflammatory condition that affects skin cell life cycle, specifically keratinocytes

cellular proliferation is significantly increased, causing cells to build up too rapidly on skins surface; buildup leads to thickening of dermis and epidermis because dead skin cells cannot shed fast enough

may take days-weeks for symptom to emerge during flare ups

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15
Q

Psoriasis Causes

A

exact cause unknown, but thought to be multifactorial

environmental factors
trauma
infections
obesity
excessive alcohol
certain meds
genetic
immunologic factors
autoimmune process in which T lymphocytes mistake normal skin cells as foreign

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16
Q

Psoriasis Onset

A

family tendency observed; severity varies (weakened immune system)

most frequently between 15-35 years and may be sudden or gradual

REMISSIONS AND EXACERBATIONS; MAY ALSO HAVE ARTHRITIS

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17
Q

Psoriasis Exacerbation Causes

A

bacteria or viral infections in any location
dry air/dry skin
skin injuries
certain meds (antimalaria agents, beta blockers, lithium)
stress
too little/too much sunlight
excessive alcohol

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18
Q

Psoriasis Papules

A

begins as small red papule, often on elbows, knees and trunk but can appear anywhere

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19
Q

Erythrodermic

A

intense erythema that covers a large area

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20
Q

Guttate

A

small pink-red spots

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21
Q

Inverse

A

erythema and irritation that occurs in armpits, groin, and skin folds

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22
Q

Plaque

A

thick, red patches covered by flaky, silver white scales (MOST COMMON)

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23
Q

Pustular

A

white blisters surrounded by red, irritated skin

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24
Q

Psoriasis Manifestations

A

pruritus
genital lesions
joint pain or aching (if arthritis present)
nail changes (thickening, yellow brown spots, pits on nail surface, separation of nail from base)
dandruff

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25
Q

Infectious Integumentary Disorders

A

skin infections are common

organisms gain access through breach in skin or mucous membranes which triggers inflammation

can occur in any skin layer or structure, may be acute or chronic, severity varies, resolves with treatment

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26
Q

Bacterial Infections

A

can be caused by any of the normal flora, mild to life threatening

staphylococcus and streptococcus genera are common culprits

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27
Q

Folliculitis

A

bacterial infection involving hair folllicles

tender, swollen areas that form around hair follicles often on neck, boobs, butt and face

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28
Q

Furuncles

A

bacterial infection beginning in hair follicles and then spread into surrounding dermis; most common on face, neck, axilla, groin, butt, back

starts as a firm, red painful nodule that develops into a large painful mass which frequently drains large amounts of purulent exudate

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29
Q

Carbuncles

A

a cluster of furuncles

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30
Q

Impetigo

A

common and highly contagious bacterial infection; can spread throughout body through self transfer of exudate

can occur without apparent skin breach but typically arises from break in skin

typically caused by staphylococci, which produce a toxin that attacks collagen and promotes spread

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31
Q

Impetigo Manifestations

A

lesions usually begin as small vesicles that enlarge and rupture, forming characteristic honey colored crust

pruritus
lymphadenopathy

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32
Q

Cellulitis

A

bacterial infection that occurs deep in the dermis and subQ tissue; appears as a swollen, warm and tender area of erythema

usually results from direct invasion of pathogens through break in skin especially where contamination is likely or spreads from existing infection

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33
Q

Cellulitis Manifestations and Complications

A

M: indicators of infections (*fever, leukocytosis, malaise, arthralgia**

C: necrotizing fasciitis, septicemia, septic shock

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34
Q

Necrotizing Fasciitis

A

a rare but serious bacterial infection that can aggressively destroy skin, fat, muscle and other tissue

typically results from highly virulent strain of gram-positive, group A beta-hemolytic streptococcus that invades through a minor cut or scrape; bacteria release toxins that directly destroy tissue, disrupt blood flow and break down tissue

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35
Q

Necrotizing Fasciitis Wound

A

first sign may be a small, reddish painful area that quickly evolves into a painful bronze or purple colored patch

center of lesion may become black and necrotic with exudate

wound may grow in less than an hour

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36
Q

Necrotizing Fasciitis Manifestations and Complications

A

M: fever, tachycardia, hypotension, confusion

C: gangrene, multi system organ failure, shock

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37
Q

Herpes Simplex Type 1

A

typically affects lips, mouth and face beginning in childhood; can involve the eyes leading to conjunctivitis

can result in meningoencephalitis

transmitted by contact with infected saliva, primary infection may be asymptomatic

38
Q

HSV 1 Pathogenesis

A
  1. after primary infection, virus remains dormant in sensory nerve ganglion to the trigeminal nerve until is is reactivated
  2. reactivation may result from infection, stress, immunosuppression, or sun exposure (painful blisters or ulcerations that are preceded by burning or tingling sensation)
  3. lesions may resolves spontaneously within 3 weeks, but healing can be accelerated with the administration of oral or topical antiviral agents
39
Q

Herpes Zoster (Shingles)

A

varicella-zoster virus, appears in adulthood years after a primary infection of varicella in childhood

virus lies dormant on a cranial/spinal nerve dermatome until activated years later; virus affects this nerve only giving the condition its typical unilateral manifestations

40
Q

Shingles Manifestations

A

pain
paresthesia
red/silvery vesicular rash that develops in along over the area innervated by affected nerve (nose sit of the head or torso)
extremely sensitive skin
pruritus

rash may persist for weeks to months

41
Q

Shingles Complications

A

neuralgia
blindness

vaccines are available to prevent both varicella and herpes zoster

42
Q

Rubella (German/3-Day Measles)

A

RNA virus enters bloodstream through respiratory route; mild in most children

43
Q

Rubella Manifestations

A

enlarged cervical and postauricular lymph nodes
low grade fever
headache
sore throat
runny nose
cough
faint pink to red maculopapular rash caused by virus dissemination to the skin

44
Q

Rubeola (Red Measles)

A

highly contagious acute viral disease of childhood (droplet transmission)

no symptoms in incubation period (7-12 days)

45
Q

Rubeola Manifestations

A

high fever
malaise
enlarged lymph nodes
runny nose
conjunctivitis
barking cough
rash that develops over head and spreads distally over the trunk, extremities, hands and feet
characteristic pinpoint white spots (Koplik) found over buccal mucosa

46
Q

Roseola

A

herpesvirus 6 or 7 infection; 6 months to 2 yrs of age

intubation of 5-15 days followed by sudden onset of fever that lasts 3-5 days

after fever, erythematous macular rash that lasts about 24 hrs (usually doesn’t require treatment)

47
Q

Tinea (Ringworm/Athletes Foot)

A

parasitic infection that causes several types of superficial fungal infections

typically manifests as a circular, erythematous rash accompanied by pruritus and burning

48
Q

Tinea Capitis

A

the scalp; common in school aged children

hair loss at site is common

49
Q

Tinea Corporis

A

involving the body

50
Q

Tinea Pedis

A

involving the feet especially the toes

51
Q

Tinea Unguium

A

involving the nails, typically the toenails

begins at the tip of one or more nails and then usually spread to other nails

turns nails white and then brown causing them to thicken and crack

52
Q

Scabies

A

result of mite infestation

male mites fertilize the females then die, female mites burrow into epidermis laying eggs over a period of several weeks through series of tracts and die after that

53
Q

Scabies Process

A
  1. larvae hatch from eggs and migrate to skin surface
  2. larvae burrow in search of nutrients and mature to repeat cycle
  3. burrowing appears as small, light brown streaks on skin
  4. burrowing and fecal matter left by the mites triggers the inflammatory process, leading to erythema and pruritus

transmission of close contact

54
Q

Pediculosis (Lice Infestation)

A

small brown insects that feed off human blood

females lay nits on hair shaft close to scalp (appear as white, small, iridescent shells on hair)
after hatching, the life bite and suck on blood
bite size develops as highly pruritic macule or papule

CLOSE CONTACT!!

55
Q

Skin Cancer

A

most frequent cancer in the US; more prevalent in males, whites, fair complexion, family history

early detection is crucial

56
Q

Basal Cell Carcinoma

A

most common; develops from abnormal growth of cells in lowest layer of epidermis

rarely metastasizes

57
Q

Squamous Cell Carcinoma

A

involves changes in the squamous cells found in the middle layer of epidermis

58
Q

Melanoma

A

melanocytes; least common type but most serious

often metastasizes

59
Q

Skin Cancer Suspicious Features

A

ABCD (larger than 6 mm)
any skin growth that bleeds or will not heal
any skin growth that changes in appearance over time

60
Q

Conjunctivitis

A

caused by viruses (most common), bacteria (staphylococcus, gonorrhea, chlamydia), allergens (pollen, dust), chemical irritants, trauma

can generate edema, pain, blurry vision, photophobia

61
Q

Viral vs Bacterial Conjunctivitis

A

viral: watery, mucus like exudate

bacterial: yellow-green exudate

HIGHLY CONTAGIOUS THROUGH DIRECT CONTACT

62
Q

Conjunctivitis Risk Factors

A

wearing contact lenses
contaminated makeup
ophthalmic meds

allergens and irritants typically produce redness, itching and excessive tearing

63
Q

Acute Otitis Media

A

infection of middle ear; common in young children due to eustachian tubes being narrower, straighter and shorter and an immature immune system

begins as viral upper respiratory infection; more common in winter

fluid collection from viral infection provides prime medium for secondary bacterial growth, usually streptococcus pneumoniae and haemophilus influenza

64
Q

Acute Otitis Media Risk Factors

A

childcare in group settings
feeding infants in supine position
environmental smoke exposure
pacifier use
orofacial deformities
history of allergic rhinitis

fluid accumulation in middle ear due to adenoid enlargement, usually due to inflammation

65
Q

Acute Otitis Media Complications

A

effusions
rupture of tympanic membrane
scar tissue formation
conductive hearing loss
mastoiditis
cholesteatoma
meningitis
osteomyelitis

66
Q

Acute Otitis Media Manifestations

A

ear pain
crying or irritability
rubbing or pulling at ear
mild hearing deficits
sleep disturbances
red and bulging tympanic membrane
indications of infection
purulent or clear exudate from external ear canal (if tympanic membrane ruptures)
n/v
diarrhea
headache

67
Q

Glaucoma

A

group of eye conditions that lead to damage to the optic nerve; caused by increased intraocular pressure and decreased blood flow to the optic nerve

pressures inside the eye can climb when the outflow of aqueous humor becomes blocked or production of aqueous humor increased to an abnormal level (increased pressures cause ischemia and degeneration of the optic nerve)

SECOND LEADING CAUSE OF BLINDNESS (diabetic retinopathy is #1)

68
Q

Open-Angle Glaucoma

A

most common type; intraocular pressure may increase gradually over an extended period of

*RISK FACTORS: FAMILY HISTORY AND AA**

because vision changes are gradual, can be overlooked or misdiagnosed as presbyopia

69
Q

Open-Angle Glaucoma Manifestations

A

painless, insidious, bilateral changes in vision (tunnel vision, blurred vision, halos around lights, decreased color discrimination)
loss of peripheral vision (tunnel vision)
patients describe vision as looking through a straw or curtains are closing

70
Q

Closed-Angle Glaucoma

A

result of a sudden blockage of aqueous humor outflow; can be acute, subacute or chronic and typically unilateral

without treatment, acute and narrow angle glaucoma can cause blindness

71
Q

Closed-Angle Glaucoma Causes

A

traum,
sudden pupil dilation (exposure to bright light after prolonged darkness)
prolonged pupil dilation (meds for eye exams)
emotional stress

72
Q

Closed-Angle Glaucoma Manifestations

A

usually sudden and worsening quickly

sudden and severe eye pain
headache
n/v
nonreactive pupil
redness
haziness of cornea
vision changes (halos around lights)

73
Q

Cataracts

A

opacity or clouding of the lens; can occur as a congenital condition or develop later on

may affects one or both eyes and doesn’t always affect eyes symmetrically

74
Q

Cataracts Risk Factors

A

family history
advancing age
smoking
UV light exposure (natural or artificial)
metabolic conditions (diabetes mellitus)
certain meds (corticosteroids)
eye injury

75
Q

Cataracts Manifestations

A

cloudy, fuzzy, foggy or filmy vision
color intensity loss
diplopia
impaired night vision gradually progressing to impaired day vision
halos around lights
photosensitivity
frequent changes in eyeglass or contact lens prescriptions

76
Q

Macular Degeneration

A

deterioration of the macular area of the retina caused by impaired blood supply to the macula that results in cellular waste accumulation and ischemia

77
Q

Macular Degeneration Risk Factors

A

ADVANCING AGE
family history
being female and white
smoking
increased UV light exposure
decreased carotenoid intake
high fat diet
cardiovascular disease
hypertension
obesity

78
Q

Macular Degeneration Manifestations

A

DRY FORM: blurry vision with loss of central vision

WET FORM: distortion of straight lines, dark spots in central vision, sudden loss of central vision

79
Q

Ménière’s disease

A

disorder of the inner ear that results from endolymph swelling which stretches the membranes and interferes with the hair receptors in the cochlea and vestibule

peak incidence is 20-50 years

80
Q

Ménière’s Disease Risk Factors

A

cause is unknown but mag be metabolic disturbances, hormonal imbalances, autoimmune, head injuries, otitis media, syphilis

allergic rhinitis
alcohol abuse
stress
fatigue
certain meds (aspirin)
respiratory infections

81
Q

Ménière’s Disease Manifestations

A

attacks typically occur in waves of acute episodes that last several months followed by brief periods of relief (triggered by changes in barometric pressure; includes intermittent episodes of vertigo, tinnitus, unilateral hearing loss, and a sensation of fullness)

n/v
diarrhea
headache
uncontrollable eye movement

C: PERMANENT HEARING LOSS

82
Q

Retinal Detachment

A

acute condition that occurs when retina separates from supporting structures

as vitreous humor collects underneath, the retina peels away from the underlying choroid; these detached areas may expand over time and the retina becomes ischemic and stops functioning causing vision loss

83
Q

Retinal Detachment Pathogenesis

A
  1. vitreous humor leaks through retinal tear and accumulates underneath retina
  2. leakage can also occur through tiny holes where the retina has thinned due to aging or other retinal disorders
  3. less commonly, fluid can leak directly underneath retina without a tear or break
84
Q

Retinal Detachment Causes

A

spontaneous
severe nearsightedness
trauma
diabetes mellitus
inflammation
degenerative aging changes
scar tissue

85
Q

Retinal Detachment Manifestations

A

typically painless flashes of light in peripheral visual field
blurred vision
floaters
darkening vision (like curtain drawing across a visual field)

86
Q

Tinnitus

A

hearing abnormal noises in the ear

may be described as a ringing, buzzing, humming, whistling, roaring or blowing

87
Q

Tinnitus Associations

A

presbycusis
exposure to excessive noise
cerumen impaction
otosclerosis
ménière’s disease
stress
head injury
acoustic neuroma
atherosclerosis
hypertension
carotid stenosis
arteriovenous malformation
caffeine
ototoxic meds (many antibiotics, aspirin, chemo, diuretics)

88
Q

Vertigo

A

illusion of motion; NOT THE SAME AS DIZZINESS

n/v

89
Q

Peripheral Vertigo

A

there is a problem with vestibular labyrinth, semicircular canals or vestibular nerve

90
Q

Peripheral Vertigo Causes

A

certain meds (amino-glycoside antibiotics)
head injuries
ménière’s disease
nerve compression
infections
inflammation

91
Q

Central Vertigo

A

there is a problem in the brain (brain stem or cerebellum)

92
Q

Central Vertigo Causes

A

arteriosclerosis
certain meds (anti seizure agents and aspirin)
alcohol
migraines
MS
seizures

Pathology (10 decks)

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