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Maddy - PCM III > SKin Changes > Flashcards

SKin Changes Flashcards

1
Q

6 Ps of acute limb ischemia

A

Parasthesia

perishing cold

pulselessness

pain

paralysis

pallor

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2
Q

superficial varicosities and edema indicate ____

A

poor venous return due to incompetent valves in the veins

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3
Q

describe how varicosities form

A

the valves in the veins don’t close properly which causes backflow and dilation of the vessel

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4
Q

describe stasis dermatitis and what causes it

A

reddish/purplish/brownish discoloration in the skin that develops over time

due to hemosiderin deposits staining the skin from red cell breakdown due to decreased blood flow or “stasis” of venous circulation

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5
Q

describe advanced stasis dermatitis

A

thickened skin, firm to the touch

“brawny edema” term often used to describe if swollen

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6
Q

describe cellulitis and its presenting symptoms

A

inflammation of the skin and subcutaneous tissue from an infection

  • marked erythema
  • increased warmth
  • increased swelling
  • sometimes skin weeping w/o any apparent open sores
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7
Q

describe the appearance and cause of janeway lesions

A

bacterial endocarditis

  • irregular macules on the soles and palms that are non-tender, last days to weeks
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8
Q

describe the appearance and cause of osler nodes

A

bacterial endocarditis

  • tender nodules 1mm-1cm on the fingers and toes and thenar and hypothenar eminences, last hours to days
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9
Q

describe the appearance and cause of splinter hemorrhages

A

bacterial endocarditis

  • microemboli in the periphery of the nail bed produced from valvular pathology

*more likely due to nail trauma if isolated or minimal involement

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10
Q

describe the appearance and cause of xanthelasmas

A

hyperlipidemia

  • lipid laden deposits on the eyelids
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11
Q

describe the appearance and cause of eruptive xanthomas on the shoulder

A

hyperlipidemia

  • umbilicated lesions (dent in the center of a papule) that can look like molluscum contagiosum (viral infection)
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12
Q

do all patient who have hyperlipidemia present with xanthomas

A

nope

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13
Q

cause of clubbing

A

chronic pulmonary disease

  • lung dz most common
  • platelet and endothelial growth factors may contribute to the process
  • peripheral hypoxia may be the trigger
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14
Q

compare (between vascular or neurogenic) the symptoms suggesting claudication:

factor: after a pt walking

A

vascular: unchanged
neurogenic: increased weakness

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15
Q

compare (between vascular or neurogenic) the symptoms suggesting claudication:

factor: palliative factors

A

vascular: stopping activity
neurogenic: bending over, sitting, or general leaning forward takes pressure off nerves

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16
Q

compare (between vascular or neurogenic) the symptoms suggesting claudication:

factor: provocative factors

A

vascular: walking uphill, increased metabolic demand neurogenic: walking downhill, increased lordosis

17
Q

compare (between vascular or neurogenic) the symptoms suggesting claudication:

factor: pulses

A

vascular: absent neurogenic: present

18
Q

list notable sx of chronic bronchitis (i know we’ve learned this a million times but just look over so you don’t forget)

A

“blue bloater”

  • chronic, productive cough
  • purulent sputum
  • hemoptysis
  • mild dyspnea
  • cyanosis
  • crackles
  • obese
19
Q

list notable sx of emphysema (i know we’ve learned this a million times but just look over so you don’t forget)

A

“pink puffer”

  • dyspnea
  • minimal cough
  • pink skin
  • pursed lip breathing
  • accessory muscle use
  • cachexia
20
Q

complications of chronic bronchitis

A
  • secondary polycythemia due to hypoxemia
  • pulm. HTN due to reactive vasoconstriction from hypoxia
  • cor pulmonale from chronic pulm. HTN
21
Q

complications of COPD

A
  • pneumothorax due to bullae (cyst)
  • weight loss due to work of breathing
22
Q

compare peripheral and central vascular disease

A

peripheral: sx seen in the extremities
central: affecting aorta, IVC, major organ vessels

23
Q

describe the proper diet to reduce risk for peripheral and central vascular dz

A

low salt

low fat

high fiber

24
Q

how does alcohol contribute to peripheral and central vascular dz

A

it contributes to cardiomyopathy and mitochondrial endothelial dysfunction also the dehydrating effects causes sludging or congestion/impairment of optimum blood flow

25
Q

what is the plan to implement therapeutic lifestyle changes (TLC) to modify sx and slow progression of vascular dz

A
  • stop smoking
  • exercise/weight loss
  • compressing/support stockings
  • psychosocial support
  • follow up regularly
26
Q

how to prioritize a step-wise behavior modification to optimize pts success

A
  • work w/ pt to decide which TLC is most manageable
  • maybe include meds
  • consider social service, physical therapy, occupational therapy, counseling, dietary education
  • set realistic goals :)
27
Q

what diagnostic tests would you use to evaluate underlying risk factors for cardiopulmonary dz

A
  • CBC (check for anemia)
  • lipid panel
  • fasting blood sugar (check for DM)
  • EKG
  • CXR
  • ankle/brachial index
  • venous/arterial doppler US
  • interventional radiology or cardiology
28
Q

what causes this physical exam finding

A

(varicosities and edema)

pour venous return due to incompetent valves

29
Q

what causes this physical exam finding

A

usually infection

(cellulitis)

30
Q

what causes this physical exam finding

A

(janeway lesion)

bacterial endocarditis

31
Q

what causes this physical exam finding

A

(oslers nodes)

bacterial endocarditis

32
Q

what causes this physical exam finding

A

(splinter hemorrhages)

bacterial endocarditis

33
Q

what causes this physical exam finding

A

(eruptive xanthomas)

hyperlipidemia

34
Q

what causes this physical exam finding

A

(clubbing)

chronic lung dz

35
Q

what causes this

A

(stasis dermatitis)

  • Due to hemosiderin deposits staining the skin from red cell breakdown
  • Occurs with decrease flow or “stasis” on venous side of circulation
36
Q

what is this

A

advanced stasis dermatitis

“brawny edema”

Maddy - PCM III (5 decks)

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