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13. SBL Exam 1 > Skin Changes in Skin, Blood, and Lymph > Flashcards

Skin Changes in Skin, Blood, and Lymph Flashcards

1
Q

Five illnesses that manifest with a diffuse maculopapular rash

A

1) measles
2) rubella
3) erythema infectiosum
4) infectious mononucleosis
5) lyme disease

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2
Q

Prodrome of measles (4)

A

1) fever
2) cough
3) coryza
4) conjunctivitis

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3
Q

Describe rash of measles

A
  • brick red, irregular maculopapular
  • appears 3-4 days after onset of prodrome
  • begins on the face and proceeds “downward and outward”, affecting palms and soles last
  • lasts 3 - 5 days
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4
Q

What PEx finding is pathgnomonic with measles?

A

koplik spots

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5
Q

Symptoms of rubella

A
  • enlargement of cerival, suboccipital, and postauricular glands
  • rash of 2 - 3 days duration
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6
Q

Rash associated with rubella

A
  • erythematous macules and papules appearing initially on the face and speading to the trunk, arms, and legs within 24 hours
  • rash lasts 2 - 3 days
  • desquamation may follow resolution of rash
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7
Q

Disease association erythema infectiosum

A

Parvovirus B19 infection, “fifith disease”

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8
Q

Describe rash of “fifth disease”

A
  • fiery red “slapped cheek” appearance
  • circumoral pallor
  • subsequent lacy, maculopapular, evanescent rash on the trunk and limbs
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9
Q

Sx besides rash in fifth disease (3)

A
  • malaise
  • headache
  • pruritus
  • (little fever)
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10
Q

common cause of myocarditis in childhood

A

parvovirus B19

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11
Q

What can parvovirus B19 mimic?

A

autoimmune states

(lupus, systemic sclerosis, antiphospholipid syndrome, vasculitis)

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12
Q

Sx Parvovirus infection in adults (3)

A
  • eczema-like rash
  • inflammatory arthritis
  • premature labor/hydrops/fetal loss in pregnancy
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13
Q

Rash associated with Lyme disease

A

erythema migrans,

a flat or slightly raised red lesion that expands with central clearing

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14
Q

Stage 1 of Lyme Disease

A

Early localized infection

Erythema migrans

(flat or slightly raised red lesion at the bite site ~1 week after tick bite)

common in areas of tight clothing (groin, thigh, axilla)

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15
Q

Lyme disease stage 2

A

Early disseminated infection

Bacteremia

  • malaise, fever, fatigue, headache, neck pain
  • secondary skin lesions (similar to primary lesion but smaller)
  • myopericardiditis, neuro manifestations, conjunctivitis
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16
Q

Lyme disease stage 3

A

Late persistent infection (months to years later)

  • arthritis
  • neurologic manifestations
  • acrodermatitis chronicum atrophicans (resembles scleroderma_
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17
Q

Cause of infectious mononucleosis

A

Epstein Barr virus

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18
Q

How is EBV transmitted?

A

By saliva, but also genital secretions

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19
Q

Symptoms of infectious mononucleosis

A
  • malaise, fever, (exudative) sore throat
  • palatal petechiae, lymphadenopathy, splenomegaly
  • occasionally a maculopapular rash
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20
Q

Lab testing for mono

A

+ heterophile agglutination test (Monospot)

atypical large lymphocytes in blood smear

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21
Q

What is Hoagland sign and when is it seen?

A

transient bilateral upper lid edema;

Mononucleosis

22
Q

Infections that cause peripheral skin eruptions (4)

A

1) meningococcemia
2) rocky mountain spotted fever
3) secondary syphilis
4) hand/foot/mouth disease

23
Q

Cause of Rocky mountain spotted fever &

route of transmission

A

Rickettsia rickettsii

Parasite of ticks, transmitted by tick bites

24
Q

Describe rash associated with Rocky mountain spotted fever

A

Begins as faint macule that progresses to large maculopapules & petechiae

Rash starts of wrists & ankles, characteristically involves palms & soles

spreads to arms, legs, & trunk

25
Q

Desribe rash of secondary syphillis

A

Rash: diffuse (may include palms & soles)

macular, papular, pustular, and combinations

Condyloma lata

Mucous patches: painless, silvery ulcerations`

26
Q

Skin infections related to Coxsackie infection

A

1) hand-foot-mouth disease
2) herpangina

27
Q

Describe rash of Hand-foot-mouth

A

Stomatitis

Vesicular rash on hands & feet

vesicles erode and form “football-shaped” eroisions surrounded by erythematous halo

28
Q

Infections that cause desquamative skin changes (3)

A

1) toxic shock syndrome
2) scarlet fever
3) erythema multiforme

29
Q

Organism that causes of Toxic Shock syndrome

A

Strains of staphylococci

30
Q

Describe rash of toxic shock syndrome

A

Diffuse macular erythematous rash

(w/ nonpurlulent conjunctivitis)

Desquamation of palms and soles is typical with recovery

31
Q

Rash associated with Scarlet fever

A

Generalized, punctate, red:

prominent on neck, in axillae, groin, and skin folds

circumoral pallor

Fine desquamation involves hands & feet

32
Q

Infections related to erythema multiforme (2)

A

1) Herpes simplex virus
2) Mycoplasma pneumoniae

33
Q

Describe erythema multiforme rash

A

Rare cutaneous or mucocutaneous eruption characterized by “target” lesions

predominantly on the face & extremities

34
Q

Non-cutaneous lesions associated with erythema multiforme

A

mucosal lesions are present in up to 70%, usually in oral cavity

predilection for the lips

35
Q

Describe the rash of varicella

A

Highly contagious exanthem, most often occurs in childhood

Usually begins on face and scalp, spreads rapidly to the trunk

Relative sparing of extremities

vesicles, pustules, and crusts

***Lesions in all stages of healing present at the same time**

36
Q

Cause of pemphigus

A

autoimmune disease

37
Q

Describe lesions of pemphigus

A

can be pruritic or painful

exposure to UV radiation may excacerbate disease

Primary lesion is a flaccid blister which may occur anywhere, but typically not the palms and soles

38
Q

Infections that cause petechial & purpuric lesions (3)

A

1) gonococcemia
2) meningococcemia
3) thrombotic thrombocytopenic purpura

39
Q

Classic triad of gonoccemia

A

1) dermatitis
2) migratory polyarthritis
3) tenosynovitis

40
Q

Cutaneous lesions associated with gonoccemia

A

Hemmorrhagic vesicopustules on an erythematous base

located on the palms and soles

Lesions may develop necrotic centers (“gun metal gray”)

41
Q

Rash associated with acute meningococcemia

A

classic petechial rash

(in severe cases, with DIC, necrosis of skin and underlying tissue may necessitate amputation –> purpura fulminans)

42
Q

Describe rash of chronic meningococcemia

A

rose-colored macules and papules

*rash may wax and wane with periodic fevers

43
Q

Pentad associated with Thrombotic Thrombocytopenic Purpura

A

1) microangiopathic autoimmune hemolytic anemia
2) thrombocytopenia (petechial lesions)
3) neurologic symptoms
4) fever
5) renal failure

44
Q

Palpable vs. Nonpalpable Purpuric disorders

A
45
Q

Most common form of skin cancer

A

basal cell carcinoma

46
Q

Describe appearance basal cell carcinoma and typical location

A

Waxy, “pearly” appearance, with telangiectatic vessels easily visible

Usually on the back, chest, and lower legs

47
Q

Describe appearance squamous cell carcinoma of the skin

A

nonhealing ulcer or warty nodule

appear as small, red, conical, hard nodules that occasionally ulcerate

48
Q

Precursor lesion to SCC

A

actinic keratosis

49
Q

Mutation associated with melanoma

A

p16

50
Q

Most common locations of melanoma

A

Back for men

Lower extremities followed by trunk for women

51
Q

Screening tool for melanoma

A

A - asymmetry

B - border

C - color (black, blue, white)

D - diameter ( >5mm)

E - evolution

*color carries the greatest sensitivity and specificity for metastatic potential

13. SBL Exam 1 (3 decks)

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