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NUR 325 Patho > Skin disorders > Flashcards

Skin disorders Flashcards

1
Q

6 parts to skin disorders

A 
Fungal Infections 
Pigmented Lesions 
Viral Infections 
Bacterial Infections 
Skin Cancers 
Miscellaneous Disorders
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2
Q

2 Types of Fungal infections

A

Superficial skin lesions

Systemic Fungal Infections

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3
Q

3 ways of fungal transmission

A

Implementation: Tineas
Inhalation: cryptococcal
Taking antibiotics: candidiasis

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4
Q

T/F fungal infection are most common in the elderly and immuno-compromised

A

True

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5
Q

T/F Fungal infection Can proliferate more easily in patients with vascular indwelling catheters, organ transplant recipients and patients receiving chemo

A

True

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6
Q

4 types of Superficial fungal skin lesions

A

Tinea pedis
Tinea captitis
Tinea versicolor
Candidiasis

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7
Q

Superficial fungal infections includes what?

A

dermatophytes/fungi that infect hair, skin and nails
Candidiasis
Tineas

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8
Q

Fungal infections =

A

mycoses or dermatophytes

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9
Q

What is the treatment for Superficial fungal infections

A

Treatment: usually can be treated with topical antifungal preparations

Systemic antifungals needed for extensive areas or for treatment failures

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10
Q

2 types of common fungi

A

Yeast= Candida albicans

Superficial dermatophytes= Tineas

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11
Q

what is Tinea pedis

A

Dry, scaling pruritic lesions

May only affect skin in the web space between the toes

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12
Q

Risk factors for tinea pedis

A

Coming into contact with infected skin or fungus in the environment

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13
Q

prevention of tinea pedis

A

Use of shower shoes, cleaning tub/shower after each use may minimize transmission

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14
Q

treatment of tinea pedis

A

Topical antifungals in most cases. Most are OTC.

Systemic antifungals for resistant cases - oral or IV

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15
Q

4 characteristics of tinea capitis

A

can affect scalp, eyebrows or eyelashes
scaly erythematous lesions and hair loss
may cause permanent alopecia (baldness)
is the most common pediatric dermatophyte

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16
Q

treatment for tinea capitis

A

PO systemic anti-fungals bid for 4-6 weeks

Topicals are NOT effective

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17
Q

what is tinea versicolor

A

a ringworm that affects the skin of the upper chest, back, or arms
Is caused by a type of yeast that lives naturally on your skin
Rash occurs when the yeast grows out of control

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18
Q

risk factors of tinea versicolor

A

Hot climate, sweating a lot, oily skin, weakened immune system, NOT contagious

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19
Q

characteristics of tinea versicolor

A

Acidic bleach from the growing yeast causes skin discoloration.
Can be spots or patches that can be white, pink, red or brown,

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20
Q

treatment of tinea versicolor

A

Topical antifungals including shampoos such as Selsum Blue

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21
Q

what is candidiasis

A

Thrush/Yeast infection

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22
Q

risk factors for candidiasis

A

Immunosuppression (iatrogenic/acquired), antibiotic use

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23
Q

Appearance of candidiasis

A

may appear as white lesions in the mouth

Beefy red with satellite lesions in intertriginous areas

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24
Q

treatment for candidiasis

A

topical anti-fungal agents

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25
Q

3 systemic fungal infections that affect lungs

A

histoplasmosis, blastomycosis, pneumocystis

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26
Q

systemic fungal infection that affects lungs AND meninges

A

cryptococcosis

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27
Q

What is histoplasmosis

A

Fungal infection that mostly affects lungs
Histoplasma capsulatum = fungus that lives in the soil
Acquired when person breaths in the dust that contains the fungi

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28
Q

when does histoplasmossis occur

A

around 10 days after exposure

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29
Q

what are the symptoms of histoplasmosis

A

usually self-limiting and stays in the lungs

Systemic infections = may occur and can be fatal

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30
Q

what is the treatment for histoplasmosis

A

usually none unless severe or chronic disease occurs

Systemic antifungals usually to treat

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31
Q

what is blastomycosis

A

Caused by Blastomyces fungus
Typically affects the lungs
Acquired by breathing in the spores = AIRBORNE

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32
Q

symptoms for blastomycosis

A

Symptoms appear 3 weeks to 3 months after exposure
Most do NOT get sick
Flu-like symptoms can develop

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33
Q

treatment for blastomycosis

A

systemic antifungals for severe cases for 6 months to 1 year

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34
Q

what does pneumocystis cause

A

Causes a form of pneumonia: pneumocystis pneumonia

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35
Q

risk factors for pneumocyctis

A

immunocompromised

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36
Q

what causes pneumocystis

A

fungus is common in the environment; AIRBORNE

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37
Q

symtpoms of pneumocystits

A

mild, flu-like, pleuritic chest pain, fatigue

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38
Q

treatment for pneumocystis

A

treatment usually combo of 2 IV antifungals and corticosteroids

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39
Q

what is Cryptococcus meningitis

A

Fungus found in soil and bird droppings
Infection in the meninges rare in healthy people
Occurs in a few days to weeks from contact

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40
Q

symptoms of Cryptococcus meningitis

A

nausea/vomiting, change in mental status, lethargy, sensitivity to light

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41
Q

treatment of Cryptococcus meningitis

A

IV/PO antifungals

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42
Q

what is Cryptococcus: PULMONARY INFECTION

A

Acquired from inhalation of the fungus found in soil
Causes a severe pneumonia with respiratory failure
Incubation times vary from 2-11 months after exposure

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43
Q

symptoms of Cryptococcus: PULMONARY INFECTION

A

SOB, coughing, fever, mental status changes

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44
Q

treatment of Cryptococcus: PULMONARY INFECTION

A

PO/IV antifungals

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45
Q

2 types of pigmented lesions

A

melasma

vitiligo

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46
Q

what is melasma

A

Characterized by dark macules on the face
More common in women
Mask of pregnancy
Oral contraceptives

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47
Q

treatment of melasma

A

Avoid sun
Bleaching creams with hydroquinone
Tretinoin/Retin-A (vitamin A derivative

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48
Q

what is vitiligo

A

Acquired condition characterized by abnormalities in the production of melanin
Pigment disappears from a patch of skin
Occurs suddenly before or around the age of 21
Affected areas spread

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49
Q

treatment and cause for vitilgo

A

no treatments

casue unknown

50
Q

4 Viral skin infections

A

Verrucae Vulgaris

Human papilloma
virus

Herpes Zoster

Herpes Simplex: HSV1/HSV2

51
Q

what is Verrucae Vulgaris

A

common wart

52
Q

transmission of Verrucae Vulgaris

A

low risk of person to person; higher risk with wet, macerated skin; nail biting, thumb suck can cause spread to nails

53
Q

who is affected by Verrucae Vulgaris

A

children and young adults more commonly

54
Q

symtpoms of Verrucae Vulgaris

A

unusual skin growth identified by person as a wart

55
Q

treatment of Verrucae Vulgaris

A

usually self-limited and resolve on their own

Cryotherapy, duct tape, topical salicylic acid

56
Q

what is Human papilloma virus

A

Considered an STD; many different types of HPV (over 200)

57
Q

transmission of HPV

A

oral
vaginial
anal sex

58
Q

treatment of hpv

A

anti-virals

59
Q

Prevention and early diagnosis for HPV

A

Vaccine

pap smears

60
Q

What is Herpes Zoster: shingles

A

Varicella zoster virus lies dormant on a dermatome segment after infection with chickenpox

61
Q

what reactivates varicella zoster virus

A

Virus becomes reactivated by immunosuppression, stress, or illness

62
Q

what is prodrome in shingles?

A

Prodrome: burning/tingling along dermatome and then rash develops with vesicles that dry and crust over

63
Q

5 characteristics of shingles

A

Characteristics: vesicles on red base that follow along dermatomal distribution-asymmetric (does not cross midline)
Usually extremely painful
Clears in 2-3 weeks
Usually occurs in people over 50; can occur in anyone who has had chicken pox
Most contagious when vesicles are weeping

64
Q

treatment for shingles

A

anti-virals

65
Q

complications of shingles

A

post-herpetic neuralgia persistent pain in the area where the rash was

66
Q

5 bacterial skin infections

A 
Impetigo 
Abscess 
Furuncle
Cellulitis
MRSA (staph)
67
Q

Causative agents for impetigo

A

Staphylococci & Streptococci

68
Q

characteristics of impetigo

A

Organisms carried in the nose

Acute & CONTAGIOUS

69
Q

appearance of impetigo

A

vesicles, pustules, honey-colored crust on red base

70
Q

treatment of impetigo

A

Topical antibacterial = Bactroban

71
Q

5 characteristics of Abcess

A

Skin inflamed and red with collection of pus
Area often raised with palpable borders
Tender
May drain purulent discharge or feel ‘fluctuant’ (fluid-filled)

72
Q

Treatment for Abcess

A

incision & drainage (I&D) and antibiotics

73
Q

Furuncle

A

Furuncle is a bacterial infection of HAIR FOLLICLE

74
Q

carbuncle

A

Carbuncle is a painful, deep swelling of the skin caused by bacteria

75
Q

Treatment for Fuuncle and carbuncle

A

I&D and antibiotics

76
Q

what causes cellulitis

A

bacterial infection of skin and surrounding tissues (usually staph or strep bacteria)
May be an initial injury or wound that becomes infected and spreads to surrounding healthy tissue
May be caused by animal or insect bites
Often occurs on the lower extremities

77
Q

Is cellulitits contagious

A

No

78
Q

Appearance of cellulitits

A

red, painful, swollen and warm to the touch

Blisters may form on the skin

79
Q

Treatment of cellulitis

A

PO systemic antibiotics, IV depending on severity

80
Q

Methicillin resistant staph infection (mrsa)

A

MRSA is caused by a type of staph bacteria that is resistant to many antibiotics

81
Q

Hospital acquired-MRSA

A

associated with invasive procedures, such as surgeries, IV tubing, artificial joints

82
Q

Community acquired-MRSA

A

often begins as painful boil

83
Q

how is mrsa transmited

A

person-to-person

84
Q

High risk for MRSA

A

high school wrestlers, child-care workers, and people who live in crowded conditions

85
Q

MRSA symptoms

A 
warm to touch
purulent drainage
fever
abscess can develop quickly 
Bacteria can burrow deep into the body
potentially life-threatening infections of bones, joints, surgical wounds, bloodstream, heart valves and lungs
86
Q

Treatment of MRSa

A

hospital acquired = IV vancomycin or Zyvox
Community acquired = Bactrim or dicloxacillin
Prophylaxis = Bactroban nasal ointment prior to surgery

87
Q

3 types of skin cancers

A

Basal cell
Squamous cell
Melanoma

88
Q

2 types of precancerous lesions

A

Actinic keratosis

Solar lentigos

89
Q

Actinic Keratosis

A

Benign lesions
Due to damage by sun’s UV rays
Common in fair skin persons
Rough, scaly, red plaques

90
Q

Solar lentios

A

Benign lesions

Also known as liver/age spots

91
Q

basal cell carcinoma

A

Most common skin cancer in white-skinned people
Increased risk with sun exposure
Most curable  usually a non-metastasizing, slow growing skin tumor

92
Q

characteristics of basal cell

A

nodular form that begins as a small, flesh-colored or pink dome shaped bump
Translucent, shiny, pearly nodule
Eventually will form an ulcer surrounded by a shiny border

93
Q

squamous cell carcinoma

A

2nd most frequent skin cancer
Increased risk with sun exposure
Curable with early treatment
Can metastasize to lymph nodes or internal organs

94
Q

characteristics of squamous cell

A

red and scaling

Keratotic, slightly elevated lesion, with an irregular border, usually with shallow chronic ulcer

95
Q

Melanoma

A

Cancer of the melanocytes
Malignant cells grow on the skin = radially spreading in the epidermis & vertically spreading deep into the dermis
Can also form internally, in the eyes, and under the nails

96
Q

risk factors for melanoma

A

Family history of melanoma,
blond/red hair,
presence of freckling on the upper back,
history or more blistering sunburns before age 20,

history of more of 3 or more years of an outdoor job as a teenager

97
Q

Where does melanoma orginiate on the body

A

Originates on skin surface but penetrates deeply into the skin
Invades the blood and lymphatic vessels ant then metastasizes to distant sites

98
Q

characteristics of melanoma (ABCDE)

A

A: Asymmetrical: lesions vary in size and shape

B: Borders: are irregular

C: Color: varies from one area to another.
Shades of tan, brown, and black; sometimes white, red, or blue

D: Diameter: greater than 6 mm/size of a pencil eraser

E: Evolving: a mole or skin lesion that looks different from the rest or is changing in size, shape or color

Most deadly form of skin cancer
Superficial spreading type = 70%
Nodular form is the most aggressive

99
Q

6 types of misc skin disorders

A 
Eczema 
Stasis dermatitis
Psoriasis 
Drug reactions 
Urticaria 
Angioedema
100
Q

eczema

A

Group of skin conditions that cause the skin to become inflamed or irritated
Not contagious
Atopic eczema: most common type; inherited tendency to develop eczema, asthma, and hay fever

101
Q

characteristics/symptoms of eczema

A

pruritis,
rash on face/back of knees/wrists/hands/feet,
skin very dry/thickened/scaly,
lesions may appear reddish and then turn burn;
lesions can ooze & crust over;
can be exacerbated by heat, cold, detergents, URI, and stress

102
Q

eczema treatment

A 
Relieve itching/prevent infection 
Lotions and creams to keep skin moist
Cold compresses
OTC hydrocortisone cream or prescription strength 
Immune modulator medications
103
Q

Stasis dermatitis (Chronic venous insufficiency)

A

Condition found primarily in the lower extremities = also know as ‘venous eczema’
Cause: poor venous circulation

104
Q

characteristics of statis dermatitis

A

More common in people over the age of 50
One way valves in legs fail and fluid and pressure builds up
Blood leaks out of the veins into the skin

105
Q

symptoms of statis dermatitis

A

redness & scaling present
Ulcerations may develop and a secondary bacterial infection may occur

edema around the ankles is often 1st sign
Skin can appear reddish, yellowish, or brown color
Itching, pain, sores that ooze/crust/scale, thickened skin around the ankles/shins, hair loss on ankles or shins

106
Q

treatment of statsis dermatitis

A

compression stockings, elevate feet above the heart, exercise, diuretics for edema, antihistamines for the itching, surgery to repair valves

107
Q

Psoriasis

A

over-active immune system, may be autoimmune

Long-term, chronic condition
Most commonly begins in young adulthood
NOT contagious
Affects 1-3% of population

Most common in adults
Research shows that there is a link between psoriasis/obesity/cardiovascular diseases

108
Q

characteristics of psoriasis

A

skin cells grow too quickly causing skin to be thick, white, silvery, or have red patches of skin  plaques
Normal skin cells grow gradually and flake off about every q 4 weeks

109
Q

treatment of psoriasis

A

keep skin moist, UV light phototherapy, corticosteroid creams/lotions, topical medications, immune modulating medications

110
Q

T/F MOST drugs can cause a local or generalized skin eruption

A

True

111
Q

Drug-induced skin reactions Appearance

A

typically, maculo-popular rash, bright red

112
Q

Drug-induced skin reactions Distribution

A

usually starts on trunk, spreads to limbs, usually does not affect face
Itches and burns
May start at any time during course of drug therapy through 2-3 weeks post-medicinal course is completed

113
Q

T/F Penicillins and cephalosporins often cause Drug-induced skin reactions

A

True

114
Q

Urticaria/Hives

A

Manifestation of an allergic reaction

Characterized by edematous plaques that cause INTENSE ITCHING

115
Q

Describe Urticaria lesions

A

raised pink/red areas surrounded by a paler halo that blanch with pressure

May see swelling of the tongue or pharynx, larynx usually spared

116
Q

Common causes of Urticaria

A

food, drinks, medications, insect stings, viral infections, dust mites, exposure to pollen or chemicals

117
Q

Histamine’s role in Urticaria

A

is mediator in most cases, causing hyper-permeabilty of the micro-vessels in the skin and allowing fluid to leak into the tissues causing edema and wheal formation

118
Q

Angioedema

A

Severe form of urticaria

Will see thicker lesions from massive transudation of fluid into the dermis/subcutaneous tissue

119
Q

Where does Angioedema usually affect

A

Typically affects the lips, periorbital area, hands, feet, penis, or scrotum

120
Q

Potential complications of angioedema

A

airway obstruction due to laryngeal edema

NUR 325 Patho (18 decks)

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