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NUE 325: Pathopharm I > Skin Disorders > Flashcards

Skin Disorders Flashcards

1
Q

Fungal transmission

A
  • implementation
  • inhalation
  • taking abx
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2
Q

fungal infections most common in

A

elderly and immuno compromised
- proliferates more easily in pt w vascular indwelling catheters, organ transplant recipients, chemo pts

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3
Q

superficial fungal infections organisms

A
  • tinea pedis
  • tinea captitis
  • tinea versicolor
  • canadiasis
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4
Q

superficial fungal infections include

A
  • mycoses or dermatophytes
  • infect hair, skin, nails
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5
Q

treatment of superficial fungal infections

A

topical

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6
Q

yeasts

A

candida albicans

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7
Q

superficial dermatophytes

A

tineas

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8
Q

tinea pedis characteristics

A
  • dry scaling pruritic lesions
  • skin affected may only be in web spaces
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9
Q

risk factors of tinea pedis

A
  • coming into contact w infected skin or fungus in the env
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10
Q

prevention of tinea pedis

A
  • shower shoes
  • cleaning tubs and showers after use
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11
Q

treatment of tinea pedis

A
  • topical antifungals usually
  • systemic for resistance (oral/IV)
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12
Q

tinea capitis characteristics

A
  • scaly erythematous lesions and hair loss
  • can cause permanent alopecia
  • most common for peds dermatophyte
    affects scalp, eyebrows, eyelashes
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13
Q

treatment for tinea capitis

A

PO systemic antifungals bid 4-6 wks
- topicals not effective

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14
Q

tinea vericolor patho

A

ring worm that affects skin of upper chest, back, arms
- rash occurs and then yeast grows out of control

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15
Q

tinea vericolor risk factors

A

hot climate, sweating, oily skin, weakened immune system
- not contagious

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16
Q

characteristics of tinea versicolor

A

acidic bleach that causes discoloration
- spots or patches that are white pink, red, brown

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17
Q

treatment of tinea veriscolor

A

topical antifungals
- shampoo
- selsum blue

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18
Q

candidiasis risk factors

A

immunosuppression or abx use

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19
Q

candidiasis appearance

A
  • white lesions in the mouth
  • beefy red satellite lesions in intertrigous areas (skin on skin)
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20
Q

candidiasis treatment

A

topical anti fungals

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21
Q

systemic fungal infections where

A
  • aggressive treatment
  • affect internal organs (intestines, urinary, lungs, brain)
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22
Q

systemic fungal infections lungs

A
  • histoplasmosis
  • blastomycosis
  • pneumocystis
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23
Q

systemic fungal infections lungs and meninges

A

cryptococcosis

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24
Q

viral skin infections

A
  • herpes zoster
  • herpes simplex
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25
Q

herpes zoster

A

shingles

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26
Q

herpes zoster infections

A
  • lies dormant on a dermatome segment after infection w chickenpox
  • virus becomes reactivated by immunosuppression, stress, illness
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27
Q

prodrome

A

burning/tingling along dermatome
- rash develops with vesicles that dry and crust over
- usually unilateral

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28
Q

characteristics of shingles

A

vesicles on red base that follow dermatomal distribution asymmetric
- xtremely painful
- clear 2-3 wks
- typically over 50 but anyone w chicken pox
- most contagious when weeping

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29
Q

treatment for shingles

A

anti viral

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30
Q

complications of shingles

A

post herpetic neuralgia persistent pain in the area where rash was

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31
Q

bacterial skin infections

A
  • impetigo
  • abscess
  • furuncle
  • cellulitis
  • MRSA
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32
Q

impetigo

A

acute and contagious infection where the organisms infect the nose
- cause vesicles, pustules, honey colored crust on red base
- staphylococcus and streptococcus

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33
Q

treatment for impetigo

A

topical antibacterial
- bactroban

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34
Q

abscess

A

inflamed, tender skin with redness and a collection of pus
- area often raised w palpable border
- may drain purulent discharge or feel fluctuant (fluid filled)

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35
Q

treatment for abscess

A

incision, drainage, abx

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36
Q

furuncle

A

bacterial infection of hair follicle

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37
Q

carbuncle

A

painful deep swelling of the skin caused by bacteria

38
Q

treatment of furuncle and carbuncle

A

incision, drainage, abx

39
Q

cellulitis cause

A

bacterial infection of the skin and surrounding tissue
- usually staph or strep
- may be initial injury or wound that becomes infected (animal or insect bites often on lower extremity

40
Q

cellulitis: contagious?

A

not contagious but can become dangerous if spreads to lymph nodes and blood stream

41
Q

cellulitis appearance

A
  • red, painful, swollen, warm to touch
  • blisters sometimes form
    mark to make sure not spreading
42
Q

treatment of cellulitis

A

PO systemic antibiotics
IV depending on severity

43
Q

MRSA

A

bacteria that is resistant to many abx
- can be hospital associated from invasive procedures like surgery, IV tubing, artificial joints
- can be community acquired which often begin as a pain full boil spread by person to person contact (wrestlers, child care workers, crowded conditions)

44
Q

symptoms of MRSA

A
  • warm to touch
  • purulent draining
  • fever
  • abscess can develop quickly
    potentially life threatening, infection can burrow deep in body, in bones, joint, surgical wounds, bloodstream, heart valves, lungs
45
Q

treatment of MRSA

A
  • hospital acquired: IV vancomycin, Zyvox
  • community acquired: bactrim, dicloxacillin
  • prophylaxis: bactroban nasal ointment prior to surgery
46
Q

types of skin cancer

A
  • basal cell
  • squamous cell
  • melanoma
47
Q

precancerous lesions

A
  • actinic keratosis
  • solar lesions
48
Q

actinic keratosis

A
  • benign lesions due to damage from UV rays
  • common in fair skin
  • rough, scaly, red plaques
49
Q

solar lesions

A
  • benign lesions also known as liver/age spots
50
Q

basal cell

A

most common but often least malignant
- most curable and usually non metastasizing

51
Q

squamous cell

A

2nd most common, can metastasize to remote areas
- curable w early treatment
- can metastasize to lymph nodes and internal organs
- inc risk w sun exposure

52
Q

melanoma

A

cancer of melanocyte
- rarer but high rate of metastasizing
- grows radially in epidermis but can go vertically deep into the dermis

53
Q

skin lesion characteristics

A
  • asymmetry
  • border
  • color
  • diameter
  • evolution/elevation
54
Q

characteristics of basal cell

A

nodular form that begins as small flesh colored or pink dome shaped bump
- translucent, shiny, pearly nodule
*ulcer w shiny border

55
Q

characteristics of squamous cell

A

red and scaling
- keratotic, slightly elevated lesion w irregular border, usually shallow chronic ulcer

56
Q

risk factors of melanoma

A

fam history
- red/blond hair
- freckling of upper back
- blistering sun burns before 20
- 3 or more years of outdoor job as teen

57
Q

where does melanomas invade

A
  • blood and lymphatic vessels
  • metastasizes to distant sites
58
Q

melanoma characteristics

A
  • A: lesions vary in size and shape
  • B: irregular
  • C: varies, brown, black, tan, sometimes red, white, blue
  • D: greater than 6 mm (size of pencil eraser)
  • E: looks different that the rest and can change in size, color, shape
59
Q

most deadly type of skin cancer

A
  • superficial spreading type= 70%
  • nodular form = most aggressive
60
Q

eczema

A

group of skin conditions that cause skin to be inflamed or irritated
- not contagious
- thought to be caused by overactive immune system

61
Q

atopic eczema

A
  • most common type
  • inherited tendency to develop eczema, asthma, hay fever
62
Q

characteristics of eczema

A

puritis, rash on face back knees wrists hands feet, skin thickens or becomes scary
- lesions appear red then burn, can ooze and crust over
- can be exacerbated by heat, cold, detergents, URI, stress

63
Q

treatment of eczema

A

relieving ithcing/preventing infection
- lotions and creams to keep skin moist
- cold compress
- OTC hydrocortisone cream or prescription strength
- immune modulator meds

64
Q

psoriasis

A

long term chronic condition that typically begins in young adult caused by an overactive immune system
- not contagious
- 1-3% of population
- caused by overactive immune system, may be autoimmune
- link btw obesity, cardiovascular disease

65
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 q 4 wks

66
Q

treatment of psoriasis

A
  • keep skin moist
  • uv light phototherapy
  • corticosteroid cream
  • topical med
  • imune modulating meds
67
Q

four major classes of anti fungal

A
  • polyenes
  • pyrmidine
  • azoles
  • mics agents
68
Q

nystatin class

A

polyene

69
Q

nystatin indications

A
  • superficial candida infections of mouth, oral mucosa, vagina, skin
70
Q

forms of nystatin

A
  • creams
  • powders
  • topical
  • vaginal
71
Q

can nystatin be given parenteral

A

NO too toxic

72
Q

side effects of nystatin

A

not many
- mild skin irritation
- NDV if oral
- poor GI absorption

73
Q

amphotericin B class

A

polyene

74
Q

amphotericin B indication

A

more often used for systemic mycoses

75
Q

amphotericin B MOA

A

binds to ergosterol causing cell wall o become leaky and ultimately destroy it

76
Q

amphotericin B route

A
  • PO
  • parenteral (usually IV)
77
Q

amphotericin B nursing considerations

A
  • high alert drug
  • iv admin must be diluted and admin slowly
  • monitor BUN, Cr, cardiac
  • must be given q other day for several months
  • pre treat w diphenhydramine, acetaminophen, aspirin to dec fever, pain, N, headache
78
Q

amphotericin B synergetic w

A

flucytosin
- allows to dec dose which allows a dec symptoms associated

79
Q

flucytosine class

A

pyrimidine

80
Q

flucytosine moa

A

inhibits fungal DNA synthesis

81
Q

flucytosine indications

A

allows for lower dose of amphotericin B to help dec se

82
Q

azoles meds

A
  • ketoconzaole
  • miconazole
  • clotrimazole
  • itraconazole
  • fluconazole
83
Q

azoles moa

A

interrupts the integrity of the cell wall by interfering w synthesis of ergosterol

84
Q

azoles indications

A

superficial and less serious fungal infections

85
Q

azoles side effects

A

topical
- redness, buring, itching
systemic
- severe GI upset (NVD)
- liver toxicity

86
Q

azoles admin

A
  • take w food
  • oral: separate at least 2 hours from antacids
87
Q

fluconazole advantages

A
  • rapidly and completely absorbed when given orally so able to reach bones, CNS, eyes, respiratory, urinary track
  • much less toxic than amphotericin *
88
Q

fluconazole disadvantages

A
  • narrow spectrum
  • many drug interactions (CYP450 pathway)
89
Q

nursing implications fluconazole

A
  • do not mix IV fluconazole
  • monitor coags
  • watch for hypoglycemia
  • inc haldol and dilantin levels
90
Q

grisefulvin/fulvicin moa

A

inhibits fungal mitosis by binding to keratin
- does not affect the cell wall or membrane

91
Q

grisefulvin/fulvicin side effects

A
  • bone marrow suppression
  • rash
  • CNS changes
  • NVD
  • anorexia
92
Q

grisefulvin/fulvicin indications

A
  • resistant germatophyte infection of scalp, skin, nails

NUE 325: Pathopharm I (23 decks)

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