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Physical Diagnosis (Lauren) > Skin, Nails > Flashcards

Skin, Nails Flashcards

1
Q

Hair, nails, sebaceous glands and sweat glands are_____

A

Appendages of the skin

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2
Q

5 Roles of the skin

A 
Protect from infection and trauma
Prevent fluid loss
Regulate temperature
Sensory
Produce Vitamin D
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3
Q

What equipment is needed for an examination of the skin?

A

Ruler (cm)-clear and bendy

Light source

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4
Q

Is it OK for the pt to leave their clothes on for a skin exam?

A

No- adequate exposure is important.

Armpit, butt, back of thighs, between toes….everywhereeeee needs to be checked

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5
Q

What 4 things are checked during the “Inspection” part of a skin exam?

A

Symmetry (is rash bilateral etc)

Color (pigmentation, pallor, cyanosis, jaundice)

Hair (distribution, amount)

Nails (color, lesions, capillary refill)

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6
Q

What 4 things are checked during the “palpation” part of a skin exam?

A

Moisture

Temperature-use back of hand

Texture

Mobility&Turgor-do forearm except in old people, use thigh

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7
Q

What does a generalized/disseminated rash look like?

A

Lesions appear widely distributed

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8
Q

What does a regional distribution of a rash look like?

A

Lesions appear in a specific region of the body

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9
Q

What is an annular lesion?

A

A round lesion with active margins and a central clearing

Annular means ring shaped

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10
Q

What does it mean if a lesion has a zosteriform shape?

A

It follows a dermatome/Nerve segment

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11
Q

What does an iris/target shaped lesion consist of?

A

A pink macule with a purple papule in the middle

Pink flat spot with purple bump

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12
Q

What does morbilliform mean?

A

Measles-like. Usually associated with viruses

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13
Q

What does violaceous mean?

A

Light purple

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14
Q

What are the ABCDEs of malignant melanoma? (E could be two things)

A 
Asymmetry
Borders (irregular)
Color- variable 
Diameter- over 6mm
Elevation or Evolving
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15
Q

What are primary skin lesions?

A

Arise from previously normal skin

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16
Q

What is a secondary skin lesion?

A

Arise from changes in primary lesions, such as scratching an initial lesion until it gets worse/infected

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17
Q

What is a macule?

A

Flat
Smaller than 1cm
Any color
Well circumscribed

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18
Q

What are some examples of macules?

A

Measles
Freckles
Petechiae

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19
Q

What is a patch?

A

Flat spot

BIGGER than 1cm

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20
Q

What is the difference between a macule and a patch?

A

A patch is bigger than 1cm

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21
Q

Mongolian spots, cafe au last spots, port wine stain, vitiligo… these are all examples of what type of lesion/

A

Patch

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22
Q

What is a papule?

A

Palpable
Circumscribed bump
No bigger than 1cm***

Can join together to form plaques

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23
Q

Warts, nevi and mollusum contagiasum are examples of?

A

Papules

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24
Q

What is a plaque?

A

Elevated, palpable rough lesion that is

Bigger than 1cm**

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25
Q

Psoriasis and eczema (when it’s elevated) are examples of

A

Plaques

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26
Q

Difference between papule and plaque?

A

Plaque is bigger than 1cm

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27
Q

What is a nodule?

A

A lesion that is deeper and firmer than a papule

Bigger than .5cm***

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28
Q

What is the difference between a papule and a nodule?

A

A nodule is deeper and firmer than a papule

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29
Q

What is a tumor?

A

A large nodule that is OVER 2cm**

Sticks deeper into the dermis too

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30
Q

Difference between a nodule and a tumor?

A

A tumor is deeper and bigger (over 2cm)

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31
Q

What is a wheal?

A

A transient**, superficial edema

Irregular borders

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32
Q

Mosquito bites and hives are examples of what/

A

Wheals

33
Q

What is a vesicle?

A

Fluid filled, round lesion that is 1cm or smaller**

34
Q

Herpes simplex, which looks like “dew drops on rose petals” is an example of ?

A

Vesicles

35
Q

What is a bulla?

A

A fluid filled round lesion that is bigger than 1cm***

BLISTER

36
Q

What is a hemorrhagic bulla?

A

A bulla that is filled with blood instead of serous fluid

37
Q

What is a pustule?

A

Elevated lesions that are filled with pus**

38
Q

Acne, impetigo and fire ant bites are examples of?

A

Pustules

39
Q

Do erosions bleed or scar?

A

No, it is loss of superficial epidermis

40
Q

What is an erosion?

A

Loss of superficial epidermis with a moist surface, but doesn’t bleed.

41
Q

What is an ulcer?

A

Loss of epidermis and dermis

42
Q

What is the difference between an erosion and an ulcer?

A

An erosion is only the superficial epidermis, it doesn’t bleed and it doesn’t scar.

An ulcer involves loss of dermis, so it bleeds and it scars when it heals.

43
Q

What is a fissure/

A

A linear crack from the epidermis to the dermis

44
Q

What is an excoriation?

A

Abrasion or scratch mark usually from scratching

45
Q

What is a crust?

A

Dried residue of serum, pus or blood

46
Q

What is a scale?

A

A thin flake of epidermis that has been shed

47
Q

Dandruff is an example of?

A

Scales on scalp

48
Q

What is lichenification?

A

Skin become thick, rough and leathery due to so much scratching.

49
Q

What type of skin condition is associated with increasing the visibility of skin markings?

A

Lichenification

50
Q

What is atrophy (wrt skin)

A

Thinning of skin with loss of normal skin markings

Skin is shinier and more translucent

51
Q

Topical steroid use is associated with what type of skin condition?

A

Atrophy

52
Q

What are petechiae?

A

Small, dark round/purple spots that represent blood outside the vessel.
Smaller than .5cm**
NON BLANCHABLE**

53
Q

What are purpura?

A

Dark red/purple spots that are BIGGER than .5cm**
Non blanchable
Represent blood outside vessel

54
Q

Difference between purpura and petechiae?

A

Purpura are bigger than .5cm

55
Q

What is ecchymosis?

A

Purple lesions that represent blood outside of vessels due to trauma or bleeding disorder.
Fade to green/yellow

56
Q

How would you tell the difference between spider angioma and a petechiae?

A

Push on it. Spider angiomas do blanch.

57
Q

How big are spider angiomas?

A

Up to 2cm

58
Q

What are cherry angiomas?

A

Small bright red papules on the trunk, associated with aging

59
Q

How big are cherry angiomas?

A

1-3mm

60
Q

Do cherry angiomas blanch?

A

No

61
Q

Do telangiectasias blanch?

A

Yes

62
Q

What are telangiectasias associated with?

A

BCC

63
Q

What are hemangiomas?

A

Big red bump secondary to dilation of dermal capillaries.

Similar to cherry angiomas, but much bigger and usually seen in children.

64
Q

What is a papulosqaumous lesion?

A

One that has:
Papules
Plaques
Scales

65
Q

What rash is associated with the 5 P’s?

A

Lichen Planus

Pruritic
Polygonal
Planar
Purple 
Papules
66
Q

Are nodular lesions benign or malignant?

A

Can be both

Nevi, cherry angiomas, SCC, BCC

67
Q

What is a vesiculobullous lesions

A

Has vesicles and bullae together

Herpes, impetigo, pemphigus

68
Q

What is pemphigus?

A

An autoimmune disease that has vesicles and bullae that rupture and the skin sloughs off.
Can be fatal

69
Q

What is clubbing a sign of?

A

Chronic hypoxia
Congenital heart disease
Lung cancer

70
Q

What are Beau’s lines?

A

Linear depressions in the nail due to trauma (or acute illness?) the lines grow out with the nail**

71
Q

Are Beau’s lines permanent?

A

No they grow out with the nail

72
Q

What is paronychia?

A

Inflammation of the nail folds (cuticle area) often due to frequent immersion in water

73
Q

What is onychocrypotosis?

A

INGROWN TOENAIL

74
Q

What are Terry’s nails?

A

White nails with a reddish brown stripe due to aging, diabetes, cirrhosis, heart failure

75
Q

What is leukonychia?

A

White spots on nails due to trauma or repeated manicuring

76
Q

What is koilonychia?

A

Spoon nail, possible iron deficiency anemia

77
Q

What is onycholysis?

A

Painless separation of the nail and the nail bed

78
Q

What can cause nail pitting?

A

Autoimmune disorders such as psoriasis, rheumatoid arthritis, lupus, alopecia areata

Physical Diagnosis (Lauren) (3 decks)

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