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Patho exam 3 > Skin part 2 > Flashcards

Skin part 2 Flashcards

1
Q

what is made of hard keratin?

A

Hair and nails

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2
Q

where is the coloring for hair created and by what cell?

A

from melanocytes at he base of the follicle

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3
Q

what causes hair to stand up or “goose bump”?

A

Arrector pili muscle

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4
Q

what is the main factor with hair growth?

A

nutritional status

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5
Q

excessive growth of hair on a woman is called?

A

Hirsutism

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6
Q

patches of hair that the cause is to thought to be autoimmune

A

Areata allopecia

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7
Q

totally hair loss from head to toe and thought to be autoimmune

A

universalis allopecia

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8
Q

hairball in the stomach from the action of pulling out one’s hair and eating it, causing GI distress

A

Tricotillimania or bezoar

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9
Q

fungal infection of the head

A

tinea capitis

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10
Q

a pt is genetically predisposed response to androgens, with androgen-sensitive and androgen-insensitive follicles. what sex are they and what do they have?

A

Male and Male-pattern alopecia

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11
Q

a pt has elevated levels of the serum adrenal androgen dehydroepiandrosterone sulfate with
no loss of hair along the frontal hairline, what sex are they and what do they have?

A

Female and Female-pattern alopecia

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12
Q

Autoimmune T-cell–mediated inflammatory disease against hair follicles that results in baldness

A

Alopecia areata

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13
Q

Androgen-sensitive areas. Abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women

A

Hirsutism

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14
Q

Produce oily/waxy matter, Meibomian glands, Lubricant for skin, Kills bacteria, Glands are activated at puberty

A

Sebaceous Glands

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15
Q

chalazion is a…?

A

Blocked Meibomian gland

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16
Q

a stye is a….?

A

A small infection forms at the base of an eyelash

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17
Q

Different types prevent overheating of the body; also secrete cerumen and milk

A

Sweat Glands

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18
Q

abundant on palms, soles of the feet, and forehead – more numerous – ducts empty onto surface of skin

A

Eccrine sweat glands

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19
Q

found in axillary and anogenital areas – ducts empty into hair follicles, little role in thermoregulation

A

Apocrine sweat glands

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20
Q

modified apocrine glands in external ear canal that secrete cerumen

A

Ceruminous glands

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21
Q

specialized sweat glands that secrete milk

A

Mammary glands

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22
Q

Mostly water, Some metabolic waste, Fatty acids and proteins (apocrine only)

A

Sweat composition

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23
Q

Helps dissipate excess heat, Excretes waste products, Acidic nature inhibits bacteria growth

A

Sweat Functions

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24
Q

Odor is created from where?

A

Bacteria sources

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25
Q

Mechanical damage, Chemical damage, Bacterial damage, Thermal damage, Ultraviolet radiation, Desiccation

A

Skin functions that protects deeper tissues

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26
Q

Aids in heat regulation/ blood reservoir, Aids in excretion of ammonia, urea and uric acid (sweat), Synthesizes vitamin D

A

Skin functions

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27
Q

these arent vitamins, only steroid hormones

A

Vitamin D

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28
Q

Ergocalciferol

A

D2

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29
Q

Cholecaleiferol

A

D3

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30
Q

what plays a major role in calcium and phosphorous absorption?

A

Vitamin D

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31
Q

children in england have a vitamin D deficiency which has a sequela of?

A

Rickettes

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32
Q

what organs are involved in the vitamin D pathway which control the serum phosphate and calcium levels?

A

Skin, liver, kidney, bones and small intestines

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33
Q

Tendency to affect certain areas in certain patterns and Response to treatment is often a clue to what it is?

A

Skin Disease

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34
Q

Most ___________ are slow growing and treatable except for ________________

A

skin cancers. and malignant melanoma

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35
Q

Name the Lesion Patterns and Shapes

A 
Linear
Clustered
Geographic (highly irregular - resembling continents/islands)
Serpiginous – snake-like, wavy margin
Annular/Arciform – circular/disc-like
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36
Q

Two factors affect significance of damage?

A

Depth of burn

Size of burned area

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37
Q 
Only epidermis is damaged
Skin is red and swollen
Pain subsides in 2–3 days 
No scarring
Complete healing complete in about one week
A

First Degree Burns

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38
Q

Epidermis and upper dermis are damaged
Skin is red with blisters
Blistering continues to extend after initial burn
Blisters heal in 10–14 days if no complications
Deeper second degree burns heal in 1–3½ months
Scarring common with second degree burns

A

Second Degree Burns AKA Partial Thickness

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39
Q

Destroys entire skin layer
Burn is gray-white or black
Ranges in color from black, brown, tan, red or white
Victim feels no pain (pain receptors are destroyed)
Sudoriforous and sebaceous glands, hair follicles, and blood vessels also destroyed

A

Third-Degree Burns AKA Full Thickness

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40
Q

The most severe of all burns

Penetrate the bone and cause bone damag

A

4th degree burns

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41
Q

Elevated, rounded, and firm
Claw-like margins that extend beyond the original site of injury
Excessive collagen formation during dermal connective tissue repair
Common in darkly pigmented skin types and burn scars

A

Keloids

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42
Q

What causes pressure ulcers

A

Pressure ulcers result from any unrelieved pressure on the skin, causing underlying tissue damage (ischemic necrosis). Pressure, Shearing forces, Friction, and Moisture

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43
Q

Pressure ulcers risk factors are?

A

Older adults in hospitals and nursing homes, Neurologic disorders that result in loss of mobility and/or sensation (spinal cord injuries, dementia, or cerebrovascular disease), Immobilization Incontinence, and Debilitation

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44
Q

Clinical Manifestations of pressure ulcers risk factors are?

A

Lying in bed without changing position or relieving pressure over an extended period, Lying for hours on hard imaging and operating tables, Chronic diseases accompanied by anemia, edema, renal failure, malnutrition, sepsis, and urinary or fecal incontinence, and Coarse bed sheets used for turning by dragging, which produces a shearing force

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45
Q

Describe the first stage of a pressure ulcer.

A

Nonblanchable erythema of intact skin

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46
Q

Describe the second stage of a pressure ulcer.

A

Partial-thickness skin loss involving epidermis or dermis (shallow ulcer)

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47
Q

Describe the third stage of a pressure ulcer.

A

Full-thickness skin loss involving damage or loss of subcutaneous tissue (Deep Ulcer)

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48
Q

Describe the fourth stage of a pressure ulcer.

A

Full-thickness skin loss with damage to muscle, bone, or supporting structures

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49
Q

Describe the ustageable stage of a pressure ulcer.

A

Unstageable if wound bed covered with eschar

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50
Q

List the Inflammatory Disorders of the skin

A 
Dermatitis = Eczema
Allergic Contact dermatitis
Atopic Dermatitis
Irritant Contact Dermatitis
Stasis Dermatitis
Seborrheic Dermatitis
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51
Q

Caused by a hypersensitivity type IV reaction

Allergen comes into contact with skin, binds to carrier protein to form sensitizing antigen; Langerhans cells process antigen, carry it to T cells, which become sensitized to antigen

Manifestations: Erythema, swelling, pruritus, vesicular lesions

A

Allergic contact dermatitis

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52
Q

Type I hypersensitivity—activation of mast cells, eosinophils, T lymphocytes, other inflammatory cells

Causes red, weeping crusts and chronic inflammation, lichenification

A

Atopic dermatitis

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53
Q

Nonimmunologic inflammation of the skin

Chemical irritation from acids or prolonged exposure to irritating substances

Symptoms similar to allergic contact dermatitis

Treatment—remove stimulus

A

Irritant contact dermatitis

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54
Q

Occurs in the legs as a result of venous stasis, edema, and vascular trauma

Sequence of events: erythema, pruritus, scaling, petechiae, ulcerations

A

Stasis dermatitis

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55
Q

Inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals

Scaly, white, or yellowish plaques

A

Seborrheic dermatitis

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56
Q

Chronic, relapsing, proliferative skin disorder

T-cell immune-mediated skin disease

Scaly, thick, silvery, elevated lesions, usually on scalp, elbows, or knees caused by a high rate of mitosis in the basal layer

Shows evidence of dermal and epidermal thickening

Epidermal turnover goes from 26-30 days to 3-4 days

Cells do not have time to mature or keratinize

A

Psoriasis

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57
Q

Various Kinds of Psoriasis are?

A

Plaque psoriasis – most common, patches or plaques

Inverse psoriasis – skin folds

Guttate psoriasis – (drops) small, distinct lesions

Pustular psoriasis

Erythrodermic psoriasis - inflammatory

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58
Q

Benign, self-limiting inflammatory disorder

Usually occurs during winter months

Herald patch: Circular, demarcated, salmon-pink, 3- to 4-cm lesion

A

Pityriasis rosea

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59
Q

Benign, inflammatory disorder of the skin and mucous membranes

Unknown origin, but T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells are involved

Nonscaling violet-colored, 2- to 4-mm lesions

Wrists, ankles, lower legs, genitalia

A

Lichen planus

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60
Q

Inflammatory disease of the pilosebaceous follicle

A

Acne vulgaris

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61
Q

Inflammation of the skin that develops in adulthood

Lesions: Erythematotelangiectatic, papulopustular and phymatous
Also: Associated with chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun

A

Acne rosacea

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62
Q

Excessive hormonally influenced sebum production

Abnormal keratinization of portions of the follicular epithelium

Response to anerobic bacterium P. acnes

Follicular rupture and inflammation

A

Acne Vulgaris

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63
Q

Inflammatory, autoimmune disease with cutaneous manifestations

Thought to be an altered immune response to an unknown antigen or response to UV wavelengths with the development of self-reactive T and B cells, decreased number of regulatory T cells, and increased proinflammatory cytokines

Autoantibodies and immune complexes cause tissue damage

A

Lupus erythematosus

64
Q

Restricted to the skin

Photosensitivity

Butterfly pattern over the nose and cheeks

Subtype of systemic lupus erythematosus (SLE)

Leads to SLE in approximately 5% of cases

A

Discoid lupus erythematosus

65
Q

Diseases that have different causes and clinical courses but share the common characteristic of vesicle, or blister, formation

A

Vesiculobullous Disorders

66
Q

List the two Vesiculobullous Disorders?

A

Pemphigus & Erythema multiforme

67
Q

Rare, chronic, blister-forming disease of the skin and oral mucous membranes

Blisters form in deep or superficial epidermis

Autoimmune disease caused by circulating IgG autoantibodies: The antibodies are against the cell surface adhesion molecule, desmoglein in the suprabasal layer of the epidermis

A

Pemphigus

68
Q

Three types of Pemphigus

A

Pemphigus vulgaris (severe)
Pemphigus foliaceus
Pemphigus erythematosus

69
Q

how do you diagnosis Pemphigus?

A

Tissue biopsies demonstrate autoantibody presence

70
Q

More benign disease than pemphigus vulgaris

Bound IgG and blistering of the subepidermal skin layer

Subepidermal blistering and eosinophils distinguish pemphigoid from pemphigus

A

Bullous pemphigoid

71
Q

Acute recurring disorder of skin and mucous membranes

Associated with allergic or toxic reactions to drugs or microorganisms

Caused by immune complexes formed and deposited around dermal blood vessels, basement membranes, and keratinocytes

“Bull’s-eye” or target lesion: Erythematous regions surrounded by rings of alternating edema and inflammation

A

Erythema multiforme

72
Q

Bullous lesions form erosions and crusts when they rupture

Affects the mouth, air passages, esophagus, urethra, and conjunctivae

Severe forms:
Stevens-Johnson syndrome (bullous form)
Toxic epidermal necrolysis

A

Erythema multiforme

73
Q

What are inflammatory skin disorders?

A

stasis and seborrheic

74
Q

Whats the events of stasis?

A

erythema, pruritus, scaling, petechiae, ulcerations

75
Q

anerobic bacterium P. acnes causes what?

A

Acne vulgaris

76
Q

Whats the diffenece btwn acne vulgaris and acne rosacea?

A

Vulgaris has comedones while rosacea is seen in adults with no comedones.

77
Q

What are autoimmune diseases caused by circulating IgG?

A

pemphigus

78
Q

What disease is associated with bound IgG and blisters?

A

Bullous pemphigus

79
Q

what is desmoglein associated with?

A
80
Q

where is desmoglein found?

A
81
Q

what are the types of pemphigus?

A

Pemphigus vulgaris (severe)
Pemphigus foliaceus
Pemphigus erythematosus

82
Q

what is associated with extensive confluent erosions and crust

A

with a few large flaccid bullae?

83
Q

what distinguish pemphigoid from pemphigus?

A

Subepidermal blistering and eosinophils

84
Q

what Vesiculobullous Disorders is associated with TEN and steven-johnson syndrome?

A

erythema multiforme

85
Q

whats the serve form of erythema multiforme with bullus?

A

steven-johnson syndrome

86
Q

what is the infection of the hair folicles?

A

folliculitis caused by s. aureus

87
Q

what is a furuncle?

A

boils/inflammation of hair follicle caused by s.aureus

88
Q

how do you know a pt has a gram + infection?

A

skin is hot and tender to touch

89
Q

scald skin syndrome from staph aureus is what type of infection?

A

gram + superfical in skin

90
Q

what is a carbuncle?

A

collection of infected hair follicles, may develop in abscesses.

91
Q

how do you know cellulitis is getting worse?

A

its ascending

92
Q

what is impetigo?

A

alpha hemolytic stept or staph
a superfical lesion on skin
kids

93
Q

what is Erysipelas?

A

group a strept

acute superficial infection of the upper dermis

94
Q

what is a superficial form of cellulitis?

A

erysipelas

95
Q

what is cellulitis?

A

infection of dermis and sub Q
caused by strept B and staph
could be localized or ascending

96
Q

where does varicella virus live for a prolonged period?

A

nerve root

97
Q

when herpes zoster shows symptoms where does it appear?

A

one sided nerve dermatome

98
Q

what are characteristics of Condylomata acuminata?

A

genital warts
Highly contagious, sexually transmitted
Cauliflower-like lesions occur in moist areas, along the glans of the penis, vulva, and anus
Oncogenic HPV a primary cause of cervical

99
Q

what is it called when Fungi cause superficial skin lesions?

A

dermatophyte

100
Q

what is mycoses?

A

fungal disorders

101
Q

mycoses caused by dermatophytes are termed

A

tinea

102
Q

name the 5 tinea

A 
Tinea capitis (scalp)
Tinea pedis (athlete’s foot)
Tinea corporis (ringworm)
Tinea cruris (groin, jock itch)
Tinea unguium (nails) or onychomycosis
103
Q

how are fungal infections diagnosed?

A

KOH prep

104
Q

what causes Tinea versicolor?

A

the organism Pityrosporum ovale

105
Q

where is Candida albicans normally found?

A

on skin, in GI tract, and in vagina

106
Q

what is unique about oral thrush?

A

it could be scrapped off

107
Q

what looks like thrush thats precancerous and cant be scrapped off?

A

oral luekoplaquea

108
Q

what are predisposing conditions for candidiasis?

A

systemic administration of antibiotics, pregnancy, diabetes mellitus, Cushing disease, debilitated states, age younger than 6 months, immunosuppression, and neoplastic diseases

109
Q

Pediculus humanus capitis

A

Lice that infest the head

110
Q

Pediculus humanus corporis

A

Lice that infest the body

111
Q

Phthirus pubis

A

Pubic lice (crabs)

112
Q

Sarcoptes scabiei

A

Itch mites

113
Q

which parasite is sexually transmitted and borrows into the skin?

A

scabies - itch mites

114
Q

what are nits?

A

lice eggs

115
Q

what are characteristics or vascular disorder?

A
116
Q

what is the MOA of uticaria?

A

Histamine release causes endothelial cells of the skin to contract
which Causes leakage of fluid from the vessels

117
Q

what immune response is uticaria?

A

type 1

118
Q

how does uticaria appear?

A

geographic type patterns that are raised

119
Q

what vascular disorder is characterized by taut skin, massive deposits of collage, inflammation, autoimmune w association of several antibodies and hypopigmentation?

A

scleroderma

120
Q

what are symptoms of scleroderma?

A

Facial skin becomes very tight
Fingers become tapered and flexed; nails and fingertips can be lost from atrophy
Mouth may not open completely
50% of patients die within 5 years

121
Q

what are types of insect bites?

A

Ticks, Mosquitoes, Flies and Spider

122
Q

Lyme disease, Rocky Mountain spotted fever

A

Ticks

123
Q

Malaria, yellow fever, dengue fever, filariasis, St. Louis encephalitis

A

Mosquitoes

124
Q

Painful bites

Urticaria, mild bleeding

A

Flies

125
Q

why is a spider bite the worst?

A

localized allergic reaction

126
Q

What disease is Autoimmune, rare, chronic, blister-forming disease of skin and oral mucous membranes and caused by IgG autoantibodies?

A

Pemphigus

127
Q

skin injury from exposure to extreme cold results in?

A

frostbite

128
Q

what causes the burning reaction in frostbite?

A

alternating cycles of vasoconstriction and vasodilation

129
Q

what causes the alternating vasoconstriction and vasodilation during frostbite?

A

Prostaglandins, thromboxanes, bradykinin and histamine (similar to burn inflammation)

130
Q

during frost bite ice crystals form where?

A

extracelluar and intracellular

131
Q

Name two nail disorders

A

Paronychia

Onychomycosis

132
Q

What nail infection is associated with the nail plate?

A

onychomycosis

133
Q

name the 4 types of benign skin tumors? MASK

A 
Seborrheic Keratosis
Benign proliferation of basal cells
Actinic Keratosis
Premalignant (in elderly)
Keratoacanthoma
Tumor arising from hair follicles
Nevi (Moles)
134
Q

what bengin skin tumor has Benign proliferation of basal cells?

A

Seborrheic Keratosis (germ layer)

135
Q

how does seborrheic keratosis appear?

A

multiple brown warty papules on nodules having stuck on appearance

136
Q

whats another name for actinic keratosis?

A

solar keratosis

137
Q

what is solar keratosis?

A

macules and papules with coarse adhearing scaling on forehead from sun damage

138
Q

what is a keratocanthoma?

A

Dome shaped tumor with a central plug

139
Q

what does a keratocanthoma with a central plug resemble?

A

Squamous cell carcinoma

140
Q

Skin cancer is categorized into cancerous what are they?

A

malignant and benign

141
Q

What is the difference between benign and malignant skin cancer?

A

malignant - metastasizes, (melanoma)

benign - does not spread, encapsulated (carcinoma)

142
Q

name the 4 types of skin cancer

A

Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma
Kaposi sarcoma

143
Q

which skin carcinoma can metastasize and to where?

A

lymph node - squamous cell carcinoma

144
Q

which are some characteristics of Basal cell carcinoma?

A

affects p53 gene
curly rolled borders
associated with UV exposure

145
Q

whats the most deadly skin cancer, with genetic predisposition? why?

A

malignant melanoma - Metastasizes rapidly to lymph and blood vessels

146
Q

what are the 4 types of Kaposi sarcoma?

A

Drug-induced immunosuppresion
Associated with AIDS
Endemic – equatorial Africa
Classic form – elderly (purple lesions)

147
Q

what virus is kaposi sarcoma associated with?

A

Kaposi-Associated Herpesvirus 8

148
Q

kaposi sarcoma affects what cell?

A

progenitus cell = Endothelial Cells

149
Q

What is ABCD rule used for?

A

used to check for malignant melanoma

150
Q

ABCD

A 
A = Asymmetry
Two sides of pigmented mole do not match
B = Border irregularity
Borders of mole are not smooth
C = Color
Different colors in pigmented area
D = Diameter
Spot is larger then 6 mm in diameter
151
Q

what characteristic would you see with kaposi?

A

Kaposi Sarcoma – dark purple macules, nodular plaques

152
Q

a Pt has white thick plaque of firm consistency and irregular margins on the inner side of the cheek and the pt was a heavy pipe smoker

A

oral leukoplakia

153
Q

3 types of vascular skin lesions

A

Strawberry Hemangioma
Cavernous Hemangioma
Port Wine Stain

154
Q

Port Wine Stain

A

sharply marginated port wine red macula occur in a distribution of the maxillary in kids

155
Q

Cavernous Hemangioma

A

large soft semispheric blue tinged swelling of dermis and sub Q

156
Q

Strawberry Hemangioma

A

a purple dermal nodular lesion near elbow of a newborn may go away

157
Q

how does Integumentary system reflects changes from genetic and environmental factors

A

skin - becomes thinner, drier, wrinkled, and demonstrates changes in pigmentation
capillary loops - Shortening and decrease in number
melanocytes and Langerhans cells # decreases
Atrophy - sebaceous, eccrine, and apocrine glands
hair - color changes, Fewer hair follicles, and growth of thinner hair

Patho exam 3 (5 decks)

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