skin problems

Question 1

uticaria

Answer 1

hives

• remove triggering agent
• avoid alcohol, overexertion, and warm environments

Question 2

phases of wound healing-3

Answer 2

1. inflammatory
2. proliferative
3. maturation

Question 3

inflammatory response-3

Answer 3

1. 3-5 days
2. vasoconstriction, clot formation, plasma leakage, WBC
3. edema, pain, erythea, warmth

Question 4

proliferative phase-7

Answer 4

1. 4th day after, 2-4 wks
2. fibrin scaffold
3. mitotic fibroblasts stimulate collagen
4. collagen and ground sub build scar tissue
5. cappillary buds
6. cap buds and collagen make granulation tissue
7. epithelial cells grow over granulation

Question 5

maturation phase-4

Answer 5

1. 3wks to 1 yr
2. collagen reorganized to increase tensile strength
3. scar tissue thinner and paler
4. mature scar firm and inelastic upon palpation

Question 6

first intention

Answer 6

wound w/o tissue loss, approximated edges, closed wound eliminates dead space

Question 7

second intention

Answer 7

deep tissue w dead space, requires gradual filling of dead space w connective tissue, not approximated

Question 8

third intention

Answer 8

wound w high infection, left open for debridement/inflammation resolution before closing

Question 9

partial thickness wounds

Answer 9

epidermis and upper dermis, re-epithelialation/resurfacing, 5-7 days

Question 10

full thickness

Answer 10

lower dermis and subcut tissue, uses granulation and contraction

Question 11

chronic wounds

Answer 11

may not show signs of infection

-increase in wound size or failure to decrease in size

Question 12

inadequate nutrition labs-3

Answer 12

1. prealbumin below 19.5
2. albumin below 3.5
3. lymphocyte count below 1800

Question 13

hydrophobic

Answer 13

nonabsorbant/waterproof, wound w little drainage and needs protection

Question 14

hydrophilic

Answer 14

absorbant material draws drainage away from ulcer surface- prevents maceration

Question 15

dry gauze dressings

Answer 15

change w strike through

Question 16

synthetic dressings

Answer 16

change when exudate causes the adhesive seal to break and leakage to occur

Question 17

wet-to-damp

Answer 17

saline moisten gauze, necrosis is mechanically removed w less trauma to healing tissue

Question 18

continuous wet gauze

Answer 18

promotes dilution of viscous exudate and softening of eschar

Question 19

topical enzyme prep

Answer 19

proteolytic acts on thick adherant eschar causes breakdown of denatured protein and more rapid seperation of necrotic tissue

Question 20

moisture-retentive dressing

Answer 20

spontaneous seperation of necrotic tissue is promoted by autolysis

Question 21

continuous negative pressure contraindications-3

Answer 21

1. anticoagulant tx
2. decreased tissue health near wound
3. any exposed blood vessels/nerves/organs

Question 22

folliculitis

Answer 22

superficial infection involving only the upper portion of the follicule
-staphylococus

Question 23

furuncles

Answer 23

boils deep in the follicule

Question 24

herpetic whitlow

Answer 24

occurs on fingertips of helath care workers who contact viral secretions

Question 25

posttherapeutic neuralgia

Answer 25

severe pain that persists after shingles

Question 26

dermatonal ditribution

Answer 26

grouped lesions that follow cranial or spinal nerve

Question 27

dermatophytosis

Answer 27

fungal infection w annular or serpiginous patches

Question 28

cutaneous anthrax

Answer 28

infected animal, painless and eschar forms reguardless of tx

Question 29

pediculosis

Answer 29

lice

Question 30

scabies

Answer 30

mite infestation

Question 31

atopic dermatitis

Answer 31

lichenification w scaling and excoriation

Question 32

drug eruption

Answer 32

begins on trunk and proceeds distally

*don’t apply corticosteroids to the face

Question 33

psoriasis

Answer 33

chronic autoimmune d/o, overstimulation of immunne sys, cells shed every 4-5 days

Question 34

actinic keratosis (premalignant)

Answer 34

small (1-10mm) macule or papule that may develop into squamous cell

Question 35

squamous cell carcinoma

Answer 35

firm, nodular lesion w crust or central area of ulceration, fixated to underlying tissue
-rapid invasion w metastasis

Question 36

basal cell carcinoma

Answer 36

pearly papule w center crater and rolled waxy borders

-metastasis rare

Question 37

melanoma

Answer 37

irregular shaped pigmented papule or plaque, especially found w birthmarks and moles

• horizontal growth phase followed by vertical growth
• rapid invasion and metastasis with increased morbidity and mortality

Question 38

vancomycin

Answer 38

never bolus, red man syndrome (histamine)