Spot the Sign

Question 1

What does cyanosis look like?

Answer 1

Blue tinge to the skin

Question 2

Why does cyanosis occur?

Answer 2

Poor circulation or not enough oxygen in the blood

Question 3

What two classifications of cyanosis are there?

Answer 3

Central or peripheral

Question 4

Discuss what central cyanosis looks like.

Answer 4

Blue lips, skin, tongue (typically involves entire body)

Question 5

Discuss what periphery cyanosis looks like.

Answer 5

Blue hands, feet, limbs (limbs usually feel cold)

Question 6

What is central cyanosis a manifestation of?

Answer 6

Congenital heart disease characterised by right-to-left pulmonary shunts

Question 7

What is peripheral cyanosis a manifestation of?

Answer 7

Diminished tissue perfusion due to shock, heart failure or peripheral vascular disease

Question 8

Name some of the differential diagnosis’ for central cyanosis

Answer 8

Pulmonary oedema, pulmonary embolism, severe pneumonia, acute severe asthma attack, COPD

Question 9

Name some of the differential diagnosis’ for peripheral cyanosis

Answer 9

Heart failure, circulatory shock, raynaud’s syndrome, cold exposure

Question 10

Which patients are unable to manifest cyanosis?

Answer 10

Severely anaemic patients

Question 11

What does cyanosis look like on intermediate skin?

Answer 11

Blue/purple lips

Question 12

Which other signs is cyanosis often accompanied with?

Answer 12

Increased RR, use of accessory muscles, nasal flaring

Question 13

Where might you see cyanosis on darker skin?

Answer 13

Easiest to spot cyanosis where the skin tone is lightest.

Look in mucous membranes (gums and around the eyes) nailbeds, palms/soles

Question 14

What is erythema nodosum?

Answer 14

Type of skin inflammation located in the hypodermis under the skin.

Question 15

What does erythema nodosum look like?

Answer 15

Reddish, painful tender lumps most commonly in the front of the legs below the knees.

Question 16

Describe the size and number of lumps in patients with erythema nodosum.

Answer 16

Range in size from about 12-100mm in diameter.
Patients can have anywhere from 2 to 50 of them.

Question 17

List some of the differential diagnosis’ for erythema nodosum.

Answer 17

-Sarcoidosis
-Strep throat
-Fungal diseases
-Inflammatory bowel disease

Question 18

Describe what erythema nodosum looks like on light skin.

Answer 18

Red, painful bumps on lower legs but can also appear on thighs, arms, torso, and face.
Bumps start out red, and then turn purple, looking like bruises as they heal.
Also flatten out while healing.

Question 19

What does erythema nodosum look like on intermediate skin?

Answer 19

Red/purple bumps on the skin

Question 20

What does erythema nodosum look like on darker skin?

Answer 20

Purple/brown lumps on the skin

Question 21

What are petechiae?

Answer 21

Non-raised patches that appear on the skin or mucous membranes.

Question 22

What are petechiae the result of?

Answer 22

Bleeding under the skin.

Question 23

Where are petechiae often seen?

Answer 23

Usually seen in clusters on the skin surface or inside mouth or eyelids.

Question 24

List the differential diagnosis’ for petechiae.

Answer 24

-infection
-drug reaction
-sepsis
-endocarditis
-scarlet fever

Question 25

What does petechiae look like on light skin?

Answer 25

Tiny purple, red or brown spots on the skin commonly appear on arms, legs, stomach, and buttocks
(the spots do not blanch under pressure)

Question 26

What do petechiae look like on intermediate skin?

Answer 26

Tiny purple/red spots

->These are best viewed in areas of lighter melaninization (abdomen, buttocks, volar surface of forearm)

Question 27

What do petechiae look like on darker skin?

Answer 27

Petechiae can’t be seen well if the skin is black or very dark brown.
Must check mucous membranes (buccal mucosa & conjunctiva of eye)