Test 4- Endocrine and Derm Flashcards
annular lesion
ring shaped
arcuate lesion
partial rings
confluent
lesions run together
described as generalized grouped lesions
herpes simplex
keratotic lesion
psoriasis
centripetal
rash moving to the center
centrifugal
rash moving away from the center
caudal
rash moving down body
discrete flat lesion (large macule); usually > 1.5 cm in diameter
patch
discrete palpable elevation of skin;
papule
Discrete palpable elevation of skin; may evolve from papule
nodule
slightly raised lesion, typically with flat surface; > 1 cm in diameter; scaling frequently present.
plaque
transient pink/red swelling of the skin; often displaying central clearing; usually pruritic and lasts
wheal
large papule or nodule; usually > 1 cm in diameter
tumor
vesicle > 0.5 cm diameter
bulla
semi-solid lesion; varies in size from several mm to several cm; may become infected
cyst
dried exudate that may have been serous, purulent, or hemorrhagic
crust
thin plates of desquamated straum corenum punctate; results from scratching
scale
shallow hemorrhagic excavation; linear or punctuate; results from scratching
excoriation
thickening of skin with exaggeration of skin creases
lichenification
hallmark of chronic eczematous dermatitis
lichenification
partial break in epidermis
erosion
linear crack in epidermis
fissure
Childhood disease characterized by sore throat, fever, and a “sandpaper” rash.
scarlet fever
scarlet fever is caused by
group a beta-hemolytic strep pyogenes
risk factors for scarlet fever
wound, burns
petechiae on palate, white coating on tongue which sheds by day 2 or 3 and leaves a “strawberry” tongue with shiny red papillae
scarlet fever
spread of rash in scarlet fever
sandpaper rash that begins on chest then spreads to abd and extremities
Pastia lines present in
scarlet fever
important to start atbx with scarlet fever to
prevent rheumatic fever
diagnostic for scarlet fever
throat cx, rapid strep test
rubella is caused by
rubivirus
rubella is most contagious when
rash is erupting
s/s of rubella
conjunctivitis, fever, occipital lymph node swelling
description of rubella rash
maculopapular that begins on face and spreads to chest.
s/s of rubella in adults
arthralgia and arthritis
diagnostic for rubella
viral cx, rubella antibodies
trx for rubella
immunization. don’t immunize during pregnancy
cause of fifth’s disease
parovirus B19
fifth’s disease stops being communicable when
rash erupts
description of fifth’s disease rash
begins on cheeks “slapped cheek”, then spreads to body and extremities
final phase of fifth’s disease rash
may be more itchy.
when children with fifth’s disease can return back to school
during rash phase when afebrile for 24 hours.
when children with fifth’s disease can return back to school
during rash phase when afebrile for 24 hours.
superficial infection of the skin which begins as small superficial vesicles which rupture and form honey-colored crusts.
impetigo
cause of impetigo
staph aureus
trx for impetigo
washing lesions, good hygiene.
Chronic, pruritic skin eruption with acute exacerbations.
eczema (atopic dermatitis)
Commonly seen in patients with other atopic illness (asthma, allergic rhinitis).
eczema (atopic dermatitis)
eczema is more common in
asians and blacks
Dennie-Morgan folds present in
eczema
description of eczema rash
red/dry skin at flexural surfaces, hands and feet.
80% of these patients have eosinophilia
eczema
trx for eczema
emollients, don’t use hot water
hIghly contagious viral illness with lesions that appear on buccal mucosa, palate, palms of hands, soles of feet, and buttocks
hand, foot, and mouth disease
hand foot and mouth disease caused by
coxsackie A16
small, red papules on tongue and buccal mucosa that can progress to ulcerative vesicles
hand foot and mouth disease
varicella virus establishes latency in the
dorsal root ganglia.
patients with varicella are infectious to others…
for 2 days before the appearance of the rash and until the lesions have crusted
description of varciella rash
begins on trunk then spreads peripherally, become vesicles, then scab in 6-10 hours.
do not give this in patients with varicella
ASA
herpes zoster involves the skin of
a single dermatome
acute phase of herpes zoster
unilateral rash that progresses to vesicles and then pustules.
pain for more than 1 month after herpes zoster
posthereptic neuralgia
contagiousness of shingles
shingles cannot be transmitted but varicella virus can.
cause of scabies
sarcoptes scabei
incubation period for scabies
3-6 weeks
description of scabies
mite burrows in b/t fingers, feet, wrists, axilla, penis. can cause scaling, vesicles, and papules.
when itching is worse at nighttime
scabies
may look like a short (5-15 mm) linear or curved gray line and may end in a tiny vesicle.
scabies
cause of pityriasis rosea
unknown, possible viral etiology
pityriasis rosea most common in
those 10-35
distribution of pityriasis rosea
herald patch on trunk, then generalized rash 1-2 weeks after
description of rash in pityriasis rosea
salmon colored oval plaques with mild itching
syphilis serology done with
pityriasis rosea
acne is caused by increased
androgen production and keratin production
inflammatory response in acne is caused by
Prop. acnes.
preteens and adolescence; whiteheads; not infected with P. acnes.
comedonal acne
adolescence; nodules, cysts, moderate to severe inflammation; usually infected with P. acnes.
nodulocystic acne
adolescence and early 20s; pustules, papules, mild inflammation; usually infected with P. acnes
inflammatory acne
acne often worsens during
first 2 weeks of trx
Chronic, pruritic, inflammatory skin disorder characterized by rapid proliferation of epidermal cells. cause is unknown
psoriasis
risk factors for psoriasis
family hx, strep infection, stress, DM
description of psoriasis
silvery, white scales on elbows, knees, and scalps that itch
+ Auspitz sign (pinpoint bleeding when lesions are scraped)
psoriasis
ESR and CRP elevated with
psoriasis
trx for psoriasis
warm soaks, oatmeal bath, emollients, sunscreen
drugs that can stimulate psoriasis
ACEI, beta blockers, NSAIDs, PCN, salicylates
Common, benign, whitish-yellow to brown raised papules or plaques that feel slightly greasy and velvety or warty and have a “stuck on” appearance.
seborrheic keratosis
seborrheic keratosis in young black women
appear on cheeks and temples
considered precursors of squamous cell carcinoma.
actinic keratosis
risk factors for actinic keratosis
sun exposure, fair skin, men
actinic keratosis description
raised, scaly, crusty lesions that appear on sun exposed areas of skin
basal cell carcinoma common in
male 40-50 year olds
common appearance is pearly transluscent nodule with overlying telangiectatic vessels
basal cell carcinoma
Usually occur in fair-skinned adults > 60 years.
squamous cell carcinoma
crusted hyperkeratotic lesions with a rough surface or flat reddish patches with an inflamed or ulcerated appearance
squamous cell carcinoma
common location of squamous cell carcinoma in smokers
lower lip
metastasis is rare with
basal cell caricnoma
ABCDE with melanoma
Asymmetry, Border irregular, Color variation, Diameter > 6 mm, Elevation above skin
common area of melanoma in whites
anterior lower leg and back
common area of melanoma in blacks
nails, hands, and feet
causes of cellulitis
Group A strep, staph aureus, MRSA, H influenza
risk factors for cellulitis
trauma, untreated furunculosis, burns, DM
diagnostics for cellulitis
C&S, CBC shows leukocytosis, elevated ESR
imaging studies done for cellulitis to r/o
osteomyelitis
trx for cellulitis
elevate extremity, moist heat, avoid swimming
an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation.
intertrigo
trx for diaper rash
avoid using baby powder, leave OTA
cause of tinea (ringworm)
Trichophyton sp.
tinea capitis caused by
daycares
tinea corporis
rash and itching with plaque on trunk
tinea cruris caused by
excessive sweating and wet clothing.
description of tinea cruris
half-moon plaques in the groin and/or upper thighs
elderly most susceptible for this kind of fungal rash
tinea pedis
risk factors for tinea versicolor
hot, humid climates, systemic corticosteroids
slightly scaly macules on the trunk, neck, and upper arms (short-sleeved shirt distribution).
tinea versicolor
in wood’s lamp exam, tinea will
fluoresce
risk factors for thyroid nodule
iodine deficiency, exposure to radiation, family hx.
nodules are usually
asymptomatic
signs of malignant thyroid nodule
firm, fixed, nontender, large nodule with no symptoms of thyroid dysfunction. cervical lymphadenopathy.
TSH and free thyroxine index in thyroid nodules
normal
best method to determine malignancy if TSH is normal or increased
fine needle biopsy
an enlarged thyroid gland with two or more nodules suggest a
metabolic cause
hypothyroidism from autoimmune destruction
Hashimoto’s
s/s of hypothyroidism
lethargy, delayed DTRs, weight gain, edema, periorbital edema, cold intolerance, constipation, infertility, depression, muscle cramps, coarse dry skin
reduced systolic and increased diastolic BP seen with
hypothyroidism
lipid levels are elevated with
hypothyroidism
diagnostic of hypothyroidism
high TSH and low T4
common cause of hyperthyroidism
Grave’s
s/s of hyperthyroidism
weight loss, heat intolerance, palpitations, thyroid enlargement, afib, frequent BMs, moist and warm skin, thin and soft hair, rapid DTRs, exopthalamus.
diagnostic of hyperthyroidism
low TSH and high T4
s/s of thyroid storm
anxiety, fever, N/V, abd pain, cardiac failure
cause of type 1 diabetes
destruction of beta cells in pancreas
s/s of type 1 diabetes
3 Ps, weight loss, dehydration, confusion
cause of type 2 diabetes
insulin resistance, abnormal insulin secretion, decrease in insulin receptors
S/S of type 2 diabetes
3 Ps, proteinuria, obesity, blurred vision, balanitis, chronic vaginitis
C peptide levels will be normal in
type 1 diabetics
C peptide levels will be elevated in
type 2 diabetics
the 3/5 criteria must be met for metabolic syndrome
increase waist circumference, FPG > 100, low HDL, triglyceride > 150, BP > 130/85.
screening for diabetes in healthy person
start at age 45 every 3 years
screening for those with BMI > 25 must have these risk factors
family hx, ethnicity, HTN, HLD, PCOS, A1C > 5.7%, CV disease
diagnostic criteria for diabetes
A1C > 6.5%, FPG > 126 mg/dL on 2 occasions, 2 hour plasma glucose > 200 mg/dL, RBG > 200 mg/dL
discrete flat change in color of skin; usually
macule
example of a patch
pityriasis rosea
example of a papule
seborrheic keratosis
example of a nodule
basal cell carcinoma
raised lesion containing clear fluid
vesicle
raised lesion containing yellow cloudy fluid
pustule
KOH shows this with tinea versicolor
hyphae and spores in “spagetti and meatball” pattern
eye exam recommendation for those with type 1 diabetes
within 5 years of diagnosis and then annually
retina changes in those with diabetes
cotton wool patches, vitreous hemorrhage, proliferation of vessels
where is the thyroid located
behind and below the cricoid cartilage
ways to test for diabetic neuropathy
tuning fork, monofilaments
koplik spots seen in
rubeola
leukoplakia
hairy tongue seen in EBV
brown patches of pigmentation on face during pregnancy
melasma
lab to help r/i or r/o hashimoto’s
antithyroid antibody
TSH is released from
anterior lobe of pituitary
thyroid feedback loop
hypothalamus releases TRH, anterior pituitary releases TSH, thyroid gland releases T3 and T4
