Week 2 - Skin, Hair and Nails Flashcards

1
Q

Validity

A

Does the test accurately identify whether the patient has a disease
 Compare test against gold standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sensitivity

A

Probability that a person with the disease has a positive test (true positive rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Specificity

A

Probability that a non-diseased person has a negative test

Positive result from a test with high specificity usually indicates disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Positive predictive value

A

Probability that a person with a positive test has the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Negative predictive value

A

Probability that a person with a negative test does not have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

BMI

A
  • Underweight <18.5
  • Normal 18.5–24.9
  • Overweight 25.0–29.9
  • Obesity I 30.0–34.9
  • Obesity II 35.0–39.9
  • Extreme obesity ≥40

If the BMI is above 25 kg/m2, assess the patient for additional risk factors for heart disease and other obesity-related diseases: hypertension, high low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, high triglycerides, high blood glucose, family history of premature heart disease, physical inactivity, and cigarette smoking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Auscultatory gap

A

Silent interval between systolic and diastolic pressures – associated with arterial stiffness and atherosclerotic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal/abnormal BP ranges

A

BP 120–129/<80 mm Hg - Elevated

130–139/80–89 mm Hg -stage 1 hypertension

≥140/90 mm Hg stage 2 hypertension

Choose the higher category for patients with SBP and DPB in two categories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Orthostatic hypotension

A

Occurs when SBP is 20mmHg or DBP at least 10mmHg lower than supine

Caused by drugs, severe blood loss, prolonged bed rest, diseases of the ANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

White coat hypertension

A

BP >140/90 in medical settings, less than 135/85 in ambulatory settings

Conditioned anxiety response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute pain

A

normal, predicted psychological response to an adverse chemical, thermal or mechanical stimulus that lasts less than 3-6 months and is commonly associated with surgery, trauma or acute illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chronic pain

A

pain not associated with cancer or other medical conditions that persist for more than 3-6 months, pain lasting more than 1 month beyond the course of an acute illness or injury or pain recurring a intervals of months or years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nociceptive (somatic) pain

A

Linked to tissue damage to the skin, musculoskeletal system or viscera (visceral pain) but sensory nervous system is intact (arthritis or spinal stenosis)

  • Dull, pressing, pulling, throbbing, spasmodic, colicky
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Neuropathic pain

A

Consequence of lesion or disease affecting the somatosensory system – damage to the CNS from stroke or trauma, nerve entrapment, pressure on spinal or peripheral nevers, referred pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinically significant weight loss

A

5% or more of usual body weight over 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Weight loss causes

A
  • Endocrine disorders
  • DM
  • Adrenal insufficiency
  • Chronic infections
  • AIDS
  • Malignancy
  • Chronic cardiac, pulmonary or renal failure
  • Depression
  • Anorexia/bulimia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Weight loss causes with high intake

A
  • DM
  • Hyperthyroidism
  • Malabsorption
  • Bulimia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drugs associated with weight loss

A
  • Anticonvulsants
  • Antidepressants
  • Digoxin
  • Levodopa
  • Metformin
  • Thyroid medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Signs of malnutrition

A
  • Weakness
  • Easily fatigued
  • Cold intolerance
  • Flaky dermatitis
  • Ankle swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Testing for aphasia

A
  • Word comprehension – one or two stage command (point to your nose)
  • Repetition – repeat a phrase of one syllable words
  • Naming – ask the patient to name parts of a watch
  • Reading
     comprehension – read a paragraph out loud
  • Writing – write a sentence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fluency

A

Rate, flow and melody of speech

22
Q

Circumlocutions

A

phrases or sentences are substituted for a word the person cannot think of, example “what you write” instead of “pen”

23
Q

Paraphasias

A

words are malformed – I write with a den (malformed), I write with a bar (incorrect), I write with a dar (invented)

24
Q

Broca aphasia

A

persevered comprehension with slow, nonfluent speech and receptive

25
Wernicke aphasia
impaired comprehension with fluent speech
26
Assessment of abstract thinking
Thought process – logic, organization, coherence, relevance of patient’s thought Thought content – what the patient things about, level of insight and judgment Perceptions – sensory awareness of objects in the environment and their interrelationships Insight – awareness of abnormal behaviors Judgement – process of comparing and evaluating alternatives when deciding on a course of action
27
Mental Status Exam
1. Orientation 2. Attention (start at 100 and keep -7) 3. Memory (long/short term). 4. New learning ability (remember 3-4 words) 5. Higher cognitive functions (calculation, abstract thinking - draw clock) 6. Depression screening 7. Substance abuse screening 8. Hallucinations/illusions
28
Epidermis
thin, avascular keratinized epithelium o Outer horny layer (dead keratinized cells0 o Stratum Basale and stratum spinosum – inner cellular layer where melanin and keratin are formed
29
Dermis
Dense layer of collegen and elastic fibers - Pilosebaceous glands (oil) - Sweat glands - Hair follicles - Terminals of cutaneous nerves
30
Subcutaneous tissue
- Carotene (yellow pigment) – lots found in palms and soles - Bilirubin- yellow-brown pigment caused by breakdown of heme in red blood cells -causes jaundice
31
Oxyhemoglobin
Red
32
Deoxyhemoglobin
Blue
33
Pilosebaceous glands
(oil) produce fatty substance secreted onto skin from hair follicles (absent in palms and soles)
34
Eccrine gland
Sweat gland, widely distributed, open onto skin surface, help control body temperature
35
Apocrine gland
found in axillary and genital regions, open to hair follicles
36
Vellus hair
short, fine, inconspicuous, relatively unpigmented
37
Terminal hair
coarser, thicker, more conspicuous, pigmented (calp and eyebrows)
38
Macule
circumscribed, flat area of color change in the skin less than 1cm in diameter
39
Patch
circumscribed flat area of color change in the skin greater than 1cm in diameter
40
Papule
small, solid elevation of the skin less than 1 centimeter in diameter
41
Plaque
large flatter elevation of the skin sometimes formed by papules coalescing
42
Nodule
solid elevation of skin greater than 1cm in diameter that extends into the deeper skin layers
43
Pustule
small, circumscribed elevation of the epidermis filled with purulent fluid
44
Vesicle
small circumscribe elevation of the epidermis containing clear fluid less than 1cm in diameter
45
Bulla
circumscribed elevation of the epidermis containing clear fluid greater than 1cm in diameter
46
Wheal
– circumscribed raised lesion consisting of dermal edema, aka hives or urticaria. Last less than 24 hours typically Common manifestation of hypersensitivity to drugs, stings, bites, autoimmunity, physical stimuli including temp, pressure and sunlight
47
Skin assessment includes
- Size - Number - Distribution – how they are scattered or spread out - Configuration – shape of single lesions and arrangement of group lesions - Texture – smooth, fleshy, verrucous or warty, scaly - Color – blanchable, non-blanchable - Black, orange, yellow, purple, blue, silver, gray - Check cap refill
48
Risk factors for melanoma
o Personal or family history of previous melanoma o ≥50 common moles o Atypical or large moles, especially if dysplastic (abnormal cells) o Red or light hair o Solar lentigines (acquired brown macules on sun-exposed areas) o Freckles (inherited brown macules) o Ultraviolet radiation from heavy sun exposure, sunlamps, or tanning booths o Light eye or skin color, especially skin that freckles or burns easily o Severe blistering sunburns in childhood o Immunosuppression from human immunodeficiency virus (HIV) or from chemotherapy o Personal history of nonmelanoma skin cancer
49
How to assess for melanoma?
ABCDE A - asymmetry B - borders irregular C - color D - diameter E - evolution, is it changing?
50
Herpes zoster
- with unilateral and dermatomal vesicles - vesicles on erythematous base on left upper abdomen and trunk in a dermatomal distribution that does not cross the midline;