Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

530 Health Assessment > Week 3: Derm > Flashcards

Week 3: Derm Flashcards

1
Q

What are the best practices for performing a skin exam? (8)

A
  1. Integrate skin exam in general exam
  2. Document what is present
  3. Ensure proper lighting
  4. Measuring tape/ruler
  5. Dermoscope
  6. Have patient in underwear in gown
  7. Ungloved hands if possible
  8. Scalp to toes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the eight characteristics that the FNP should describe of every skin lesion?

A
  1. Number
  2. Size
  3. Color
  4. Shape
  5. Texture
  6. Primary Lesion
  7. Location
  8. Configuration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

define lesion

A

any single area of altered skin - may be singular or multiple

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

How do you record the following characteristics: Number and size

A

Number: if multiple, record how many, estimate if numerous

Size: length and width in mm or cm

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

What are some ways to describe color? (3)

A
  1. skin colored = same shade as patient’s skin
  2. blanching = red lesion that becomes white when pressure is applied, suggests inflammation
  3. non-blanching = bright red or violaceous that stays red when pressure is applied, suggests vascular involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some ways to describe configuration? (4)

A
  1. unilateral
  2. dermatomal
  3. grouped
  4. linear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is this primary lesion?

A

Macule: flat and <1cm

Photo is an example of morbilliform drug eruption

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

What is this primary lesion?

A

Patch: flat, >1cm

Photo is an example of seborrheic dermatitis

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

What is this primary lesion?

A

Papule: raised <1cm

Photo is an example of basal cell carcinoma

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

What is this primary lesion?

A

Plaques: raised >1cm, can be lichenified

Photo is an example of plaque psoriasis

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

What is this primary lesion?

A

Vesicle: raised, clear fluid-filled, <1cm

Photo is an example of herpes zoster

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

What is this primary lesion?

A

Bulla: raised, clear fluid-filled >1cm

Photo is an example of inherited skin fragility disorder

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

What is this primary lesion?

A

Pusutle: small palpable collection of neutrophils or keratin that appears white

Photo is an example of bacterial folliculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is this primary lesion?

A

Furuncle: inflamed hair follicle, multiple furuncles combine to form a carbuncle

Photo is an example of both furuncles and a carbuncle

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

What is this primary lesion?

A

Nodule: larger, deeper under the layer of the skin than a papule

Photo is an example of a keloid

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

What is this primary lesion?

A

Subcutaneous mass vs. cyst: masses are typically a well defined area of abnormal growth, where cysts are a distinct collection of fluid

Photo on the left: excised cyst

Photo on the right: lipoma or subcutaneous mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is this primary lesion?

A

Wheal: localized dermal edema

Photo is an example of urticaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is this primary lesion?

A

Burrow: small linear pathways in the epidermis

Photo is an example of scabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some terms used to refer to the shape of a lesion? (5)

A
  1. Circular
  2. oval
  3. Annular: ring like with central clearing
  4. Nummular: ring like with no central clearing
  5. polygonal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some terms used to refer to the texture of a lesion? (4)

A
  1. smooth
  2. fleshy
  3. verrucous/warty
  4. scaly (fine, keratotic, greasy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is this condition? What are the classic characteristics?

A

Actinic Keratosis

  • Easier to feel than see
  • Superficial keratotic papules come and go on sun damaged skin
  • Precursor to SCC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is this condition and what does it mimic?

A

Superficial xerosis or sebhorreic dermatitis

  • Mimics actinic keratosis
23
Q

What is this condition and what are it’s characteristics? (hint there are 3 types)

A
  1. Superficial basal cell carcinoma: Pink patch that does not heal
  2. Nodular basal cell carcinoma: Pink papule often with translucent or pearly appearance and overlying telangiectasias, may have focal pigmentation
  3. Ulcerated basal cell carcinoma: nonhealing ulcer, resulting in rolled border
24
Q

What mimics basal cell carcinoma? (4)

A
  1. Actinic keratosis
  2. Sebaceous hyperplasia
  3. Fibrous papule
  4. Squamous cell carcinoma: smooth but firm border
25
Q

What exam findings are concerning for malignant melanoma?

A

ABCDE(EFG): if two or more are present, consider biopsy and referral to dermatologist

  1. Asymmetry
  2. Irregular Border
  3. Color - within the mole but also within surrounding moles
  4. Diameter greater than 6mm
  5. Evolving or changing
  6. EFG: elevated, firm to palpation, growing rapidly over several weeks
26
Q

What is this? What are it’s characteristics (color and size, shape, pulsatility/effect of pressure, distribution, significance)

A

Spider Angioma

  • Color and size: firey red, from very small to 2cm
  • Shape: central body, sometimes raised, surrounded by erythema and radiating legs
  • Pulsatility/effect of pressure: often seen in the center of the spider when pressure with a glass slide is applied, pressure on the body causes blanching of the spider
  • Distribution: face, neck, arms, upper trunk
  • Significance: normal and common on the face and chest, seen in pregnancy and liver disease
27
Q

What is this? What are it’s characteristics? (color and size, shape, pulsatility/effect of pressure, distribution, significance)

A

Spider Vein

  • Color and size: bluish, size variable, from very small to several inches
  • Shape: variable, may resemble a spider or be linear, irregular, cascading
  • Pulsatility and effect of pressure: absent, pressure over the center does not cause blanching, but diffuse pressure blanches the veins
  • Distribution: most often on the legs, near veins, also on the anterior chest
  • Significance: often accompanies increased pressure in the superficial veins as in varicose veins
28
Q

What is this? What are it’s characteristics? (color and size, shape, pulsatility/effect of pressure, distribution, significance)

A

Cherry Angioma

  • Color and size: Bright or ruby red, may become purplish with age, 1-3mm
  • Shape: round, flat or sometimes raised, may be surrounded by a pale halo
  • Pulsatility and effect of pressure: absent, may show partial blanching especially if pressure applied with edge of a pinpoint
  • Distribution: trunk, also extremities
  • Significance: none, increases in size and numbers with aging
29
Q

What are examples of sun damage? (6)

A
  1. Solar lentigo: bilaterally symmetric brown macules located on sun-exposed skin, including the face, shoulder and arms and hands (left picture)
  2. Actinic purpura: ecchymoses limited to the dorsal forearms and hands but not extending above the shirt sleeve line on the upper arm (right picture)
  3. Wrinkles: increased sun damage and tanning leads to deeper wrinkles at an earlier age
  4. Solar elastosis: yellowish white macules or papules in sun-exposed skin especially on forehead
  5. Poikiloderma: red patches in sun-damaged areas, especially the V of the neck and lateral neck, with fine telangiectasias, both hyper and hypopigmentation
  6. Cutis rhomboidalis nuchae: deep wrinkles on the posterior neck that crisscross
30
Q

What are some abnormal nail findings? (7)

A
  1. Onychomycosis: fungal infection
  2. Onchyolysis: painless separation of the whitened opaque nail plate from the pinker translucent nail bed
  3. habit tic deformity: pushing on nails/picking at cuticles, looks like a christmas tree
  4. melanonychia : increased pigmentation in the nail matrix
  5. Nail biting: can cause trauma to the nail
  6. Paronychia: superficial nail infection
  7. Clubbing: bulbous swelling of the soft tissue at the nail base
31
Q

What skin findings would you expect in a patient with chronic renal disease? (5)

A

pallor, xerosis, uremic frost, half and half nails, calciphylaxis

32
Q

What skin findings would you expect in a patient with Crohn disease? (4)

A

erythema nodosum, pyoderma gangrenosum, enterocutaneous fistulas, aphthlous ulcers

33
Q

What skin findings would you expect in a patient with Cushing disease? (9)

A

striae, atrophy, purpura, ecchymoses, telangiectasaias, acne, moon facies, buffalo hump, hypertrichosis

34
Q

What skin findings would you expect in a patient with diabetes? (7)

A

pruritis, diabetic dermopathy, acanthosis nigricans, candidiasis, neuropathic ulcers, necrobiosis lipoidica, eruptive xanthomas

35
Q

What skin findings would you expect in a patient with dyslipidemias? (2)

A

xanthomas, xanthelasma

36
Q

What skin findings would you expect in a patient with hypo (6) vs. hyperthyroidism (6)?

A
  • Hypo: dry, rough and pale skin, coarse and brittle hair, myxedema, alopecia (eyebrows), skin cool to touch, thin and brittle nails
  • Hyper: warm, moist, soft and velvety skin, thin and fine hair, alopecia, vitiligo, pretibial myxedema, hyperpigmentation
37
Q

What skin findings would you expect in a patient with Kawasaki disease? (5)

A

mucosal erythema, strawberry tongue, cherry red lips, polymorphous rash, erythema of the palms and soles with later desquamation of the fingertips

38
Q

What skin findings would you expect in a patient with liver disease? (7)

A

jaundice, spider angiomas and other telangiectasias, palmar erythema, terry nails, pruritis, purpura, caput medusae

39
Q

What skin findings would you expect in a patient with leukemia/lymphoma? (9)

A

pallor, exfoliative erythroderma, nodules, petechiae, ecchymoses, pruritis, vasculitis, pyoderma gangrenosum, bullous disease

40
Q

What skin findings would you expect in a patient with meningococcemia?

A

angular or stellate purpuric patches and plaques with gunmetal gray center; progresses to ecchymoses, bullae, necrosis

41
Q

What findings would you expect in a patient with neurofibromatosis? (4)

A

neurofibromas, café au lait spots, freckling in the axiallae (crowe sign), plexiform neurofibroma

42
Q

What skin findings would you expect in a patient with lupus? (3)

A

malar erythema, periungual erythema, interphalangeal erythema

43
Q

What are is the APGAR scoring for a newborn’s skin?

A
  • 0: blue, pale
  • 1: pink body, blue extremities
  • 2: pink all over
44
Q

Where would you assess an infant’s skin for cyanosis? What would you consider on the DDx for an infant with cyanosis?

A
  • Assess the mouth, tongue and conjunctivae as well as skin color
  • DDx:
  • Acrocyanosis: bluish discoloration in the palms and soles
  • Cyanotic congenital heart disease
  • Central cyanosis: hands and feet, lips, tongue, sublingual tissues
  • Harlequin dyschromia: transient cyanosis of one half of the body or extremity
45
Q

What is this? What are it’s characteristics?

A

Miliaria rubra: scattered vesicles on an erythematous based , result from obstruction of the sweat gland ducts

46
Q

What is this and what are it’s characteristics?

A

Erythema toxicum: erythematous macules with central pinpoint vesicles

47
Q

What is this and what are its characteristics?

A

Pustular melanosis: small vesiculopustules over a brown macular base; seen more commonly in black infants

48
Q

What is this and what are it’s characteristics?

A

Milia: pinhead-size white, pearly papules, without surrounding erythema on the nose, chin and forehead result from retention of sebum in the openings of the sebaceous glands

49
Q

What is this and what are its characteristics?

A

Cutis marmorata: vasomotor changes in the dermis and subcutaneous tissue, response to cooling or chronic exposure to radiant heat, bluish mottled & lattice-like appearance

50
Q

What is this and what are it’s characteristics?

A

physiologic jaundice: related to acclimation outside of the womb, if persists past 5 days consider abnormal

51
Q

What is this and what are it’s characteristics?

A

Midline hair tufts: over lumbosacral spine region suggests possible spinal cord defect

52
Q

What are some benign birthmarks found in infants? (6)

A
  1. eyelid patch
  2. Salmon patch: splotchy pink mark
  3. Café au lait spots: light brown pigmented lesions <1 to 2 cm at birth
  4. Multiple lesions might indicate neurofibromatosis
  5. Congenital dermal melanocytosis
  6. Mongolian patch/slate blue patches: dark or bluish pigmentation over the buttocks and lower lumbar regions
53
Q

In the pediatric population, what are some wart-like lesions and how do they appear on exam?

A
  1. Verruca vulgaris: dry, rough warts on hands
  2. Verruca plana: small, flat warts
  3. Plantar warts: tender warts on feet
  4. Molluscum contagiosum: dome-shaped, fleshy lesions with central umbilication
  5. Adolescent acne: open and closed comedones, inflamed pustules
54
Q

What are some commons skin lesions during childhood and how do they appear on exam?

A
  1. Insect bites: intensely pruritis, red, distinct papules characterize these lesions
  2. Tinea capitis: scaling, crusting and hair loss along with painful plaque and occipital lymph node
  3. Urticaria: pruritis, allergic sensitivity reaction
  4. Scabies: intensely itchy papule and vesicles, sometimes burrows, most often on extremities
  5. Tinea corporis: this annular lesion has central clearing and papules along the border
  6. Pityriasis rosea: oval lesions on trunk, often in a christmas tree pattern, herald patch

530 Health Assessment (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions