Week 6 - Abnormal Findings: Lesions + Lab Assessment

Question 1

What is a primary lesion?

Answer 1

• When a lesion develops on unaltered skin

Question 2

What is a secondary lesion?

Answer 2

• When a lesion changes over time (scratching/itching)

Question 3

How should you assess a lesion? (3)

Answer 3

1. Health history: pain, healing, cause, when and where it started, spreading, contagious, environmental, itching, fever, stress
2. Inspection: color, elevation, pattern or shape, size, location, and distribution on body. Any excaudate?
3. Palpitation: depth, pain, temperature, easily removed “brushed off” - cause bleeding Blanch with pressure?

Question 4

What are the types (structure) of primary lesions? (6)

Answer 4

• macule and patch
• papule and plaque
• nodule and tumour
• Wheal and urticaria (hives)
• Vesicle and Bulla
• Cyst and pustule

Question 5

What are the types of secondary skin lesions? (10)

Answer 5

• crust
• scale
• fissure
• erosion
• Ulcer (pressure sore)
• Excoriation (scratch or abrasion)
• Scar
• Atrophic scar
• Keloid
• Lichenification
  do not need to know all

Question 6

What are the different shapes and configurations of lesions and wounds?

Answer 6

Question 7

ABCDE is the acronym used to assess moles. What does it stand for?

Answer 7

Asymmetry
Border Irregularity
Colour Variation
Diameter > 6mm (bigger than pencil head)
Evolution (change over time) - rapid change is a red flag “ugly duckling”

Question 8

What are some other objective assessments of the integumentary System?

Answer 8

1. Assess the nail beds for any abnormalities and hygiene
   - clubbing, discoloration
2. Inspect the oral cavity
3. Palpate and inspect the scalp

Question 9

What should you inspect in the oral cavity? (5)

Answer 9

• moist mucous membranes
• any lesions
• halitosis (bad breath)
• Furrowed tongue
• Condition of the teeth (broken, clean, bleeding gums)

Question 10

What are you looking for when palpating and inspecting scalp? (3)

Answer 10

• tenderness
• sores/lesions
• infestations (ie. head lice)

Question 11

What is done in a laboratory assessment to determine tissue integrity?(3 points, 6)

Answer 11

1. Wound Cultures - swab to know
2. Albumin
   - for growth and repair
   - more likely to have skin breabkdown
   - hard time healing
3. Biopsy

Question 12

What are 5 biopsy methods?

Answer 12

• curettage
• Shave
• Punch biopsy
• Excisional
• incisional