Clinical Exam - Skin And Lymph

Front 1

ecchymoses

Back 1

discoloration caused by injury

Front 2

petechiae

Back 2

discoloration not caused by injury; smaller than 0.5 cm

Front 3

purpura

Back 3

discoloration not caused by injury; larger than 0.5 cm

Front 4

mercury poisioning

Back 4

generalized red flush; widespread miliarial rash; doesn't feel well

Front 5

telangiectases

Back 5

fine, irregular red lines; little masses of venules; refill erratically

Front 6

vascular spiders

Back 6

arterial; refill in organized way

Front 7

macule

Back 7

(freckles, flat moles, measles)

Front 8

papule

Back 8

(wart, elevated mole)

Front 9

patch

Back 9

(vitiligo, port-wine stain)

Front 10

plaque

Back 10

(psoriasis, seborrhic and actinic keratoses)

Front 11

wheal

Back 11

(insect bites, urticaria, allergic reaction)

Front 12

nodule

Back 12

(erythema nodosum, lipoma)

Front 13

tumor

Back 13

(neoplasms, lipoma)

Front 14

vesicle

Back 14

(varicella, herpes zoster)

Front 15

bulla

Back 15

(blister, pemphigus vulgaris)

Front 16

pustule

Back 16

(impetigo, acne)

Front 17

cyst

Back 17

(sebaceous, acne)

Front 18

scale

Back 18

(flaking of skin with dry skin, drug reaction)

Front 19

lichenfication

Back 19

(chronic dermatitis)

Front 20

keloid

Back 20

irregular-shaped, elevated, progressively enlarging scar
grows beyond boundary of wound; caused by excessive collagen formation

Front 21

scar

Back 21

thin to thick fibrous tissue, replaces skin following injury or laceration to dermis

Front 22

excoriation

Back 22

(abrasion, scratch, scabies)

Front 23

fissure

Back 23

(athlete's foot, cracks at mouth corners)

Front 24

erosion

Back 24

(varicella, variola after rupture)

Front 25

ulcer

Back 25

(decubiti)

Front 26

crust

Back 26

(scab, eczema)

Front 27

atrophy

Back 27

(striae, aging)

Front 28

cutis marmorata

Back 28

transient mottling (marks with spots or smear of color) when infant is exposed to decreased temperature

Front 29

erythema toxicum

Back 29

pink papular rash with vesicles superimposed on thorax, back, butt, abdomen; may appear 24-48 hours and resolves after several days; expected color change in infant

Front 30

harlequin color change

Back 30

clearly outlined color change as infant lies on side,
dependent half becomes pink and upper half is pale

Front 31

mongolian spots

Back 31

irregular areas of deep blue pigmentation; usually in sacral or gluteal region

Front 32

telangiectatic nevi (stork bites)

Back 32

flat deep pink localized areas on back of neck

Front 33

epidermal verrucous nevi

Back 33

warty lesions in linear or whorled pattern, pigmented or skin color; associated with skeletal, CNS and ocular abnormalities

Front 34

cafe au lait patches

Back 34

flat, evenly pigmented spots varying in color from light brown to black; associated with neurofibromatosis, pulmonary stenosis, temporal lobe dysrhythmia, tuberous sclerosis

Front 35

supernumerary nipples

Back 35

associated with renal abnormalities

Front 36

hair collar sign

Back 36

ring of long dark coarse hair surrounding midline scalp nodule; associated with neural tube closure defects of scalp

Front 37

persistent pruritus

Back 37

may indicated chronic renal failure, cholestatis liver disease, Hodgkin disease, DM

Front 38

vernix caseosa

Back 38

whitish, moist, cheese-like substance that covers newborn infants

Front 39

milia

Back 39

small whitish, discrete papules on the face, sebacceous glands are immature and become clogged

Front 40

Dennie-Morgan fold

Back 40

an extra crease or pleat of skin below the eye due to chronic rubbing and inflammation

Front 41

molluscum fibrosum

Back 41

cutaneous tags that are a result of epithelial hyperplasia

Front 42

skin changes in pregnancy:

Back 42

striae gravidarum; telangiectasis; hemanigomas; cutaneous tags; increase in pigmentation; chloasma (mask of pregnancy)

Front 43

itching in pregnancy can occur due to:

Back 43

stretching of the skin; jaundice; pregnancy-specific dermatosis

Front 44

expected lesions in the older adult:

Back 44

cherry angiomas; seborrheic keratoses; sebaceous hyperplasia; cutaneous tags (acrochordon); cutaneous horns; senile lentigines

Front 45

seborrheic keratoses

Back 45

pigmented, raised, warty lesions; must be distinguished from actinic keratoses which have the potential to be malignant

Front 46

senile lentigines

Back 46

irregular, round, gray-brown lesions with a rough surface; may be called age or liver spots

Front 47

why does the hair turn gray or white?

Back 47

melanocytes stop functioning

Front 48

lentigo

Back 48

brown macule that appears in sun-exposed areas

Front 49

corn

Back 49

flat or slightly elevated; smooth, hard surface; "soft": caused by pressure of bony prominence against softer tissue;"hard": sharply delineated with conical appearance where pressure is exerted

Front 50

callus

Back 50

area of hyperkeratosis, not usually tender

Front 51

eczematous dermatitis

Back 51

epidermal breakdown due to intracellular vesiculation, has 3 stages: acute: erythematous, pruritic weeping vesicles subacute: erythema and scaling chronic: thick lichenified pruritic plaques

Front 52

furnicle

Back 52

acute localized staphylococcal infection; begins as a follicular abscess and spreads to surrounding dermis and subcut tissue, becomes a pustule, may rupture or need surgery

Front 53

folliculities

Back 53

staph infection of hair follicle and surrounding dermis, pustule

Front 54

cellulitis

Back 54

strep or staph infection of skin and subcut tissue; lymphatic streaks and lymphadenopathy may be present

Front 55

tinea

Back 55

noncandidal fungal infection, usually classified according to anatomic location: cruris (groin/thigh), unguium (nails)

Front 56

pityriasis rosea

Back 56

self-limiting inflammation of unknown cause, primary round plaque with scaling with eruption weeks later with a distribution along the ribs giving a Christmas tree pattern, not contagious

Front 57

psoriasis

Back 57

disease of keratin synthesis, dry silvery scaling papules/plaques

Front 58

rosacea

Back 58

chronic inflammatory disorder characterized by telangiectasia, erythema, papules, pustules in central area of the face; tissue hypertrophy of the nose (rhinophyma) may occur, comedomes are never present

Front 59

drug eruptions

Back 59

discrete/confluent erythematous maculopapules, pruritus

Front 60

herpes zoster (shingles)

Back 60

viral infection usually of a single dermatome, red swollen plaques or vesicles filled with purulent fluid
pain in the dermatome can start days before the rash

Front 61

herpes simplex

Back 61

viral infection, tenderness, pain, paresthesia, mild burning

Front 62

cutaneous anthrax

Back 62

spore forming bacterium, pruritic macule or papule that enlarges into an ulcer, central necrosis, associated with lymphangitis and lymphadenopathy

Front 63

smallpox

Back 63

variola virus, direct transmission by infected saliva, most infectious during 1st week, rash first appears on mouth/pharynx/face/forearms and spreads to trunk and legs; starts as flat red lesions that evolve at same rate then become vesicular, pustular and crust

Front 64

basal cell carcinoma

Back 64

most common form of skin cancer, arises in basal layer of epidermis, warning signs include: open sore, reddish patch, shiny nodule, pink growth and scarlike area

Front 65

squamous cell carcinoma

Back 65

second most common skin cancer, arises in the epithelium, soft mobile elevated masses with a surface scale, warning signs: wartlike growth, scaly red patch, open sore, elevated growth with a central depression

Front 66

malignant melanoma

Back 66

skin cancer that develops from melanocytes

Front 67

kaposi sarcoma

Back 67

malignant tumor of endothelium and epithelial layer of skin, soft vascular bluish-purple and painless lesions, macular or papular, opportunistic infection in those with HIV, can have lesions on skin, GI tract, lungs liver lymph nodes bones etc

Front 68

alopecia areata

Back 68

hair shaft is poorly formed and breaks off at the skin surface

Front 69

paronychia

Back 69

inflammation of the paronychium produces redness swelling and tenderness at the lateral and proximal nail folds, purulent drainage

Front 70

tinea unguium

Back 70

fungal infection of the nail, hyperkeratotic debris accumulates in nail plate causing it to turn yellow or white and the nail to separate from the nail bed (onycholysis), nail plate crumbles

Front 71

subungual hematoma

Back 71

caused by trauma to the nail plate causing immediate bleeding and pain

Front 72

leukonychia punctata

Back 72

white spots on the nail due to minor injury or manipulation of the cuticle

Front 73

habit-tic deformity

Back 73

caused by biting or picking the proximal nail fold of the thumb with the index finger, results in horizontal sharp grooving in a band that extends to tip of nail

Front 74

koilonychia (spoon nails)

Back 74

central depression of the nail with lateral elevation of the nail plate that produces a concave curvature and spoon appearance, associated with iron deficiency, syphillis, fungal dermatoses and hypothyroidism

Front 75

beau lines

Back 75

transverse depressions at the base of the lunulae in all the nails, associated with coronary occlusion, hypercalcemia and skin disease, caused by stress that temporarily interrupts nail formation

Front 76

white banding (terry nail)

Back 76

transverse white bands covering the nail except for a narrow zone at the distal tip, associated with cirrhiosis and hypoalbuminemia

Front 77

psoriasis

Back 77

pitting, onycholysis, discoloration and subungual thickening, yellow scaly debris accumulates, can cause splinter hemorrhage

Front 78

warts

Back 78

epidermal neoplasms caused by viral infection, can occur at nail fold and extend under the nail

Front 79

digital mucous cysts

Back 79

contain a clear, jelly like substance and occurs on the dorsal surface of the distal phalanx, longitudinal groove may occur

Front 80

pruritic urticarial papules and plaques of pregnancy (PUPPP)

Back 80

benign dermatosis that usually arises in the 3rd trimester of a 1st pregnancy, begins on abdomen and spreads to thighs buttocks and arms, halos of blanching surround the papules, larger bullae don't occur and not periumbilical (herpes)

Front 81

herpes gestationis

Back 81

rare autoimmune disorder of pregnancy, not related to the viral infection, initially periumbilical erythematous urticarial patches and plaques, progress to vesicle and blisters, pruritus, can develop necrosis of affected skin and kidney damage

Front 82

seborrheic dermatitis

Back 82

chronic recurrent erythematous scaling eruption localized where sebaceous glands are concentrated; craddle cap

Front 83

miliaria (prickly heat)

Back 83

irregular red macular rash caused by occlusion of sweat ducts during periods of heat

Front 84

impetigo

Back 84

highly contagious staph or strep infection of the epidermis, causes pruritis, burning and regional lymphadenopathy, starts as a macule then changes to a vesicle or bulla, crusts

Front 85

acne vulgaris

Back 85

stagnation of sebum and comedo formation in the pilosebaceous follicle with bacterial invasion

Front 86

reddened patchiness

Back 86

suggest richer capillary bed, caused by capillary hemangioma, nevus flammeus or vasculosus and telangiectatic nevus

Front 87

chickenpox

Back 87

fever mild malaise and pruritic maculopapular skin eruption that becomes vesicular, occurs with several stages of maturity at one time, complications include conjunctival involvement, bacterial infection, viral pneumonia, encephalitis, aseptic meningitis, myelitis, Guillain-Barre, Reye syndrome

Front 88

measles (rubeola)

Back 88

prodromal fever, conjunctivitis, coryza and bronchitis followed by a red blotchy rash, Koplik spots on buccal mucosa, macular then maculopapular, complications include infection of resp tract and CNS

Front 89

german measles (rubella)

Back 89

mild and febrile, maculopapular rash, starts with fever, coryza, sore throat and cough, macular then papular rash, Forschheimer spots on soft palate, infection during 1st trimester can cause congenital rubella syndrome

Front 90

trichotillomania

Back 90

loss of scalp hair caused by physical manipulation, can lead to trichobezoar (lump of hair in stomach after being swallowed)

Front 91

causes of balding in children:

Back 91

scalp ringworm
alopecia areata
trichotillomania
abusive hair pulling

Front 92

bruises

Back 92

when associated with abuse it occurs over soft tissue
accidental bruises occur over bony prominences

Front 93

lacerations

Back 93

those of the frenulum and lips are associated with forceful feeding
can be caused by bite marks

Front 94

burns

Back 94

common are stocking and glove distribution indicating placement into a hot water or surface
can be differentiated from accidental by looking for splash marks (spilled hot liquid)

Front 95

stasis dermatitis

Back 95

erythematous scaling weeping patches, secondary to edema of chronic peripheral vascular disease

Front 96

solar keratosis (senile actinic keratoses)

Back 96

slightly raised erythematous lesion, secondary to chronic sun damage and has malignant potential

Front 97

morbilliform

Back 97

maculopapular lesions that become confluent on the face and body

Front 98

target lesion

Back 98

pink macules with purple central papules

Front 99

punctation

Back 99

central umbilication or dimpling

Front 100

yellow discoloration of the nail

Back 100

nail color caused by psoriasis or fungal infection or chronic resp disease

Front 101

darkening of the nail

Back 101

nail color caused by antimalarial drug therapy, candidal infection, hyperbilirubinemia and chronic trauma

Front 102

green-black discoloration of the nail

Back 102

nail color caused by Pseudomonas infection (no pain) or subungual hematoma (pain)

Front 103

single blue-black nail

Back 103

nail color caused by melanoma or bruising/bleeding from trauma

Front 104

generalized blue nails

Back 104

nail color caused by cyanosis due to asthma, cardiac disorders or anemia, silver poisioning, med side effect, Wilson disease (inherited)

Front 105

Longitudinal red or brown streaks

Back 105

nail abnormalities caused by splinter hemorrhage, may occur with psoriasis of nail matrix or injury to prox nail fold (habit-tic deformity)

Front 106

Longitudinal white streaks or transverse white bands

Back 106

systemic disorder cause this nail abnormality

Front 107

Longitudinal ridges and grooves

Back 107

expected nail abnormality or caused by lichen planus

Front 108

Transverse grooves

Back 108

repeated trauma causes this nail abnormality

Front 109

Transverse rippling of nail plate

Back 109

chronic inflammation with chronic paronychia or eczema cause this nail abnormality

Front 110

Transverse depression at base of lunula

Back 110

stress temporarily interrupts nail formation causing this nail abnormality

Front 111

Depression in nail

Back 111

syphilis, high fevers, peripheral vascular disease, DM can cause this nail abnormality

Front 112

Pitting

Back 112

psoriasis causes this nail abnormality

Front 113

Broadening and flattening

Back 113

secondary syphilis causes this nail abnormality

Front 114

halo nevus

Back 114

this nevus is usually benign, can occur with melanoma

Front 115

intradermal nevus

Back 115

this nevus has no indications for removal except cosmetic

Front 116

junction and compound nevi

Back 116

these nevi should be removed if exposed to repeated trauma

Front 117

hairy nevus

Back 117

this nevus should be removed if changes occur

Front 118

size of a normal mole

Back 118

less than 6 mm

Front 119

macule

Back 119

flat, circumscribed areas that is a change in the color of the skin, less than 1 cm in diameter

Front 120

papule

Back 120

elevated, firm circumscribed area, less than 1 cm in diameter

Front 121

patch

Back 121

flat, nonpalpable, irregular-shaped macule greater than 1 cm in diameter

Front 122

plaque

Back 122

elevated, firm and rough lesion with flat top surface greater than 1 cm in diameter

Front 123

wheal

Back 123

elevated irregular-shaped area of cutaneous edema; solid, transient variable diameter

Front 124

nodule

Back 124

elevated firm circumscribed lesion; deeper in dermis than a papules; 1-2 cm in diameter

Front 125

tumor

Back 125

elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter

Front 126

vesicle

Back 126

elevated circumscribed superficial, not into dermis; filled with serous fluid, less than 1 cm in diameter

Front 127

bulla

Back 127

vesicle greater than 1 cm in diameter

Front 128

pustule

Back 128

elevated superficial lesion; similar to a vesicle but filled with purulent fluid

Front 129

cyst

Back 129

elevated circumscribed encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semi-solid material

Front 130

telangiectasia

Back 130

find, irregular red lines produced by capillary dilation

Front 131

scale

Back 131

heaped-up keratinized cells; flaky skin; irregular; thick or thin; dry oily; variation in size

Front 132

lichenification

Back 132

rough thickened epidermis secondary to persistent rubbing, itching or skin irritation; often involves flexor surface of extremity

Front 133

keloid

Back 133

irregular shaped elevated progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing

Front 134

scar

Back 134

thin to thick fibrous tissue that replaces normal skin following injury or laceration to the dermis

Front 135

excoriation

Back 135

loss of the epidermis; linear hollowed-out crusted area

Front 136

fissure

Back 136

linear crack or break from epidermis to the dermis; may be moist or dry

Front 137

erosion

Back 137

loss of part of the epiermis; depressed moist glistening follows rupture of a vesicle or bulla

Front 138

ulcer

Back 138

loss of epidermis and dermis; concave; varies in size

Front 139

crust

Back 139

dried serum, blood or purulent exudates; slightly elevated; size varies; brown, red, black, tan or straw colored

Front 140

atrophy

Back 140

thinning of skin surface and loss of skin markings; skin translucent and paper-like

Front 141

faun tail nevus

Back 141

tuft of hair overlying the spinal column at birth; may be associated with spina bifida occulta

Front 142

Elephantiasis

Back 142

massive accumulation of lymphedema throughout body from widespread inflammation and obstruction of lymphatics by filarial worms

Front 143

Wuchereria bancrofti or Brugia malayi

Back 143

common filiarial worms that cause elephantiasis

Front 144

Lymphangioma and cystic hygroma

Back 144

results of obstruction of developing lymph vessels

Front 145

Lymphedema

Back 145

hypoplasia and maldevelopment of lymph system

Front 146

Milroy disease

Back 146

primary lymphedema

Front 147

serum sickness

Back 147

Urticaria and other rashes, lymphadenopathy, joint pain, fever, facial edema; 7-10 days after provoking substance, can recur

Front 148

Pneumocystis carinii pneumonia

Back 148

common opportunistic infection in AIDS

Front 149

cat scratch disease

Back 149

Most common cause of subacute or chronic inflammation in kids

Front 150

roseola infantum (HHV-6)

Back 150

Fever followed by morbilliform rash; Usually 7-12 mo old

Front 151

toxoplasmosis

Back 151

Single enlarged and nontender node; hx of eating raw meat

Front 152

Epstein-Barr virus (mono)

Back 152

Sx: pharyngitis, fever, fatigue, malaise, splenomegaly, hepatomegaly, rash; Anterior and posterior cervical are most common affected nodes

Front 153

Epstein-Barr virus

Back 153

Virus found in Burkitt lymphoma and nasopharyngeal carcinoma

Front 154

acute suppurative lymphadenitis

Back 154

caused most often by strep and staph bacteria

Front 155

Actinomycotic adenitis

Back 155

dental disease causing acute suppurative lymphadenitis

Front 156

Pasteurella multocida infection

Back 156

cat scratch disease

Front 157

Virchow node

Back 157

in L supraclavicular region indicative of abdominal or thoracic malignancy