Pathophysiology- Skin Disorders Ch 27

Front 1

What are the layers of the skin?

Back 1

Epidermis
Dermis
Subcutaneous (hypodermis)

Front 2

What is responsible for water-proofing the skin?

Back 2

Keratin

Front 3

What gives skin its pigment? What cells produce it?

Back 3

Melanin ; melanocytes

Front 4

Lack of melanin production

Back 4

Albinism

Front 5

What skin disorder might you have if you have no protection against the sunlight?

Back 5

Albinism

Front 6

If you have lack of melanocytes, what skin disorder would you have?

Back 6

Albinism

Front 7

If your melanocytes lose the ability to produce melanin what disorder would you have?

Back 7

Vitiligo

Front 8

Small areas of hypopigmentation is called

Back 8

Vitiligo

Front 9

Patches of darker skin is called

Back 9

melasma

Front 10

Connective tissue contains both __________and ________fibers.

Back 10

elastic and collagen fibers

Front 11

Which section of the skin contains melanocytes

Back 11

Basal layer of the epidermis

Front 12

Which layer contributes the most to the flexibility and strength of the skin?

Back 12

Dermis

Front 13

Which layer of the skin contains the nerves and blood vessels?

Back 13

Dermis and hypodermis

Front 14

Which layer of the skin includes sensory receptors for pressure, touch, pain, and temperature?

Back 14

Dermis (Meissner's and Pacinian corpuscles)

Front 15

A loss of turgor in the skin would likely indicate

Back 15

Dehydration

Front 16

Which layer within a hair follicle does mitotic growth occur?

Back 16

Stratum basale

Front 17

What is the muscle associated with hair follicles? What type of nerve innervation caused it to contract?

Back 17

Arrector pili muscle ; sympathetic NS

Front 18

Which gland produces sebum? When does this secretion begin?

Back 18

Sebum ; at puberty

Front 19

What type of sweat glands are all over your body?

Back 19

Eccrine

Front 20

What type of sweat glands are found in axillae, scalp, face, and external genitalia?

Back 20

Apocrine (ducts open into canal or hair follicles)

Front 21

Which layer of the skin contains connective tissue?

Back 21

Dermis and hypodermis

Front 22

Which layer of the skin contains fat cells?

Back 22

Hypodermis (subcutaneous)

Front 23

Which layer of the skin contains fibroblasts?

Back 23

Hypodermis

Front 24

Which layer of the skin contains macrophages?

Back 24

Hypodermis

Front 25

Which layer of the skin contains nerves?

Back 25

Dermis and hypodermis

Front 26

What type of muscle is the arrector pili muscle?

Back 26

Smooth

Front 27

What does you skin synthesis with ultraviolet stimulation? What is this required for?

Back 27

Vitamin D ; absorption of calcium in the intestinal mucosa

Front 28

Name two ways in which your skin regulates your body temperature.

Back 28

1- vasodilation (warming)
2- evaporation of sweat (cooling)

Front 29

Give an example of a systemic disorder which might cause a skin lesion

Back 29

Liver disease

Front 30

Give an example of a systemic infection which would cause skin lesions

Back 30

Chickenpox

Front 31

What is another name for itching of the skin?

Back 31

Pruritus

Front 32

Small, flat circumscribed lesion of a different color than the normal skin

Back 32

Macule

Front 33

Small, firm (solid) elevated lesion

Back 33

Papule

Front 34

Thin walled, raised, fluid filled lesion

Back 34

vesicle or blister

Front 35

Cavity in the tissue

Back 35

Ulcer

Front 36

Firm, raised, deep lesion

Back 36

Nodule

Front 37

Raised, filled with pus lesion

Back 37

pustule

Front 38

slightly elevated, flat "scaly like" lesion

Back 38

plaque

Front 39

Crack in the lesion

Back 39

Fissure

Front 40

Pruritus could be caused by

Back 40

Allergic reaction
chemical irritation (due to insect bite)
Parasites, like scabeis

Front 41

What might pruritus interdigitally indicate?

Back 41

Scabies

Front 42

Although the exact mechanism for pruritus is not fully understood, we know _________ is released

Back 42

Histamine

Front 43

Infection resulting from pruritus is usually due to

Back 43

Breaking the skin barrier by scratching

Front 44

What treatments is recommended for pruritus?

Back 44

topical agents to reduce itch sensation
antihistamine
glucocorticoids

Front 45

Cryosurgery is a treatment for which type of skin lesion?

Back 45

Precancerous lesions

Front 46

What type of inflammatory disorder would be caused by exposure to an antigen?

Back 46

Contact dermatitis

Front 47

Does direct chemical or mechanical irritation involve an immune response?

Back 47

NO (only inflammatory response)

Front 48

What is another name for hives?

Back 48

Urticaria

Front 49

What is the cause of urticaria? Where other than the skin can it occur?

Back 49

Ingestions of substances that results in a type I hypersensitivity; in the pharyngeal mucosa

Front 50

What should you check for if a patient has urticaria? What risk is involved?

Back 50

Swelling around the mouth
Check airway
Urticaria often leads to anaphylatic shock!

Front 51

What is another name for atopic dermatitis?

Back 51

Eczema

Front 52

Diagnose.
Erythematous rash with serous exudate on the face, chest, and shoulders

Back 52

Infant eczema (atopic dermatitis)

Front 53

Diagnose.
Dry, scaly, pruritic rash on the knees and inner elbows

Back 53

Adult eczema (atopic dermatitis)

Front 54

Chronic inflammation resulting from a response to allergens (eosinophilia and increased serum IgE levels)

Back 54

Eczema (atop dermatitis)

Front 55

What is the treatment for atopic dermatitis?

Back 55

Antihistamines, glucocorticoids

Front 56

when is the typical onset of psoriasis?

Back 56

Teen years

Front 57

Rash that results from abnormal T-cell activation

Back 57

Psoriasis

Front 58

In which inflammatory disorder is there an excessive keratinocyte proliferation?

Back 58

Psoriasis

Front 59

Itching or burning lesions on the face, scalp, knees, and elbows are characteristic of which skin disorder?

Back 59

Psoriasis

Front 60

During psoriasis exacerbation, skin lesions are (wet/dry)

Back 60

wet

Front 61

During psoriasis remission, skin lesions are (wet/dry).

Back 61

Dry

Front 62

An example of a plaque

Back 62

Psoriasis,during remission

Front 63

Which inflammatory skin disorder is a symptom of an auto immune disorder?

Back 63

Pemphigus

Front 64

What is the problem in pemphigus?

Back 64

Autoantibodies disrupt the cohesion between epidermal cells (often causing the epidermis to separate from the basal layer)

Front 65

Pemphigus causes which of the following to form?
1- Blisters (bullae)
2- Plaque
3- Nodules

Back 65

1- Blisters (bullae)

Front 66

After the skin sheds in pemphigus, what might the patient experience?

Back 66

Pain, and risk of secondary infection due to open area

Front 67

Diagnose.
This is an extensive case of which skin disorder?
What other factors might contribute?

Back 67

Steven-Johnson syndrome.
Extensive form of pemphigus.
Often secondary to allergic reactions to medications.

Front 68

Diagnose.
Which stage is this in?

Back 68

Psoriasis.
Exacerbation

Front 69

Diagnose.
What does this result from?
How would you treat?

Back 69

Eczema (in an adult- flexor surface)
Eosiniphilia and increased serum IgE levels (due to allergens)
Glucocorticoids and antihistamines

Front 70

Diagnose.
How is this disorder different in infants and adults?

Back 70

Atopic Dermatitis (eczema)
In infants, usualyl erythrematous with serous exudate that occurs on face, shoulders, and chest.
In adults, lichenificaiton (dry, scaly, pruritic) often on flexro surfaces

Front 71

Glucocorticoids, tar preparations, and anti-metabolites are treatments for which skin disorder?

Back 71

Psoriasis

Front 72

Glucocorticoids and immunosuppressants are treatments for which skin disorder?

Back 72

Pemphigus

Front 73

Diagnose.
What is present in all cases of this disorder?
What could this lead to?

Back 73

Scleroderma.
Increased collagen deposition, inflammation and fibrosis with decreased capillary networks
Renal failure, intestinal obstruction, respiratory failure due to distortion of the tissues.

Front 74

Scleroderma could occur as a skin disorder or ___________.

Back 74

systemic, affecting viscera

Front 75

What is the primary cause of scleroderma?

Back 75

Unknown

Front 76

diagnose.
Hard, shiny, tight immovable areas of the skin

Back 76

Scleroderma

Front 77

Diagnose.
Impaired movement of mouth and eyes.

Back 77

Scleroderma

Front 78

Cellulitis is an infection of the _____ and _______ tissues

Back 78

dermis, subcutaneous

Front 79

Another name for cellulitis

Back 79

erysipelas

Front 80

What does "iatrogenic" mean?

Back 80

Complication arising from medical treatment (example= drug interaction)

Front 81

Which skin infection is usually a secondary infection due to an injury or iatrogenic?

Back 81

Cellulitis (erysipelas)

Front 82

What is the most common causative agent in cellulitis? Second most?

Back 82

Staph aureus ; Streptococcus

Front 83

Where is cellulitis most commonly found?

Back 83

In the lower trunks and legs

Front 84

Diagnose.
Red streaks running along lymph vessels proximal to the infected area

Back 84

Cellulitis

Front 85

Diagnose.
What layers of the skin are infected?

Back 85

Cellulitis (erysipelas)
Dermis and Hypodermis

Front 86

Another name for a boil?

Back 86

Furuncle

Front 87

diagnose.
Causative agent?
What is this filled with and what is meant by autoinoculation?

Back 87

Boil (furuncle)
S. aureus
Filled with purulent exudate; if squeezed, it can result in the spread of infection to other areas of the skin.

Front 88

diagnose.
what is this a collection of?

Back 88

Carbuncle.
Collection of furuncles that coalesce to form a large infected mass.

Front 89

Diagnose.
What is causative agent? Other possibilities
In which age group is this infection most common?

Back 89

Impetigo.
staph aureus (also streptococcis pyogenes and combination of staph or strep)
Infants and children

Front 90

What skin infection is caused by one of the following agents?
Staph aureus
Streptococcus pyrogenes
combination of staph and strep

Back 90

Impetigo

Front 91

what treatment is used for impetigo?

Back 91

Topical antibiotics in the early stages. If lesions are extensive, systemic antibiotics are given

Front 92

Infection caused by gram-positive, group A, beta-hemolytic streptococcus

Back 92

Necrotizing Faciitis

Front 93

In necrotizing faciitis, which type of bacteria are usually present, aneraobic, or aerobic?

Back 93

combination of both

Front 94

What allows streptococcus to breakdown tissue?

Back 94

secretion of exotoxins

Front 95

The history of a person with necrotizing faciitis usually includes...

Back 95

minor trauma or infection in the skin and subcutaneous tissue of an extremity

Front 96

Which is associated with necrotizing faciitis?
fever / no fever
bradycardia / tachycardia
hypotension / hypertension

Back 96

fever
tachycardia
hypotension
*also mental confusion, diorientation, and possible organ failure

Front 97

How would you treat this?

Back 97

Aggressive antimicrobial therapy, fluid replacement, excision of all infected tissue, amputation

Front 98

Most common cause of cold sores or fever blisters?

Back 98

HSV-1

Front 99

Most common cause of genital herpes?

Back 99

HSV-2

Front 100

Where does herps virus remain latent? What triggers an exacerbation?

Back 100

In the sensory ganglion ; stress, common cold, sun exposure

Front 101

How is herpes spread?

Back 101

With direct contact from fluid from the lesion

Front 102

Name two complications of HSV when spread to other areas

Back 102

Eye- keratitis
Finger- Herpetic whitlow (painful)

Front 103

Another name for warts?

Back 103

verrucae

Front 104

what are most common kind of warts? What is the causative agent of these?

Back 104

Plantar warts ; HPV types 1-4

Front 105

What causes genital verrucae?

Back 105

HPV 6 and 11

Front 106

What is another name for a fungal infection?

Back 106

Mycoses

Front 107

Most mycoses are superficial. When might it spread systemically?

Back 107

In immunocompromised patients

Front 108

Which fungal agent is associated with diabetic patients?

Back 108

Candida

Front 109

Tinea capitis

Back 109

Fungal infection of the scalp

Front 110

Tinea corporis

Back 110

Fungal infection of the body, particularly non-hairy parts

Front 111

Tinea pedis

Back 111

Fungal infection of the foot

Front 112

Tinea urguium

Back 112

Fungal infection of the nails (usually toenails)

Front 113

When do male and female scabies die?

Back 113

males- after fertilizing female
females- after laying the eggs into epidermis

Front 114

Pediculus humanus corporis

Back 114

body lice

Front 115

Pediculus humanus capitis

Back 115

head lice

Front 116

Pediculus humanus pubis

Back 116

pubic lice

Front 117

Why do louse bite human host?

Back 117

Suck blood for production of ova

Front 118

What is excoriation

Back 118

Break or damage of the skin

Front 119

Why do excoriations occur in pediculosis?

Back 119

From scratching

Front 120

What are keratoses?

Back 120

Benign lesions associated with aging or skin damage

Front 121

Diagnose.
What is this caused by?

Back 121

Seborrheic keratoses
Results from proliferation of basal cells (usually leads to an oval elevation that is smooth or rough and dark in color... usually looks like verruca, due to old age)

Front 122

Diagnose.
What was this skin probably exposed to?

Back 122

actinic keratoses (AKs- "sunspots")
Ultraviolet radiation

Front 123

Painless, malignant tumor of the epidermis

Back 123

Squamous cell carcinoma

Front 124

Where is squamous cell carcinoma most commonly found? Where else could it be found?

Back 124

Face and neck
Base of tongue

Front 125

What is the typical prognosis of squamous cell carcinoma?

Back 125

Good, if removed early

Front 126

Highly metastatic form of skin cancer

Back 126

Malignant melanoma

Front 127

Where does Malignant melanoma develop?

Back 127

Melanocytes

Front 128

A newly-formed nevus could be an indication of what?

Back 128

Malignant melanoma (nevus is a mole)

Front 129

Multicolored lesion with an irregular border

Back 129

Malignant melanoma

Front 130

treatment for Malignant melanoma?

Back 130

Surgical removal and radiation plus chemotherapy

Front 131

Malignant melanoma is suspected in any nevus that shows:

Back 131

A change in appearance
B change in border
C change in color
D change in diamter

Front 132

Lesions that occur in imunnocompromised patients (typically AIDS)

Back 132

Kaposi's sarcoma

Front 133

Kaposi's sarcoma may affect skin and ___________.

Back 133

Viscera

Front 134

Where are the malignant cells in Kaposi's sarcoma?

Back 134

Endothelium of small blood vessels

Front 135

Purplish macules, nonpruritic, nonpainful

Back 135

Kaposi's sarcoma