Nura 201 - Integumentary System

Front 1

Folliculitis

Back 1

Superficial infection of the upper portion of the follicule.
Pustule with minimal erythema, crusting.
Often caused by staph organisms.

Front 2

Furuncles

Back 2

"Boils". Deeper within the follicule. Erythematous around follicule, painful. Requires abx, possible incision and drain.

Front 3

MRSA Antibiotics

Back 3

Bactrim
Doxycycline
Clindamycin
Muprocin

Front 4

MRSA Systemic Manifestations

Back 4

Fever, chills, sepsis

Front 5

MRSA Nursing Care & Prevention

Back 5

Contact isolation. Appropriate hygenic measures. Compresses on boils. Discuss appropriate dressing. Nasal swab for colonization.

Front 6

Impetigo Causes

Back 6

Caused by group a beta-hemolytic strep. Very contagious, assc. w/ poor hygiene.

Front 7

Impetigo Symptoms

Back 7

Vesiculopustular lesions with crusts (honey colored) pruritic, erythema.

Front 8

Impetigo Management

Back 8

Abx, systemic and topical. Proper hygiene. Monitor for hematuria and renal function (glomerulonephritis).

Front 9

Herpes Simplex 1

Back 9

Fever blister, cold sore. Stays in nerve root ganglion and returns during stress, menses, sun exposure.

Front 10

Herpes Simplex 1 Symptoms

Back 10

First occur 3-7 days. Grouped vesicles, painful, local erythematous base. Can have systematic symptoms, ulcerate, crust.

Front 11

Herpes Simplex 1 Tx

Back 11

Tx of symptoms, moist compresses, topical anesthetics, antivirals:
Acyclolvir, famciclovir, valacyclovir.

Front 12

Herpes Simplex 2

Back 12

Generally genital infections, frequent reoccurrence.
Very painful. Management similar to HSV 1.
Spread by sexual contact.

Front 13

Herpes Zoster Virus

Back 13

Activation of varicella-zoster (occurs with immunosuppression). Contagious if not immune to varicella-zoster.

Front 14

Herpes Zoster Symptoms

Back 14

Vesicles on erythematous base, usually unilateral on trunk, thigh, ophthalmic branch of trigeminal nerve, mandibular branch.
Severe burning pain, neuralgia.

Front 15

Herpes Zoster Tx

Back 15

Antivirals, analgesics, gabapentin for neuralgia. Tx of symptoms. Narcotic pain meds. Topical anesthetics AFTER lesions heal.

Front 16

Herpes Zoster Complications

Back 16

Permanent vision damage from eye infections.
Post-herpetic neuralgia (common in elderly)

Front 17

Tinea Capitus

Back 17

Contagious fungal infection of head. "Cradle cap."

Front 18

Tinea Capitus Symptoms

Back 18

Patches of redness and scaling with pustules or papules at edges that may spread to the hairline or neck. Can cause temporary hair loss.

Front 19

Tinea Capitus Tx

Back 19

Encourage appropriate hygienic, individual combs, brushes/towels. Antifungal creams/shampoos (Nizoral, Lotrim)

Front 20

Tinea Pedis

Back 20

Athlete's foot. Scaling, maceration with fissures between toes. Toenails can be affected and have secondary bacterial infections. High rate of recurrence. Tx with topical antifungals.

Front 21

Tinea Corporis

Back 21

Ringworm. Usually animal origin. Rings of reddened scaly patches with clear centers in clusters on the face, arms, shoulders. Tx with topical antifungals (griseofulvin)

Front 22

Candidiasis

Back 22

Yeast infection, thrush. Common in skin folds, perianal region, oral mucous membranes. Assc. with compromised immune, abx therapy.

Front 23

Candidiasis Symptoms

Back 23

Pustules that become a red, denuded, advancing border, may have whitish discharge. Itching and burning.

Front 24

Candidiasis Treatment / Management

Back 24

Topical antifungals, sporanox, fluconazole. Descrease moisture, proper skin hygiene, monitor glucose.

Front 25

Eczema (Atopic Dermatitis)

Back 25

Chronic, relapsing, superficial inflammatory, pruritic.
Immune mediated, genetic link.
Linked with asthma or allergic rhinitis.

Front 26

Eczema Symptoms

Back 26

Xerosis: dry skin that cracks easily
Acute: Vesicles, exudates, crusts
Subacute: scaling with erythema & excoriation
Chronic: Darkened, thickened skin

Front 27

Eczema Management

Back 27

Hydrate skin, humidifier in winter, Topical abx & corticosteroids, antihistamines, loose clothing, avoid triggers that cause flares. Immunomodulator ointments: Protopic, Elidel

Front 28

Acne

Back 28

Inflammatory disorder of pilosebaceous hair follicles. Occur most on face, chest, shoulders & back.

Front 29

Acne Symptoms

Back 29

Closed comedones - whiteheads
Open comedones - blackheads
Nodules - larger areas of inflammation
Cysts - compressible nodules

Front 30

Acne Stages

Back 30

Mild - 25% of face, no nodules
Moderate - 50% of face, several pustules & nodules
Severe - => 75% of face, scarring

Front 31

Acne Management (Non-Pharm)

Back 31

Wash skin w/ mild soap, balanced diet & adequate fluids, proper exercise & rest.

Front 32

Acne Medications

Back 32

Comedonal - Topical Tretinoin QHS
Mild Acne - Benzac, erythromycin, clindamycin
Inflammatory Acne - Vibramycin, Minocin, Tetracycline, E-Mycin PO

Front 33

Psoriasis

Back 33

Chronic dermatitis with rapid turnover of epidermal cells, mature in 3-4 days instead of 28 days. Genetic disposition.

Front 34

Psoriasis Symptoms

Back 34

Sharply demarcated scaling, papules and plaques of scalp, elbows, and knees, white silvery patches, can affect nails. Arthritis in 5-8%.

Front 35

Psoriasis Tx/Management

Back 35

No cure, only management. Topical corticosteroids
Tar, UVA therapy, Systemic Treatment, Cytotoxics (methotrexate), Immunosuppressants (cyclosporine)

Front 36

Seborrheic Keratoses

Back 36

Common benign epidermal growth of keratinocytes and melanocytes. Usually on face, shoulders, chest and back.

Front 37

Seborrheic Keratoses Symptoms

Back 37

Begins as a small slightly elevated papule or plaque,
slow enlargement, surface becomes rough and warty.
Color varies: yellow, brown, black. Common in middle-older age.

Front 38

Seborrheic Keratoses

Back 38

Curretage, Electrodisiccation, Cryosurgery

Front 39

Actinic Keratoses

Back 39

Flat or slightly elevated, dry, scaly, rough, red base, premalignant. Caused by sun damage. If untreated can develop into squamous cell cancer.

Front 40

Actinic Keratoses Tx/Management

Back 40

Curettage , cryosurgery, topical 5FU , Aldara (may cause blistering)

Front 41

Basal Cell Carcinoma

Back 41

Basal cells do not mature and continue to enlarge and form. Sun, genetics, x-ray risk factors. Center can erode and ulcerate, borders are raised and waxy.

Front 42

Basal Cell Carcinoma Tx/Management

Back 42

Cryosurgery, incision. 95% cure rate, slow growing and rare mets, usually only locally invasive.

Front 43

Squamous Cell Carcinoma

Back 43

Papule, plaque or nodule with indistinct borders, scaling horny crusts, erosions or ulcerations.
Most common on lip, ear, previously damaged skin.
Invades dermis: potentially metastatic to regional lymph if untreated.

Front 44

Squamous Cell Carcinoma Tx/Management

Back 44

Excision (Moh's Surgery), Radiation

Front 45

Malignant Melanoma

Back 45

Arises from melanocytes. Occurs anywhere on skin, usually on back or legs. High degree of mets.

Front 46

Malignant Melanoma Symptoms

Back 46

Flat/raised, eroded/ulcerated. A-asymmetry, B-border irregular, C-color varied, D-diameter larger than 6 mm.
Color varies: red, black, blue, white, gray, brown, pink in the same lesion. Spreads by local ext (lymph, blood).

Front 47

Malignant Melanoma Tx/Management

Back 47

Wide excision with amputation PRN, staging, chemotherapy, immunotherapy, hyperthermia with chemo.