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66 Cards in this Set
- Front
- Back
What is psoriasis? |
chronic, recurrent, inherited inflammatory condition with well-defined erythematous plaques or papules w/ silvery scales |
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What are the etiology and risk factors of psoriasis? |
Unknown cause but hereditary (multiple genes involved). Possible immune disorder. Onset or flare-ups triggered by skin irritation (eg. mech, chem, infection, UV, drugs, stress, hormones). |
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What is the pathogenesis of psoriasis? |
Not fully understood BUT: accelerated proliferation of keratinocytes (4 days vs28 normally) T cell activity (cause or effect role unknown) -- triggers angiogenesis |
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What are five clinical manifestations of psoriasis? |
(1)erythematous papules or plaques w/ silvery scales, (2)itchy, (3)Scalp, chest, elbows, knees, groin, skin folds, lower back, buttocks (extensor sides), (4)one lesion -- -- numerous patches (Recurrent and persistent), (5)10% develop psoriatic arthritis |
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What is Lupus Erythematosus? |
chronic, inflammatory connective tissue disorder |
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What are the 2 main classes of Lupus Erythematosus? |
(1)cutaneous LE, (2)Systemic LE (SLE) |
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What are eight risk factors/etiology of Lupus Erythematosus? |
(1)Unknown cause, (2)Autoimmune, (3)Genetics, (4)Hormonal, (5)Environmental, (6)immunological, (7)smoking |
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What are four clinical manifestations of Lupus Erythematosus? |
(1)butterfly (malar) rash w chronic cutaneous LE, (2)discoid lesions (chronic cutaneous lesions w raised edges/central depression) - usually on sun-exposed areas, (3)Rash lasts from hours to days, (4)Precipitated by sun exposure |
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What are Polymyositis & Dermatomyositis? |
Uncommon disease. Diffuse, recurrent inflammatory myopathies -- systemic weakness esp shoulder & pelvic girdles, neck and pharynx. |
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What is the etiology of Polymyositis & Dermatomyositis? |
Unknown. Autoimmune with poss T cell attack on muscle cells. May be drug induced. Viral cause? |
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What is the pathogenesis of Polymyositis & Dermatomyositis? |
Diffuse or focal muscle fiber degeneration (exacerbation)followed by regeneration of new muscle cells (remission) |
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What are seven clinical manifestations of Polymyositis & Dermatomyositis? |
(1)Symmetrical proximal muscle weakness, (2)Malaise, (3)Weight loss, (4)Fatigue, (5)Aching muscles, (6)Muscle wasting in long standing cases, (7)50% cardiac involvement |
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How does the polymyositis affect dermatomyositis? |
Dermatomyositisis is diagnosis when rash occurs w Polymyositis |
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What are cold injuries? |
i.e. Frostbite or hypothermia. Vasoconstriction -- tissue temp dcr'd (-2o C) -- ice crystal formation -- expand extracellular spaces. Compression of cells -- cell and tissue damage. Reperfusion can be significant cause of damage (incr'd capillary permeability and histamine release -- blood clot formation). Rewarm w/ caution-no rubbing or massaging. Can lead to extensive tissue necrosis and gangrene. |
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What are burns? |
Thermal, chemical, electrical or radiation. Burns occur when energy from a heat source is transferred to tissues of the body |
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What are three factors that influence the severity of burns? |
(1)burn depth, (2)burn size "rule of nines", (3)location |
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What are two clinical manifestations of burns? |
(1)Thermal, chemical, electrical or radiation, (2)Burns occur when energy from a heat source is transferred to tissues of the body |
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What are three major phases of burns? |
(1)emergent phase (injury), (2)acute phase (48 - 72 hours after injury), (3)rehabilitation phase |
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What are eight types of treatments for burns? |
(1)Cleansing, (2)Removal of damaging agent (i.e. chemical, tar), (3)Removal of dead tissue, (4)Topical antimicrobial creams, (5)Sterile dressing (6)Pain Meds, (7)Skin Grafts, (8)ROM exercises |
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What is a skin ulcer? |
various causes (diabetes, arterial insufficiency, radiation damage, prolonged pressure, etc) |
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What is a pressure ulcer? |
aka bed sore / decubitus ulcer. Persistent pressure -- damage of tissues (usually over bony areas). Change in skin temp, consistency or sensation -- loss of superficial layers (e.g. abrasion) -- loss of deep layers -- tissue destruction |
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What are six treatments for pressure ulcers? |
(1)Prevention!!! (2)Ulcer is cleansed thoroughly, (3)Keep ulcer moist, (4)Topical antibiotics, (5)Surgical debridement of necrotic tissue, (6)Skin grafting |
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What are pigmentation disorders? |
Pigmentation is determined by melanin. Formation of melanin affected by: Heat, Trauma, Radiation, Heavy metals, Carotene |
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What is hyperpigmentation? |
Increased pigmentation |
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What is the difference between primary and secondary hyperpigmentation? |
Primary (nevi, freckles, liver spots, café au lait spots). Secondary (eg. phototoxic rxn to drugs; melasma, pregnancy mask). |
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What is Melasma? |
Melasma is an acquired hypermelanosis of sun-exposed areas. Melasma presents as symmetrically distributed hyperpigmented macules. (Chloasma is a synonymous term sometimes used to describe the occurrence of melasma during pregnancy.) The most important factor in the development of melasma is exposure to sunlight. |
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What is hypopigmentation? |
decreased pigmentation |
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What is vitiligo? |
Pathogenesis: melanocytes are destroyed – mechanism unknown. Theories regarding destruction of melanocytes include autoimmune mechanisms, cytotoxic mechanisms, an intrinsic defect of melanocytes, oxidant-antioxidant mechanisms, and neural mechanisms. |
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What is the clinical manifestation of vitiligo? |
Small or large circumscribed areas of depigmentation |
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What five other pathologies is vitiligo associated with? |
(1)hypothyroidism, (2)pernicious anemia, (3)DM, (4)Addison’s disease, (5)stomach carcinoma |
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What is alopecia? |
Loss of hair from the scalp. May be focal (areata) or diffuse. Alopecia areata. Etiology: Autoimmune or fungal/bacterial |
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What is diffuse alopecia? |
Typically aging males. Idiopathic , though strong hereditary component. In women it is usually a sign of hormonal disorders or nutritional deficiency. Also caused by cytotoxic drugs Ex. Chemotherapy |
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What is skin cancer? |
MC Cancer/ Cancer with the greatest increase in incidence inUSA. Affecting almost all > 65 yo white. MCC: sun (UVB) – UV protection esp important 0-20y. |
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What are two examples of benign tumours? |
(1)Seborrheic Keratosis, (2)Nevi |
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What is Seborrheic Keratosis? |
Hereditary proliferation of epidermal keratinocytes. Often after middle age. Lesions appear following hormone therapy or inflammation. Lesions on chest, back and face. Waxy, smooth/verrucous (wart-like), raised lesions that can be yellow, skin-colored, dark brown or black |
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What is nevi? |
(Moles) – start in youth. Collection of melanocytes (brown, black, flesh-coloured). Seldom undergoes transition to malignant melanoma –but it can. Note: change in size, colour or texture; bleeding; excessive itching -- REFER |
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What are two precancerous conditions skin conditions? |
(1)Actinic (aka solar) Keratosis, (2)Bowen’s Disease |
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What is Actinic (aka solar) Keratosis? |
Common in older population, especially fair complexion. Affects nearly 100% of older Caucasians. ½ of all skin cancers start as Actinic Keratosis most common precursor or lesion for squamous cell carcinoma. |
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What are two clinical manifestations of Actinic (aka solar) Keratosis? |
(1)Well-defined, crusty, sandpaper-like patch or bump on chronically sun-exposed areas, (2)May itch of prickle. |
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What can cause Actinic (aka solar) Keratosis? |
Due to many years of UV exposure on sun-exposed parts. Damage caused by overexposure to sunlight results in abnormal cell growth. Cells involved = epidermal keratinocytes. |
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What is Bowen's disease? |
AKA Squamous cell carcinoma in situ. May progress to SCC. Cells involved : Epidermal keratinocytes. Can occur anywhere on skin or mucous membranes. Less common –associated w/ arsenic exposure. |
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What is a clinical manifestation of Bowen's disease? |
Brown to reddish brown, scaly plaque with well defined margins |
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What are four malignant neoplasms? |
(1)Basal Cell Carcinoma, (2)Squamous Cell Carcinoma, (3)Malignant Melanoma, (4)Kaposi’s Sarcoma |
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What is basal cell carcinoma? |
Most common malignant tumour in Caucasians. From basal cells in epidermis. Slow-growing with no blood vessel invasion. Significant local epidermis/dermis damage. Rarely metastasizes. Pathogenesis unclear. No known precursors |
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What is the etiology and risk factors of basal cell carcinoma? |
Etiology: sun, UV tanning Risk Factors: blond/fair skin, Burns, Immunosuppression, Genetic predisposition |
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What are five clinical manifestations of basal cell carcinoma? |
(1)MC sites head, neck, trunk, (2)starts as a small, shiny papule on sun exposed area, (3)after several months -- pearly quality, raised border, telangectasia, (4)Painless, (5)can invade deeper tissues/ulcerate if not detected |
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What is Squamous Cell Carcinoma? |
2nd most common skin cancer in Caucasians. Tumour of epidermal keratinocytes –predominantly sun-exposed areas (ears, lips, mouth, backs of hands) |
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What are the etiology and risk factors of squamous cell carcinoma? |
Etiology: sun, UV tanning, burns, radiation therapy, arsenic,c arcinogens Risk Factors: blond/fair skin, pre-malignant lesions, chronic irritation or inflammation |
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What is the pathogenesis of squamous cell carcinoma? |
UV radiation -- epithelial cell DNA damage -- damaged cells have deficient repair mechanisms -- malignancy |
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What are four clinical manifestations of squamous cell carcinoma? |
(1)Red papule w/ scaly, crusted appearance, (2)poorly defined margins, (3)may appear lumpy or nodular (like a wart), (4)may ulcerate, can be invasive and can metastasize |
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What is Malignant Melanoma? |
neoplasm of melanocytes |
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What are the four types of malignant melanoma? |
(1)Superficial spreading melanoma, (2)Nodular melanoma, (3)Lentigo Maligna melanoma, (4)Acral Lentigo melanoma |
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What is superficial spreading melanoma? |
Most common (70%). Can occur from pre-existing mole (50%) or normal skin (50%). Spreads superficially for years. Asymptomatic |
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What is nodular melanoma? |
>men. Blue, black nodule on the skin. Appears suddenly and spreads into dermis quickly |
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What is lentigo maligna melanoma? |
Less common. Comes from pre-existing lentigo. Large flat freckle (3-6cm). |
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What is Acral Lentigo melanoma? |
Uncommon. But is the most common melanoma in dark-skinned people. Typically appears on the palms, soles, or under the nails |
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What is the etiology of malignant neoplasms? |
holiday sun exposure/work indoors. Chronic irritation. |
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What are five risk factors for malignant neoplasms? |
(1)red/blond hair, green/blue eyes, (2)North European ancestry, (3)Atypical Mole Syndrome (genetic-large # irregular moles), (4)UV/tanning exposure, (5)Pilots/flight crews exposed to ionizing radiation of Cosmic origin |
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What is the pathogenesis of malignant neoplasms? |
intense UV exposure. Pre-existing mole -- similar to Squamous cell (but different cell type) |
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What are six clinical manifestations of malignant neoplasms? |
(1)anywhere on the body, (2)~70% arise from pigmented nevi and 50% from normal skin, (3)maculopapular rash or lesion, (4)gradually develops irregular, raised borders, (5)within borders -- coloured spots (red, blue, white, black) or little nodules, (6)Increased risk for metastasis -- clues are bleeding or ulceration |
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What are the ABCD's of moles? |
A: Asymmetry B: Border (irregular edges, scalloped or indefinite edges) C: Colour (funky: black, browns, red, white, and occ blue) D: Diameter (> pencil eraser) |
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What is Kaposi’s Sarcoma? |
vascular tissue malignancy (ie. not actually skin tumour, but manifests in the skin, mucous membranes + other organs) |
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What is the etiology of Kaposi's Sarcoma? |
HHV-8 (5-10% gen pop’n, up to 70% homosexual males; increase with increased number of partners) |
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What are the two types of Kaposi's Sarcoma? |
Classic KS (older Mediterranean men)-Genetic predisposition Epidemic KS (immunodeficient, AIDs or transplant, etc) |
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What is the pathogenesis of Kaposi's Sarcoma? |
HHV-8 mechanism of trasmission unknown. KS is an angioproliferative tumour. Cell origin is unclear – thought to be pluripotentmesenchymal progenitor |
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What are six clinical manifestations of Kaposi's Sarcoma? |
(1)Epidemic KS commonly on upper body involving LN, lungs, GI, (2)Classic KS occurs on lower extremities, (3)raised papules/thickened plaques, oval-shaped, red to brown, (4)Itching, (5)Pain, (6)Fever, chills, night sweats, anorexia, diarrhea, dyspnea, cough chest pain |