Advanced Pathophysiology- Chapter 47

Mrs. Chin says, "If rubella is such a mild illness, why do we vaccinate against it?"

Although rubella is a mild illness, if a pregnant woman gets rubella early in pregnancy, it causes the developing baby to have serious birth defects or even die before birth.

Recurrent pruritic red, scaly, crusted lesions on cheeks, knees, ankles, and elbows, or may be more widespread

Atopic dermatitis

What is the difference between atopic dermatitis and diaper dermatitis?

Atopic dermatitis is associated with a history of allergy and an impaired epidermal barrier to allergens, but diaper dermatitis is an irritant contact dermatitis initiated by prolonged exposure to urine and feces

Fungi that thrive on keratin

Dermatophytes

Angie's mother says, "Our dog has fleas. Maybe Angie has flea bites instead of scabies. Do the bites look different?" How should the physician assistant respond?

Flea bites are very different from the scabies that Angie has. Instead of the lines that you see with scabies, flea bites tend to occur in clusters. The bites are raised and have a small red puncture in the middle.

What is the difference between the cause of hand, foot, and mouth disease and the cause of scabies?

Hand, foot, and mouth is caused by a virus, but scabies is caused by a parasite that infests the skin

Benign tumor formed from rapid growth of vascular endothelial cells that causes formation of extra blood vessels

Hemangioma

Children who have atopic dermatitis often have elevated levels of the antibody _______________ and often also have _______________, which also involves this antibody.

IgE; asthma

Acute pruritic vesicles that rupture with a honey-colored serum and form yellow to white-brown crusts or pustular lesions

Impetigo

"My grandson has impetigo," says Mrs. Grey. "What is that? Is it like chickenpox?"

Impetigo is quite different from chickenpox. A virus causes chickenpox, but impetigo is a bacterial infection of the skin

"I am not used to working with children," says Nurse Singh. "I need a quick reminder of the characteristics of the rash in chickenpox and in measles."

In chickenpox (varicella), the rash begins as pruritic macules that son become vesicles, burst, and scab over. Often, all three forms of the lesions are visible at the same times. With measles (rubeola), the rash remains macular, usually is not pruritic, and is preceded by fever. Characteristically, chickenpox rash begins on the trunk, scalp, or face and measles rash begins on the head and spreads to the trunk. They both spread to the extremities.

A pediatric nurse says, "I saw a child with strange dome-like structures on their skin. The pediatrician said it was molluscum contagiosum, but they did not prescribe any treatment. Why not treat it?"

Molluscum contagious is caused by a pox virus that stimulates the epidermal cell proliferation that makes that strange structure. This condition is not dangerous and it usually goes away without treatment within 6-9 months.

Fungal infections

Mycoses

A congenital malformation of the dermal capillaries

Port wine stain

What is the difference between rubeola and rubella?

Rubeola is measles, but rubella is German measles, a milder viral disease

Pruritic linear lesions that itch more at night; may also have vesicles and papules

Scabies

Why did the physician assistant at the urgent care facility instruct Angie's mother to wash Angie's clothes, bed linen, and towels with hot water and dry them on the hottest cycle, even though they were clean already?

Scabies is transmitted by direct contact and also though mites or eggs living on clothing or bed linen that was contaminated recently.

Redness and tenderness of skin that becomes widespread, followed by painful blisters, bullae, and sloughing of skin

Staphylococcal scalded-skin syndrome

What causes the itching of scabies infestation?

The itching probably is due to immune system response to the larval stage of the scabies mite.

What causes the linear lesions of scabies?

The linear lesions are burrows made by the scabies mite in which it lays eggs

What is the major complication of scabies?

The major complication is secondary infection of the lesions damaged further by scratching.

White plaques or spots in the mouth that lead to shallow ulcers that may bleed when the plaques are removed; may spread to the groin or other areas

Thrush

Erythematous, round or oval scaling patches that spread peripherally with clearing in the center, primarily on nonhairy parts of the face, trunk, and limbs in asymmetrical distribution

Tinea corporis

What is the difference between variola and varicella?

Variola is smallpox, but varicella is chickenpox

Mrs. Dreyer's son Donny, age 6, had a high fever, enlarged cervical lymph nodes, runny nose, and a "barking" cough. She took him to a pediatric nurse practitioner, who told her that Donny probably had measles and would break out in a rash in a day or two. The rash came the very next day. "Donny has measles, just as the nurse practitioner said. All she did was take Donny's temperature, feel his neck, and look carefully in his mouth," says Mrs. Dreyer. "How did she know he had measles?"

When the NP looked in Donny's mouth, she probably saw some white spots surrounded by red rings called Koplik spots that are characteristic of measles. Along with his fever and other symptoms, Donny had a classic case of measles right before the rash appears.

Name a type of hormone and a bacterium that contribute to the development of acne.

androgens; bacterium: cutibacterium acnes

Identify the type of infection: Impetigo

bacterial

Two blood-sucking parasites are _______________, which are nocturnal, and _______________, which attach their eggs (also known as _______________) to hair shafts.

bedbugs; lice; nits

In staphylococcal scalded-skin syndrome, the toxin (circulates to, is produced in) the skin.

circulates to

A single acne lesion is a comedo. What is the plural of this term?

comedones (or comedos)

Cutaneous vascular malformations grow proportionately with the child and (then, do not) regress.

do not

The pathophysiology of atopic dermatitis involves interplay between an abnormal (epidermal, lymphatic) barrier and a dysregulated response of the (endocrine, immune) system.

epidermal; immune

Roseola infantum, also known as (herpes zoster, exanthema subitum), causes a (pruritic, nonpruritic) rash that appears (before, after) a high fever, primarily in (infants, adolescents).

exanthema subitem; nonpruritic; after; infants

Identify the type of infection: Thrush

fungal

Identify the type of infection: Tinea capitis

fungal

Identify the type of infection: Tinea corporis

fungal

Infantile hemangiomas tend to (shrink, grow) during the first few years of life and then (shrink, grow).

grow; shrink

Children who have chickenpox have a risk for developing _______________ _______________, also known as _______________, later in life.

herpes zoster; shingles

Impetigo is a (mildly, highly) contagious infection of the skin with streptococci or (gonococci, staphylococci); the lesions begin as (macules, vesicles) that rupture to form a honey-colored (crust, ulcer).

highly; staphylococci; vesicles; crust

Erythema toxicum _______________ is a benign, erythematous accumulation of macules, papules, and pustules that appear at birth or 3 to 4 days after birth and then spontaneously resolve within a few _______________.

nenatorum; weeks

The technical term for lice infestation is ____________________.

pediculosis

Candida albicans penetrates the epidermal barrier more easily than other microorganisms because it secretes keratolytic _______________ and other enzymes.

proteases

Miliaria is caused by occlusion of the _______________ ducts in infants.

sweat

The technical name for ringworm is _______________ _______________; this condition is spread by direct or indirect contact with infected persons, kittens, or _______________.

tines corporis; puppies

Low-flow vascular malformations involve capillaries, _______________, and lymphatics; high-flow malformations involve _______________.

veins; arteries

Identify the type of infection: Herpes zoster

viral

Identify the type of infection: Measles

viral

Identify the type of infection:Chickenpox

viral

Identify the type of infection:Molluscum contagiosum

viral

22. This comedones are closed at the surface of the skin. Is it a blackhead or a whitehead?

whitehead