Leik integumentary system review

A 52-year-old farmer presents with a pearly papule with rolled borders and visible blood vessels on the bridge of the nose that has slowly enlarged over 2 years. What is the diagnosis, treatment, and patient education?

Basal cell carcinoma; surgical excision or Mohs surgery; use sunscreen and monitor for new lesions

A 67-year-old construction worker presents with a rough scaly lesion on the lower lip that ulcerates and bleeds intermittently. What is the diagnosis, treatment, and education?

Squamous cell carcinoma; surgical excision; avoid tobacco and excessive sun exposure

A 45-year-old patient reports a mole that has become asymmetrical with irregular borders and multiple colors. What is the priority diagnosis and treatment?

Melanoma; urgent biopsy and surgical removal

A patient presents with a dark lesion larger than 6 mm that recently changed shape and color. Which melanoma warning sign is most concerning?

Evolving lesion

A 22-year-old patient develops fever, painful mouth sores, and widespread blistering rash after starting lamotrigine. What is the diagnosis and priority treatment?

Stevens-Johnson syndrome; discontinue medication and hospitalize immediately

A patient presents with grouped painful vesicles along the right chest dermatome and burning pain. What is the diagnosis, treatment, and education?

Herpes zoster; antiviral therapy; avoid contact with immunocompromised individuals until lesions crust

A diabetic patient presents with redness, warmth, swelling, and tenderness of the lower leg with fever. What is the diagnosis and treatment?

Cellulitis; antibiotics

A patient with cellulitis develops severe pain out of proportion, crepitus, and rapidly spreading swelling. What emergency condition should be suspected?

Necrotizing fasciitis

A bedridden nursing home resident has nonblanchable redness over the sacrum. What stage pressure injury is present and what education is important?

Stage 1 pressure injury; reposition every 2 hours

A patient presents with partial-thickness skin loss and a fluid-filled blister over the coccyx. What stage pressure injury is present?

Stage 2 pressure injury

A patient presents with a pressure ulcer exposing muscle and bone. What stage pressure injury is this?

Stage 4 pressure injury

A wrestler develops circular itchy lesions with raised borders and central clearing. What is the diagnosis, treatment, and education?

Tinea corporis; topical antifungal medication; avoid sharing towels and sports equipment

A child presents with intense nighttime itching and burrows between the fingers. What is the diagnosis and treatment?

Scabies; permethrin cream

A patient develops hives, wheezing, hypotension, and lip swelling after eating shellfish. What is the diagnosis and first-line treatment?

Anaphylaxis; epinephrine

A patient reports recurrent facial flushing and pustules worsened by alcohol and spicy foods. What is the diagnosis and education?

Rosacea; avoid triggers such as alcohol and spicy foods

A patient presents with thick silvery plaques on the elbows and knees. What is the diagnosis and common trigger education?

Psoriasis; stress may worsen symptoms

A patient develops honey-colored crusted lesions around the mouth after scratching insect bites. What is the diagnosis and treatment?

Impetigo; topical or oral antibiotics

A patient presents with target-shaped rash after hiking in a wooded area. What disease should be suspected and treated?

Lyme disease; doxycycline

A patient presents with petechiae, fever, neck stiffness, and nonblanching rash. What life-threatening condition should be suspected?

Meningococcemia

A patient presents with yellow skin, dark urine, and generalized itching. What underlying problem should be evaluated?

Liver disease

A patient has velvety hyperpigmented plaques on the neck and axilla. What condition is commonly associated?

Insulin resistance

A patient presents with spoon-shaped nails and fatigue. What deficiency is most likely?

Iron deficiency anemia

A patient presents with cyanosis and clubbing of the fingernails. What chronic problem is commonly associated?

Hypoxia

A patient with severe acne is prescribed isotretinoin. What critical patient education is required?

Avoid pregnancy during treatment

A patient taking doxycycline develops severe sunburn after minimal sun exposure. What patient education is necessary?

Use sunscreen and protective clothing

A patient using topical corticosteroids for several months develops thin fragile skin. What adverse effect is occurring?

Skin atrophy

A patient presents with painful draining nodules in the axilla. What is the diagnosis and education?

Hidradenitis suppurativa; weight loss and smoking cessation may help reduce flares

A patient develops diffuse skin peeling and mucosal involvement after taking sulfa antibiotics. What severe condition is suspected?

Toxic epidermal necrolysis

A patient presents with a butterfly rash across the cheeks and nose worsened by sunlight. What disease is suspected and what education is important?

Systemic lupus erythematosus; avoid sun exposure

A patient with diabetes presents with a black necrotic toe and foul-smelling drainage. What complication is occurring?

Gangrene

A patient presents with sharply demarcated bright red warm skin on the face with fever. What infection is most likely?

Erysipelas

A patient reports severe itching after taking morphine. What common reaction is occurring?

Histamine release

A patient develops urticaria shortly after taking penicillin. What medication is first-line treatment for mild symptoms?

Antihistamine

A patient presents with white patches in the mouth that scrape off easily after antibiotic use. What is the diagnosis and treatment?

Oral candidiasis; antifungal medication

A patient presents with diffuse hair loss, weight gain, dry skin, and fatigue. What endocrine disorder should be suspected?

Hypothyroidism

A patient presents with warm moist skin, tremors, palpitations, and weight loss. What endocrine disorder is likely?

Hyperthyroidism

A burn patient presents with blistering and severe pain involving the epidermis and dermis. What type of burn is this and what treatment is appropriate?

Second-degree burn; cool water and wound care

A burn patient has white leathery painless skin after a house fire. What burn degree is present?

Third-degree burn

A patient develops painful grouped vesicles on the lips during times of stress. What is the diagnosis and treatment?

Herpes simplex virus; antiviral medication

A patient presents with generalized pruritus and jaundice. Which organ system should be assessed?

Hepatobiliary system

A patient presents with a rough scaly lesion from chronic sun exposure that may become malignant. What is the diagnosis and treatment?

Actinic keratosis; cryotherapy or topical therapy

A patient with psoriasis asks about treatment goals. What education should be provided?

Treatment controls symptoms but does not cure the disease

A patient presents with severe acne and nodules on the face and back. What medication may be used for severe cystic acne?

Isotretinoin

A patient develops sudden lip swelling and tongue swelling after lisinopril use. What emergency condition is occurring?

Angioedema

A patient presents with diffuse redness and warmth of the skin after a cut on the leg. What diagnosis and treatment are indicated?

Cellulitis; antibiotics

A patient with chronic venous insufficiency develops a shallow ulcer above the medial ankle. What type of ulcer is this?

Venous stasis ulcer

A patient with diabetes develops a deep plantar foot ulcer with loss of sensation. What type of ulcer is this?

Diabetic neuropathic ulcer

A patient presents with painful ulcers on the fingertips worsened by cold exposure. What autoimmune disease may be associated?

Scleroderma

A patient with eczema asks about skin care. What education is appropriate?

Use moisturizers regularly and avoid harsh soaps

A patient presents with dry itchy flexural rash and history of allergies. What is the diagnosis?

Atopic dermatitis

A patient with atopic dermatitis asks about triggers. What commonly worsens eczema?

Hot showers and harsh soaps