Integumentary Function:
K.B. is a 40-year-old white female with a 5-year history of Psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of Psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque Psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.
Case Study 1 Questions:
Name the most common triggers for Psoriasis and explain the different clinical types.
There are several types of pharmacological treatments for Psoriasis. Explain the different types, and indicate which would be the most appropriate approach to treat this relapse episode for K.B.
Include non-pharmacological options and recommendations for Psoriasis.
Medication review and reconciliation are always important for all patients. Describe and specify why in this particular case is important to know what medications the patient is taking.
Sensory Function:C.J. is a 27-year-old male who started to present crusty and yellowish discharge on his eyes 24 hours ago. In the beginning, he thought that by washing his eyes vigorously the discharge will go away but on the contrary, it increased causing blurry vision, especially in the morning. Once he clears his eyes of the sticky discharge his visual acuity is normal again. Also, he has been feeling a throbbing pain in his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment, you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, and his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging, and red.
With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.
Based on your answer to the previous question regarding the etiology of eye affection, which would be the best therapeutic approach to C.J’s problem? Include any additional treatment or approach to any other diagnosis or complication present in this case.
Review Topics for Chapters 13 & 14 (Integumentary & Sensory
Functions)
Remember: This is just to guide you on contents, but you are expected to review
both chapters from your course textbook.
Chapter 13 – Integumentary Function
1-Changes in the skin that indicate a pressure ulcer
2-Skin lesions for each different type of psoriasis
3-Review the lesion types/description, and most common locations in conditions:
Lichen planus, Pityriasis rosea, Psoriasis, Acne rosacea.
4- Skin lesions of most concern (shapes, borders, color, description, consistency,
etc.)
5-Review Herpes zoster and how to explain a patient its pathophysiology
6-Tinea corporis (ringworm) Type of infection?
7- Review lesion descriptions for Impetigo, Rubella, Tinea capitis, Atopic
dermatitis and how to recognize each of them in a presented case.
8 -Describe Skin lesions caused by tinea corporis
9- What is the cause of molluscum contagiosum?
10- Review possible complications after being exposed to a fire.
11- Pitting on the fingernails in children. This finding is correlated with which skin
condition?
12-Common effect of a type I hypersensitivity response to ingested substances
13-Causes Verrucae?
14-Causes the pruritus associated with scabies?
15- Major predisposing factor to squamous cell carcinoma?
16-Identify the condition that is the result of a immune dysfunction leads to the
production of chemicals that cause vasoactive and other inflammatory
manifestations of the face.
17-Review Furuncles, Cellulitis, Necrotizing fasciitis, Verrucae and how to
identify them by a description of their lesions.
18-Treatment for atopic dermatitis
19- Review lesion descriptions for Seborrheic keratosis, Actinic keratosis,
Melanoma, & Telogen effluvium.
20-Review Albinism, Vitiligo, Cafe au lait macules, & Mongolian spots.
• From specific case scenarios, review how to identify/differentiate between
conditions as follows:
21-Tinea versicolor (tinea corporis, tinea cruris), candidiasis, scabies, contact
dermatitis, scabies, pediculosis pubis acne vulgaris, molluscum contagiosum ,
pityriasis rosea.
22-Study acne treatments.
23-Treatment for Impetigo
24-Poison Ivy and hypersensitivity reaction type.
25-Infected hair follicles lesions/diagnosis
26-Treatment strategy for a stable eschar in an elderly patient.
27- Nevus flammeus – instructions to parents
28- Description of Paronychia, onychomycosis, tinea manum, herpes whitlow.
29-Ways to distinguish a wart from a callus.
30-Basal cell carcinoma description/origin.
31-Part of the extracellular matrix and is involved in skin maintaining moisture.
32-Review integumentary disorders that can be associated with Hypertension,
cardiovascular disease, inflammatory bowel disease, and other autoimmune
disorders.
33-Type of dermatitis and characterized by pruritus with lesions that have an
indistinct border.
34-Hallmark of dermatitis
35-Cells of the dermis release histamine.
36-Integumentary changes associated with aging.
37-Cells in the epidermis are antigen-presenting cells that form part of the innate
immune system.
38-Lesions generally found in fair-skinned individuals and are considered
precursors to squamous cell carcinoma.
Chapter 14 – Sensory Function
1-Pinkeye is characterized by inflammation of which structure?
2-Irregular curvature of the cornea or lens condition
3-Trachoma cause
4-Condition that causes gradual clouding of the lens of the eye
5-Pathological change with macular degeneration
6-Review vertigo on Ménière syndrome
7-Early effect of age-related macular degeneration
8-Review conditions: Hordeolum, Pterygium, Pinguecula, Ptosis and identify them
in a case given
9-Type of pain that results from noxious stimuli to the skin, joints, muscles, and
tendons.
10-Type of pain that results from noxious stimuli to the internal organs.
11-Age-related hearing loss.
12- Different type of conjunctivitis and causes of each one.
13-Review blepharitis, keratitis, entropion, chalazion
14-Review acute otitis media, Meniere Disease, otitis externa, Tinnitus
15-Different types of glaucoma
16-Manifestations of Meniere Disease
17-The foundation of most eye cancer treatments
18-Viral infection in the inner ear, which affects the vestibular portion of cranial
nerve VIII.
• From specific case scenarios, review how to identify/differentiate between
conditions as follows:
19- Viral conjunctivitis, bacterial conjunctivitis, keratitis & acute angle glaucoma.
20- Causes of Conjunctivitis
21- Instructions for a patient over 40 that started having difficulty with reading.
22- Education for the parents of a child with viral conjunctivitis.
23-Common cause of Otitis Media in children (microorganism).
24- Review Dacryocystitis and the strategies to teach the mother of an infant to
care for a child diagnosed with it.
25- What would you teach the patient’s family of an elderly adult with moderate
hearing loss regarding approaching strategies.
26- Explain phantom pain to a patient with an amputation.
27-Know different types of pain neuropathic, referred, visceral, intractable, and
how to recognize them in specific case scenarios.
28-Complications of acute otitis media.
29- Review Dextromethorphan as a common ingredient in several over-the-counter
cough medicines and the reason for some of its side effects on high dosages and
precautions.
30-Part of the spinal cord where first-order neurons, second-order neurons, and
interneurons converge.
31-Types of fibers that reduce and block nociceptive input.
32-Review the theory related to modulation of pain by small and large fibers to
specialized cells.
33-Review the phenomenon in which less provocation is needed to cause pain or
perceived pain increases with the same level of stimuli.
34-Review the structural rational behind the sense of “popping” in the ears when
flying.