Integ: Pathologies

Question 1

What is Cellulitis?

Answer 1

A fast spreading inflammation that occurs as a result of a bacterial infection of the skin and connective tissues.

• It can develop anywhere under the skin, but will typically affect the extremities

Question 2

What is the Etiology for Cellulitis?

Answer 2

This is caused by particular bacterial infections including streptocci or staphylococci.

• Predisposing factors to cellulitis include an increased age, immunosuppression, trauma, the presence of wounds or venous insufficiency

Question 3

What are the S/S of Cellulitis?

Answer 3

Sx’s may include localized redness that may spread quickly, skin that is warm or hot to touch, local abscess or ulceration, tenderness to palpation, chills, fever, and malaise

Question 4

What is done for treatment for Cellulitis?

Answer 4

A pt with suspected cellulitis should be immediately reffered to a physician for further assessment.

• Cellulits requires pharm intervenion using systemic antibiotics
• Differential diagnoses should attempt to rule out DVT’s and contact dermatitis.
• PT may be warranted for wound care. Cellulitis can lead to sepsis or gangrene if not properly treated

Question 5

What is Contact Dermititis?

Answer 5

This is a superficial irritation of the skin resulting from localized irritation (e.g., poison ivy, latex, soap, jewelry sensitivity).

• This condition can be acute or chronic based on exposure to the precipitating agent.
• Contact dermatitis is a very common skin disease that can occur at any age.

Question 6

What is the Etiology of Contact Dermitis?

Answer 6

This occurs with exposure to mechanical, chemical, environmental or biological agents.

• Nickel, rubber, latex, and topical antibiotics are common precipitating agents

Question 7

What are the S/S of Contact Dermitits?

Answer 7

Pts experience intence itching, burning, and red skin in areas corresponding to the location of the topical irritation

• Edema may also occur in the area of sensitivity and symptoms can expand beyond the initial point of topical irritation

Question 8

What is the treatment for Contact Dermititis?

Answer 8

The focus of treatment should be on identifying and removing the source of irrittation

• Topical steroid application is commonly employed
• Acute lesions should resolve with treatment once exposure to the external irritant has been removed.

Question 9

What is Eczema?

Answer 9

Also referred to as dermatitis, is used to describe a group of disorders that cause chronic skin inflammation typically due to an immune system abnormality, allergic reaction or external irritant

Question 10

What is the Etiology of Eczema?

Answer 10

This is based on the particular form of the disorder.

• Infants and children are at higher risk for eczema, however, many outgrow the condition with age.
• The geriatric population is also to an increased risk for many forms of eczema

Question 11

What are the S/S of Eczema?

Answer 11

Red or brown-gray, itch, lichenified skin plaques that may be exacerbated by some topical agents such as soaps and lotions

• The younger population will also frequently experience oozing and crusting of the patchy areas of irritation

Question 12

What is done for treatment for Eczema?

Answer 12

Pharm intervention are varibale ranging from topical or oral corticosteroids to oral antibiotics and antihistamines.

• Cold compress and other modalities may assist with reducing the itch
• Stress management techniques and avoidance of extreme temperatures should be employed to avoid potential exacerbations of the condition

Question 13

What is Dry Gangrene?

Answer 13

Gangrene is referred to as “dry” when there is loss of vascular supply resulting in local tissue death

• Fingers, toes, and limbs are most often affected.
• The hardened tissue is not painful, however, there may be significant pain at the line of demarcation
• Dry gangrene typically develops slowly and in some cases results in auto-amputation

Question 14

What is the Etiology of Dry Gangrene?

Answer 14

This occurs most commonly in blood vessel disease, such as diabetes or atherosclerosis

• It develops when blood flow to an affected area is impaired, typically as a result of poor circulation
• Infection is typically not present in dry gangrene, however, dry gangrene can progress to wet gangrene if infection occurs

Question 15

What are the S/S of Dry Gangrene?

Answer 15

This presents as dark brown or black nonvisable tissue that eventually becomes a hardened mass (mummified)

• The patient may complain of cold or numb skin and they may present with pain

Question 16

What can be done for treatment for Dry Gangrene?

Answer 16

This is a serious medical condition and requires immediate medical intervention.

• Depending on the severity, gangrene is treated by pharm intervention, sugery, and hyperbolic oxygen therapy

Question 17

What is Wet Gangrene?

Answer 17

Gangrene referred to as “wet” if there is an associated bacterial infection in the affected tissue

• Gangrene may develop as a complication of an infected untreated wound
• Swelling resulting from the bacterial infection causes a sudden stoppage of blood flow

Question 18

What is the Etiology of Wet Gangrene?

Answer 18

This can develop after a severe burn, frostbite or injury and requires immediate treatment since it tends to spread very quickly and can be fatal.

• There is cessation of blood flow that starts a chain of events including invasion by bacteria at the affected site.
• As a result of the occluded blood supply, the white blood cells are unable to fight the infection

Question 19

What are the S/S Wet Gangrene?

Answer 19

Swelling and pain at the site of infection, change in skin color from red to brown to black, blisters that produce pus, fever, and general malaise

Question 20

What can be done for treatment for Wet Gangrene?

Answer 20

This is a very serious medical condition and requires immediate intervention

• Surgical debridement of the gangrene and intravenous antibiotic treatment are typical interventions for wet gangrene
• Depending on the severity, gangrene is treated by pharm intervention, sugery, and hyperbaric oxygen therapy

Question 21

What is Onychomycosis?

Answer 21

This refers to a fungal infection that primarily affects the toenails and nailbeds.

• This is dividied into subtypes, but are typically medically treated in a similar fashion

Question 22

What is the Etiology of Onychomycosis?

Answer 22

Acquiring a fungal infection can be a fairly common occurrance.

• Risk factors include manicures and pedicures with unsterile utensils, possessing nail injuries or deformities, excess skin moistur, wearing closed toe shoes, and an impaired immune response

Question 23

What are the S/S of Onychomycosis?

Answer 23

Yellow or brown nail discoloration; hyperkeratosis and hypertrophy of the nail causing it to partially detach from the nailbed

Question 24

What can be done for treatment for Onychomycosis?

Answer 24

Manual debridement of the nail and topical antifungal meds are primary interventions

• Fungal infections may return to the nailbeds and in some cases, the nails may have permanent damage

Question 25

What is Plaque Psoriasis?

Answer 25

This is a chronic autoimmune disease of the skin and is the most common of the 5 types of psoriasis - T-cells trigger inflammation within the skin and produce an accelerated rate of skin cell growth. The skin cells accumulate in raised red patches on the surface of the skin

Question 26

What is the Etiology of Plaque Psoriasis?

Answer 26

Some pts have a genetic predisposition to this - Other factors may trigger psoriasis, such as injury to the skin, insufficient or excess sunlight, stress, excessive alcohol, HIV infection, smoking, and certain meds

Question 27

What are the S/S of Plaque Psoriasis?

Answer 27

The primary symptom is red raised blotches that typically present in a bilateral fashion for example over both knees or elbows. - These plaques can appear anywhere on the body and will ted to itch and flake. - Complications can include arthritis, pain, severe itching, secondary skin infections, and side effects secondary to pharm interventions

Question 28

What can be done for treatment for Plaque Psoriasis?

Answer 28

The primary goal for treatment of plaque psoriasis is to control the symptoms and prevent secondary infection. - Treament varies widely from topical applications to systemic meds and phototherapy. - Plaque Psoriasis is a life-long condition that can be effectively managed and controlled through the various stages and exacerbations

Question 29

What is Tinea Pedis?

Answer 29

This is commonly referred to as Athlete's foot, is a superficial fungal infection which causes epidermal thickening and a scaly skin appearance. This fungus is opportunistic and will rapidly multiply in a warm and moist environment (e.g., between the toes)

Question 30

What is the Etiology of Tinea Pedis?

Answer 30

Risk factors include wearing closed toe shoes that don't allow airflow, prolonged periods of moisture or wetness, excessive sweating, and possessing small nail or skin abrasions. - This infection is contagious through direct or when making contact with a surface containing the tinea pedis infection

Question 31

What are the S/S of Tinea Pedis?

Answer 31

- Itching - Redness - Peeling skin between the toes - Pain - Odor - In more severe cases, breaks in skin continuity

Question 32

What can be done for treatment for Tinea Pedis?

Answer 32

Pharm intervention includes topical or oral antibiotics depending on the severity of symptoms. - Tinea Pedis may persist or recur and more long-term management may be required. - Prevention includes thorough drying of the feet when bathing or swimming, wearing sandals around public pools or showers, changing socks frequently, proper hygiene, and avoiding shoe wear that creates a moist environment