MARYVILLE NURS 623 COMPREHENSIVE STUDY GUIDE
2026 FULL QUESTIONS AND SOLUTIONS GRADED A+
● Basics with skin conditions. Answer: •Alopecia •Rash •Pruritus •Uticaria •Pigmentation
change Skin lesion—New vs. Change
● HPI questions for skin problems. Answer: Duration of symptoms Precipitating factors
•Medications •Food •Occupation •Outdoors •Hobbies/Sport participation •Exposure to insects
•Jewelry/metals/chemicals •Family history Is it: Local or systemic Pruritus- all day or worse at
night Uticaria - duration Pigmented changes
● Pigmentation/Changes of the skin Diff diagnosis. Answer: Nevi- brown, beige or pink(<
5mm) Melanoma Related to pregnancy- melasma (mask of pregnancy) Addison disease Side
effect of medication- steroid therapy
● skin lesions. Answer: Macule - flat, nonpalpable (freckle, petechia) Papule - PALPABLE,
solid elevation of skin (elevated nevus) Nodule - elevated solid mass, deeper and firmer than
papule (wart) Tumor - solid mass deep in subcutaneous tissue (epithelioma) Wheal -
irregularly shaped, elevated area (hive, mosquito bite Vesicle - elevation of skin with serous
(clear) fluid Pustule - similar to vesicle but filled with pus (acne) Ulcer - deep loss of skin
(venous statis ulcer) Atophy - thinning of skin Bullae-Clear fluid-filled blisters > 10 mm in
diameter. These may be caused by burns, bites, irritant or allergic contact dermatitis, and drug
reactions.
● primary versus secondary skin lesions. Answer: Primary skin lesions are those which
develop as a direct result of the disease process. Secondary lesions are those which evolve
from primary lesions or develop as a consequence of the patient's activities.
● Parasitic Skin Infections. Answer: scabies and lice
● Scabies. Answer: Highly contagious infestation that occurs mainly in children, young
adults, health care workers, and institutionalized persons of all ages. Subjective: Complaints
of intense itching that is usually more severe at night. Objective:Earliest physical sign is small
1 to 2 mm red papules located in areas of body most attractive to mites. Itching, excoriation, ,
crusting, and scaling may be present making it hard to see scabies. Diagnostics:Ink burrow
test
, ● Scabies treatment. Answer: Permethrin 5% cream (Remember you have 5 fingers)- leave
on for 8-14 hours then shower- daily for 7 days. Oral antihistamines for itching, topical steroids
for itching. The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present. Starve mites by sealing them in a bag for
about 10 days.
● Lice treatment. Answer: Permethrin 1% leave on for 10 mins then rinse. May repeat in 7
days if needed.
● Fungal skin infections. Answer: · Candidiasis- bright, beefy red rash treat with topical
antifungal, · Dermatophytoses - the tineas (ringworm) · Onychomycosis treat with Terbinafine
for 6-12 weeks (only 73-79% effective, educate patient. · Fungal infections survive on keratin,
so considered superficial. · Pathogens: Epidermophyton, trichophyton, microsporum. · Those
at risk are DM and immunocompromised. · Diagnostics: KOH
● Tinea corporis (Ringworm of body). Answer: Hx of erythematous round and elevated
pruritic lesion that grows in size & starts to clear in the center Miconazole 2% cream BID x4
weeks, Clotrimazole 1%, Terbafine 1%
● Tinea capitus (ringworm of head). Answer: Children common. Painless bald spot, may
have kerion that looks like honeycomb, inflammation. Boggy mass containing broken hairs
and oozing purulent material from follicular orifices Systemic antifungals - Griseofulvin BID for
2-4 months or 2 weeks after negative cultures. Teratogenic - use 2nd method of
contraception. OR terbinafine cream
● Tinea versicolor (skin, AKA pityriasis versicolor). Answer: Round or oval lesions of
hypo or hyperpigmentation macule, located mainly on back chest, arms, sometimes
neck/face. Sometimes very fine scales seen. Agent P oribiculare causes round, pityrosporum
ovale causes oval Clotrimazole 1% cream and solution BID up to 4 weeks
● Bacterial infections of the skin. Answer: · Impetigo · highly contagious Cellulitis · Keflex
(1st gen cephalosporine) 10-14 days, or dicloxacillin, · PCN allergy use Erythromycin. · non
purulent assume staph aureus Purulent cellulitis · I&D first line · NO 1st gen cephalosporine ·
Consider MRSA- Bactrim, Cleocin, Doxycycline
● Impetigo. Answer: Honey crusted plaques, usually on face Bullous: begin as small vesicles
that rupture easily with serous fluid turning into crust Nonbullous, vesticulopustular: thick,
adherent lesions, dirty yellow-colored crust with erythematous margins Treatment: Clean
lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin). With no treatment,
it is self-limiting 2-3 wks
2026 FULL QUESTIONS AND SOLUTIONS GRADED A+
● Basics with skin conditions. Answer: •Alopecia •Rash •Pruritus •Uticaria •Pigmentation
change Skin lesion—New vs. Change
● HPI questions for skin problems. Answer: Duration of symptoms Precipitating factors
•Medications •Food •Occupation •Outdoors •Hobbies/Sport participation •Exposure to insects
•Jewelry/metals/chemicals •Family history Is it: Local or systemic Pruritus- all day or worse at
night Uticaria - duration Pigmented changes
● Pigmentation/Changes of the skin Diff diagnosis. Answer: Nevi- brown, beige or pink(<
5mm) Melanoma Related to pregnancy- melasma (mask of pregnancy) Addison disease Side
effect of medication- steroid therapy
● skin lesions. Answer: Macule - flat, nonpalpable (freckle, petechia) Papule - PALPABLE,
solid elevation of skin (elevated nevus) Nodule - elevated solid mass, deeper and firmer than
papule (wart) Tumor - solid mass deep in subcutaneous tissue (epithelioma) Wheal -
irregularly shaped, elevated area (hive, mosquito bite Vesicle - elevation of skin with serous
(clear) fluid Pustule - similar to vesicle but filled with pus (acne) Ulcer - deep loss of skin
(venous statis ulcer) Atophy - thinning of skin Bullae-Clear fluid-filled blisters > 10 mm in
diameter. These may be caused by burns, bites, irritant or allergic contact dermatitis, and drug
reactions.
● primary versus secondary skin lesions. Answer: Primary skin lesions are those which
develop as a direct result of the disease process. Secondary lesions are those which evolve
from primary lesions or develop as a consequence of the patient's activities.
● Parasitic Skin Infections. Answer: scabies and lice
● Scabies. Answer: Highly contagious infestation that occurs mainly in children, young
adults, health care workers, and institutionalized persons of all ages. Subjective: Complaints
of intense itching that is usually more severe at night. Objective:Earliest physical sign is small
1 to 2 mm red papules located in areas of body most attractive to mites. Itching, excoriation, ,
crusting, and scaling may be present making it hard to see scabies. Diagnostics:Ink burrow
test
, ● Scabies treatment. Answer: Permethrin 5% cream (Remember you have 5 fingers)- leave
on for 8-14 hours then shower- daily for 7 days. Oral antihistamines for itching, topical steroids
for itching. The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present. Starve mites by sealing them in a bag for
about 10 days.
● Lice treatment. Answer: Permethrin 1% leave on for 10 mins then rinse. May repeat in 7
days if needed.
● Fungal skin infections. Answer: · Candidiasis- bright, beefy red rash treat with topical
antifungal, · Dermatophytoses - the tineas (ringworm) · Onychomycosis treat with Terbinafine
for 6-12 weeks (only 73-79% effective, educate patient. · Fungal infections survive on keratin,
so considered superficial. · Pathogens: Epidermophyton, trichophyton, microsporum. · Those
at risk are DM and immunocompromised. · Diagnostics: KOH
● Tinea corporis (Ringworm of body). Answer: Hx of erythematous round and elevated
pruritic lesion that grows in size & starts to clear in the center Miconazole 2% cream BID x4
weeks, Clotrimazole 1%, Terbafine 1%
● Tinea capitus (ringworm of head). Answer: Children common. Painless bald spot, may
have kerion that looks like honeycomb, inflammation. Boggy mass containing broken hairs
and oozing purulent material from follicular orifices Systemic antifungals - Griseofulvin BID for
2-4 months or 2 weeks after negative cultures. Teratogenic - use 2nd method of
contraception. OR terbinafine cream
● Tinea versicolor (skin, AKA pityriasis versicolor). Answer: Round or oval lesions of
hypo or hyperpigmentation macule, located mainly on back chest, arms, sometimes
neck/face. Sometimes very fine scales seen. Agent P oribiculare causes round, pityrosporum
ovale causes oval Clotrimazole 1% cream and solution BID up to 4 weeks
● Bacterial infections of the skin. Answer: · Impetigo · highly contagious Cellulitis · Keflex
(1st gen cephalosporine) 10-14 days, or dicloxacillin, · PCN allergy use Erythromycin. · non
purulent assume staph aureus Purulent cellulitis · I&D first line · NO 1st gen cephalosporine ·
Consider MRSA- Bactrim, Cleocin, Doxycycline
● Impetigo. Answer: Honey crusted plaques, usually on face Bullous: begin as small vesicles
that rupture easily with serous fluid turning into crust Nonbullous, vesticulopustular: thick,
adherent lesions, dirty yellow-colored crust with erythematous margins Treatment: Clean
lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin). With no treatment,
it is self-limiting 2-3 wks
