APEA 3P PREDICTOR CERTIFICATION EVALUATION QUESTIONS AND
ANSWERS
◉ Plaque. Answer: solid raised lesion with flat top (psoriasis)
◉ Bulla/Bullae. Answer: elevated superficial blister filled with
serous fluid (2nd degree burn, impetigo)
◉ Pustule. Answer: circumscribed elevated lesion containing pus
(acne pustules)
◉ Secondary Skin Lesions-Lichenification. Answer: thickening of the
epidermis with exaggeration of normal skin due to chronic skin
itching (eczema)
◉ Secondary skin lesions- Scale. Answer: flaking skin (psoriasis)
◉ Secondary skin condition-crust. Answer: dried exudate (impetigo)
◉ Secondary skin condition-ulceration. Answer: eroding of
epidermis and dermis (if deep can involve subcutaneous tissue)
,◉ Secondary skin condition-scar. Answer: permanent fibrotic
change following damage to dermis (surgical scars)
◉ Secondary skin condition-keloids/hypertrophic scars. Answer:
overgrowth of scar tissue (more common in Black and Asian
descent)
◉ Rule of 9's. Answer: Head and neck = 9%
Upper Ex = 9% each
Lower Ex = 9% each
Front trunk = 18%
Back trunk = 18%
◉ Rule of 9's =-child leg. Answer: Chlid one leg=13.5%
One leg adult =18%
◉ Rule of 9's =child head. Answer: Child head- 18% (half of adult %)
◉ First degree (superficial):. Answer: Red to bright red skin and
tenderness/pain
,◉ second-degree (partial-thickness) burns. Answer: Painful red
skin, bullae (blisters), reddened/weepy skin
--> BLISTERS START AT SECOND DEGREE
◉ third-degree (full-thickness) burns. Answer: Pain sensation
absent. Pale/white color, charred skin, leather-like texture
◉ Criteria for Burn Center Referral:. Answer: Face, hands, feet,
genitals, major joints
Electrical burns, lightning burns
Partial thickness burns >10% of total body surface area
Third degree burns in any age group
◉ If pt. has a Sulfa allergy and can't use Silvadene what is the
alternative?. Answer: Bacitracin, Polysporin/Triple antibiotic cream
or ointment
◉ Cellulitis. Answer: Bacteria (Gram Positive):
Streptococcus (beta hemolytic strep), Staph aureus (MRSA)
◉ Cellulitis Symptoms:. Answer: Diffused pink to red colored skin,
warm to touch, and may become abscessed
If red streaks radiating from infection it has spread to lymph nodes
(lymphangitis)
, Usually within the deep dermis and is poorly demarcated (poor
boundaries)
Most common location is the lower legs
-->If pt. has DM and develops cellulitis watch for osteomyelitis
◉ Cellulitis treatment. Answer: First line: Abscess/cellulitis is I&D
(if <5 cm no PO antibiotic needed) • Check for tetanus vaccine status
Nonpurulent: Cephalexin (Keflex) 500 mg or Dicloxacillin q 6 hours
for 5-10 days
Purulent (MRSA): Wound culture o Follow up in 48 hours Bactrim
BS BID x 10 days o If you suspect osteomyelitis order an MRI
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
◉ Erysipelas:. Answer: Bacteria: Group A Streptococcus
Located: • Involves upper dermis and superficial lymphatics • Found
on the cheeks and shins
◉ Erysipelas: Symptoms. Answer: Symptoms: • Bright red plaque or
induration with sharp or elevated margins on the face or lower legs
• If fever and chills present pt. is septic (hospitalization is
recommended)
ANSWERS
◉ Plaque. Answer: solid raised lesion with flat top (psoriasis)
◉ Bulla/Bullae. Answer: elevated superficial blister filled with
serous fluid (2nd degree burn, impetigo)
◉ Pustule. Answer: circumscribed elevated lesion containing pus
(acne pustules)
◉ Secondary Skin Lesions-Lichenification. Answer: thickening of the
epidermis with exaggeration of normal skin due to chronic skin
itching (eczema)
◉ Secondary skin lesions- Scale. Answer: flaking skin (psoriasis)
◉ Secondary skin condition-crust. Answer: dried exudate (impetigo)
◉ Secondary skin condition-ulceration. Answer: eroding of
epidermis and dermis (if deep can involve subcutaneous tissue)
,◉ Secondary skin condition-scar. Answer: permanent fibrotic
change following damage to dermis (surgical scars)
◉ Secondary skin condition-keloids/hypertrophic scars. Answer:
overgrowth of scar tissue (more common in Black and Asian
descent)
◉ Rule of 9's. Answer: Head and neck = 9%
Upper Ex = 9% each
Lower Ex = 9% each
Front trunk = 18%
Back trunk = 18%
◉ Rule of 9's =-child leg. Answer: Chlid one leg=13.5%
One leg adult =18%
◉ Rule of 9's =child head. Answer: Child head- 18% (half of adult %)
◉ First degree (superficial):. Answer: Red to bright red skin and
tenderness/pain
,◉ second-degree (partial-thickness) burns. Answer: Painful red
skin, bullae (blisters), reddened/weepy skin
--> BLISTERS START AT SECOND DEGREE
◉ third-degree (full-thickness) burns. Answer: Pain sensation
absent. Pale/white color, charred skin, leather-like texture
◉ Criteria for Burn Center Referral:. Answer: Face, hands, feet,
genitals, major joints
Electrical burns, lightning burns
Partial thickness burns >10% of total body surface area
Third degree burns in any age group
◉ If pt. has a Sulfa allergy and can't use Silvadene what is the
alternative?. Answer: Bacitracin, Polysporin/Triple antibiotic cream
or ointment
◉ Cellulitis. Answer: Bacteria (Gram Positive):
Streptococcus (beta hemolytic strep), Staph aureus (MRSA)
◉ Cellulitis Symptoms:. Answer: Diffused pink to red colored skin,
warm to touch, and may become abscessed
If red streaks radiating from infection it has spread to lymph nodes
(lymphangitis)
, Usually within the deep dermis and is poorly demarcated (poor
boundaries)
Most common location is the lower legs
-->If pt. has DM and develops cellulitis watch for osteomyelitis
◉ Cellulitis treatment. Answer: First line: Abscess/cellulitis is I&D
(if <5 cm no PO antibiotic needed) • Check for tetanus vaccine status
Nonpurulent: Cephalexin (Keflex) 500 mg or Dicloxacillin q 6 hours
for 5-10 days
Purulent (MRSA): Wound culture o Follow up in 48 hours Bactrim
BS BID x 10 days o If you suspect osteomyelitis order an MRI
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
◉ Erysipelas:. Answer: Bacteria: Group A Streptococcus
Located: • Involves upper dermis and superficial lymphatics • Found
on the cheeks and shins
◉ Erysipelas: Symptoms. Answer: Symptoms: • Bright red plaque or
induration with sharp or elevated margins on the face or lower legs
• If fever and chills present pt. is septic (hospitalization is
recommended)
