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In which age group are milia an expected finding?
A. Newborns
,B. Young children
C. Adolescents
D. Older adults - Answer: A: CorrectMilia are small, whitish, discrete papules on the face; they are
commonly found during the first 2 to 3 months of life. The sebaceous glands function in an immature
fashion at this age and are easily plugged by sebum. Answers b, c, and d are incorrect.
Mr. Babson is a 74-year-old man who presents to your office with a complaint of a "spot" on his chin and
wants to know whether it is cancerous. Which of the following signs or symptoms indicates a need for
further medical investigation?
A. The "spot" is a reddish brown color.
B. The "spot" has been on his chin for 20 years.
C. The "spot" bleeds easily when it is touched.
D. The "spot" is slightly raised and circumscribed. - Answer: C: CorrectA "spot" that bleeds easily when it
is touched may be indicative of a more serious condition like basal cell carcinoma, the most common
form of skin cancer.
A 6-year-old girl has freckles over her nose and cheeks. The examiner will recall that freckles are a type
of:
A. macule.
B. papule.
C. nodule.
D. patch. - Answer: A:correctA macule is a flat, circumscribed area that is a change in the color of the
skin usually less than 1 cm in diameter. Freckles, flat moles, petechiae, and measles are examples of
macules.
Mrs. Tomberg brings her 4-day-old infant to your office with a concern of a yellowish skin tone. Which of
the following statements best describes the rationale for the skin tone?
,A. Increased formation of subcutaneous tissue causes a yellow hue.
B. Capillaries broken during the birth process turn the skin slightly yellow as bruises heal.
C. The yellowish color results from increased fat metabolism and heat production.
D. The infant has hyperbilirubinemia. - Answer: D:CorrectHyperbilirubinemia, or physiologic jaundice, is
present to a mild degree in many newborn infants. It usually starts after the first day of life and
disappears by the eighth to tenth day but may persist for as long as 3 to 4 weeks. Intense and persistent
jaundice suggests liver disease, a hemolytic process, or severe, overwhelming infection.
Mr. Russel is a 17-year-old adolescent patient who presents with a complaint of acne. He asks the
examiner why teens have more problems with acne than children. Which of the following would be an
appropriate response?
A. "Children have better hygiene habits than adolescents because of parental guidance."
B. "Adolescents have reduced blood flow to the epidermal layer of the skin, making them more prone to
infections."
C. "At puberty, adolescents begin to secrete more oil from sebaceous glands."
D. "Children have very little skin mass, which prevents development of acne." - Answer: C:
CorrectDuring adolescence, the apocrine glands enlarge and become active, causing increased axillary
sweating and sometimes body odor. Sebaceous glands increase sebum production in response to
increased hormone levels, primarily androgen, giving the skin an oily appearance and predisposing the
individual to acne.
While examining the skin of an 87-year-old woman, the nurse observes significant tenting. Which of the
following best explains that finding?
A. Small tags of skin form on the neck.
, B. The skin becomes thin and takes on a parchment-like appearance.
C. The skin becomes dry with significant flaking.
D. There is a loss of adipose tissue and elasticity. - Answer: D:CorrectTenting occurs in the older adult as
a result of loss of adipose tissue and elasticity. The skin often appears to hang loosely on the bony frame
as a result of a general loss of elasticity, loss of underlying adipose tissue, and years of gravitational pull.
Mr. Allen is a 66-year-old man who presents to your clinic for follow-up for his chronic obstructive
pulmonary disease (COPD). When assessing for the presence of clubbing, the examiner specifically
examines:
A. the width of the nail base.
B. the angle of the nail base.
C. the thickness of the nail.
D. the color of the nail. - Answer: B:CorrectThe average nail base angle should measure 160 degrees. In
clubbing, the nail base is boggy and the angle increases and approaches or exceeds 180 degrees.
Another method of assessment is the Schamroth technique. Clubbing is associated with a variety of
respiratory and cardiovascular diseases, cirrhosis, colitis, and thyroid disease.
Mrs. Jones presents with a complaint of a spot on her skin. Which type of lesion can develop in an
already present nevi?
A. Malignant melanoma
B. Squamous cell carcinoma
C. Basal cell carcinoma
D. Kaposi sarcoma - Answer: A: CorrectMalignant melonoma is the most lethal form of skin cancer that
develops from melanocytes. Squamous cell carcinoma, basal cell carcinoma, and Kaposi sarcoma rarely
develop in an already existing nevi.