NRNP 6560 Final exam|Complete Graded A+

NRNP 6560 Final exam|Complete Graded A+ EPAP expiratory positive airway pressure CPAP continuous positive airway pressure a treatment for apnea involving keeping a patient's airways open using air pressure delivered via a face mask IPAP=EPAP ABCDE asymmetry, border, color, diameter >6mm, evolving skin eruptions or exanthema 3 groups 1. Macular and maculopapular lesions 2. vesicular or bullous lesions 3. pustular, petechial, or purpuric lesions secondary changes of skin lesions comedones, crusting, excoriation, lichenification, scales, scarring, telangiectasia acne inflammatory disease of the skin involving the sebaceous glands and hair follicles causes: corticosteriods, isoniazid bullous lesions Caused by exfoliative toxins A and B Have the appearance of wrinkled tissue paper Lead to widespread desquamation of the skin Patients are left vulnerable to secondary bacterial infections causes: barbiturate overdose, penicillamine, sulfonamides eczematous dermatitis most common inflammatory skin disorder, several forms including irritant contact dermatitis allergic contact dermatitis and atopic dermatitis causes: abx, methyldopa, phenylbutazone, sulfonamides erythemia multiforme Hypersensitivity reaction characterized by targetoid rash and bullae; *HSV and mycoplasma infections; EM with oral mucosa and fever is steven-johnson syndrome causes: barbiturates, hydantois, penicillin, salicylates, sulfonamides, sulfonylureas erythema nodosum inflammation of subcutaneous tissues resulting in tender, erythematous nodules; may be an abnormal immune response to a systemic disease, an infection, or a drug causes: contraceptives, sulfonamides exfoliative dermatitis a condition in which there is widespread scaling of the skin, often with pruritus, erythroderma, and hair loss causes: allopurinal, gold, indomethacin, phenylbutazone lichenoid eruption violaceous to purple, polygonal lesions that resemble those seen in lichen planus Causes: cholorquine, chlorpropamide, mepacrine, quinidine, quinine, thiazides photosensitivity increased reaction of the skin to exposure to sunlight causes: amiodarone, nalidixic acid, sulfonamides, tetracycline pigmentation coloration caused by deposit, or lack, of colored material in the tissues causes: chloroquine, heavy metals, mepacrine Psoriasiform rash causes: gold, methyldopa purpura multiple pinpoint hemorrhages and accumulation of blood under the skin causes: cytotoxic drugs, meprobamate, quinidine, quinine systemic lupus erythematosus (SLE) chronic autoimmune inflammatory disease of collagen in skin, joints, and internal organs causes: hydralazine, isoniazid, penicillamine, procainamide urticaria allergic reaction of the skin characterized by the eruption of pale red, elevated patches called wheals or hives causes: aspirin, imipramine, penicillin, serum, toxoid, vaccines Bulla a large blister that is usually more than 0.5 cm in diameter Comedones plug of keratin and sebum wedged in a dilated pilosebaceous crust accumulated dried exudate Excoriation a superficial loss of skin, e.g., by scratching lichenification area of increased epidermal thickening with exaggerated skin markings, caused by constant rubbing (atopic eczema) keloid a sharply elevated, irregularly shaped, progressively enlarging scar due to excessive collagen formation in the dermis during connective tissue macule flat, colored spot on the skin nodule circumscribed, palpable area of the skin that is >0.5 cm in diameter and appears in part or wholly within the dermis papule A circumscribed, solid elevation of skin < 1cm in diameter, with no visible fluid patch large macule, >2cm in diameter plaque circumscribed, disk-shaped elevated area of the skin >1cm diameter purpura multiple pinpoint hemorrhages and accumulation of blood under the skin pustule raised spot on the skin containing pus scales flakes or dry patches made up of excess dead epidermal cells scar area of fibrous tissue that replaces the lost epidermis stria streak-like, linear, atrophic, pink, purple, or white lesion caused by stretching of the skin Telangiectasia skin lesion due to permanently enlarged and dilated blood vessels that are visible ulcer loss of epidermis and part or whole of the dermis vesicle visible accumulation of fluid beneath the epidermis (<0.5 cm in diameter) weal circumscribed, elevated area of cutaneous edema Dermatitis Medicamentosa Hypersensitivity reaction to a drug. onset is abrupt, widespread, and symmetric erythematous eruption type 1: immediate-type immunologic reaction IgE mediated manifested by urticaria and angioedema of skin or mucosa, edema of other organ, and fall in BP (anaphylatic shock) Type 2: Cytotoxic reaction drug or causative agent causes lysis of cells, such as platelets or leukocytes, or may, by combo with another drug, produce antibodies (immune complexes) that causes lysis or phagocytosis type 3: serum sickness, drug-induced vasculitis IgG and IgM antibodies are formed against a drug manifested by vasculitis, urticaria-like lesions, arthritis, nephritis, alveolitis, hemolytic anemia, thrombocytopenia, and agranulocytosis type 4: morbilliform (exanthematous) reaction cell-mediated immune reaction sensitized lymphocytes react with the drug, releasing cytokines, resulting in cutaneous inflammatory response Drug rash with eosinophilia syndrome (DRESS) - present as hepatits, eosinophilia, pneumonia, lymphadenopathy, and nephritis -symptoms may last 2-6 weeks after beginning the medication, most commonly associated with anticonvulsants, sulfonamines, beta blockers, antimicrobials, antidepressants, and allopurinal medication m/c cause of urticaria and maculopapular allergic skin reaction penicillin-based medicaiton and trimethoprim-sulfamethoxazole penicillin-sensitive patients cephalosporins are assocaited with reaction in 5-15% carbapenems 15-30% red man syndrome not an allergic reaction, associated with vanc often responds to slowing of infusion rate and administration of antihistamine ACE-I chronic cough and angioedema Beta Blockers precipitate asthma and should not be given to patients at high risk of anaphylaxis, BB may block the action of epi anticonvulsants and sulfonamines m/c cause of toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) radiocontrast media and opiois stimulate mast cell histamine release through a non-IgE-mediated mechanism lab and diagnostic for drug eruption LFT as a baseline skin bx allergy skin test