Question 1

Cutaneous vasculitis develops from the deposit of which substance?
A)Immune complexes
B)Immunoglobulin E (IgE)
C)Complement proteins
D)T lymphocytes

Accepted Answer

Cutaneous vasculitis involves the deposit of immune complexes, initiating an uncontrolled inflammatory response and causing the lesions that are often polymorphic.

Question 2

Lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythematous characterize which type of psoriasis?
A)Plaque
B)Inverse
C)Guttate
D)Erythrodermic

Accepted Answer

The description provided is characteristic of only lesions observed in plaque psoriasis. These lesions are well-demarcated, thick, silvery, scaly, erythematous plaque surrounded by normal skin. Inverse psoriasis is rare and is seen in skinfolds. Guttate psoriasis small papules appear after a streptococcal infection. Erythrodermic psoriasis covers a large portion of the body with red, scaling lesions.

Question 3

The healthcare professional is assessing four patients for pressure ulcer formation. What is the first change in the skin that the professional would note if a patient were developing a pressure ulcer?
A)Blanchable erythema of intact skin
B)Nonblanchable erythema of intact skin
C)Blister at the site of pressure
D)Reddish-purple discoloration

Accepted Answer

Nonblanchable erythema of intact skin, usually over bony prominences, characterizes stage 1 pressure ulcers. A blister would indicate a deep tissue pressure injury as would a reddish-purple discoloration. Blanchable erythema of intact skin would not indicate any pressure damage.

Question 4

Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of the skin?
A)Histiocytes
B)Fibroblasts
C)Mast cells
D)Macrophages

Accepted Answer

Only mast cells release histamine and play a role in hypersensitivity reactions in the skin. Histiocytes are macrophages that reside in loose connective tissue and phagocytize pigments and the debris of inflammation. Fibroblast cells secrete collagen and connective tissue matrix. Macrophages are phagocytic.

Question 5

Which cells of the dermis secrete connective tissue matrix?
A)Macrophages
B)Mast cells
C)Fibroblasts
D)Histiocytes

Accepted Answer

Only fibroblasts secrete the connective tissue matrix and collagen. Macrophages are phagocytic cells. Mast cells release histamine and play a role in hypersensitivity reactions in the skin. Histiocytes are a type of macrophage found in loose connective tissue.

Question 6

A patient shows the healthcare professional a collection of infected hair follicles on the back of the neck is red, painful, and draining. What condition does the professional educate the patient on?
A)Erysipelas
B)Furuncles
C)Carbuncles
D)Boils

Accepted Answer

The term carbuncle is used to identify a collection of infected hair follicles occurring most often on the back of the neck, the upper back, and the lateral thighs. The lesion begins in the subcutaneous tissue and lower dermis as a firm mass that evolves into an erythematous, painful, and swollen mass and drains through many openings. Erysipelas is a bacterial infection with firm red spots that coalesce together. A furuncle, or boil, is a deep, firm, red, painful nodule that changes into a fluctuant cyst.

Question 7

Which type of dressings should the healthcare professional apply to pressure ulcers?
A)Flat and dry
B)Flat, moisture-retaining
C)Bulky and dry
D)Bulky, moisture-retaining

Accepted Answer

Superficial pressure ulcers should be covered with flat, nonbulky dressings that cannot wrinkle or cause increased pressure or friction. The dressing should be moisture-retaining such as Hydrogel.

Question 8

Keloids are caused by excessive amounts of which substance in the corneum during connective tissue repair?
A)Elastin
B)Collagen
C)Stroma
D)Reticular fibers

Accepted Answer

Abnormal wound healing with excessive fibroblast activity and collagen formation during dermal connective tissue repair cause keloids. The other substances are not associated with keloid formation.

Question 9

Which receptors of the sympathetic nervous system regulate heat loss through the skin?
A)Cholinergic
B)b-Adrenergic
C)a-Adrenergic
D)Anticholinergic

Accepted Answer

Heat loss can be regulated by varying blood flow through the skin by opening and closing the arteriovenous anastomoses in conjunction with evaporative heat loss of sweat. The sympathetic nervous system regulates vasoconstriction and vasodilation through a-adrenergic receptors only.

Question 10

A child has been diagnosed with ringworm and the parent asks how to get rid of this parasite. What response by the healthcare professional is most appropriate?
A)"We have several antibiotics that can be used."
B)"Ringworm is actually a fungal infection of the skin."
C)"Actually, ringworm is an old name for pemphigus."
D)"Inexpensive topical antifungals often work well."

Accepted Answer

Tinea corporis (ringworm) is a fungal infection of the skin and is not actually an infestation of worms. The healthcare professional should educate the parent to this fact.

Question 11

Which component of the epidermis initiates immune responses and provides a defense against environmental antigens?
A)Langerhans cells
B)Merkel cells
C)Keratinocytes
D)Melanocytes

Accepted Answer

Langerhans cells (a type of dendritic cell) and dermal dendritic cells initiate an immune response by presenting processed antigen to T cells, thus providing a defense against environmental antigens. This function is not carried out by Merkel cells, keratinocytes, or melanocytes.

Question 12

What clinical manifestations do allergic contact and stasis dermatitis have in common?
A)Petechiae and hyperpigmentation
B)Edema and vesicular lesions
C)Scaling and crusting of lesions
D)Erythema and pruritus

Accepted Answer

Only erythema and pruritus are exhibited with both conditions.

Question 13

What term is used to identify skin lesions that are elevated, rounded, and firm with irregular clawlike margins that extend beyond the original site of injury?
A)Psoriasis
B)Dermatitis
C)Acne
D)Keloid

Accepted Answer

Keloids typically send out clawlike projections from the margins.

Question 14

In latex allergies, which immunoglobulin (Ig) is associated with an immediate reaction?
A)IgA
B)IgE
C)IgG
D)IgM

Accepted Answer

Latex allergy can be either a type IV hypersensitivity to chemicals used in latex rubber processing or a type I immediate hypersensitivity, with IgE antibodies formed in response to latex rubber protein.

Question 15

In allergic contact dermatitis, which cells possess the antigens and present them to T cells?
A)Langerhans cells
B)Merkel cells
C)Keratinocytes
D)Macrophages

Accepted Answer

In allergic contact dermatitis, Langerhans cells process the antigen and carry it to T cells that then become sensitized to the antigen-releasing cytokines and chemokines, leading to leukocyte infiltration and inflammation. Merkel cells are associated with touch receptors and function as slowly adapting mechanoreceptors when stimulated by deformation of the epidermis. Keratinocytes produce keratin, a scleroprotein that provides protection from mechanical stress. Keratin is the main constituent of skin, hair, and nail cells.

Question 16

The student learns that which skin lesion is mediated by the immunoglobulin E (IgE)-stimulated release of histamine, bradykinin, or kallikrein from mast cells?
A)Dermatitis
B)Scleroderma
C)Urticaria
D)Cutaneous vasculitis

Accepted Answer

Only urticaria is mediated by the IgE-stimulated release of histamine, bradykinin, or kallikrein from mast cells or basophils, or both, which causes the endothelial cells of skin blood vessels to contract. Dermatitis is a general term for a particular type of skin inflammation. Scleroderma can be local or systemic and involves connective tissue. Cutaneous vasculitis involves the deposit of immune complexes.

Question 17

A healthcare professional assesses a patient who presents with a single lesion on the trunk that is circular, demarcated, and salmon pink. The lesion measures approximately 3 to 4 cm in diameter. What treatment option does the professional educate the patient about?
A)Narrow-band ultraviolet light therapy
B)Oral erythromycin regime
C)Keratolytic agent application
D)Consistent photoprotection

Accepted Answer

This patient has a herald patch, seen in pityriasis rosea. Treatments include medication for itching and erythromycin and acyclovir. UV light therapy is a treatment for lichen planus. Keratolytic agents are used in psoriasis. Photoprotection is vital in acne rosacea.

Question 18

A patient in the clinic is diagnosed with dermatitis. The patient states that a previous healthcare professional diagnosed eczema. What response by the healthcare professional is best?
A)"Both are general terms for a specific inflammatory response in the skin."
B)"Eczema is an older, outdated term. The preferred term is dermatitis."
C)"No, it's not eczema. Eczema has yellowish scaly plaques."
D)"If it were eczema, it would have blisters that go away on their own."

Accepted Answer

The most common inflammatory disorder of the skin is eczema, or dermatitis. Eczema and dermatitis are general terms that describe a particular type of inflammatory response in the skin-these terms can be used interchangeably. Yellowish scaly plaques are seen in seborrheic dermatitis. Self-limiting blisters can be seen in bullous pemphigoid.

Question 19

Which gland releases secretions that are important in thermoregulation and cooling of the body through evaporation?
A)Sebaceous
B)Apocrine
C)Eccrine
D)Exocrine

Accepted Answer

The eccrine sweat glands are distributed over the body, with the greatest numbers in the palms of the hands, soles of the feet, and forehead. These secretions are important in thermoregulation and cooling of the body through evaporation. Sebaceous glands secrete sebum which is a lipid substance that protects from drying. Apocrine glands are found in the axillae, scalp, face, abdomen, and genital area and have very limited proven function. Exocrine glands secrete substances onto the epithelial surface; an example is a sweat gland.

Question 20

The healthcare professional educates a community group that chickenpox (varicella) may be followed years later by which disorder?
A)Erysipelas
B)Cytomegalovirus
C)Warts
D)Herpes zoster

Accepted Answer

The same herpesvirus-varicella-zoster virus (VZV)-causes both herpes zoster (shingles) and varicella (chickenpox). Varicella is the primary infection, followed years later by herpes zoster, particularly among those who are immunosuppressed. Varicella-zoster virus does not produce erysipelas, cytomegalovirus, or warts.

Quiz 47: Structure, Function, and Disorders of the Integument

Cutaneous vasculitis develops from the deposit of which substance?

Lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythematous characterize which type of psoriasis?

The healthcare professional is assessing four patients for pressure ulcer formation. What is the first change in the skin that the professional would note if a patient were developing a pressure ulcer?

Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of the skin?

Which cells of the dermis secrete connective tissue matrix?

A patient shows the healthcare professional a collection of infected hair follicles on the back of the neck is red, painful, and draining. What condition does the professional educate the patient on?

Which type of dressings should the healthcare professional apply to pressure ulcers?

Keloids are caused by excessive amounts of which substance in the corneum during connective tissue repair?

Which receptors of the sympathetic nervous system regulate heat loss through the skin?

A child has been diagnosed with ringworm and the parent asks how to get rid of this parasite. What response by the healthcare professional is most appropriate?

Which component of the epidermis initiates immune responses and provides a defense against environmental antigens?

What clinical manifestations do allergic contact and stasis dermatitis have in common?

What term is used to identify skin lesions that are elevated, rounded, and firm with irregular clawlike margins that extend beyond the original site of injury?

In latex allergies, which immunoglobulin (Ig) is associated with an immediate reaction?

In allergic contact dermatitis, which cells possess the antigens and present them to T cells?

The student learns that which skin lesion is mediated by the immunoglobulin E (IgE) -stimulated release of histamine, bradykinin, or kallikrein from mast cells?

A healthcare professional assesses a patient who presents with a single lesion on the trunk that is circular, demarcated, and salmon pink. The lesion measures approximately 3 to 4 cm in diameter. What treatment option does the professional educate the patient about?

A patient in the clinic is diagnosed with dermatitis. The patient states that a previous healthcare professional diagnosed eczema. What response by the healthcare professional is best?

Which gland releases secretions that are important in thermoregulation and cooling of the body through evaporation?

The healthcare professional educates a community group that chickenpox (varicella) may be followed years later by which disorder?