Chapter 47: Alterations of the Integument in Children
MULTIPLE CHOICE
1. Which immunoglobulin (Ig) is elevated in atopic dermatitis?
a.
IgA c. IgE
b.
IgM d. IgG
ANS: C
In the acute phase of atopic dermatitis, inflammation is associated with the activation of T
helper 1 (Th-1) cells with an overexpression of cytokines (interleukin [IL]Ð4, IL-5, and IL-
13) and chemokine ligand 1 (CCL1) and 18 (CCL18) with increases in IgE, eosinophils, and
macrophages. The remaining options will not be elevated as related to atopic dermatitis.
PTS: 1 REF: Page 1654
2. Which leukocytes are elevated in atopic dermatitis?
a.
Eosinophils c. Basophils
b.
Neutrophils d. Monocytes
ANS: A
In the acute phase of atopic dermatitis, inflammation is associated with the activation of T
helper 1 (Th-1) cells with an overexpression of cytokines (interleukin [IL]Ð4, IL-5, and IL13)
and chemokine ligand 1 (CCL1) and 18 (CCL 18) with increases in IgE, eosinophils, and
macrophages. Other leukocytes will not be elevated as related to atopic dermatitis.
PTS: 1 REF: Page 1654
3. Which clinical manifestation is considered the hallmark of atopic dermatitis?
a.
Papular rash c. Vesicles that burst and form crusts
b.
High fever d. Itching
ANS: D
Of the options, only itching is considered a hallmark of atopic dermatitis, and rubbing and
scratching to relieve the itch are responsible for many of the clinical changes of atopic der-
matitis.
PTS: 1 REF: Pages 1654-1655
4. Frequently, diaper dermatitis is secondarily infected with which organism?
a.
Escherichia coli c. Proteus spp.
b.
Candida albicans d. Staphylococcus aureus
ANS: B
Of the options available, frequently the infant with diaper dermatitis is secondarily infected
with C. albicans.
PTS: 1 REF: Page 1655
5. The disruption in cellular adhesion observed in bullous impetigo is caused by an
exfoliative toxin related to which organism?
, a.
Staphylococcus aureus c. Escherichia coli
b.
Streptococcus pyogenes d. Candida albicans
ANS: A
Bullous impetigo is a rare variant of impetigo caused by S. aureus. The staphylococci produce
a bacterial toxin called exfoliative toxin (ET), which causes a disruption in desmosomal adhe-
sion molecules with blister formation characteristic of bullous impetigo. This selection is the
only option that identifies the correct organism.
PTS: 1 REF: Page 1656
6. The staff member of a crowed day care center is a source for which bacterial infection?
a.
Atopic dermatitis
b.
Staphylococcal scalded-skin syndrome
c.
Impetigo
d.
Tinea capitis
ANS: C
Impetigo is a common bacterial skin infection in infants and children and is particularly infec-
tious among people living in crowded conditions with poor sanitary facilities or in settings
such as day care facilities. The other options are not as infectious as impetigo.
PTS: 1 REF: Page 1656
7. Skin lesions that rupture, creating a thin, flat, honey-colored crust, are the hallmark
clinical manifestation of which skin disorder?
a.
Rubella c. Atopic dermatitis
b.
Tinea capitis d. Bullous impetigo
ANS: D
Of the options available, only the vesicular impetigo lesions that begin as small vesicles with
a honey-colored serum are the hallmark clinical manifestation of bullous impetigo. Yellow
to white-brown crusts form as the vesicles rupture and extend radially (see Figure 47-4).
PTS: 1 REF: Page 1656
8. Skin lesions caused by tinea corporis are best described as:
a.
Pink-to-red coalescing maculopapular rash on the scalp or trunk
b.
Vesicles that rupture, creating a thin, flat, honey-colored crust
c.
Circular (round or oval) lesions with erythema and scaling patches
d.
Red papules, vesicles, and pustules in clusters
ANS: C
Lesions caused by tinea corporis are often erythematous, round, or oval-scaling patches that
peripherally spread with clearing in the center, creating the ring appearance, which is why this
disease is commonly referred to as ringworm. None of the other options accurately describe
the lesions associated with tinea corporis.
PTS: 1 REF: Pages 1657-1658
9. What is a common contact source of tinea corporis?
a.
Mites c. Ponies
MULTIPLE CHOICE
1. Which immunoglobulin (Ig) is elevated in atopic dermatitis?
a.
IgA c. IgE
b.
IgM d. IgG
ANS: C
In the acute phase of atopic dermatitis, inflammation is associated with the activation of T
helper 1 (Th-1) cells with an overexpression of cytokines (interleukin [IL]Ð4, IL-5, and IL-
13) and chemokine ligand 1 (CCL1) and 18 (CCL18) with increases in IgE, eosinophils, and
macrophages. The remaining options will not be elevated as related to atopic dermatitis.
PTS: 1 REF: Page 1654
2. Which leukocytes are elevated in atopic dermatitis?
a.
Eosinophils c. Basophils
b.
Neutrophils d. Monocytes
ANS: A
In the acute phase of atopic dermatitis, inflammation is associated with the activation of T
helper 1 (Th-1) cells with an overexpression of cytokines (interleukin [IL]Ð4, IL-5, and IL13)
and chemokine ligand 1 (CCL1) and 18 (CCL 18) with increases in IgE, eosinophils, and
macrophages. Other leukocytes will not be elevated as related to atopic dermatitis.
PTS: 1 REF: Page 1654
3. Which clinical manifestation is considered the hallmark of atopic dermatitis?
a.
Papular rash c. Vesicles that burst and form crusts
b.
High fever d. Itching
ANS: D
Of the options, only itching is considered a hallmark of atopic dermatitis, and rubbing and
scratching to relieve the itch are responsible for many of the clinical changes of atopic der-
matitis.
PTS: 1 REF: Pages 1654-1655
4. Frequently, diaper dermatitis is secondarily infected with which organism?
a.
Escherichia coli c. Proteus spp.
b.
Candida albicans d. Staphylococcus aureus
ANS: B
Of the options available, frequently the infant with diaper dermatitis is secondarily infected
with C. albicans.
PTS: 1 REF: Page 1655
5. The disruption in cellular adhesion observed in bullous impetigo is caused by an
exfoliative toxin related to which organism?
, a.
Staphylococcus aureus c. Escherichia coli
b.
Streptococcus pyogenes d. Candida albicans
ANS: A
Bullous impetigo is a rare variant of impetigo caused by S. aureus. The staphylococci produce
a bacterial toxin called exfoliative toxin (ET), which causes a disruption in desmosomal adhe-
sion molecules with blister formation characteristic of bullous impetigo. This selection is the
only option that identifies the correct organism.
PTS: 1 REF: Page 1656
6. The staff member of a crowed day care center is a source for which bacterial infection?
a.
Atopic dermatitis
b.
Staphylococcal scalded-skin syndrome
c.
Impetigo
d.
Tinea capitis
ANS: C
Impetigo is a common bacterial skin infection in infants and children and is particularly infec-
tious among people living in crowded conditions with poor sanitary facilities or in settings
such as day care facilities. The other options are not as infectious as impetigo.
PTS: 1 REF: Page 1656
7. Skin lesions that rupture, creating a thin, flat, honey-colored crust, are the hallmark
clinical manifestation of which skin disorder?
a.
Rubella c. Atopic dermatitis
b.
Tinea capitis d. Bullous impetigo
ANS: D
Of the options available, only the vesicular impetigo lesions that begin as small vesicles with
a honey-colored serum are the hallmark clinical manifestation of bullous impetigo. Yellow
to white-brown crusts form as the vesicles rupture and extend radially (see Figure 47-4).
PTS: 1 REF: Page 1656
8. Skin lesions caused by tinea corporis are best described as:
a.
Pink-to-red coalescing maculopapular rash on the scalp or trunk
b.
Vesicles that rupture, creating a thin, flat, honey-colored crust
c.
Circular (round or oval) lesions with erythema and scaling patches
d.
Red papules, vesicles, and pustules in clusters
ANS: C
Lesions caused by tinea corporis are often erythematous, round, or oval-scaling patches that
peripherally spread with clearing in the center, creating the ring appearance, which is why this
disease is commonly referred to as ringworm. None of the other options accurately describe
the lesions associated with tinea corporis.
PTS: 1 REF: Pages 1657-1658
9. What is a common contact source of tinea corporis?
a.
Mites c. Ponies
