NU 545 Comprehensive Predictor Verified
Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct
Detailed Answers
Guaranteed Pass!!Current Update
1. Psoriasis exacerbation - ANSWER Assessment-Physical Findings
Erythematous, well-demarcated papules and plaques covered with silver scales,
typically appearing on the scalp, chest, elbows, knees, back, and buttocks in a
symmetrical distribution
In mild psoriasis: plaques scattered over a small skin area
In moderate psoriasis: plaques more numerous and larger (up to several
centimeters in diameter)
In severe psoriasis: plaques covering at least one-half of the body
Friable or adherent scales
Fine bleeding points or Auspitz sign after attempts to remove scales
Thin, erythematous guttate lesions, alone or with plaques, and with few scales
(see Identifying types of psoriasis)
Small indentations or pits, and yellow or brown discoloration of fingernails or
toenails
In severe cases, separation of the nail from the nail bed
2. Psoriasis dx and tx - ANSWER Diagnostic Test Results-Laboratory
Rheumatoid factor is negative.
,Erythrocyte sedimentation rate may be normal.
Uric acid level may be elevated (pustular psoriasis).
Diagnostic Test Results-Diagnostic Procedures
Skin biopsy can help rule out other diseases (rarely done).
Treatment-General
Depends on the psoriasis type, extent, and effect on the patient's quality of life
Lesion management
Lukewarm baths
Oatmeal baths
Ultraviolet B light or natural sunlight; home phototherapy
Smoking cessation
Avoidance of aggravating medications
Excimer laser
Treatment-Diet
Avoidance of alcohol
Treatment-Medications
Emollients, such as petroleum and thick creams
Topical steroids, such as hydrocortisone, mometasone, triamcinolone (low to
medium potency), betamethasone dipropionate, fluocinonide (strong potency),
,clobetasol, and halobetasol (super-strong potency; reserved for refractory
plaques)
Vitamin D analogs such as calcipotriene or calcitriol ointment
Topical retinoids such as tazarotene
Systemic agents, such as methotrexate, cyclosporine, and acitretin
Oral steroids for severe or life-threatening cases
Biological agents, such as etanercept, alefacept, efalizumab, and infliximab
Topical immunosuppressants such as tacrolimus and pimecrolimus
Methotrexate once weekly as long-term therapy
Other topical agents, such as salicylic acid, coal tar, and anthralin
Treatment-Surgery
Surgical nail removal to treat severely disfigured or damaged nails caused by
psoriasis
3. Basal cell carcinoma and gene alteration - ANSWER BCC is a surface
epithelial tumor of the skin originating from undifferentiated basal or stem
cells. BCC arises from mutation in the TP53 tumor-suppressor gene, leading
to loss of keratinocyte repair functions and apoptosis resistance of DNA-
damaged cells. Other oncogenic pathways include inhibition of the PCTH
gene with over expression in the Sonic Hedgehog signaling pathway (codes
for smoothened protein important for cell growth and differentiation).
4. MODS - Definition - ANSWER Definitions of MODS
1.The progressive dysfunction of TWO OR MORE ORGAN SYSTEMS as a result of an
uncontrolled inflammatory response to severe illness or injury.
, 2. The presence of altered organ function in an acutely ill patient such that
homeostasis cannot be maintained without interventions.
Descriptions of MODS
• Altered functions of multiple organs—usually
occurring SEQUENTIALLY, not all at the same time—in an acutely ill
patient.
• Generally accepted that a patient with
dysfunction of at least two or more organ
systems has MODS
• PT OUTCOME IS DIRECTLY RELATED TO THE # OF ORGANS THAT FAIL.
*often begins with SIRS-->MODS*
MODS information
• Difficult to treat due to incomplete understanding of its pathophysiology
• Bacterial infection is the most common event leading to MODS
5. MODS- etiology, risk factors, and pathophysiology - ANSWER MODS
etiology
*CAUSES*
• Most common causes: Sepsis and septic shock
• Dead tissue/injured tissue-burns, trauma
• Infection-pyelonephritis, peritonitis
• Perfusion deficits
• Persistent sources of inflammation
• Acute lung injury usually present in some form
Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct
Detailed Answers
Guaranteed Pass!!Current Update
1. Psoriasis exacerbation - ANSWER Assessment-Physical Findings
Erythematous, well-demarcated papules and plaques covered with silver scales,
typically appearing on the scalp, chest, elbows, knees, back, and buttocks in a
symmetrical distribution
In mild psoriasis: plaques scattered over a small skin area
In moderate psoriasis: plaques more numerous and larger (up to several
centimeters in diameter)
In severe psoriasis: plaques covering at least one-half of the body
Friable or adherent scales
Fine bleeding points or Auspitz sign after attempts to remove scales
Thin, erythematous guttate lesions, alone or with plaques, and with few scales
(see Identifying types of psoriasis)
Small indentations or pits, and yellow or brown discoloration of fingernails or
toenails
In severe cases, separation of the nail from the nail bed
2. Psoriasis dx and tx - ANSWER Diagnostic Test Results-Laboratory
Rheumatoid factor is negative.
,Erythrocyte sedimentation rate may be normal.
Uric acid level may be elevated (pustular psoriasis).
Diagnostic Test Results-Diagnostic Procedures
Skin biopsy can help rule out other diseases (rarely done).
Treatment-General
Depends on the psoriasis type, extent, and effect on the patient's quality of life
Lesion management
Lukewarm baths
Oatmeal baths
Ultraviolet B light or natural sunlight; home phototherapy
Smoking cessation
Avoidance of aggravating medications
Excimer laser
Treatment-Diet
Avoidance of alcohol
Treatment-Medications
Emollients, such as petroleum and thick creams
Topical steroids, such as hydrocortisone, mometasone, triamcinolone (low to
medium potency), betamethasone dipropionate, fluocinonide (strong potency),
,clobetasol, and halobetasol (super-strong potency; reserved for refractory
plaques)
Vitamin D analogs such as calcipotriene or calcitriol ointment
Topical retinoids such as tazarotene
Systemic agents, such as methotrexate, cyclosporine, and acitretin
Oral steroids for severe or life-threatening cases
Biological agents, such as etanercept, alefacept, efalizumab, and infliximab
Topical immunosuppressants such as tacrolimus and pimecrolimus
Methotrexate once weekly as long-term therapy
Other topical agents, such as salicylic acid, coal tar, and anthralin
Treatment-Surgery
Surgical nail removal to treat severely disfigured or damaged nails caused by
psoriasis
3. Basal cell carcinoma and gene alteration - ANSWER BCC is a surface
epithelial tumor of the skin originating from undifferentiated basal or stem
cells. BCC arises from mutation in the TP53 tumor-suppressor gene, leading
to loss of keratinocyte repair functions and apoptosis resistance of DNA-
damaged cells. Other oncogenic pathways include inhibition of the PCTH
gene with over expression in the Sonic Hedgehog signaling pathway (codes
for smoothened protein important for cell growth and differentiation).
4. MODS - Definition - ANSWER Definitions of MODS
1.The progressive dysfunction of TWO OR MORE ORGAN SYSTEMS as a result of an
uncontrolled inflammatory response to severe illness or injury.
, 2. The presence of altered organ function in an acutely ill patient such that
homeostasis cannot be maintained without interventions.
Descriptions of MODS
• Altered functions of multiple organs—usually
occurring SEQUENTIALLY, not all at the same time—in an acutely ill
patient.
• Generally accepted that a patient with
dysfunction of at least two or more organ
systems has MODS
• PT OUTCOME IS DIRECTLY RELATED TO THE # OF ORGANS THAT FAIL.
*often begins with SIRS-->MODS*
MODS information
• Difficult to treat due to incomplete understanding of its pathophysiology
• Bacterial infection is the most common event leading to MODS
5. MODS- etiology, risk factors, and pathophysiology - ANSWER MODS
etiology
*CAUSES*
• Most common causes: Sepsis and septic shock
• Dead tissue/injured tissue-burns, trauma
• Infection-pyelonephritis, peritonitis
• Perfusion deficits
• Persistent sources of inflammation
• Acute lung injury usually present in some form
