Scenario Dr. Sam Lee is a dermatologist who employs several medical assistants i

Question

Scenario

Dr. Sam Lee is a dermatologist who employs several medical assistants in his busy private practice. Melissa Bauman, CMA (AAMA), has worked for Dr. Lee since graduating from a medical assisting program last year. Melissa works as a clinical specialist, whose primary responsibilities are to perform telephone screening, prepare patients for procedures, and assist Dr. Lee as needed. To fulfill her responsibilities in the dermatology practice, Melissa must be familiar with common diseases and disorders that affect the skin, must assist with dermatologic procedures, and must be prepared to reinforce patient education about the treatment and prevention of dermatologic conditions. Answer each question.

• What is the basic anatomy and physiology of the integumentary system?

• What are common diseases and disorders that affect the integumentary system?

• How can Melissa determine the difference between the levels of burn injuries?

• Why is it important that Melissa understand the concepts of staging and grading of malignant tumors?

• What are the primary malignancies of the skin?

• What dermatologic procedures should Melissa be prepared to perform?

Explanation / Answer

1.The integumentary system is composed of skin and it's accessory organs. It contains millions of cells specialized nerve endings hair follicles muscles and sweat and sebaceous glands to keep our body cool and lubricate the skin .thickness of skin varied at different parts of body .skin has 3 layers as

1.Epidermis :-it contain cells called keratinocytes. It is composed of thin uppermost layer of skin .keratin a protein makes outermost layer of epidermis and acts as barrier. Helps in controlling water loss.Epidermis has 95% keratinocytes cells and 5%cells are melonocytes containing the melanin.melanin protects us from UV radiations.

2.dermis:-it is reffered as true skin .it is connective tissue containing collagen and elastin fibres. Collagen prevents tearing of skin and elastin fibres makes skin resilient .Dermis has network of blood vessels lymph hair follicles sweat and sebaceous glands.

3.subcutaneous layer:-it is composed of fatty or adipose tissue. Fatty cells provide insulation. As we age it considerably thins. It also contain blood vessels and nerves.

Qno2.As the skin is openly exposed it is prone to various disorders and diseases .such as infections. Inflammatory processes ,tumours,.allergic reactions.

INFECTIONS

Bacterial infections include

Impetigo:-caused by streptococci. Mostly occurs in children

Acne:-caused by inherited predisposition, hormonal imbalance or flactuation,humidity or due to oily creams.

Roseacea: occurs in women of ages 30-60 years .it causes inflammation and pastule formation.

Cellulitis:- caused by streptococci

FUNGAL INFECTIONS include tinea pedis or false foot , tinea cruris,tinea corporis.

Viral infection include

Warts :-caused by human papilloma virus

Herpes simplex or cold sores caused by simplex virus type 1.

Parasites like itch mite cause scabies and lice cause pediculosis.

Inflammatory skin disorders include seborrheic dermatitis, contact dermatitis and eczema .

Autoimmune skin disorders include psoriasis, systematic impus erythematosus etc.

Qno3.

Skin may be damaged by exposure to high temperatures causing skin burns .burns are grouped into 3 stages

1.superficial burn or ist class burn:- in this epidermis is affected. No blister formation .pain is observed in this type of burn .

2.partial thickness burn or second degree burn :- it destroys entire epidermis and varying depths of dermis .blisters are found .more pain is experienced. Deep burns may destroy hair follicles and sebaceous glands.

3.Full thickness burn or third degree burn:- it destroys all the layers of skin .Affected area becomes charred or white with firm texture. There is no pain as nerve endings are destroyed. Circulatory collapse respiratory distress and septic shocks occurs in this.

Qno4:-

Abnormal growth or neoplam may be benign or malignant .benign tumor is confined to a cell while malignant tumour affects neighbouring tissues. Malignant tumors are classified in the basis of their grade and stage .gradding is histologic cellular classification of tumor.stagging means whether tumor cells have spread or they are at their original position. Gradding and stagging determine the extent of malignant tissue involvement. Which allows us to plan a treatment accordingly.

Qno5 .

There are 3 types of skin malignancies which can occur.they are

Basal cell carcinomas .Squamous cell carcinomas and Melanomas.

Qno6.

The dermatological procedures that Melissa be prepared to perform are as

Skin testing for allergies

Percutaneous test

Patch test

Intradermal test.

Radioallergosorbent test

Laser surfacing.

Thanks .hope you have got what you wanted

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