Structure, Function, and Disorders of the Integument
Questions and answers
MULTIPLE CHOICE
1. Which component of the epidermis initiates immune
... [Show More] responses and provides a defense against environmental antigens?
a. Langerhans cells c. Keratinocytes
b. Merkel cells d. Melanocytes
ANS: A
Langerhans cells (a type of dendritic cell) and dermal dendritic cells initiate an immune re- sponse by presenting processed antigen to T cells, thus providing a defense against environ- mental antigens. This function is not true of the other options.
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2. Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of the skin?
a. Histiocytes c. Mast cells
b. Fibroblasts d. Macrophages
ANS: C
Only mast cells release histamine and play a role in hypersensitivity reactions in the skin.
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3. Which cells of the dermis secrete connective tissue matrix?
a. Macrophages c. Fibroblasts
b. Mast cells d. Histiocytes
ANS: C
Only fibroblasts secrete the connective tissue matrix and collagen.
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4. Which gland releases secretions that are important in thermoregulation and cooling of the body through evaporation?
a. Sebaceous c. Eccrine
b. Apocrine d. Exocrine
ANS: C
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 thermoregula- tion and cooling of the body through evaporation. This function is not true for the other op- tions.
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5. Which receptors of the sympathetic nervous system regulate heat loss through the skin?
a. Cholinergic c. 𝛼-Adrenergic
b. §-Adrenergic d. Anticholinergic
ANS: C
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 sympa- thetic nervous system regulates vasoconstriction and vasodilation through 𝛼-adrenergic recep- tors only.
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6. What is the first change in the skin that indicates 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
ANS: B
Nonblanchable erythema of intact skin, usually over bony prominences, characterizes stage 1 pressure ulcers. This selection is the only option that accurately identifies the initial skin change indicative of a pressure ulcer.
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7. Which type of dressings should be applied to pressure ulcers?
a. Flat and dry c. Bulky and dry
b. Flat and moist d. Bulky and moist
ANS: B
Superficial pressure ulcers should be covered with flat, nonbulky dressings that cannot wrin- kle or cause increased pressure or friction. Spontaneous healing will occur more quickly if the ulcer is kept moist with an occlusive dressing.
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8. 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 c. Acne
b. Dermatitis d. Keloid
ANS: D
Of the options available, only keloids typically send out clawlike prolongations.
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9. Keloids are sharply elevated, irregularly shaped, progressively enlarging scars caused by ex- cessive amounts of which substance in the corneum during connective tissue repair?
a. Elastin c. Stroma
b. Collagen d. Reticular fibers
ANS: B
Abnormal wound healing with excessive fibroblast activity and collagen formation during dermal connective tissue repair cause keloids. The other options are not associated with keloid formation.
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10. In allergic contact dermatitis, which cells possess the antigens and present them to T cells?
a. Langerhans cells c. Keratinocytes
b. Merkel cells d. Macrophages
ANS: A
In allergic contact dermatitis, only 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.
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11. In latex allergies, which immunoglobulin (Ig) is associated with an immediate reaction?
a. IgA c. IgG
b. IgE d. IgM
ANS: B
Latex allergy can be either a type IV hypersensitivity to chemicals used in latex rubber pro- cessing or a type I immediate hypersensitivity, with IgE antibodies formed in response to latex rubber protein. This selection is the only correct option available.
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12. What medical term is used to identify an inflammatory disorder of the skin that is often con- sidered synonymous with dermatitis and characterized by pruritus with lesions that have an in- distinct border?
a. Eczema c. Atopic dermatitis
b. Psoriasis d. Pityriasis rosea
ANS: A
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 skinÑthese terms can be used interchangeably. Pruritus, lesions with indistinct borders, and epidermal changes generally characterize diseases that are considered eczematous. Of the available options, only eczema is associated with these characteristics.
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13. What clinical manifestations do allergic contact and stasis dermatitis have in common?
a. Petechiae and hyperpigmentation c. Scaling and crusting of lesions
b. Edema and vesicular lesions d. Erythema and pruritus
ANS: D
Only erythema and pruritus are exhibited with both conditions.
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14. Lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythema- tous characterize which type of psoriasis?
a. Plaque c. Guttate
b. Inverse d. Erythrodermic
ANS: A
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.
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15. Which skin disorder begins with a single lesion that is circular, demarcated, and salmon pink, measures approximately 3 to 4 cm in diameter, and is usually located on the trunk?
a. Lichen planus c. Psoriasis
b. Pityriasis rosea d. Acne rosacea
ANS: B
Of the options available, only pityriasis rosea begins as a single lesion known as a herald patch. This lesion is circular, demarcated, and salmon pink; it measures approximately 3 to 4 cm in diameter and is usually located on the trunk.
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