Assessment of Pain;Skin,hair and nails.

• Define pain 
• Differentiate between acute pain and chronic pain. 
• Why do people have individualized responses to pain?

a.     Outline the steps involved in investigating pain as a present problem.

b.     List cultural considerations when taking a history and performing a physical examination related to pain.

• Which personal and social history factors should be explored in a patient in pain?
• When a patient complains of pain, how should it be assessed?    
• Describe how to determine cuff size in an adult patient.  
• Pain is known as which vital sign?  
• Why is it difficult to assess pain in older adults?  

Mr.  Hannigan is a 48-year-old man who presents to the emergency department  with a complaint of headache that has not been relieved in 3 days. He  now complains of visual disturbance and an inability to concentrate.

1. Describe the key indications when taking the blood pressure.

2. Describe the correct cuff size for a patient.

3. What signs and symptoms beside an elevated blood pressure would you expect the patient to exhibit?

Which  structure and its physiologic properties protect against microbial and  foreign substance invasion and minor physical trauma? 

How is hair formed, and what are its components? 

Which type of cells are nails, and into what will these cells convert?

Contrast differences between basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and Kaposi sarcoma.

Describe the expected clinical manifestations of each condition. :

Primary lesions

a.             Macule

b.             Papule

c.             Nevi

d.             Patch

e.             Plaque

f.              Wheal

g.             Nodule

h.             Tumor

i.              Vesicle

j.              Bulla

k.             Pustule

l.              Cyst

m.            Vitiligo

n.             Rhinophyma

o.             Genital herpes

Secondary lesions

a.             Scale

b.             Lichenification

c.             Keloid

d.             Scar

e.             Excoriation

f.              Fissure

g.             Erosion

h.             Ulcer

i.              Crust

j.              Atrophy

JK  is a 44-year-old white woman with a 2-year history of psoriasis. Her  family history includes her father with allergies and asthma and her  mother with psoriasis. JK returns today for an increase in symptoms, and  she wants to improve the appearance of her skin.

1. What is the underlying cause of psoriasis?

2. What are the common signs and symptoms of this disease?