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Med Procedures - Quiz 3 > Derm procedures > Flashcards

Derm procedures Flashcards

1
Q

Describe liquid nitrogen

A

Destructively cold, clear liquid

-346 F

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2
Q

How is liquid nitrogen maintained?

A

Vacuum sealed container

  • Must have pressure relief valve
  • Delivered to facility, placed in large storage container, then transferred to smaller containers for daily use, refilled daily
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3
Q

Liquid nitrogen MOA

A
  • Destroys tissue

- Causes inflammatory response

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4
Q

Process of liquid nitrogen treatment

A

Freeze - destroy tissue - causes separation - blister - scab - resolution once scab heals (hopefully)

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5
Q

Indications for liquid nitrogen

A 
Warts
Skin tags
Seb keratoses
Lentiginies
Actinic keratoses
Early BCC/SCC
*DO NOT FREEZE IF IT NEEDS A BIOPSY
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6
Q

Which conditions should NOT be frozen with liquid nitrogen?

A

Anything that needs a biopsy

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7
Q

Downsides of liquid nitrogen treatment

A
  • Hypopigmentation
  • Depressed scarring
  • Nerve damage
  • Incomplete lesion resolution
  • Painful
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8
Q

Procedure of liquid nitrogen

A
  • Each spot frozen for approx 10 secs
  • Freeze 1-2 mm beyond lesion
  • Trigger hold (continuous vs. pulsing)
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9
Q

If liquid nitrogen tx is near the eye, what should be done?

A

Cover eye with gauze

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10
Q

Post liquid nitrogen expectations

A
  • Area will blister within 12 hrs
  • Blister will dry and for a scab in a few days
  • Scab will persist 1-2 weeks
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11
Q

Post liquid nitrogen care

A

None needed - ok to wet, no bandage, no abx ointment

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12
Q

Where may swelling occur after liquid nitrogen treatment?

A

Inferior to treatment site (gravity)

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13
Q

Follow up for liquid nitrogen therapy

A

Depends on what you are treating - ALWAYS see pt back if AK/BCC/SCC

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14
Q

What is saucerization?

A

Deeper shave biopsy

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15
Q

Define shave biopsy/removal

A

Superficial removal/biopsy of a lesion

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16
Q

Is shave biopsy/removal a clean or sterile procedure?

A

CLEAN - wear gloves, prep with alcohol and local anesthetic

17
Q

What instruments are used in shave biopsy/removal?

A

15 blade on a scalpel handle OR small handheld blade (Dermablade)

18
Q

Shave biopsy/removal should include how much skin?

A

Include epidermis and uppermost dermis (no deeper than 1 mm)

19
Q

What can be used for hemostasis after shave biopsy/removal?

A

Aluminum chloride or electrocautery

20
Q

What should be done after taking the shave biopsy/removal?

A

Apply vaseline or bacitracin and band-aid

21
Q

After care of shave biopsy/removal

A
  • Start 24 hrs after procedure
  • Perform daily x 5 days
  • Wash w/soap and water
  • Apply Vaseline or bacitracin
  • Apply band-aid
  • Review s/s of infection w/pt
  • Let pt know when to expect biopsy results
22
Q

Complications of shave biopsy/removal

A
  • Infection
  • Scarring
  • Bleeding
  • Nerve damage
  • Incomplete removal
23
Q

Define punch biopsy/excision

A

Method of obtaining a specimen at full thickness (all layers) using a punch instrument

24
Q

Indications for punch biopsy

A

Diagnose lesions, eruptions, hair evaluations

25
Q

Indications for punch excision

A

Nevi, cysts, dermatofibromas

26
Q

Punch biopsy sizing

A
  • Rash biopsy 4 mm
  • Hair biopsy 4 mm
  • Cyst removal 6-8 mm
27
Q

Is punch biopsy a clean or sterile procedure?

A

Clean - wear gloves, cleanse area w/alcohol, use local anesthetic

28
Q

How to remove punch biopsy/excision specimen?

A

Use needle to pierce it and then cut at bottom of specimen (do NOT use forceps because it may crush tissue making pathology reading difficult)

29
Q

Why shouldn’t forceps be used in punch biopsy?

A

Crushes skin tissue causing difficulty for pathology reading

30
Q

Post treatment of punch biopsy/removal

A
  • Small punches (1.5-2 mm) can be left to heal by secondary intentino
  • If larger, close wound by suturing (3 mm punch is 1 suture)
  • Vaseline/bacitracin and a pressure dressing

Med Procedures - Quiz 3 (4 decks)

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