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Surgery EOR (billie) > Dermatologic > Flashcards

Dermatologic Flashcards

1
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A
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2
Q

What are the three main classifications of burns?

A

Superficial (1st degree), partial-thickness (2nd degree), full-thickness (3rd degree)

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3
Q

What is the hallmark of a superficial burn?

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Redness, pain, no blisters (e.g., sunburn)

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4
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How do partial-thickness burns present?

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Red, painful, and blistered

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5
Q

What is the appearance of full-thickness burns?

A

White, charred, painless due to nerve damage

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6
Q

What is the Rule of Nines?

A

A method to estimate total body surface area (TBSA) affected by burns

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7
Q

What is the most critical initial treatment for severe burns?

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Fluid resuscitation, typically using the Parkland formula (4 mL/kg per %TBSA)

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8
Q

What is the Parkland formula for burns?

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4 mL/kg per %TBSA, half given in the first 8 hours, remainder in the next 16 hours

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9
Q

What topical antibiotic is commonly used in burn management?

A

Silver sulfadiazine and topical Bacitracin

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10
Q

What is the greatest risk for burn victims?

A

Infection

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11
Q

When should you consider transferring a burn patient to a burn center?

A

When TBSA >10%, involvement of face, hands, feet, genitals, or full-thickness burns

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12
Q

What lab abnormalities are common in burn patients?

A

Hypovolemia, hyperkalemia, metabolic acidosis

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13
Q

How are inhalation injuries associated with burns treated?

A

Airway management with oxygen or intubation as necessary

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14
Q

What is the indication for escharotomy in burn patients?

A

To relieve pressure from circumferential burns and restore circulation

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15
Q

What is the most common pathogen causing cellulitis?

A

Group A Streptococcus (Strep pyogenes)

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16
Q

What are the typical signs of cellulitis?

A

Redness, swelling, warmth, and tenderness of the skin

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17
Q

What is the first-line treatment for uncomplicated cellulitis?

A

Oral antibiotics like cephalexin or dicloxacillin

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18
Q

What distinguishes cellulitis from erysipelas?

A

Erysipelas involves more superficial layers with sharply demarcated edges

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19
Q

What is the key risk factor for developing cellulitis?

A

Skin break or injury such as a cut or insect bite

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20
Q

What imaging is used if an abscess or deep infection is suspected with cellulitis?

A

Ultrasound or CT scan

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21
Q

How do you manage purulent cellulitis?

A

Empiric antibiotic therapy targeting MRSA (e.g., clindamycin, doxycycline)

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22
Q

What condition must be ruled out in rapidly progressing cellulitis?

A

Necrotizing fasciitis

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23
Q

What population is at high risk for recurrent cellulitis?

A

Patients with chronic lymphedema or venous insufficiency

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24
Q

What is the role of IV antibiotics in cellulitis?

A

For severe cases or failure of oral antibiotics

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25
What is the most common type of skin cancer?
basal cell carcinoma
26
How does basal cell carcinoma typically present?
Pearly, raised lesion with telangiectasia, often on sun-exposed areas
27
What is the main distinguishing feature of squamous cell carcinoma?
Firm, scaly, red papules or plaques, often with ulceration
28
What is the ABCDE rule for melanoma?
Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolving
29
What is the preferred treatment for basal cell carcinoma?
Surgical excision or Mohs micrographic surgery
30
What is the best initial diagnostic step for suspected melanoma?
Excisional biopsy with narrow margins
31
What is the treatment for localized melanoma?
Wide excision with sentinel lymph node biopsy
32
What type of biopsy should be avoided in melanoma?
Shave biopsy due to inadequate depth
33
What is the role of immunotherapy in advanced melanoma?
Checkpoint inhibitors (e.g., nivolumab) improve survival in metastatic disease
34
What is the most common site of metastasis for melanoma?
Lymph nodes and distant skin sites
35
What is the primary treatment for squamous cell carcinoma?
Excision with clear margins
36
How is actinic keratosis related to squamous cell carcinoma?
Actinic keratosis is a precancerous lesion that can progress to squamous cell carcinoma
37
What is an epidermal inclusion cyst?
A benign cyst containing keratinous material
38
How does an epidermal inclusion cyst present?
Mobile, firm, subcutaneous nodule often with a central punctum
39
What is the treatment for asymptomatic epidermal inclusion cysts?
Observation unless inflamed or symptomatic
40
What is the definitive treatment for an inflamed or infected cyst?
Incision and drainage followed by excision after inflammation resolves
41
What complication can arise from an untreated infected epidermal inclusion cyst?
abscess formation
42
How do you differentiate an epidermal inclusion cyst from a lipoma?
Cysts have a central punctum and are usually firmer, while lipomas are soft and lobulated
43
What is the recurrence rate after excision of an epidermal inclusion cyst?
Low if completely excised, including the cyst wall
44
What causes an epidermal inclusion cyst?
Blockage of a hair follicle or skin trauma
45
What is the most common location for epidermal inclusion cysts?
Face, neck, and trunk
46
What is the histological finding in an epidermal inclusion cyst?
A cyst lined by squamous epithelium containing lamellated keratin
47
What is the appearance of a ruptured epidermal inclusion cyst?
Painful, erythematous nodule with cheesy white discharge
48
What is the best treatment for a ruptured cyst with secondary infection?
Incision, drainage, and oral antibiotics
49
How can epidermal inclusion cysts be prevented?
There is no reliable prevention method, but avoiding trauma may help reduce risk
50
What is hidradenitis suppurativa?
A chronic inflammatory condition of the apocrine glands leading to abscesses, scarring, and sinus tracts
51
What are common sites of hidradenitis suppurativa?
Axillae, groin, perineal, and inframammary areas
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What is the initial treatment for mild hidradenitis suppurativa?
Topical clindamycin or oral antibiotics like tetracyclines
53
What is the primary risk factor for hidradenitis suppurativa?
Obesity, smoking, and family history
54
What is the Hurley staging system for?
It classifies the severity of hidradenitis suppurativa into three stages
55
What is the treatment for moderate to severe hidradenitis suppurativa?
Oral antibiotics, anti-TNF agents (e.g., infliximab), or surgical excision
56
What is the role of lifestyle changes in managing hidradenitis suppurativa?
Weight loss and smoking cessation can help reduce flares
57
What complication can arise from untreated hidradenitis suppurativa?
Formation of sinus tracts and severe scarring
58
What is the role of surgery in hidradenitis suppurativa?
Wide excision of involved skin in advanced cases
59
How do you differentiate hidradenitis suppurativa from other skin infections?
Chronicity, location, and the presence of sinus tracts and multiple abscesses
60
What is the most common presentation of hidradenitis suppurativa?
Painful nodules, abscesses, and draining sinus tracts in apocrine gland-bearing areas
61
What systemic treatments are considered for hidradenitis suppurativa?
Biologic agents like adalimumab in severe cases
62
What is the recurrence rate of hidradenitis suppurativa after surgery?
High, particularly in patients who continue smoking or do not lose weight
63
What is a lipoma?
A benign tumor of adipose tissue
64
How does a lipoma typically present?
Soft, mobile, and painless subcutaneous mass
65
What is the treatment for symptomatic lipoma?
Surgical excision
66
What imaging is used to confirm a lipoma?
Ultrasound or MRI if deep or atypical
67
How can you differentiate a lipoma from a sarcoma?
Lipomas are typically soft and painless, while sarcomas may be firmer and painful
68
What is the recurrence rate of a lipoma after excision?
Low if completely excised
69
What is the histological appearance of a lipoma?
Well-circumscribed mass of mature adipocytes
70
What is the most common location for lipomas?
Trunk, shoulders, and neck
71
What complication can arise from a rapidly growing lipoma?
Rarely, a liposarcoma, though most lipomas are benign
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What is the usual size range of lipomas?
Typically less than 5 cm, but they can grow larger
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What is the most common treatment for multiple lipomas?
Observation unless symptomatic or concerning features present
74
What are the concerning features of a lipoma that warrant further investigation?
Rapid growth, pain, or firmness
75
What is the genetic condition associated with multiple lipomas?
Familial multiple lipomatosis
76
What are the stages of pressure ulcers?
* Stage 1: Non-blanchable erythema * Stage 2: Partial-thickness skin loss * Stage 3: Full-thickness skin loss * Stage 4: Full-thickness tissue loss with exposed bone, tendon, or muscle
77
What is the most common site for pressure ulcers?
Bony prominences such as the sacrum, heels, and hips
78
What is the primary cause of pressure ulcers?
Prolonged pressure leading to ischemia of soft tissues
79
What is the best initial management for a stage 1 pressure ulcer?
Pressure relief and skin protection with barrier creams
80
What is the gold standard for diagnosing the extent of a pressure ulcer?
Clinical examination, but MRI can be used to assess deeper tissue involvement
81
How are stage 3 and 4 pressure ulcers treated?
Debridement, wound care, and possibly surgical intervention
82
What are the risk factors for developing pressure ulcers?
Immobility, poor nutrition, and incontinence
83
What role do nutritional supplements play in pressure ulcer prevention?
Protein and vitamin C supplementation can aid in healing
84
What complication can result from an untreated stage 4 pressure ulcer?
Osteomyelitis or sepsis
85
What is the key prevention strategy for pressure ulcers in bedridden patients?
Regular repositioning and use of pressure-relieving mattresses
86
How is infection in a pressure ulcer diagnosed?
Wound culture and biopsy if osteomyelitis is suspected
87
What is the primary complication of pressure ulcers in elderly patients?
High risk of infection leading to morbidity and mortality
88
What is the purpose of aspiration of a seroma or hematoma?
To drain accumulated fluid and prevent infection or dehiscence
89
What is the indication for incision and drainage of an abscess?
To evacuate pus and prevent further infection or systemic spread
90
What are the different types of skin biopsies?
Shave biopsy, punch biopsy, and excisional biopsy
91
When is a punch biopsy most appropriate?
For diagnosing small lesions or rashes that require full-thickness skin samples
92
What is the difference between a skin graft and a skin flap?
Skin grafts are avascular tissues transplanted to a wound, while flaps maintain their original blood supply
93
What is the primary indication for a skin graft?
To cover large wounds or burns where primary closure is not possible
94
What is the role of suturing in dermatologic procedures?
To close wounds, reduce infection risk, and promote proper healing
95
What is a common complication of a skin graft?
Graft failure due to infection or inadequate blood supply
96
What factors increase the risk of postoperative wound infection in dermatologic surgeries?
Poor nutrition, immunosuppression, diabetes
97
What is the primary step in perioperative dermatologic risk assessment?
Identifying factors like previous radiation, smoking, or steroid use that can impair wound healing
98
What is a seroma and how is it managed?
A collection of fluid that accumulates after surgery, often treated with aspiration or drainage
99
What is a common complication of incision and drainage of abscesses?
Recurrence of infection or fistula formation if the abscess is not fully drained

Surgery EOR (billie) (24 decks)

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