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Surgery EOR (billie) > Dermatologic > Flashcards

Dermatologic Flashcards

1
Q
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?

A

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

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4
Q

How do partial-thickness burns present?

A

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?

A

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?

A

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
Q

What is the most common type of skin cancer?

A

basal cell carcinoma

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26
Q

How does basal cell carcinoma typically present?

A

Pearly, raised lesion with telangiectasia, often on sun-exposed areas

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27
Q

What is the main distinguishing feature of squamous cell carcinoma?

A

Firm, scaly, red papules or plaques, often with ulceration

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28
Q

What is the ABCDE rule for melanoma?

A

Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolving

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29
Q

What is the preferred treatment for basal cell carcinoma?

A

Surgical excision or Mohs micrographic surgery

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30
Q

What is the best initial diagnostic step for suspected melanoma?

A

Excisional biopsy with narrow margins

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31
Q

What is the treatment for localized melanoma?

A

Wide excision with sentinel lymph node biopsy

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32
Q

What type of biopsy should be avoided in melanoma?

A

Shave biopsy due to inadequate depth

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33
Q

What is the role of immunotherapy in advanced melanoma?

A

Checkpoint inhibitors (e.g., nivolumab) improve survival in metastatic disease

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34
Q

What is the most common site of metastasis for melanoma?

A

Lymph nodes and distant skin sites

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35
Q

What is the primary treatment for squamous cell carcinoma?

A

Excision with clear margins

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36
Q

How is actinic keratosis related to squamous cell carcinoma?

A

Actinic keratosis is a precancerous lesion that can progress to squamous cell carcinoma

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37
Q

What is an epidermal inclusion cyst?

A

A benign cyst containing keratinous material

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38
Q

How does an epidermal inclusion cyst present?

A

Mobile, firm, subcutaneous nodule often with a central punctum

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39
Q

What is the treatment for asymptomatic epidermal inclusion cysts?

A

Observation unless inflamed or symptomatic

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40
Q

What is the definitive treatment for an inflamed or infected cyst?

A

Incision and drainage followed by excision after inflammation resolves

41
Q

What complication can arise from an untreated infected epidermal inclusion cyst?

A

abscess formation

42
Q

How do you differentiate an epidermal inclusion cyst from a lipoma?

A

Cysts have a central punctum and are usually firmer, while lipomas are soft and lobulated

43
Q

What is the recurrence rate after excision of an epidermal inclusion cyst?

A

Low if completely excised, including the cyst wall

44
Q

What causes an epidermal inclusion cyst?

A

Blockage of a hair follicle or skin trauma

45
Q

What is the most common location for epidermal inclusion cysts?

A

Face, neck, and trunk

46
Q

What is the histological finding in an epidermal inclusion cyst?

A

A cyst lined by squamous epithelium containing lamellated keratin

47
Q

What is the appearance of a ruptured epidermal inclusion cyst?

A

Painful, erythematous nodule with cheesy white discharge

48
Q

What is the best treatment for a ruptured cyst with secondary infection?

A

Incision, drainage, and oral antibiotics

49
Q

How can epidermal inclusion cysts be prevented?

A

There is no reliable prevention method, but avoiding trauma may help reduce risk

50
Q

What is hidradenitis suppurativa?

A

A chronic inflammatory condition of the apocrine glands leading to abscesses, scarring, and sinus tracts

51
Q

What are common sites of hidradenitis suppurativa?

A

Axillae, groin, perineal, and inframammary areas

52
Q

What is the initial treatment for mild hidradenitis suppurativa?

A

Topical clindamycin or oral antibiotics like tetracyclines

53
Q

What is the primary risk factor for hidradenitis suppurativa?

A

Obesity, smoking, and family history

54
Q

What is the Hurley staging system for?

A

It classifies the severity of hidradenitis suppurativa into three stages

55
Q

What is the treatment for moderate to severe hidradenitis suppurativa?

A

Oral antibiotics, anti-TNF agents (e.g., infliximab), or surgical excision

56
Q

What is the role of lifestyle changes in managing hidradenitis suppurativa?

A

Weight loss and smoking cessation can help reduce flares

57
Q

What complication can arise from untreated hidradenitis suppurativa?

A

Formation of sinus tracts and severe scarring

58
Q

What is the role of surgery in hidradenitis suppurativa?

A

Wide excision of involved skin in advanced cases

59
Q

How do you differentiate hidradenitis suppurativa from other skin infections?

A

Chronicity, location, and the presence of sinus tracts and multiple abscesses

60
Q

What is the most common presentation of hidradenitis suppurativa?

A

Painful nodules, abscesses, and draining sinus tracts in apocrine gland-bearing areas

61
Q

What systemic treatments are considered for hidradenitis suppurativa?

A

Biologic agents like adalimumab in severe cases

62
Q

What is the recurrence rate of hidradenitis suppurativa after surgery?

A

High, particularly in patients who continue smoking or do not lose weight

63
Q

What is a lipoma?

A

A benign tumor of adipose tissue

64
Q

How does a lipoma typically present?

A

Soft, mobile, and painless subcutaneous mass

65
Q

What is the treatment for symptomatic lipoma?

A

Surgical excision

66
Q

What imaging is used to confirm a lipoma?

A

Ultrasound or MRI if deep or atypical

67
Q

How can you differentiate a lipoma from a sarcoma?

A

Lipomas are typically soft and painless, while sarcomas may be firmer and painful

68
Q

What is the recurrence rate of a lipoma after excision?

A

Low if completely excised

69
Q

What is the histological appearance of a lipoma?

A

Well-circumscribed mass of mature adipocytes

70
Q

What is the most common location for lipomas?

A

Trunk, shoulders, and neck

71
Q

What complication can arise from a rapidly growing lipoma?

A

Rarely, a liposarcoma, though most lipomas are benign

72
Q

What is the usual size range of lipomas?

A

Typically less than 5 cm, but they can grow larger

73
Q

What is the most common treatment for multiple lipomas?

A

Observation unless symptomatic or concerning features present

74
Q

What are the concerning features of a lipoma that warrant further investigation?

A

Rapid growth, pain, or firmness

75
Q

What is the genetic condition associated with multiple lipomas?

A

Familial multiple lipomatosis

76
Q

What are the stages of pressure ulcers?

A
  • 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
Q

What is the most common site for pressure ulcers?

A

Bony prominences such as the sacrum, heels, and hips

78
Q

What is the primary cause of pressure ulcers?

A

Prolonged pressure leading to ischemia of soft tissues

79
Q

What is the best initial management for a stage 1 pressure ulcer?

A

Pressure relief and skin protection with barrier creams

80
Q

What is the gold standard for diagnosing the extent of a pressure ulcer?

A

Clinical examination, but MRI can be used to assess deeper tissue involvement

81
Q

How are stage 3 and 4 pressure ulcers treated?

A

Debridement, wound care, and possibly surgical intervention

82
Q

What are the risk factors for developing pressure ulcers?

A

Immobility, poor nutrition, and incontinence

83
Q

What role do nutritional supplements play in pressure ulcer prevention?

A

Protein and vitamin C supplementation can aid in healing

84
Q

What complication can result from an untreated stage 4 pressure ulcer?

A

Osteomyelitis or sepsis

85
Q

What is the key prevention strategy for pressure ulcers in bedridden patients?

A

Regular repositioning and use of pressure-relieving mattresses

86
Q

How is infection in a pressure ulcer diagnosed?

A

Wound culture and biopsy if osteomyelitis is suspected

87
Q

What is the primary complication of pressure ulcers in elderly patients?

A

High risk of infection leading to morbidity and mortality

88
Q

What is the purpose of aspiration of a seroma or hematoma?

A

To drain accumulated fluid and prevent infection or dehiscence

89
Q

What is the indication for incision and drainage of an abscess?

A

To evacuate pus and prevent further infection or systemic spread

90
Q

What are the different types of skin biopsies?

A

Shave biopsy, punch biopsy, and excisional biopsy

91
Q

When is a punch biopsy most appropriate?

A

For diagnosing small lesions or rashes that require full-thickness skin samples

92
Q

What is the difference between a skin graft and a skin flap?

A

Skin grafts are avascular tissues transplanted to a wound, while flaps maintain their original blood supply

93
Q

What is the primary indication for a skin graft?

A

To cover large wounds or burns where primary closure is not possible

94
Q

What is the role of suturing in dermatologic procedures?

A

To close wounds, reduce infection risk, and promote proper healing

95
Q

What is a common complication of a skin graft?

A

Graft failure due to infection or inadequate blood supply

96
Q

What factors increase the risk of postoperative wound infection in dermatologic surgeries?

A

Poor nutrition, immunosuppression, diabetes

97
Q

What is the primary step in perioperative dermatologic risk assessment?

A

Identifying factors like previous radiation, smoking, or steroid use that can impair wound healing

98
Q

What is a seroma and how is it managed?

A

A collection of fluid that accumulates after surgery, often treated with aspiration or drainage

99
Q

What is a common complication of incision and drainage of abscesses?

A

Recurrence of infection or fistula formation if the abscess is not fully drained

Surgery EOR (billie) (23 decks)

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