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Derm > Exam 1 - Benign Lesions, Wound Care, Lab, Antiseptics, Local Anesthetics > Flashcards

Exam 1 - Benign Lesions, Wound Care, Lab, Antiseptics, Local Anesthetics Flashcards

1
Q

Name the lesion:
Non-palpable localized change in skin color < 1cm

A

Macule

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2
Q

Name the lesion:
Non-palpable localized change in skin color > 1cm

A

Patch

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3
Q

Name the lesion:
Solid, elevated lesion in epidermis < 5mm

A

Papule

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4
Q

Name the lesion:
Solid, elevated lesion in epidermis > 5mm

A

Plaque

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5
Q

Name the lesion:
Solid, elevated lesion extending into the dermis or subcutaneous tissue > 5mm - 2cm

A

Nodule

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6
Q

Name the lesion:
Solid, elevated lesion extending into the dermis or subcutaneous tissue > 2cm

A

Tumor

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7
Q

Name the lesion:
Localized edema in epidermis causing irregularly shaped lesion

A

Wheal

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8
Q

Name the lesion:
Localized accumulation of serous fluid in epidermis < 5mm

A

Vesicle

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9
Q

Name the lesion:
Localized accumulation of serous fluid in epidermis > 5mm

A

Bullae

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10
Q

Name the lesion:
Localized accumulation of pus < 5mm

A

Pustule

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11
Q

Name the lesion:
Fluid-filled or solid mass in skin extending into dermis or subcutaneous tissue

A

Cyst

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12
Q

Name the lesion:

A

Seborrheic Keratosis

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13
Q

Name the lesion:

A

Seborrheic Keratosis - Rough type

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14
Q

Name the lesion:

A

Dermatosis Papulosa Nigra

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15
Q

What are the most common benign skin neoplasms (2)?

A

Seborrheic Keratosis
Nevi

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16
Q

Tx of Seborrheic Keratosis

A

None
Cryotherapy
Dermabrasion
Punch biopsy
Lasers/Chemical peels
Shave biopsy (if black w/o horn cysts)

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17
Q

Name the lesion:

A

Acrochordon (skin tag)

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18
Q

Acrochordon DDX

A

Intradermal nevi
Neurofibroma

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19
Q

Name the lesion:

A

Dermatofibroma

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20
Q

Name the lesion and the diagnostic test

A

Dermatofibroma
“Dimple sign”

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21
Q

Tx of dermatofibroma

A

None
Full-thickness excision (will produce a scar)

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22
Q

Dermatofibroma DDX

A

Nevi
Malignant Melanoma
Dermatofibrosarcoma Protuberans

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23
Q

Name the lesion:

A

Keloid

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24
Q

Name the lesion:
Enlargement of the scar within the boundary of the original scar

A

Hypertrophic scarring

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25
Q

Name the lesion:
Enlargement of the scar beyond the original scar boundary

A

Keloid

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26
Q

Name the lesion:

A

Hypertrophic Scar

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27
Q

Tx of keloids

A

Silicone-based therapy (gel, sheets, spray)
Laser therapy
Cryotherapy
Surgery (last option due to recurrence)

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28
Q

Name the lesion:

A

Chondrodermatitis Nodularis Chronica Helicis

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29
Q

Risk factors for Chondrodermatitis Nodularis Helicis

A

Actinic damage, cold exposure, trauma, local ischemia

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30
Q

Name the lesion:
Early - central crust at apex
Long standing - dense rolled edges

A

Chondrodermatitis Nodularis Helicis

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31
Q

Chondrodermatitis Nodularis Helicis DDX

A

SCC
BCC
Actinic Keratosis

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32
Q

Name the lesion:

A

Epidermal Inclusion Cyst

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33
Q

Epidermal Inclusion Cysts are filled with “trapped” _______

A

Keratin

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34
Q

Which are more common, epidermal inclusion cysts, or sebaceous cysts?

A

Epidermal inclusion cysts

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35
Q

Pilar cyst DDX

A

Lipoma
Nasal glioma
Gardner’s Syndrome

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36
Q

Name the lesion:

A

Milia (milium)

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37
Q

Tx of milia

A

Infants - Resolve spontaneously
Adults - #11 scalpel and express, retinoid therapy with multiple

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38
Q

Name the lesion:

A

Meibomian Cyst

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39
Q

Name the lesion:

A

Digital Mucous Cyst (myxoid cyst)

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40
Q

Name the lesion:

A

Ganglion Cyst

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41
Q

Name the lesion:

A

Sebaceous Hyperplasia

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42
Q

Sebaceous Hyperplasia DDX

A

BCC
Small keratoacanthoma
Molluscum contagiosum
Syringoma

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43
Q

Name the lesion:

A

Syringoma

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44
Q

What is the most common tumor of the intraepidermal sweat glands?

A

Syringoma

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45
Q

Are Syringomas Autosomal Dominant or Recessive?

A

AD

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46
Q

Where can syringomas appear on the body?

A

Lower lids, forehead, vulva, abdomen, chest

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47
Q

Who is she?

A

Lipoma

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48
Q

Lipoma DDX

A

Liposarcoma
Angiolipoma
Metastatic malignant tumors

49
Q

Name the lesion:

A

Neurofibroma

50
Q

Name the lesion and the diagnostic sign

A

Neurofibroma
“Buttonhole” sign

51
Q

Von Recklinghausen’s Disease is associated with what lesions?

A

Neurofibromas

52
Q

Von Recklinghausen’s Disease sxs

A

Multiple neurofibromas
Cafe-au-lait spots
Axillary freckling

53
Q

Neurofibroma DDX

A

Skin tags
Dermal nevi

54
Q

Name the lesion:
Smooth or slightly elevated, most are hairless

A

Junctional Nevi

55
Q

Name the lesion:
Slightly elevated, smooth or warty, more elevated with age, hair may be presesnt

A

Compound Nevi

56
Q

Name the lesion:

A

Halo Nevi (compound nevi)

57
Q

Name the lesion:

A

Dermal Nevi

58
Q

(True or False) Symptomatic nevi should always be regarded suspiciously

A

True chainz

59
Q

Name the lesion:

A

Atypical Nevi

60
Q

(True or False) Atypical Nevi increase the risk for developing primary melanoma

A

True
(3-20 fold risk)

61
Q

Who is she??
Lesion with irregular margins, superficial, ruddy granular tissue, painless, exudative, firm edema/woody

A

Venous Ulcer

62
Q

Who is she??
Lesion on the lateral malleolus, between toes, or phalangeal heads. Pale deep wound bed, painful, pale dry granulation, thin/shiny/dry skin, pallor, cool, deminished pulses.

A

Arterial Ulcer

63
Q

Who is she??
Lesion on buttocks, perineum, upper thigh, skin folds.
Red, partial thickness (limited to epidermis/dermis), no necrosis, painful and itchy.

A

Incontinence Associated Dermatitis

64
Q

Who is she??
Lesion that is circumscribed and usually over bony prominences, partial to full thickness deep tissue injury, slough or eschar.

A

Pressure injury

65
Q

Who is she??

A

Venous Ulcer

66
Q

Who is she??

A

Arterial Ulcer

67
Q

Who is she??

A

Incontinence Associated Dermatitis

68
Q

Who is she??

A

Lipodermatosclerosis

69
Q

What are the 4 healing stages?

A

Hemostasis
Inflammatory
Proliferative
Maturation

70
Q

What is the pH of the skin

71
Q

Wound thickness - Superficial

A

Epidermis only (abrasion, laceration, burn)

72
Q

Wound thickness - Partial thickness

A

Epidermis and partial dermis only. Pink and painful, no slough. (Partial skin thickness burn, skin tear)

73
Q

Wound thickness - Full thickness

A

Through dermis and and into the subcutaneous tissue. Possibly to muscle, tendon, or bone. Often develops slough. (Laceration, venous insufficiency)

74
Q

Drainage - Sanguineous

A

Blood or bleeding

75
Q

Drainage - Serosanguineous

A

Thin bloody looking or pink

76
Q

Drainage - Serous

A

Thin yellow, green, tan, or brownish. Can form crusting if dry.

77
Q

Drainage - Purulent

A

Yellow, greenish, thick

78
Q

What is undermining?

A

A spot where the skin is no longer connected to the subcutaneous fat/muscle.

79
Q

What is slough?

A

Yellow fibrinous tissue of fibrin, pus, proteinaceous material. Can be found on the surface of a previously clean wound bed. Thought to be associated with bacterial activity.

80
Q

What are the two types of forceps typically in an NUNM suture pack?

A

Smooth Adson forceps
Brown-Adson Toothed Forceps

81
Q

Know the difference between the structure and use of needle holders vs. hemostats.

A

Needle Holders: Straight and short knurled jaws to prevent needle from rolling.

Hemostats: Crosshatched/toothed surface in contrast to needle holders. Used to retrieve foreign bodies in wound, clamp bleeding vessels or tourniquet.

82
Q

What is the most commonly used scalpel blade for minor surgery?

A

15 (small lesions)

83
Q

What needle sizes are used: Aspirating a cyst/ganglion

A

14, 16, 18 - 1.5”

84
Q

What needle sizes are used: Drawing up anesthetics/bicarb

A

20, 21, 22 - 1” or 1.5”

85
Q

What needle sizes are used: Injecting anesthetics for minor surgery

A

25-30 gauge
Most common 27 gauge - 1” or 1.5”

86
Q

Which is better for healing: Inversion or eversion of the skin?

87
Q

Most common needle size used at NUNM

88
Q

Any process that eliminates or kills all forms of life, including transmissible agents (such as fungi, bacteria, viruses, spore forms, etc). May not destroy prions.

A

Sterilization

89
Q

Destroy microorganisms (but not endospores and viruses) found on non-living objects by destroying the cell wall or interfering with the cell metabolism.

A

Disinfection

90
Q

Process of using heat, chemicals, or UV rays to kill most or nearly all microorganisms on skin, in wounds, on mucous membranes, on clothing, and on hard surfaces.

A

Antisepsis

91
Q

Name the commonly used antiseptics

A

Alcohol
Iodine
Chlorhexidine gluconate
Hydrogen peroxide
Nonionic surfactants

92
Q

What are the pros/cons of nonionic surfactants?

A

No adverse effects in wounds, but has no antibacterial actvitiy

93
Q

(True or False) Anesthetics (other than cocaine) are generally vasodilators

94
Q

What are the most widely used local anesthetic agents (Esters)

A

Procaine (Novocaine)
Tetracaine (Pontocaine)

95
Q

What are the most widely used local anesthetic agents (Amides)

A

Lidocaine (Xylocaine)
Bupivacaine (Marcaine)

96
Q

Which nerve fibers are most sensitive to actions of local anesthetics?

A

Small nerve fibers

97
Q

What are the benefits of adding epinephrine to injections?

A

Vasoconstrictive (stops bleeding), longer lasting effects

98
Q

With the administration of local anesthetics, what sensation or function disappears first and which follow in that order?

A

Sensation of pain, cold/warmth, touch, deep pressure, motor function

99
Q

Into which tissues is it not safe to inject local anesthetics containing epinephrine?

A

Ears, nose, fingers, toes, penis

100
Q

What is the purpose of adding sodium bicarbonate to local anesthetics?

A

Reduces pain, decreases the onset and increases the duration of local anesthetics.

101
Q

Allergic reaction is more common with (Esters/Amides)

102
Q

(Esters/Amides) are hydrolyzed by plasma esterase and excreted via the kidneys

103
Q

(Esters/Amides) are primarily metabolized by the endoplasmic reticulum in the liver

104
Q

Ester or Amide?
Procaine (Novocaine)

105
Q

Ester or Amide?
Tetracaine

106
Q

Ester or Amide?
TAC Topical

107
Q

Ester or Amide?
Opthaine (Proparacaine Hydrochloride)

108
Q

Ester or Amide?
Cetacaine (Rostra Spray)

109
Q

Ester or Amide?
Lidocaine (Xylocaine)

110
Q

Ester or Amide?
Bupivacaine (Marcaine)

111
Q

Ester or Amide?
Mepivacaine

112
Q

Ester or Amide?
Prilocaine (EMLA cream)

113
Q

TAC Topical indications

A

Sutures, pediatric pts

114
Q

Opththaine indications

A

Topical eye application
Ocular pressure testing

115
Q

Cetacaine (Rostra Spray) indications

A

Mucous membrane (NOT conjunctiva)
Skin tag in mouth
Overriding gag reflex

116
Q

Lidocaine duration with and without epi

A

Without 30-60 min
With 120-360 min

117
Q

Buprivacaine (Marcaine) onset and duration

A

2-3 hour duration
Slow onset 8-12 min

118
Q

(True or False) Mepivacaine can be used with epi

A

False, it is already slightly vasoconstrictive

119
Q

Prilocaine (EMLA cream) onset and duration

A

1 hour onset
4 hour duration

Derm (1 decks)

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