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Procedures > Final Reverse > Flashcards

Final Reverse Flashcards

1
Q

Plaster is:1. Easier to mold but more thermogenic - skin burns2. More absorbent - exudates3. Longer to harden - 10 min & fully by 8hFiberglass1. Hardens fully w/in 1-2h2. More expensive3. Require protective gowns due to resin

A

Plaster vs. fiberglass splints

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2
Q
  1. Tx of simple nondisplaced Fx2. Immobilize closed reduction of joints & Fx3. Tx severe sprains & strains4. Tx congenital deformities5. Manage chronic foot & ankle conditions
A

Indications of casts

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3
Q
  1. Before 3-4 days of injury (compartment syndrome)2. Concealing infection
A

Contraindications to casts

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4
Q
  1. Cast dermatitis2. Pressure sores - ulcers3. DVT4. Nerve injury5. Transient muscle atrophy & joint stiffness6. Compartment syndrome
A

Complications of casts

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5
Q

Tx achilles tendonitisEvery other time - keep at 90 degrees

A

When would you splint the ankle in equines position?

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6
Q
  1. Scaphoid Fx2. DeQuervian’s
A

Thumb spica splint

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7
Q

Fx of 4th/5th metacarpals/digits

A

Ulnar gutter splint

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8
Q
  1. Metacarpal Fx2. Soft tissue injury3. Carpal tunnel
A

Volar wrist spint

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9
Q
  1. Distal radial (Colles)2. Ulnar Fx
A

UE sugar-tong splint

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10
Q
  1. Tibia injury2. Fibula injury3. Jones Fx
A

Short leg posterior splint

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11
Q

Posterior ankle injuries

A

Lower leg sugar tong “stirrup” splint

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12
Q
  1. Removal of post traumatic/non-traumatic knee effusion - relief of pain2. R/o suspicious Dx3. Need for fluid analysis (GS, culture, cell counts, crystal analysis, PCR)
A

Indications for arthrocentesis

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13
Q
  1. Burns, infected tissue2. Prosthetic joints - needs referral3. Hemarthrosis when underlying coagulopathy has not been corrected
A

Contraindications for arthrocentesis

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14
Q
  1. Bleeding, infection, cartilage damage, fluid reaccumulation 2. Injury to neurovascular structures3. Allergic rxns to meds For bursal aspiration also:1. Development of a chronic sinus tract - especially when bursa connects to the joint2. Spreading RA to the bursa
A

Complications for arthrocentesis

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15
Q

Max extension - lateral approach Space medially btwn the femoral condyles & behind the patella

A

Where is the best site to aspirate a knee?

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16
Q
  1. Arthropathies2. Bursitis3. Tendonitis4. Plantar fasciitis5. RA6. Ganglion cysts7. Trigger points8. Carpal tunnel9. Neuromas
A

Indications for joint ejections

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17
Q
  1. Prosthetics2. Tumors3. Infections4. Neuro conditions5. Bleeding issues
A

Contraindications to joint injections

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18
Q

Olecranon

A

What is the most accessible bursa?

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19
Q

Posteriolateral humeral head Fx

A

What is a Hills-Sachs lesion?

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20
Q

Fx or tear of the glenoid ligament or bone

A

What is a Bankhart lesion?

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21
Q

Axillary nerve damage

A

Pt presents w/ paresthesias associated with a shoulder dislocation..what should you suspect?

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22
Q
  1. Stimson technique/Milch maneuver2. Kocher maneuver3. Hippocratic maneuverConscious sedation w/ Fentanyl & Midazolam Velpeau sling Old people move at 3wks, young 6 wksVigorous motion old people 6 wks, young 3 mo
A

How do you reduce a shoulder dislocation?

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23
Q

Shoulder reductionPt prone, arm hanging with 5-15lb wt, traction w/ rotationDoesn’t work w/ adhesive capsulitis

A

Stimson technique

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24
Q

Shoulder reduction Slow external rotation w/ a downward traction

A

Kocher maneuver

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25
Q

Shoulder reductionLongitudinal traction w/ contralateral pulling to reduce humeral head

A

Hippocratic maneuver

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26
Q

MCP dorsal dislocations

A

Which type of finger dislocations might need open reductions?

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27
Q

Digital lidocaine blockAxial traction & flexionFull extension splint for 6 wksDIP? Same but splint in flexion for 2-4wks

A

How to reduce PIP dislocations?

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28
Q

Thumb

A

MC MCP joint dislocation?

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29
Q
  1. 4 or more2. Facial furuncles from nose bridge to corners of the mouth3. Perianal abscesses w/ rectal extension
A

Contraindications to abscess drainage

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30
Q

Hidradenitis Suppurativa Multiple recurrences - Need surgery

A

What should you suspect if Pt has abscesses in axilla & groin?

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31
Q

Warm compresses, continue breast feeding abx - Dicloxacillin, Bactrim Not responding? US to r/o abscess

A

Tx mastitis

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32
Q

MSSA & MRSA Tx - I&D + Keflex +/- Bactrim Allergic? Clindamycin or DoxyRefractory? Tigecycline

A

MC organisms causing abscesses

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33
Q
  1. Peritonsillar/retropharyngeal2. Ant. triangle of neck3. Supraclavicular fossa4. Deep axillary5. AC space 6. Groin7. Popliteal space
A

Concerning anatomic locations for draining abscesses

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34
Q
  1. > 5mmPLUS2. Cellulitis3. Comorbidities4. FB penetrating wounds/bites
A

When to give abx after draining abscess?

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35
Q

Nail matrix ablation w/ 88% phenol soln.

A

How to prevent ingrown toenail from regrowing?

36
Q

DressingBreaks down tissue…good for necrosis

A

What is DuoDerm & what is it used for?

37
Q

Xeroform

A

What type of dressing keeps a moist wound bed?

38
Q

TelfaAvoid removing new tissue

A

What type of dressing is non-adherent?

39
Q

Occlusive

A

What types of dressings should you avoid with PVD?

40
Q

Insides come out

A

What is evisceration?

41
Q

Separation

A

What is dehiscence?

42
Q

ex. AlgiDERM & AlgisiteFrom brown seaweed - absorb 20x their weightBest for infected wounds w/ heavy exudate

A

What are alginates & when are they used?

43
Q

Ex. E-Z DermGel/film for partial thickness wounds like burns/abrasionsBarrier protection, moist environment, minimizing protein loss & pain

A

What are Biosynthetic dressings & when are they used?

44
Q

Ex. BCG MatrixUsed in non-infected areas, partial & full thickness wounds except 3rd degree burnsPromotes debridement & granulation via extra collagenRequires another primary dressing to absorb exudate

A

What are collagen dressings & when are they used?

45
Q

Ex. MepilexAbsorbent & protective for skin tears & granulating woundsCan be primary/secondary dressings

A

What are foam dressings & when are they used?

46
Q

Ex. DuoDERMFor necrotic woundsNot for heavy exudates/infected wounds

A

What are hydrocolloids & when are they used?

47
Q

Ex. Aquacel Can be used as fillerGood for moderate exudate to maintain moist bed for granulation Allows for autolytic debridemnet Conforms to wound

A

What are Hydrogel dressings & when are they used?

48
Q

Ex. TegadermSecondary dressingWaterproof & microbial resistant - allows excess moisture to evaporate

A

What are transparent film dressings & when are they used?

49
Q

Negative pressure wound therapyExposed vital structures, florid infection, CA, ischemic wounds, fragile wounds. allergies Mechanism: Inc. blood flow, dec. inflammation/bacterial burden/devitalized tissue

A

When should you avoid wound vacs?

50
Q
  1. Intact skin - blanchable erythema2. Partial thickness tissue loss involving epidermis +/- dermis 3. Full thickness - NOT into underlying fascia4. Full thickness w/ extension into underlying structures
A

Decubitus ulcers

51
Q

Aggressive SCC in area of chonic inflammation

A

What is a Majolin ulcer?

52
Q

Removes part of epidermis & upper dermis Snip, saucerization (deep shave), curettageContraindicationsL1. Melanoma/dysplastic nevi2. Hair/dermal components3. Suspected sclerosing BCC

A

Shave Bx

53
Q

Incisional - removes part of lesionExcisional - removes whole lesion2-8mm Heal by secondary intention

A

Punch Bx

54
Q
  1. Chest2. Upper back 3. Arms
A

Which areas are high risk for keloids?

55
Q

Drysol / cautery

A

How do you stop bleeding after shave Bx?

56
Q

NO

A

Is curettage sent to pathology?

57
Q

> 8 mm Use ellipse pattern w/ 4:1 length:width ratioAbx?Groin, lower extremities, high risk, prosthetic materials, oral lesions

A

What size lesions should you excise?

58
Q

Pts w/ implantable electronic devisesFacial PPE required - respirator or high filtration face mask

A

When should you avoid electrosurgery?

59
Q

Shave

A

What type of Bx should you use for facial lesions?

60
Q
  1. Median cubital - MC for phlebotomy2. Cephalic3. Basilic
A

What veins are in the antecubital fossa?

61
Q

No more than 2 mins

A

How long can the tourniquet be left on?

62
Q
  1. Blood cultures2. Red 3. Gold4. Light blue5. Green/Lavender6. Gray
A

CLSI recommended order of blood draw

63
Q

q72h

A

How often should an IV catheter be changed?

64
Q
  1. Ammonia2. CO23. Lactate
A

When is arterial sampling preferred over venous?

65
Q
  1. No arterial pulse2. Abnormal allen test3. Arterial disease4. Coagulopathy5. AV shunt6. Cellulitis7. Uncooperative Pt
A

Contraindications to arterial puncture?

66
Q
  1. Blood - 15-302. IV - 15-303. Arterial - 40-604. Arterial line 30-455. Intradermal - 15 6. SQ - 457. IM - 90
A

Angles for blood punctures

67
Q
  1. BP monitoring2. Frequent blood gas sampling
A

Indications for arterial line

68
Q

Influenza & yellow fever

A

Allergic to eggs, which vaccines should you avoid?

69
Q

Hep B

A

Allergic to Baker’s yeast, which vaccines to avoid?

70
Q

Varicella

A

Allergic to gelatin, which vaccines to avoid?

71
Q
  1. MMR2. Varicella3. Live attenuated flu4. Yellow fever
A

Which vaccines should pregnant & IC avoid?

72
Q

Slow absorption - good for delayed rxnsVolar forearm best - distal to AC space15 degrees - DONT massage

A

Intradermal injections

73
Q

Optimal abs. in fatty regionsBetter w/ lipophilic & lower volume drugs Good locations: lower abd, thigh, lower lat back

A

SQ injections

74
Q

Best absorptionHighly vascular Best sites - deltoid, vastus lateralusVentrogluteal - risk of sciatic nerve injury3 deltoid

A

IM injections

75
Q

IM - more risk of sciatic nerve injuryV technique

A

Technique for ventrogluteal injection

76
Q

No - IM vaccines don’t need to aspirate

A

IM injection of flu vaccine, do you need to aspirate first?

77
Q
  1. > 60 min surgery2. ICU postop3. Procedure involving urinary tract, prostate, colon/rectum or major GYN 4. Limited mobility postop
A

Indications for urinary cath in surgical Pts

78
Q
  1. Injury - blood clot at meatus Relative - urethral stricture, recent urinary tract surgery
A

Contraindications to urinary cath

79
Q

F - 3.5-5 cmM - 15-17 cm 3 cuvres - penile, membranous, prostatic

A

Length of urethra

80
Q

Age/2 + 8 Infants <6mo. - feeding tube 5F

A

What size urinary cath to use in kiddos?

81
Q

18-20 F

A

Urinary cath size w/ BPH?

82
Q
  1. Rectal bleeding2. Anorectal pain3. Pruritis4. Anal discharge5. Mass found on DRE
A

Indications for performing anoscopy

83
Q
  1. Severe rectal pain 2. Perirectal abscess, acutely thrombosed hemorrhoid, anal fissure3. Imperforate anus/severe anal stricture 4. Recent anorectal surgery
A

Contraindications for anoscopy

84
Q

Pregnancy

A

Contraindication for endometrial Bx?

85
Q
  1. Abnl bleeding2. Postmenopausal bleeding3. Amenorrhea for 1 yr4. Endometrial dating of menstrual cycle5. Infertility6. Response to hormonal therapy7. Atypical glandular cells on Pap8. Prior Dx of endometrial hyperplasia9. FH
A

Indications for endometrial Bx

86
Q

Test for presence of posteriorly dislocated hip Abduct hips until touching table - feel clunk as femur pops back into acetabulum

A

Ortolani test

87
Q

Test for ability to sublux or dislocate an intact but unstable hip Dislocates hipBring leg down - pull leg forward & adduct w/ posterior force

A

Barlow test

Procedures (4 decks)

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