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Plastic Surgery( Grabb)Ali jasim > Hand infection > Flashcards

Hand infection Flashcards

1
Q

Patients who use tobacco should be expected to have slower
healing.

A

T

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2
Q

The location of
wounds can influence decision-making.

A

T

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3
Q

Signs of progressing infection

A

pain with passive ROM and
ascending lymphangitis,

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4
Q

A critical step in the workup of hand infection is determining
whether a patient needs hospitalization versus outpatient management

A

T

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5
Q

Hospitalization Indications

A

ascending lymphangitis,
a failed trial of oral antibiotics,
systemic symptoms,
elevated white blood cell (WBC) count,
needing operative intervention,
a high risk of not following-up.

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6
Q

indications
for surgical management

A

Fluctuance, purulent drainage, and worsening pain

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7
Q

MRSA infections tend to present with more skin
necrosis

A

T

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8
Q

Immunocompromised
patients are more susceptible to fungal, mycobacteria

A

T

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9
Q

Tissue culture will be
more reliable than culture swabs

A

T

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10
Q

Elevation and rest are standard treatment adjuncts for infection
and are important components of pain management.

A

T

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11
Q

position of function

A

wrist extended 30°, MCP flexed 90°, digits extended

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12
Q

Hand soaks are commonly used in the acute setting and rehabilitation phase,

A

T

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13
Q

report better pain
control and ability to perform ROM exercises when the hand is submerged in warm solution

A

T

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14
Q

, treatment comprises hand soaks, oral antibiotics, and hand elevation. A first-generation cephalosporin of acute paronychia

A

T

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15
Q

I + D is performed by incising the skin longitudinally

A

T

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16
Q

Chronic paronychias present as longstanding induration, pain, erythema along the nail fold, nail plate ridges, elevation of the skin off the
nail plate, and occasional drainage

A

T

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17
Q

The nail plate may be thickened and
discolored in chronic paronychia

A

F The nail plate may be thickened and
discolored due to concomitant onychomycosis

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18
Q

antifungal coverage for Candida albicans with nystatin or itraconazole is generally required, along with marsupialization (excision of
semilunar patch of eponychial skin and subcutaneous tissue down to
the germinal matrix

A

T

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19
Q

Topical gentian violet is a historic treatment for
chronic paronychia that is gaining popularity again

A

T

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20
Q

Because of the
extensive septae within the pulp, infection remains localized within a
small compartment

A

T

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21
Q

A felon can present without swelling

A

T throbbing
pain, often without visible external swelling until infection is advanced

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22
Q

scars can become hypersensitive

A

T

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23
Q

Delay in I + D of these abscesses can result in pulp necrosis,
osteomyelitis, or extension of infection into the flexor sheath.

A

T

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24
Q

Untreated infectious tenosynovitis leads to

A

stiffness, chronic
pain, osteomyelitis, and ascending limb-threatening infection

25
Q

If caught within 24 to 48 hours with mild or equivocal Kanaval signs, treated with with IV antibiotics, rest, elevation, and inpatient monitoring alone

A

T

26
Q

Whom should
undergo surgical decompression in the operating room

A

Anyone presenting with symptoms longer than 48 hours, Kanaval
signs, or worsening symptoms with conservative management

27
Q

hand therapy can be
started 24 to 48 hours after surgery

A

T

28
Q

indicators of a poor prognosis.in flexor tenosynovitistes

A

Subcutaneous purulence and
digit ischemia on presentation

29
Q

the most common hand infection

A

Cellulitis

30
Q

Indication of admission with cellulitis

A

Ascending lymphangitis, elevated WBC, altered mental status, or lack of response to oral
antibiotics warrant inpatient admission and IV antibiotics

31
Q

Surgery is
not indicated for cellulitis

A

T

32
Q

X-rays should be performed if there is suspicion
of a retained foreign body or fracture in case of fight bite fracture

A
33
Q

Fight bites require exploration of the wound to rule out jointspace infection, as the MCP joint is violated in 70% of cases.

A

T

34
Q

Percentage of deep space infection?

A

Deep-space infections comprise 5% to 15% of all hand infections

35
Q

abscess in the thenar region after a puncture wound will be blocked from moving ulnarly toward the small finger by the mid palmar septum

A

t

36
Q

collar button abscess can moved proximally through the parona space

A

F collar button abscess originating
volar webspace and confined distally, because the strong palmar aponeurosis blocks infection from spreading proximally

37
Q

collar button abscess spreads dorsally into the dorsal subcutaneous tissues

A

T

38
Q

Collar button abscesses
generally require volar and dorsal incisions for complete drainage;

A

T

39
Q

Thenar abscesses
can be managed with a dorsal incision and dissection between the
first dorsal interosseous and adductor pollicis muscles.

A

T

40
Q

transverse incisions within the webspace cause adduction contractures and should be avoided.

A

T

41
Q

There are two types of of necrotizing faciates

A

type 1, involving multiple anaerobic and aerobic bacteria, and
type 2, involving group A Streptococcus
and Staphylococcus sp

42
Q

MRSA has been isolated in up
to 39% of cases

A

T

43
Q

Signs of hemodynamic
instability, such as hypotension, tachycardia, and altered mental status are indicative of septic shock.

A

T

44
Q

A classic sign of necrotizing fasciitis is

A

cloudy dishwasher drainage,
due to necrosis of the fascia.

45
Q

Amputation must be considered in the setting of
advanced muscle necrosis and septic shock

A

T

46
Q

Patients should be placed in the intensive care unit if
there is any concern of hemodynamic instability

A

T

47
Q

Patients will
generally need extensive soft tissue reconstruction once infection is
cleared

A

T

48
Q

Because joints are avascular
immune privileged sites

A

T

49
Q

Haemophilus influenza (in children), and
Neisseria gonorrhoeae are the most common pathogens in septic arthrites

A

T

50
Q

The wrist joint is
opened via a longitudinal dorsal skin incision

A

T

51
Q

Automated pulse lavage is
avoided, because the excessive pressure can damage cartilage

A

T

52
Q

Mycobacteria are notoriously
difficult to culture; suspicion should be raised for mycobacteria when
rice bodies are found at time of debridement or granulomas are
found on pathology

A

T

53
Q

Sporotrichosis is a fungal infection more common in gardeners

A

T

54
Q

Herpetic whitlow causes a burning sensation for I or 2 days, followed by
erythema and blistering around the thumb of fingers

A

T

55
Q

Tzanck smear confirms diagnosis.

A

T

56
Q

Aggressive
debridement and unroofing of vesicles is ill-advised and can predispose patients to bacterial superinfection

A

T

57
Q

The standard
for diagnosing osteomyelitis is bone biopsy

A

T

58
Q

The ideal time to treat a hand infection is within the first 24 hours

A

T

59
Q

Any wound present for longer than 6 months should be biopsied
to rule out cancer,

A

T

Plastic Surgery( Grabb)Ali jasim (92 decks)

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