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Minor Surgery > Midterm (not covered in review) > Flashcards

Midterm (not covered in review) Flashcards

1
Q

What size syringe for irrigation?

A

20ml

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2
Q

Size of suture for Face/Head vs General Body

A

Face/Head: 5-0, 6-0, 7-0

Gen: 3-0, 4-0, 5-0, 6-0

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3
Q

MC synthetic polymer suture material that is ABSORBABLE

A

Vicryl

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4
Q

MC absorbable on skin?

A

Nylon

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5
Q

Most effective method of instrument sterilization?

A

Chemical

- ethylene oxide or ozone gas

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6
Q

Dry and Cold Sterilization?

A

not very useful.
Cold is Least Effective
Dry - in emergencies

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7
Q

what antiseptic is good for mucous membranes like the vagina?

A

iodine and iodophor solutions

  • requires 2min of contact time
  • rapidly inactivated
    ex. Betadine
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8
Q

MC iodophor for pre-surgical antiseptic use?

A

Povidone-iodine (Betadine)

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9
Q

What is Hibiclens?

A

good alt to iodophors

  • 6+ hrs action on skin
  • good on kids
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10
Q

nonionic surfactants

  • good and bad?
A

good for eye and cornea
- no antibacterial activity

  • it’s a newer type of would cleanser
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11
Q

What is the 1st line of defense against invasion of secondary infx?

A

sterile technique… proper sterile field

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12
Q

one of the most important Q’s to ask pt is?

A

gums bleed?

–> blood dyscrasia

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13
Q

What does PARQ stand for?

A

procedure
alternatives
risk
Q’s

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14
Q

in pre-op Dx section of minor surgery report form, put?

A

reason the lesion was removed

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15
Q

Anesthetics other than _____ are generally _______.

A

cocaine

vasodilators

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16
Q

amides metabolized by?

esters by?

A

amides: LR ER
esters: KD - plasma esterase

17
Q

What may diminish effects of local anesthetics?

A

hypercalcemia, hypernatremia, hypokalemia

18
Q

actions of local anesthetics:

A
  1. sensation of pain
  2. temp
  3. touch
  4. pressure
  5. motor
    * recovered in reverse order
19
Q

side effects of inadvertent intravascular admin… esp if they contain what?

A

EPI

- LOC, convulsions, CV - hypotension, fatigue, depress contractions of SM, asthma

20
Q

EPI effects

A
  • vasoconstrictor makes surgery easier bc less bleeding
  • prolongs duration of anesthesia by retarding absorption
  • minimized amt anesthesia needed
  • so decreases toxicity

BAD: hypoxic damage - aka no digits, genitalia

21
Q

Red label anesthetic bottles

A
  • contain EPI

- blue dont

22
Q

full vasoconstriction w EPI requires how long?

A

5-10min

  • (commercially premixed: 1:100,000)
  • (added to lidocaine 1:200,000)
23
Q

strengths of anesthetics w EPI greater than ______ increase risk for side-effects

A

1:100,000

24
Q

EPI is labeled “pregnancy category C” bc?

A

shown to reduce uterine blood flow in animals —> may induce premature labor

25
Q

MAO inhibitors can cause a _________ by creating a pool of endogenous catecholamines

A

hypertensive crisis

* don’t use local anesthetics on pts taking MAO inhibitors

26
Q

Tetracyclics in the presence of exogenous EPI can produce _____?

A

a prolonged HTN crisis and dysrhythmia

27
Q

less than ____ of pts receiving local anesthetics see a true allergic response

A

1%

* rarely see outright anaphylactic shock

28
Q

commonly used drugs for topical anesthesia?

effective where?

A

cocaine, tetracaine, lidocaine

- effective for mucous membranes (nose, mouth, throat, tracheobronchial tree, esoph, GU tract)

29
Q

Infiltration Anesthesia (is local) is when injection into tissue wo considering course of cutaneous nerves

  • adding epi does what?
  • procedure?
A
  • doubles duration of action
  • decreases total amts used by 33%
  • Procedure: inject around/within skin
30
Q

Strength of anesthesia for field block?

procedure:

A
  • same or higher than infiltration
  • less drug can be used to provide greater area of anesthesia
  • Procedure: inverted V
  • provide anesthesia distal to site of injection
31
Q

if uncertain which anesthetic may cause a drug rxn, use?

A

methyl paraben preservative-free, single dose ampoules

32
Q

Cocaine

  • concentration, max dose
  • onset, duration
  • mechanism of action
A
  • 4%, 200mg
  • almost immediate, 120min
  • prevents uptake of NE at synapses
33
Q

topical opthalmic drop is what?

A

tetracaine

34
Q

Lidocaine

  • max dose
  • duration
A
  • 300mg

- 1.5-2 hrs

35
Q

EMLA - whats so special?

A
  • bridges gap bet topical and infiltration anesthesia - depth of 5mm
  • safe for genital, mucous membranes
  • dont apply to broken, inflamed skin
36
Q

ethyl chloride is a?

- duration

A

vapocoolant

- 15-60 sec

37
Q

early warning signs of ANAPHYLAXIS

A
  • warmth flushing
  • itching
  • lightheadedness
  • sudden fatigue
  • sense of “something not being right”
  • —–> STOP, then find EPI, Benadryl, and O2
38
Q

Rapid ANAPHYLAXIS Tx

A 
EPI HCL 1:1000
0.3-0.6 cc subQ or IM
- repeat every 15-30min as needed
- avoid toxicity (scs - HTN, chest pain, tachycardia, HA)
- admin. 02 w mask 
- admin. benadryl
TO HOSPITAL
39
Q

EPI pen concentration

A

1: 1000

- (epipen jr is 1:2000)

Minor Surgery (3 decks)

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