Minor Surg Flashcards

1
Q

macule

A

< 1cm

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2
Q

papule, vesicle

A

<1cm

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3
Q

bullae

A

> 1cm, clear, fluid filled

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4
Q

hyperkeratosis

A

Stratum corneum, e.g. warts, corns, calluses

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5
Q

parakeratosis

A

psoriasis, dandruff

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6
Q

acantholysis

A

loss of desmosomes/keratinocytes

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7
Q

acanthosis

A

diffuse epidermal hyperplasia

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8
Q

Seborrheic keratosis

A

stuck on

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9
Q

dermatofibroma

A

secondary to trauma

cryo

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10
Q

lipoma

A

subQ, movable

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11
Q

Actinic keratosis

A

electrocautery, 5-FU

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12
Q

Karposi sarcoma

A

HHV-8, round oval papules on legs and mucosa

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13
Q

BCC and SCC incidence increased with what exposure

A

arsenic

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14
Q

BCC

A

Telangectasia surround
only grow where hair grows
Less likely to MET
5-FU, radiation, remove

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15
Q

SCC

A

Fast growing, crusty
more likely to bleed
Excision, Mohs

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16
Q

Melanoma

A

> 6mm = worse prognosis
acral- most aggressive
sup spreading - most common

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17
Q

Erysipelas

A

strep ifxn of sup lymph

demarcated borders

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18
Q

Cellulitis

A

strep ifxn of dermis

cephalexin, TMP/SMX

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19
Q

Rubella

A

cranial–>caudal
CLAD
fever

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20
Q

Measles

A

cough, coryza, conjunctivitis, Koplik spots
cranial–>caudal
**subacute sclerosing panencephalitis

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21
Q

Tinea versicolor

A

gold hue on woods lamp

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22
Q

Vitiligo

A

Tx: copper, vit D, phenylalanine

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23
Q

Erythema multiforme

A

Herpes, Mycoplasma, drugs

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24
Q

Steven Johnson Syndrome

A

Bactrim, Cephalosporins, Anti-convulsants, NSAIDs, allopurinol
+ Nikolsky sign
Cell-mediated cytotoxic reaction against keratinocytes leading to massive apoptosis

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25
Q

paronychia

A

cephalexin, compresses

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26
Q

Felon

A

subQ abscess

antibiotics, may need to filet open, I&D

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27
Q

Pemphigus Vulgaris

A

+ Nikolsky sign
Anti-Desmoglein antibodies
DEADLY
Methotrex, Cyclosporine, steroids

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28
Q

Granuloma annulare

A

small flesh papules

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29
Q

Psoriasis

A

Nail pitting

Arthritis

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30
Q

Rosacea

A

oral doxycycline

metronidazole

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31
Q

Lichen planus

A
papules
plaques
pruritic
purple
polygonal
planar
Wickham Striae

Assoc with Hep C
steroids + methotrex/cyclosporine

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32
Q

Brown recluse bite

A

Necrotoxic

Painful

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33
Q

Erythema Nodosum

A

lesions of subQ fat (ant shins)

Sarcoid, TB, Leprosy, Histoplasmosis, Coccidiomycosis, Crohn’s Dz

34
Q

Impetigo

A

staph or strep

mupirocin

35
Q

pityriasis rosea

A

harold patch

post URI

36
Q

Bullous pemphigoid

A

Bx: epidermal blisters and anti-basement membrane IgG

37
Q

Hairy leukoplakia

A

white painless patches, cannot be scraped off

EBV (HIV pts)

38
Q

2% glutaraldehyde

A

10 mins to disinfect

10 hrs to sterilize

39
Q

Boiling sterilizes..

A

> 30 mins

40
Q

Dry heat sterilizes

A

160C/320F x 1 hr

41
Q

Autoclave sterilizes

A

15 psi at 121 C x 15 mins

42
Q

Disinfect SKin

A

10% betadine x 3 or 0.4% chlorhexidine gluconate

43
Q

Don’t suture wounds older than

A

8-12 hrs (24 on face)

44
Q

Remodeling

A

30-40% strength by 3-4 weeks

80% at 1 year

45
Q

Vertical mattress

A

easy to evert under tension, better for cosmesis

46
Q

Horizontal mattress

A

high tension wounds and fragile tissue

palms/soles

47
Q

Continuous running

A

rapid, not cosmetic, less secure; high risk of infection - poor eversion

48
Q

Absorbable natural

A

catgut and chromic catgut

digested by enzymes

49
Q

Absorbable synthetic

A

polyglactic/vicryl
polyglycolic/dexon
polydioxanone/PDS

hydrolyzed by body

50
Q

Non-absorbable natural

A

silk
stainless steel
polyester/polybuster

51
Q

Non-absorbable synthetic

A

nylon

polypropylene/prolene

52
Q

Face/Neck sutures

A

5-0, 6-0; 3-5 days

53
Q

Arm/Hands sutures

A

4-0, 5-0; 7-10 days

54
Q

Trunk/Legs/Feet/Scalp

A

3-0, 4-0; 7-14 days

55
Q

Post-op

A

keep dry/limit movement x 24-28 hrs

56
Q

Infections most common

A

4-10 days post-op

57
Q

Hematoma

A

arises after 24-72 hrs

58
Q

Dehiscence

A

resuture in 48-72 hrs

59
Q

Amides

A

metabolized in liver
Lidocaine
Bupivacaine/Marcaine
Mepivacaine/Carbocaine

60
Q

Ester

A
metabolized in peripheral tissues by pseudocholinesterase
Benzocaine
Proparacaine
Cocaine
TAC 
Procaine/Novacaine
61
Q

Adverse Rxn to anasthetics

A

bradycardia, cardiac arrest, heart block - treat with high dose 02
allergy/HSN - diphenhydramine if mild, epi + oxygen if severe
autonomic - self-limiting

62
Q

Uses of Epi in anesthestics

A

decrease bleeding, oozing
prolongs duration by decr absorption
decreases risk of toxic rxn by decreasing amount of circulating anesthetic

63
Q

epi dose

A

1:200,000, max = 0.2mg

antidote = Mag and B6 (for COMT)

64
Q

Never use epi with…

A

TCAs, MAO-i, thyrotoxicosis, CVD

65
Q

NDs cannot perform…

A
Location- eyes, nose, axilla, goin, po nech
Large size/blood supply
Deep
Young children
Pt on anti-coag/bleeding disorder
Pulsating lesion
Keloid formers
Systemic illness/immunocomp
66
Q

Liquid Nitro for cryo

A

freeze, thaw, refreeze with 2-3mm zone around lesion for 10-30 s
blister - scab
may depigment

C/I malignancy, Raynauds, sensitive skin

67
Q

Electrosurgery

A

Sterile electrode with (+) destroys tissue and coagulates bv

C/I flammable ethanol, metal implants, jewelry

68
Q

Electrocautery

A

indirect electrical current. precise. no blood loss

69
Q

Hyfrecation

A

Direct, high frequency current. Precise, minimal blood loss

70
Q

Excisional bx

A

3:1 elliptical, 30 angle, #15 blade

parallel to Langer’s lines

71
Q

Incisional bx

A

narrow elliptic taken within a larger lesion to dx

72
Q

Shave

A

diagnostic and therapeutic. healing is rapid with min scarring

73
Q

Punch (aka trephine)

A

4mm most common. Full thickness of dermis with min scarring. Traction skin perpendicular to Langer’s lines. must go 1-2 mm beyond borders

74
Q

11

A

Puncture abscess, incisions, stabbing, I and D

75
Q

15

A

Blunt dissection, excision, trimming, elliptical excisions

76
Q

10

A

Like #15 for thick skin

77
Q

3

A

disposable

78
Q

Toothed adson forceps

A

does not crush skin. for suturing

79
Q

iris scissors

A

fine dissection, not for sutures

80
Q

Metzenbaum scissors

A

blunt dissection