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minor surger brainscape Flashcards

1
Q

universal precautions (3)

A
  • blood and body fluids of all patients should be consider infections
  • barriers and sharps
  • Hep B is most commonly transimitted infection
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2
Q

what is the most commonly transmitted infection?

A

Hep B

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3
Q

autoclave sterilization method

A

15 PSI @ 121 degrees C for 15 min

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4
Q

Dry heat

A

320 degrees F for 60 min

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5
Q

boiling

A

> 30 min

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6
Q

2% glutaraldehyde

A
  • 10 min to disinfect

* 10 hr to sterilize

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7
Q

how is intact skin disinfected?

A
  • 10% betadine three times OR

* 0.4% chlorhexidine gluconate

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8
Q

how are open wounds disinfected?

A

irrigation with normal saline

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9
Q

name the types of wounds

A
  • puncture
  • abrasion
  • laceration
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10
Q

when to refer a puncture wound?

A

when any nerve, tendon, joint, or chest/abdomen involved

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11
Q

what do you do if a large item is involved with a puncture wound?

A
  • leave item
  • stabilize
  • secure and refer
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12
Q

normal procedures with a managable puncture wound

A
  • clean
  • debride
  • leave open with sterile dressings
  • consider tetanus shot
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13
Q

normal procedures with abrasions

A
  • clean
  • debride
  • dress
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14
Q

time frames when not to suture a laceration

A
  • 8-12 hours on body

* 24 hours on face

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15
Q

what is a keloid scar?

A

scarring that occurs beyond area of wound

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16
Q

name the stages of healing?

A
    1. hemostasis
    1. inflammation
    1. proliferation
    1. remodeling
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17
Q

characteristics of hemostasis

A

coagulation and formation of fibrin clot

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18
Q

characteristics of healing, time frame

A
  • hemostasis, begins immediately
  • inflammation, proceeds from days 1-4
  • proliferation days 3-21
  • remodeling 3 weeks to 18 months
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19
Q

characteristics of healing, name cellular involvement

A
  • platelets (secrete cytokines)
  • neutrophils within 5-6 hours, last 3-4 days to destroy bacteria
  • macrophages (inflammation to repair and phagocytize)
  • basal cells migrate to wound within 24-48 hours
  • keratinocytes proliferate 1-2 days after injury
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20
Q

characteristics of healing, proliferation

A
  • post hemostasis, inflammation
  • days 3-21
  • granulation tissue = new capillaries + fibroblasts
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21
Q

characteristics of healing, remodeling

A
  • 30-40% strength at 3 weeks

* 80% at 1 year

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22
Q

what is contracture in regards to healing?

A

abnormal formation of tight scar due to excessive contraction.

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23
Q

suture type: difficult to evert skin, “railroad track”

A

simple interrupted

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24
Q

suture type: better to evert skin and cosmesis

A

vertical mattress

25
Q

suture type used for larger deeper wounds

A

deep / buried

26
Q

suture type with high risk of infection

A

continuous running

27
Q

absorbable sutures reactivity

A

plain catgut > chromic catgut > synthetic sutures

28
Q

half life of plain catgut

A

7-10 day

29
Q

suture types with 2-3 week half life

A
  • chromic catgut
  • polyglactic/vicryl
  • polyglycolic/dexon
30
Q

suture with longest half life

A
  • 4-6 weeks

* polydioxanone/PDS

31
Q

remove sutures on face / neck after

A

3-5 days

32
Q

remove sutures on arm / hands after

A

7-10 days

33
Q

remove sutures on trunk / legs after

A

7-14 days

34
Q

remove sutures on feet / scalp after

A

7-14 days

35
Q

10 cc of 1% = ___ mg

A

100 mg

36
Q

1 cc of 1% = ___ mg

A

10 mg

37
Q

metabolizes amide anesthetics

A

liver

38
Q

amide anesthetics

A
  • lidocaine
  • bupivacaine
  • mepivacaine
39
Q

onset and duration of lidocaine

A
  • 1-10 min onset

* 30-60 min duration

40
Q

max dose for lidocaine

A
  • child 3.3-4.5 mg/kg max 75-110 mg

* adult 4.5 mg/kg max 300 mg

41
Q

onset and duration bupivacaine

A
  • 8-12 min onset

* 3-4 hour duration

42
Q

onset and duration of mepivacaine

A
  • 8-12 min onset

* 2-2.5 hour duration

43
Q

metabolizes ester anesthetics

A

peripheral plasma

44
Q

topical esters

A
  • benzocaine
  • proparacaine
  • cocaine
  • tetracaine
45
Q

infiltrative esters

A

procaine / novocaine

46
Q

toxic adverse reactions of anesthetics

A

CNS depressant > hypotension > bradycardia > cardiac arrest

47
Q

TX for toxic amounts of anesthetic

A

O2

48
Q

adverse reactions are more common in type of anesthetics

A

esters

  • benzocaine
  • proparacaine
  • cocaine
  • tetracaine
  • procaine/novocaine
49
Q

why use epinephrine?

A
  • decrease oozing/bleeding
  • prolongs duration / decreases absorption
  • risk toxic reaction
50
Q

dose of epinephrine

A

1 : 200,000, max of 0.2 mg

51
Q

antidote to epinephrine

A

Magnesium and B6 to push COMT metabolism

52
Q

never use epinephrine with

A
  • end-arteries
  • MAOi
  • TCAs
  • thyrotoxicosis
  • severe CVD
53
Q

minor surgery procedures NDS cannot perform

A
  • locations: eyes, nose, axilla, groin, neck
  • large size / blood supply
  • depth
  • young children
  • patient taking anti-coagulant or bleeding d/o
  • pulsating lesion
  • keloid formers
  • immunocompromised
54
Q

blade used in excisional biopsy

A

15

55
Q

length ratio in excisional biopsy

A

3 to 1

56
Q

degree angle of ends of excisional biopsy`

A

30 degrees

57
Q

space necessary for punch biopsy

A

1-2mm beyond border

58
Q

blunt dissection, excision, trimming

A
  • # 15
  • # 10 for thick skin
  • metzenbaum for blunt dissection
59
Q

puncture abcess and stabbing

A

11

0 minor surgery (1 decks)

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