Minor Surgery Flashcards
Which local anesthetic ia an amide prototype?
Lidocaine
Which local anesthetic is an ester prototype?
Procaine
Which local anesthetic should you NEVER deliver IV?
Bupivacaine - due to slow onset and long duration
Which size scalpel is used for I&D?
11
Which size scalpel is used most often for biopsy and excision?
15
Which size scalpel is used for areas of thick or tough skin?
10
What are the adverse effects of lidocaine systemically?
Drowsiness, heart block, arrhythmias
When you use forceps with and without teeth?
w/ - tissue handling
w/o - suture, foreign body, ok to crush
What is the formula for maximum dose of a local anesthetic?
(Pt wt x Max dose in mg/kg )/10
What is the max dose for lidocaine? w/ epinephrine?
3-4mg/kg
7mg/kg
Where is lidocaine metabolized?
Liver
Where is procaine metabolized? What is the metabolite?
Peripherally - plasma enzymes. PABA
10cc of a 1% solution of lidocaine contains how much lidocaine?
100mg
1cc of a 1% lidocaine solution contains how much lidocaine?
10mg
When would you avoid using epinephrine?
Distal procedures - ears, nose, fingers, toes, clit, penis
What is a sign of local anesthesia CARDIOVASCULAR TOXICITY?
Hypotension
What is the best treatment for a TOXIC reaction?
Oxygen
What suture type has the highest likelihood of tissue reaction?
Chromic gut
What would be indications for a non-absorbable deep suture?
Tendon repair
How are sutures sized?
As the number goes higher, suture becomes smaller (similar with IV catheters). Smallest suture 6-O
What type of suture is Nylon (absorbable/nonabsorbable, synthetic/natural)
Non Absorbable, synthetic
What are the four cardinal signs of purulent tenosynovitis?
1) Slight finger flexion 2)Fusiform swelling of the finger
3) Pain on passive or active extension of the finger
4) Tenderness along the tendon sheath into the palm
Contraindications to I&D include…
Recurrent abscesses
Term: Destruction of all living microorganisms including bacterial spores
Sterilization
What is Universal Precaution?
Blood and body fluids of all patients should be considered potentially infectious, washing hands and sterilization, OSHA enforces
What type of suture provides less resistance as it passes through tissue and is least likely to harbor bacteria?
Monofilament - i.e. Nylon
Which intention: wounds too contaminated to close initially but may be closed after 3-4 days post tx
Tertiary intention
Term: disruption of blood vessels, extravasation of blood constituents, initiation of the coagulation cascade and formation of a fibrin clot
Hemostasis
Which intention: approximated wound that is sutured immediately
Primary intention
Which intention: unable to close wound, dehiscence, allowed to heal from the inside out
Secondary intention
This stitch is great for everting skin edges and precise approximation of wound edges with little tension.
Vertical mattress
The easy and most versatile stitch can cause “railroad track” scarring
Simple interrupted
Urea paste dissolution and antifungal oral medications are appropriate treatments for what condition?
Onychomycosis
What type of cyst can be treated by simple rupture by pressure, simple aspiration, or surgical excision?
Ganglion cyst - an aneurysm in the tendon sheath that tend to recur
This stitch is used for triangular flaps.
Half-buried mattress
This stitch is placed in the dermis and is not visible. It works best in wounds where there is minimal tension and a clean, linear wound.
Subcuticular running
What nutrient/enzyme is known to promote wound healing?
Bromelain
Most common organism to cause wound infections.
Staph aureus
What type of suture is steel (absorbable/non absorbable, braided/monofilament)
Non absorbable, monofilament
Poor hemostasis can cause what to form?
Hematoma
This regional nerve block is useful for providing anesthesia to the tip fo the little finger.
Ulnar
This regional nerve block is injected into the anatomical snuff box to provide anesthesia to the lateral aspect of the proximal thumb.
Radial
For the trunk, legs, feet or scalp, use the following type (size) of suture and remove after how many days?
3-O, 7-14 days
Is cryotherapy indicated for cervical warts?
Yes. NOT for melanoma, SCC, and BCC
T/F: Electrocautery is indicated for actinic keratoses.
T
Elliptical excisions should have a length to width ratio of _____ with corners at ___ degree angles.
3:1, 30
Elliptical excisions should ideally be made with a # ____ blade, initially cutting ____ to the skin.
15, perpendicular
Most dangerous skin tumor
Malignant melanoma
Indicated treatment for infections that result in a collection of purulent material in a circumscribed and closed cavity.
I&D
Term: benign tumor of encapsulated fat arising from the subcutaneous fascia.
Lipoma
