Minor Surgery

Question 1

Which local anesthetic ia an amide prototype?

Answer 1

Lidocaine

Question 2

Which local anesthetic is an ester prototype?

Answer 2

Procaine

Question 3

Which local anesthetic should you NEVER deliver IV?

Answer 3

Bupivacaine - due to slow onset and long duration

Question 4

Which size scalpel is used for I&D?

Answer 4

11

Question 5

Which size scalpel is used most often for biopsy and excision?

Answer 5

15

Question 6

Which size scalpel is used for areas of thick or tough skin?

Answer 6

10

Question 7

What are the adverse effects of lidocaine systemically?

Answer 7

Drowsiness, heart block, arrhythmias

Question 8

When you use forceps with and without teeth?

Answer 8

w/ - tissue handling

w/o - suture, foreign body, ok to crush

Question 9

What is the formula for maximum dose of a local anesthetic?

Answer 9

(Pt wt x Max dose in mg/kg )/10

Question 10

What is the max dose for lidocaine? w/ epinephrine?

Answer 10

3-4mg/kg

7mg/kg

Question 11

Where is lidocaine metabolized?

Answer 11

Liver

Question 12

Where is procaine metabolized? What is the metabolite?

Answer 12

Peripherally - plasma enzymes. PABA

Question 13

10cc of a 1% solution of lidocaine contains how much lidocaine?

Answer 13

100mg

Question 14

1cc of a 1% lidocaine solution contains how much lidocaine?

Answer 14

10mg

Question 15

When would you avoid using epinephrine?

Answer 15

Distal procedures - ears, nose, fingers, toes, clit, penis

Question 16

What is a sign of local anesthesia CARDIOVASCULAR TOXICITY?

Answer 16

Hypotension

Question 17

What is the best treatment for a TOXIC reaction?

Answer 17

Oxygen

Question 18

What suture type has the highest likelihood of tissue reaction?

Answer 18

Chromic gut

Question 19

What would be indications for a non-absorbable deep suture?

Answer 19

Tendon repair

Question 20

How are sutures sized?

Answer 20

As the number goes higher, suture becomes smaller (similar with IV catheters). Smallest suture 6-O

Question 21

What type of suture is Nylon (absorbable/nonabsorbable, synthetic/natural)

Answer 21

Non Absorbable, synthetic

Question 22

What are the four cardinal signs of purulent tenosynovitis?

Answer 22

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

Question 23

Contraindications to I&D include…

Answer 23

Recurrent abscesses

Question 24

Term: Destruction of all living microorganisms including bacterial spores

Answer 24

Sterilization

Question 25

What is Universal Precaution?

Answer 25

Blood and body fluids of all patients should be considered potentially infectious, washing hands and sterilization, OSHA enforces

Question 26

What type of suture provides less resistance as it passes through tissue and is least likely to harbor bacteria?

Answer 26

Monofilament - i.e. Nylon

Question 27

Which intention: wounds too contaminated to close initially but may be closed after 3-4 days post tx

Answer 27

Tertiary intention

Question 28

Term: disruption of blood vessels, extravasation of blood constituents, initiation of the coagulation cascade and formation of a fibrin clot

Answer 28

Hemostasis

Question 29

Which intention: approximated wound that is sutured immediately

Answer 29

Primary intention

Question 30

Which intention: unable to close wound, dehiscence, allowed to heal from the inside out

Answer 30

Secondary intention

Question 31

This stitch is great for everting skin edges and precise approximation of wound edges with little tension.

Answer 31

Vertical mattress

Question 32

The easy and most versatile stitch can cause "railroad track" scarring

Answer 32

Simple interrupted

Question 33

Urea paste dissolution and antifungal oral medications are appropriate treatments for what condition?

Answer 33

Onychomycosis

Question 34

What type of cyst can be treated by simple rupture by pressure, simple aspiration, or surgical excision?

Answer 34

Ganglion cyst - an aneurysm in the tendon sheath that tend to recur

Question 35

This stitch is used for triangular flaps.

Answer 35

Half-buried mattress

Question 36

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.

Answer 36

Subcuticular running

Question 37

What nutrient/enzyme is known to promote wound healing?

Answer 37

Bromelain

Question 38

Most common organism to cause wound infections.

Answer 38

Staph aureus

Question 39

What type of suture is steel (absorbable/non absorbable, braided/monofilament)

Answer 39

Non absorbable, monofilament

Question 40

Poor hemostasis can cause what to form?

Answer 40

Hematoma

Question 41

This regional nerve block is useful for providing anesthesia to the tip fo the little finger.

Answer 41

Ulnar

Question 42

This regional nerve block is injected into the anatomical snuff box to provide anesthesia to the lateral aspect of the proximal thumb.

Answer 42

Radial

Question 43

For the trunk, legs, feet or scalp, use the following type (size) of suture and remove after how many days?

Answer 43

3-O, 7-14 days

Question 44

Is cryotherapy indicated for cervical warts?

Answer 44

Yes. NOT for melanoma, SCC, and BCC

Question 45

T/F: Electrocautery is indicated for actinic keratoses.

Answer 45

T

Question 46

Elliptical excisions should have a length to width ratio of _____ with corners at ___ degree angles.

Answer 46

3:1, 30

Question 47

Elliptical excisions should ideally be made with a # ____ blade, initially cutting ____ to the skin.

Answer 47

15, perpendicular

Question 48

Most dangerous skin tumor

Answer 48

Malignant melanoma

Question 49

Indicated treatment for infections that result in a collection of purulent material in a circumscribed and closed cavity.

Answer 49

I&D

Question 50

Term: benign tumor of encapsulated fat arising from the subcutaneous fascia.

Answer 50

Lipoma