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minor surg/proctology > minor surgery > Flashcards

minor surgery Flashcards

1
Q

define surgery

A

branch of medicine that treats disease, injury, and deformities by manual or operative methods

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2
Q

superficial

A

near surface

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3
Q

define abrasion

A

wearing away of structure thru unusual or mechanical means

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4
Q

benign

A

non-malignant

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5
Q

lesion

A

any pathological or traumatic discontinuity of tissue or loss of function of a part

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6
Q

foreign body

A

any material lodged in human tissue that is foreign

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7
Q

excise

A

to cut off

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8
Q

incise

A

to cut into

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9
Q

ligate

A

to tie off

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10
Q

sound

A

to probe deep with a blunt instrument

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11
Q

debride

A

to clean away damaged or necrotic tissue

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12
Q

-tome

A

to cut

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13
Q

-ectomy

A

to remove or cut out completely

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14
Q

antiseptic

A

substance that will inhibit growth and development of microorganisms w/o destroying them

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15
Q

local anesthetic

A

agent whose primary effect is to bring about temp loss of local sensory nerve function

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16
Q

stages of anesthetic (loss of what sensations)

A

first lose pain, then pressure and touch

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17
Q

3 complications of minor surgery

A

1=anxiety

pre/post op bleeding
reaction to anesthetic

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18
Q

best age range for minor surgery

A

15-65

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19
Q

3 body types

A

ectomorph, mesomorph, endomorph

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20
Q

which body type has the worst prognosis/ greatest risk

A

endomorph

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21
Q

what 3 special tests should be ordered prior to surgery

A

UA, clotting time/prothrombin, and CBC

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22
Q

4 methods of instrument sterilization are

A

steam autoclaving, gas autoclaving, dry + cold sterilization

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23
Q

which instrument sterilization technique is most effective?

A

gas autoclaving

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24
Q

what gas chemical is used with gas autoclaving?

A

ethylene oxide

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25
Q

instrument sterilization technique that is effective (kills bacteria and spores) but dulls instruments

A

steam autoclaving

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26
Q

what is the downside (2) of gas autoclaving

A

expensive and deadly to humans

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27
Q

downside to dry sterilization

A

does not kill spores

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28
Q

iodine bath is the MC method for which sterilization

A

cold sterilization

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29
Q

when would you use cold sterilization

A

for instruments that can’t be autoclaved: scissors, non-disposable scalpels

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30
Q

T/F shaving is recommended

A

false- should cut instead

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31
Q

how many times should you clean skin with antiseptic before surgery

A

at least five

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32
Q

strength/effectiveness of antiseptics determined by

A

phenol coefficient

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33
Q

5 coal tar group antiseptics

A

phenol, cresol, resorcinol, thymol, trinitrophenol

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34
Q

antiseptic that is also known as carbolic acid

A

phenol

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35
Q

phenol can be used as an ingredient in a chest rub called ____

A

camphorated phenol (30% phenol)

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36
Q

phenol can be used for itching/burning d/t poison oak/ivy that is called…

A

phenolated lotion of calamine

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37
Q

antiseptic that has a phenol coefficient of 3X, brown liquid, and tarry odor

A

cresol

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38
Q

antiseptic that is color and odorless with coefficient of -1X

A

resorcinol

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39
Q

50% conc of this antiseptic is used for linseed oil soap (to disinfect rooms and equipment

A

cresol

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40
Q

antiseptic used on telephone poles and railroad ties

A

cresol

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41
Q

.25-.5% conc of this antiseptic can be used as vaginal douche

A

cresol

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42
Q

this antiseptic with 5-10% conc can be used to treat psoriasis, ezcema, and erysipelas

A

resorcinol

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43
Q

antiseptic that is colorless, but aromatic and very dis-solvable in alcohol

A

thymol

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44
Q

this antiseptic can be used in mouth washes

A

thymol

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45
Q

this antiseptic is used to treat fungus and hookworm

A

thymol

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46
Q

antiseptic also known as picric acid

A

trinitrophenol

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47
Q

antiseptic with phenol coefficient of 7X, no smell, bitter, yellow, and will stain

A

trinitrophenol

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48
Q

antiseptic that can be used on burns and superficial wounds, but only 9% of body otherwise too caustic

A

trinitrophenol

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49
Q

a group of antiseptic that contains mercury is called..

A

dye group

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50
Q

4 antiseptics in the dye group are:

A

proflavin dihydrochloride
methylrosaniline
methylthionine chloride
merthiolate

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51
Q

antiseptic that is used to saturate gauze; treatment of conjunctival gonorrhea + otitis media, furunculosis and carbunculosis

A

proflavin dihydrochloride

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52
Q

antiseptic also known as gentian violet

A

methylrosaniline

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53
Q

antiseptic Used for tx of chronic cystitis, fungus, burns, and ringworm

A

methylrosaniline

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54
Q

antiseptic that is effective against gram + bacteria (ie staph)

A

methylrosaniline

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55
Q

antiseptic also known as thymerol and thymersol

A

methiolate

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56
Q

this antiseptic contains 50% mercury

A

methiolate

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57
Q

this antiseptic is effective against spore bearing bacteria and fungicide; used as final scrub in pre-op skin prep

A

merthiolate

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58
Q

antiseptic also known as methylene blue

A

methylthionine chloride

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59
Q

antiseptic that is a dark green powder, used mainly as urinary antiseptic and to dx vag fistulas

A

methylthionine chloride

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60
Q

halogen containing group of antiseptic contains either (3)

A

chlorine, iodine, or bromine

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61
Q

an antiseptic that is a yellowish gas that is deadly when inhaled

A

chlorine

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62
Q

antiseptic that is used to make Dankins solution

A

chlorine

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63
Q

antiseptic that Dissolves bacteria, pus, and necrosed tissue w/o disturbing clots. Best for open wounds, but irritates intact skin

A

chlorine

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64
Q

antiseptic with metallic luster and odor that is more soluble with potassium iodide

A

iodine

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65
Q

an antiseptic that is a popular choice for surgical scrubs and skin prep

A

iodine

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66
Q

is a patient is allergic to iodine can use ___

A

benzalkonium chloride aka zephiran

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67
Q

benzalkonium chloride aka

A

zephiran

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68
Q

___ MC used in skin prep and cold sterilization (contains iodine)

A

beta dyne

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69
Q

5% iodine conc =

A

lugol’s solution

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70
Q

what is lugols solution

A

5% conc of iodine that can be applied to external mucosal lining

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71
Q

an antiseptic that is effective for warts, excess tissue, ulcers, canker sores, and cauterization of bleeders.

A

silver nitrate

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72
Q

antiseptic used in crede treatement

A

silver nitrate

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73
Q

___ also contains silver and used to treat chronic/acute sinusitis

A

argyrol

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74
Q

poor antiseptic that: When over 80% concentration it will harden protein coat of bacteria, making it harder to penetrate. Less than 50% and it will draw water out of the cell and dehydrate them

A

alcohol (MC form ethanol)

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75
Q

antiseptic that oxidates protein of bacteria; very powerful- never apply to patient… used for biopsies

A

formaldehyde

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76
Q

another name for formaldehyde

A

formalin

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77
Q

an antiseptic that bubbles debris to surface

A

hydrogen peroxide

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78
Q

antiseptic that…. MC 3% concentration for washing/lavaging wounds and ulcers
Cannot use on closed cavity
Diluted to 1:5 parts water= effective mouth rinse for gingivitis

A

hydrogen peroxide

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79
Q

3 antiseptics used as astringents

A

boric acid; potassium aluminum sulfate, and zinc

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80
Q

antiseptic that reduces swelling of mucous membrane

A

boric acid

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81
Q

antiseptic: 10% concentration for skin irritation, 2% for conjunctivitis, 2-4% for open wounds, burns, abscesses, and vaginal packs for vaginitis.

A

boric acid

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82
Q

antiseptic: used for skin irritation, .5-1% to stop bleeding of small cuts (septic pencil for shaving nicks)

A

Potassium aluminum sulfate aka alum

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83
Q

antiseptic used for burns and skin diseases (usually in oxide form)

A

zinc

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84
Q

___good as fungicidal and antiseptic. Used for irrigating ears, athletes foot, insect bites, animal scratches, etc

A

Hydroxyquinoline sulfate:

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85
Q

tea tree oil good for which infection

A

staph

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86
Q

aka neomycin polymycin (used for dressing to aid in anti-infection)

A

bacitracin

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87
Q

MC topical post op ointment

A

neosporin

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88
Q

wound cleaning solution: Effective against gram - and + bacteria, fungi, and viruses. Brand names: betadine, operand, acudyne, and clonidine

A

providone-iodine

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89
Q

effective against gram + bacteria. Mostly used for hand scrubbing- also toxic to open wounds. Marked under names Hibiclens and STERIS tat.

A

chlorhexidine

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90
Q

new, potentially useful wound cleanser w/nonionic detergent. Most suited for wound cleansing of face- no antibacterial activity though. Under name Shur-Clens

A

pluronic-F-68

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91
Q

good against gram + bacteria; recent studies show potential toxicity, but Remains alternative for hand scrubbing b/c of cumulative and protective buildup in the skin. Under name PHisoHex

A

hexachlorophene

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92
Q

percentage of antiseptic to be used

A

1-2% only

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93
Q

T/F: toxicity with local anesthetic and epinephrine is caused by the anesthetic and not epinephrine

A

true

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94
Q

disadvantages of epinephrine

A

vasoconstriction, increase potential for infection

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95
Q

gauge needle used for anesthetic

A

25-27

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96
Q

topical skin refriderant that can be used as a pre-injectable for those with anxiety

A

ethyl chloride

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97
Q

what do you need to do after inserting needle into skin before injecting anesthetic

A

pull back on plunger to make sure didn’t hit vein/artery

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98
Q

anesthetic should be introduced….(method)

A

on the move

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99
Q

method of introducing local anesthetic where portal of entry has been created by trauma (ie laceration)- needle is introduced to exposed edge of skin

A

direct filtration

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100
Q

MC method of introducing local anesthetic- preferred if wound is dirty- decrease risk of infection better than direct infiltration

A

field block

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101
Q

another name for field block

A

parallel margin infiltration

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102
Q

MC type of nerve block

A

digital

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103
Q

when would one use nerve block?

A

when nail removal or complete anesthesia of digit required or with eye/mouth

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104
Q

another name for procaine

A

novocaine

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105
Q

anesthetic that can be with or w/o epinephrine and used for all types of conduction anesthesia. Ester base solution- less desirable d/t higher risk of toxic reaction. Only 1% conc needed

A

procaine/novocaine

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106
Q

another name for tetracaine

A

pontocaine

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107
Q

anesthetic that is very potent and toxic (10x more potent than procaine). Only used for spinal block… not for chiro minor surgery use

A

tetracaine/pontocaine

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108
Q

another name for lidocaine

A

xylocaine

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109
Q

anesthetic that is MC - can be with or w/o epinephrine. Amide based solution= lower toxicity, rapid diffusibility, topical activity and chemically stable. Immediate results

A

lidocaine/xylocaine

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110
Q

another name for mepivacaine

A

carbocaine

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111
Q

anesthetic that is amide based and common. Better for procedures where longer time frames are needed. Slightly vasoconstrictive (caution with distal end organs) no epinephrine

A

Mepivacaine (carbocaine)

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112
Q

another name for bupivacaine

A

marcaine

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113
Q

anesthetic that is newer amide solution. Slow onset of action, but longer lasting

A

Bupivacaine (marcaine)

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114
Q

anesthetic that is best used for pediatric patients *but vasoconstrictive

A

TAC

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115
Q

what is in TAC

A

equal parts mix tetracaine .5%, (adrenalin chloride) epinephrine 1:2000, and cocaine 11.8%

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116
Q

another name for ophthaine

A

proparacaine hydrochloride

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117
Q

anesthetic that is .5% glycerine solution for topical eye application. Applied via eyedrops and best for foreign body removal or ocular pressure testing. Onset: 13 secongs and lasts 15-20 minutes.

A

Ophthaine (proparacaine hydrochloride)

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118
Q

anesthetic that is contraindicated for hypersensitivity reactions, allergies, cardiac disease, and hyperthyroidism- prolonged use could lead to loss of vision

A

Ophthaine (proparacaine hydrochloride)

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119
Q

another name for cetacaine

A

rostra spray

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120
Q

anesthetic that is topical for mucous membranes only- not conjunctiva though. Good for overriding gag reflex or as pre-injectable. Only lasts 1-5 minutes and contains small amt of tetracaine and benzocaine

A

rostra spray (cetacaine)

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121
Q

topical skin refrigerant that is highly flammable- used as pre-injectable. Can also be used for lancing furuncles and carbuncles where inoculation has risks of introducing infection into deeper adjacent tissues. Anesthetic effect short lived: 15-30seconds DC not allowed to use in practice

A

ethyl chloride

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122
Q

T/F: local effects of anesthetic will self resolve

A

true

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123
Q

systemic effects of anesthetic include: (5)

A

hypotension, bradycardia, seizures, and vasovagal syncope, and allergic response

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124
Q

MC effect of local anestehtic aside from pain/anxiety

A

fainting (vasovagal syncope)

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125
Q

what usually causes inadvertent reactions to local anesthetic

A

injection of solution into vessel directly (vein)

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126
Q

1st phase of wound healing (1/6)

A

immediate response to injury

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127
Q

2nd phase of wound healing (2/6)

A

inflammatory phase

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128
Q

3rd phase of wound healing (3/6)

A

epithelialization (scab formation)

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129
Q

4th phase of wound healing (4/6)

A

neovascularization

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130
Q

5th phase of wound healing (5/6)

A

collagen synthesis

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131
Q

6th phase of wound healing (6/6)

A

wound contraction- forming of scar

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132
Q

how long can it take to get back to full strength of tissue after injury

A

6-12months

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133
Q

T/F: primary wounds usually can be closed with sutures or skin tape

A

true

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134
Q

what usually causes a primary union

A

knife wound

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135
Q

what is the “golden period” to perform surgery w/o complications

A

6hours

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136
Q

which wounds are best for secondary union

A

Significant tissue loss or devitalization (avulsion, infractions, ulcerations, abscesses). Best to let heal by secondary union or intention.

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137
Q

T/F you can close a secondary union with sutures

A

FALSE

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138
Q

T/F tertiary union/delayed closures can be closed with suture after 3-4 days of observation

A

true

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139
Q

T/F tertiary union need antibiotics

A

true

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140
Q

what are 3 conditions/habits that will cause alterations in wound healing?

A

diabetes, smoking, strong anesthetics

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141
Q

which type of wound can involve muscle but not nerve

A

superficial

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142
Q

type of wound that involves tendons and vasculature

A

deep

143
Q

type of wound where there is no significant loss or implantation of debris

A

simple

144
Q

puncture wounds are a type of which wound

A

simple

145
Q

type of wound that has loss/damage of tissue, contain foreign matter

A

complex

146
Q

2nd degree burns are considered what type of wound

A

complex

147
Q

type of wound likely to become infected, has debris

A

dirty

148
Q

Studies show that presence of _______ organisms per gram of tissue represents critical mass necessary to cause infection

A

100,000

149
Q

signs of infection for lacerations that have been sutured include: erythema extending ___cm beyond wound margin

A

1cm

150
Q

signs of infection for lacerations that have been sutured include: palpable induration greater than __cm and redness, purulent discharge, and wound splitting

A

.5cm

151
Q

MC infection caused by which bacteria

A

staphylococcus aureus (44-80%)

152
Q

other type of bacteria that cause infection include: E. coli, proteus, enterobacter, klebsiella, and ____

A

strep

153
Q

__X increase in infection rate with 20% wt loss in chronically ill patient

A

3x

154
Q

how long after wound does infection risk increase

A

5hrs

155
Q

what is the name of the vaccine for tetanus

A

anti-tetanus prophylaxis

156
Q

full immunization of tetanus includes how many doses with boosters every ___ yrs

A

3 doses; 10yrs

157
Q

wound closure term: amount of tissue taken when placing a suture needle in skin/fascia

A

bite

158
Q

wound closure term: number of times the suture material is looped around in order to secure a knot.

A

throw

159
Q

wound closure term: each knot of a suture consists of a series of ____

A

throws

160
Q

wound closure term: ___ sutures placed on surface of skin for final closure and made of nonabsorbable material (aka skin closures)

A

superficial sutures

161
Q

___ sutures made with absorbable material, placed in the superficial fascia or dermis with knot buried in wound

A

deep

162
Q

single sutures tied separately whether deep or superficial

A

interrupted

163
Q

wound closure effected by taking several bites the full length of the wound without tying individual knots. *knots are only ties at the beginning and end of the closure to secure the suture material

A

continuous/running

164
Q

debridement is done with a #___ scalpel

A

15

165
Q

T/F: hemostatis doesn’t need to be obtained before wound closure can be carried out

A

false- must obtain- use gauze with direct pressure to stop bleeding if needed

166
Q

T/F everted sutures leave nasty scars

A

false- inverted sutures leave scars- want to use everted sutures

167
Q

which suture technique is the MC for clean wound w/o complications such as deep involvement or multiple openings

A

simple interrupted

168
Q

___ suture used for areas of high stress

A

vertical mattress

169
Q

___ suture done by taking a shallow 1st loop and a deep second loop then tie off.

A

vertical mattress

170
Q

__ suture are simple interrupted sutures cannot be used towards the triangulated end of a flap- this suture draws the tip into place by taking a bit through the deeper layer.

A

apical

171
Q

apex of cut of apical suture must point towards (head/heart)

A

heart

172
Q

___ suture also called pull out suture is when an injury is closed under some tension (decreases scarring)

A

intradermal subcuticular

173
Q

can add a ___ to a suture: small section of surgical rubber or small square of a surgical glove can be rolled into shape of tube and inserted into the inferior most aspect of a wound during closure

A

penrose drain

174
Q

3 types of absorbable suture material

A

polyglycolic acid
polyglycan-910
gut

175
Q

absorbable suture material that is suture of choice aka PGA and dexon

A

polyglycolic acid

176
Q

absorbable suture material that is: Braided synthetic polymer which is less reactive and better able to resist infection from invading bacteria. Great for knot security and holds half its tensile strength for 25 days.
Hard to work with when wet

A

polyglycolic acid

177
Q

absorbable suture material that is: synthetic polymer for deep closure. Great workability but not as good of knot security. Holds tensile strength better. AKA PG910, Vircryl

A

polyglycan-910

178
Q

what type of animal gut is used?

A

sheep

179
Q

sheep gut treated with ___ to retard absorption

A

chromic salt

180
Q

2 downsides to using gut as suture material

A

Less strength and wound security than synthetics and has more tissue reaction

181
Q

monofilament nylon has poor knot security due to memory of monofilament- must make at least ___ throws otherwise will unravel

A

6

182
Q

3 types of nonabsorbable suture material that can be used

A

monofilament nylon, polypropylene, and braided

183
Q

nonabsorbable suture material that is MC for minor wounds and lacerations. Able to resist infections, minor tissue reaction, good tensile strength and wound security

A

monofilament nylon

184
Q

non-absorbable suture material aka ethilon or dermalon

A

monofilament nylon

185
Q

___ is another monofilament polymer -strongest and best wound security. Less likely to cause skin irritation and just as good at infection resistance as nylon. However, poor knot security, and more difficult to work with.

A

polypropylene (prolene)

186
Q

___ nonabsorbable sutures are less commonly used today

A

braided

187
Q

Braided nonabsorbable sutures less commonly used today (silk, cotton, braided nylon). Have excellent workability and knot security but prone to ____

A

tissue reactivity and infection- best to remove ASAP

188
Q

(cut/ tapered) needles have a nice sharp edge while (cut/tapered) is closer to a sewing needle- puncture vs cut

A

cut- nice edge; tapered=puncture

189
Q

3 advantages to wound taping

A

easy to apply, noninvasive, no anesthesia needed

190
Q

2 conditions where wound taping isn’t recommended

A

wounds with tension/irregular/concave

and with moisture/oily skin

191
Q

moist wound healing also known as

A

occlusive wound dressing

192
Q

advantage of occlusive wound dressing

A

prevents crust formation

193
Q

4 types of occlusive wound dressing

A

films; foams; hydrocolloids; hydrogels

194
Q

occlusive wound dressing that is: thin, transparent, adherent polyurethane’s. Transmit water vapor, oxygen, and carbon dioxide. Non-absorbent. However, likely to remove new skin when epithelium layer forms

A

film

195
Q

occlusive wound dressing that has: minimal absorption; nonadherent material taped in place over wound

A

foams

196
Q

occlusive wound dressing that is: water impermeable, opaque, gas impermeable, absorbent. Will gradually separate from wound- only time new one should be applied.

A

Hydrocolloids

197
Q

occlusive wound dressing that is: semitransparent, nonadhesive, absorbent (aka doctor spenko’s second skin)

A

hydrogels

198
Q

T/F: fractures are often overlooked in open wounds or bleeding injuries

A

true

199
Q

____dressing: MC for burns and skin grafts. Have bacteriostatic action and can be readily removed after soaking in water

A

petrolatum coated

200
Q

controlled cell proliferation to a limited sense. Cells adapt to stress. Simplest non-involved type of tumor (ie: calluses or hyperkeritization)

A

hyperplasia

201
Q

type cell proliferation: an adaptive substitute of one type of fully differentiated adult cell from another type of adult cell. Common with excretory ducts of any gland of the body where there is chronic irritation and inflammation

A

metaplasia

202
Q

most severe and potentially dangerous type of cell proliferation. Loss of regularity of individual cells as well as loss of architectural orientation. Exhibit pleomorphism- vary in size, shape, and possess large irregular nuclei.

A

dysplasia

203
Q

3 types of malignant skin tumors

A

basal cell carcinoma
squamous cell carcinoma
melanoma

204
Q

MC type of skin cancer and easiest to treat

A

basal cell carcinoma

205
Q

MC cause of basal cell carcinoma and squamous cell carcinoma is…

A

UV light

206
Q

this type of malignant skin tumor is slow growing (1-2yrs for lesion to reach 1cm), rarely penetrates the base membrane and less than 1% metastasize

A

basal cell carcinoma

207
Q

basal cell carcinoma lesions that are left untreated have ____ borders and a _____

A

raised rolled borders and ulcerated/necrotic center

208
Q

this type of malignant skin tumor has the Appearance of non-healing ulcer and MC: upper lip, paranasal folds, ears, cheeks, and axillary regions

A

squamous cell carcinoma

209
Q

T/F: growth rate of squamous cell carcinoma is rapid

A

true- and easily metastasizes

210
Q

this type of malignant skin tumor is the most dangerous but least frequent- lethal if metastasizes and must be referred out immediately

A

melanoma

211
Q

this type of malignant skin tumor is Jet black ( color variation), asymmetry, border irregularity, diameter increase, elevation/evolution. sometimes has visible vascularization

A

melanoma

212
Q

T/F: melanoma in late stages will have nevi that will ulcerate or bleed with microtrauma

A

true

213
Q

T/F: melanoma has rapid onset and lesion will change shape and color.

A

true- if it does this refer immediately for excersion and biopsy

214
Q

___% of head and neck cancers begin in the oral cavitiy

A

75%!! always check

215
Q

___ are benign skin tumors that are Bulging structures resulting from excessive formation of collagen in the healing stages of a wound

A

keloids

216
Q

____ are benign tumors consisting of encapsulated fat tissue arising from the subcutaneous fascia (painless)

A

lipomas

217
Q

___ are Tumor like structures that are caused by blockage of the duct of a sebaceous gland located next to hair follicle. Sebaceous material will continue to be produced by the gland but has no portal of exit making it enlarged (grape-gold ball size)

A

sebaceous cyst

218
Q

how can you differentiate a lipoma from a sebaceous cyst

A

there will be a small central well in the middle of the raised lump of a sebaceous cyst

219
Q

___ is associated with a trichilemmal/pilar cyst filled with keratin found on the scalp that may be indistinguishable from a sebaceous cyst

A

WEN

220
Q

verrucae vulgaris is also known as

A

warts

221
Q

___ are Benign epithelial growth formed by hypertrophy of the papillae. May occur at any location on the cutaneous or mucous membrane surfaces.

A

warts

222
Q

T/F warts are caused by a virus and can transfer from one person to another

A

true: papovavirus

223
Q

___ is an excellent method of treatment for warts but ___ is the most common

A

surgical excision; electrodesiccation

224
Q

___ are Small growths of skin in many areas. It is a layer of skin covering a central stalk of fibrous tissue that contains a nutrient artery and vein

A

papillomas

225
Q

what is another name for papilllomas

A

skin tags

226
Q

___ is a bengin, hard, hornlike projections extending above the level of the skin.

A

cutaneous horn

227
Q

___percent of cutaneous horns can become malignant

A

12%

228
Q

___ are benign, hard, round, moveable, slow growing, non-inflammatory lesions. Composed of bundles of connective tissue that are cartilaginous in their hardness

A

fibromas

229
Q

___ is a benign, cystic swelling surrounded by a fibrous tissue wall and occurring in the vicinity of joint capsules and tendon sheaths.

A

ganglia

230
Q

liquid nitrogen can be used to treat superficial skin lesions (ie warts) and obtain biopsies with minimal scarring and rarely need anesthetic. this method is called?

A

cryosurgery

231
Q

T/F only one treatment of cryosurgery is needed

A

false- often need more than 1 treatment

232
Q

___ is a type of treatment that uses a small, hand held cordless. requires local anesthesia for most lesions, some scarring but self sterilization

A

electrocautery

233
Q

___ is a type of treatment that is ideal for all superficial skin lesions. Requires local anesthetic, does scar, and not self sterilizing but lowccost and portable

A

hyfrecator

234
Q

with hyfrecator you should warn the patient of what

A

burning smell

235
Q

T/F you can not obtain biospy easily with hyfrecator

A

true

236
Q

___ is a type of treatment that combines cutting and coagulation with minimal scarring. requires local anesthetic but can obtain specimen and self sterilizing

A

radio-surgery

237
Q

like hyfrecator, ___ also causes burning smell- probably moreso

A

radiosurgery

238
Q

__ is a type of treatment of light amplification by stimulated emission of radiation. does cost a lot and require special training but lots of other uses

A

laser

239
Q

____ are local staphylococcal infections of the skin and the subcutaneous tissue.
All start as infection of hair follicle or sebaceous glad and progress to small area of induration with central necrosis

A

furuncles and carbuncles

240
Q

what is the difference between a furuncle and carbuncle

A

furuncles is a singular formation, if extends to another area and reaches considerable size then it is a carbuncle

241
Q

another name for a furuncle (single formation)

A

boil

242
Q

furuncles take ___ days to become fully “ripe” with central core of necrosis and are painful

A

4-6

243
Q

if furuncle/carbuncle is left untreated and increase in temp what happens?

A

“toxemia”- results in absorption form the area of infection and outcome can be serious- life threatening

244
Q

___ is the simplest type infection that involves the distal phalanx. Appears along the nail near the base. Result of staphylococcus aureus invasion following trauma or biting off hangnail (painful and swollen)

A

paronychia

245
Q

T/F: can not use epinephrine additive to control bleeding of distal organs

A

true

246
Q

human bites commonly contain which organism and require referral

A

eikenella coorodens

247
Q

what is the best treatment for snake bite

A

immobilization splint at heart level

248
Q

T/F: ice, sucking out poison, and tourniquets are acceptable treatments for snake bites

A

false! they all complicate the problem

249
Q

what is a commonly used antivemon for widow spider

A

lyovac

250
Q

brown spiders have ___ poison that causes: anorexia, apathy, dehydration during first 8 hours.

A

loxoscles

251
Q

loss of heat due to wet clothing/contact with metal is known as

A

conduction

252
Q

loss of heat due to high wind velocity/ wind chill is known as

A

convection

253
Q

loss of heat due to difference in temp gradients between body and surrounding environment

A

radiation

254
Q

with freezing temps you will get these 3 symptoms in this order

A

stinging, burning, then numbness

255
Q

when reach numbness stage of cold, skin will become ___ in color

A

wax-white

256
Q

when heating a cold area, you may experience which symtpoms

A

itching/tingling and redness

257
Q

with cold exposure, you could get chilblains which are…

A

nodular swellings surrounded by reddened area of hyperemia or cyanotic flat swellings in exposed area

258
Q

T/F chilblains can cause symptoms (tingling, pain, aggravation to warmth) long after exposure to cold

A

true

259
Q

with exposure to cold, be cautious of how rewarm body: external warming should be done by ____ while internal ___

A

external: dry warmth and internal warm liquids

260
Q

when should you go to the hospital/ER after cold exposure

A

if vesicles or blebs appear

261
Q

serious burn is considered if extends __% in kids and __% in adults

A

10% kid; 15% adult

262
Q

which degree of burn involves epidermis only and manifests as an erythematous reaction (ie: sunburn). No blisters or systemic effects except maybe nausea, headache, or malaise.

A

first

263
Q

which degree burn is most common and has more marked local tissue disturbance with capillary wall destruction- edema and bleb formation.

A

second

264
Q

which degree of burn has destruction and tissue loss with scarring and requires pt to go to ER

A

third

265
Q

furuncles and carbuncles have a central necrosis known as

A

a pustule

266
Q

which antiseptic is teratogenic? (think would cleaning solutions..)

A

hexachlorophene

267
Q

what is the best treatment for conjunctivitis

A

2% boric acid

268
Q

2-4% boric acid is used to treat what?

A

conjunctiva, irrigation of open wounds, burns, abscesses, and vag pack

269
Q

most common and serious complication to wound laceration repair is..

A

infection

270
Q

what should be applied to an abscess if less than 5cm

A

clindamycin

271
Q

condylomata lata=

A

syphilis

272
Q

condylomata acuminata=

A

HPV

273
Q

undermining procedures are..

A

used to reduce wound tension

274
Q

what tool is used for undermining

A

scissors

275
Q

epinephrine causes what

A

vasoconstriction

276
Q

T/F: tetraunion can be closed after 3-4 days observation

A

true

277
Q

T/F: you can close secondary union with suture after 3-4 days observation

A

NO! best left to heal w/o sutures

278
Q

a patient takes a lot of aspirin…this may cause?

A

increased bleeding

279
Q

you should worry about patients taking coumadin or heparin (heart meds) because..

A

cause increase bleeding

280
Q

what about diuretics? (dyazide and lasix) what should you worry about

A

decreased BP

281
Q

why is there an increased risk with patients with resp complaints (asthma, COPD, emphysema)

A

decreased oxygen intake leads to acidosis

282
Q

an example of resident human flora is…

A

staph epidermis

283
Q

an example of transient human flora is..

A

staph aures (MC cause infection)

284
Q

when is a surgical site considered infected?

A

if produces pus or suppurates within 30 days

285
Q

what is an exception to the “surgical site infection” rule

A

abcesses

286
Q

the max dose for anesthetics is ___ cc

A

30cc

287
Q

epinephrine with 1% lidocaine max dose is ___cc

A

50cc

288
Q

what are disadvantages of using epinephrine

A

potentiates wound infection, potential necrosis of distal end organs, risk of small bleeder going unnoticed (leads to post op hemorrhaging)

289
Q

a ___ cc syringe is used for wound irrigation and lavage

A

50cc

290
Q

povidone, betadine, and methiolate are used for…

A

iodine based scrubs used as pre-op skin prep

291
Q

direct filtration is good because you don’t need to pierce the skin again, but what are some cons

A

causes trauma- changes shape of area and secondary inflammation possible increased infection risk

292
Q

which conditions would you use field block for

A

sebaceous cystectomy, lipmectomy, excision, foreign body removal

293
Q

aside from injecting anesthetic directly into a vessel, what else can cause a toxic reaction

A

rapid absorption from highly vascular area or excessive volume or conc of anesthetic

294
Q

the epidermis (outer layer of skin) has 2 layers- what are they (stratum….)

A

stratum germinativum and stratum corneum

295
Q

the stratum germinativum (basal layer) does what that is important to wound healing

A

provide cells for new epidermis formation during wound repair

296
Q

the stratum corneum (basal layer) does what that is important to wound healing

A

its the most superficial layer, kerantinized and gives final cosmetic appearance

297
Q

the dermis (deep to the epidermis) contains ____ that elaborate collagen

A

fibroblasts

298
Q

hair follicles and sebaceous glands found in the ____ layer

A

reticular

299
Q

____ is the key layer for achieving proper wound repair

A

dermis

300
Q

an injury in the ____ layer could create dead space leading to hematoma

A

supericial fascia

301
Q

injury to the superficial fascia layer could have increased risk of infection because…

A

contains fat that could lead to increased bacterial growth

302
Q

anesthetic should be injected between which two layers

A

dermis and superficial fascia

303
Q

antitetanus prophylaxis is what

A

vaccine for tetanus

304
Q

with ___ bites of skin edges, fewer sutures required

A

wider

305
Q

careful with wide bites because

A

could lead to marginal ischemia and necrosis of skin edges

306
Q

you can alleviate excessive tension by (_____ sutures)

A

placing a few deep sutures

307
Q

with needle size, the larger the number the ___ the diameter

A

smaller

308
Q

another name for benadryl

A

diphenhydramine HCL

309
Q

what can you give to a patient having an allergic reaction to lidocaine

A

benadryl

310
Q

T/F antiseptics should not be used in wounds

A

true- just to decontaminate skin

311
Q

____ is a good absorbable suture material for diabetics

A

polyglyconate monofilament

312
Q

why is polyglyconate monofilament a good suture material for diabetics?

A

has long lasting tensile strength (these wounds heal slowly)

313
Q

for non-absorbable materials, ______ is best because has more tensile strength and decreased infection risk compared to silk and braided polyester

A

nylon braided polybutilate coated polyester

314
Q

T/F: treatment of ganglia within scope of practice

A

false

315
Q

why are interrupted sutures a good option

A

can be removed or replaced individualy

316
Q

CAM support includes

A

bromelain, comfrey, aloe vera, honey, vitamin C, propolis, tumeric, catendula

317
Q

why is vitamin C good for minor surgery CAM support

A

collagen synthesis

318
Q

____ is a good treatment for verrucae

A

nitric acid and bichloracetic acid (more recent)

319
Q

what is matricectomy

A

surgically or chemically destroying all or part of base of nail portion

320
Q

MC tumor of head/neck

A

squamous- basal MC body

321
Q

what is hirschprung dz

A

congenital megacolon

322
Q

MC bacteria from dog bite

A

pasteurella multocida

323
Q

steam autoclaving temperature and pressure

A

120 C 750mmHG/14PSI

324
Q

sebaceous cysts have a central ___

A

well

325
Q

T/F warts have a central well

A

no! no “central”

326
Q

T/F ganglionic cyst on wrist is solid

A

no- a cyst is a swelling surrounded by fibrous tissue

327
Q

what size suture material is best for fine suturing of face

A

5-0 or 6-0

328
Q

neomycin polymycin is found in…

A

bacitracin AND neosporin

329
Q

Chlorhexidine vs hexachlorophene names

A

chlor=hebiclen STARIS
hexa=phisohex
both effective for gram + bacteria

330
Q

T/F chlorhexidine is teratogenic

A

false- hexachlorophene is

331
Q

sebaceous cyst exercised with ____ - an excision designed so that scar runs parallel with existing skin crease

A

elliptical

332
Q

define elliptical excision

A

an excision designed so that scar runs parallel with existing skin crease

333
Q

wound cleaning solution that can be used in wound around eye and doesn’t sting

A

poloxamer 188 LF

334
Q

rolled border/edge with central ulceration is a sign of what 2 conditions

A

basal cell or squamous cell in anus

335
Q

silver nitrate vs boric acid

A

silver nitrate: tx warts, ulcers, cauterize bleeders. “crede treatment” (for conjuctiva gonorrhea). .25-1% tx infection of mucous membrane, sinuses, throat.
boric acid: astringent gp; decrease mucousal membrane swelling; 10%conc tx skin irritation, 2% conjuctivITIS; 2-4% burns/abcess/vag pack

336
Q

proflavin dihydrochloride vs boric acid

A

pro. dihydro: dye gp (cont mercury) used to saturate gauze; treat furuncles/carbuncles; was #1 tx for conj gonorrhea and otitis media before antibiotics
boric acid: astringent gp; decrease mucousal membrane swelling; 10%conc tx skin irritation, 2% conjuctivITIS; 2-4% burns/abcess/vag pack

337
Q

proflavin dihydrochloride vs silver nitrate

A

pro. dihydro: dye gp (cont mercury) used to saturate gauze; treat furuncles/carbuncles; was #1 tx for conj gonorrhea and otitis media before antibiotics
silver nitrate: tx warts, ulcers, cauterize bleeders. “crede treatment” (for conjuctiva gonorrhea). .25-1% tx infection of mucous membrane, sinuses, throat.

338
Q

5% conc of ______ is called lugol’s solution

A

iodine

339
Q

iodine used in ____ and ____ as skin prep/cold sterilization

A

beta dyne and providyne

340
Q

what should you apply to an abcess?

A

penecillin!

341
Q

gas used for gas autoclaving

A

ethylene oxide

342
Q

best suture material for diabetics

A

polyglyconate monofilament (Maxon) and polydioxanone monofilament (PDS) – both absorbable

343
Q

pyrexia definition

A

fever

344
Q

pyrexia and pain with sitting and deification and coughing are S/S of ___ or ____

A

abcess/ ano fistula

345
Q

delayed closure also known as..

A

tertiary union

346
Q

5-0 and 6-0 braided silk is for

A

fine suturing about the face and fingers

347
Q

5-0 and 6-0 nylon (ethilon/dermalon) is for

A

fine suturing about the face and hands

348
Q

_____ is for heavy work about the scalp and limbs- especially areas of high stress such as across a joint

A

3-0 and 4-0 braided silk

349
Q

3-0 and 4-0 nylon (ethilon/dermalon) is for

A

minor wounds and lacerations about the scalp, trunk, and extremities

350
Q

5-0 plain catgut vs 3-0 and 4-0 plain catgut

A

5-0: fine vessel ties and fine interrupted subcut. sutures of face
3-0 4-0: for larger vessel ties… trunk and limbs

351
Q

____ is for repair of deeper structures where a longer period of time for security is desirable

A

4-0 chromic catgut

352
Q

what suture material is used for pull out/ subcuticular sutures

A

4-0, 5-0, 6-0 polypropylene (prolene)

353
Q

4-0 polyglycolic acid (dexon) used for..

A

deep closures of the scalp, trunk, and extremities

354
Q

5-0 polyglycolic acid (dexon)

A

deep closures of the hand and face

minor surg/proctology (2 decks)

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