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Minor Surgery > MSurgII Midterm > Flashcards

MSurgII Midterm Flashcards

1
Q

With electrofulgeration, how do you hold the electrode?

A

with the electrode away from the skin, producing a spark and a shallow effect

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2
Q

How do you hold the electrode with electrodessication?

A

you touch the skin with the electrode or insert it into the skin to destroy deeper tissues

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3
Q

What effects are produced by the hyfrecation machine by Conmed?

A

electrofulguration and electrodessication

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4
Q

What are the advantages of a thermal pencil cautery (hot wire loop)?

A

Low cost ($15-$20), individual sterile packaging, disposable, safe around the eyes, safe with pacemakers, helpful in sublingual hematomas

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5
Q

What are some of the advantages of electrosurgical devices?

A

Simple, rapid, controls bleeding, compact, affordable, sterile conditions and sutures not required, use for a variety of lesions

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6
Q

What are some disadvantages of electrosurgical devices?

A

Safety risk, hypertrophic scars, “Channeling” of current down vessels and nerves, smoke may carry particles, delayed hemorrhage, slow healing if large area, obliteration of histology, artifacts at margins

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7
Q

What the advantages of cryotherapy?

A

fast, easy, no need for anesthesia, less scarring than electrosurgery. no risk of transmitting infections through the respiratory tract, less scarring

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8
Q

What are the disadvantages of cryotherapy verses electrosurgery?

A

More likely to cause hypo pigmentation, less effective for pedunculate condylomata, slower results, more postoperative swelling, transient discomfort

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9
Q

What are the advantages and disadvantages of scalpel versus electrosurgery?

A

Advantages: best for shave biopsies and excisions, inexpensive, disposable, “cleaner edge”, better wound healing and cosmetic result

Disadvantages: does not control bleeding, small risk of accidentally cutting yourself

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10
Q

What are the advantages of electrosurgery over laser treatment?

A

less expensive, easier to use, does not require a subspecialist

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11
Q

What are the advantages of laser treatment over electrosurgery?

A

good for “resurfacing”, efficiently cut/coagulate/destroy tissue

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12
Q

What are the contraindications/cautions base on the patient for use of electrosurgery?

A

pacemakers, metal plates/pins/prosthetics, body folds, malignancy, eyes

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13
Q

Is electrosurgery an appropriate treatment for melanoma? For a lesion around the eye?

A

NO

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14
Q

T/F: The radiosurgery machine is more efficient for cutting than the Hyfrecator, with less tissue damage (less ‘lateral heat’)

A

TRUE

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15
Q

T/F: There are different power settings on electrosurgical machines, useful for different functions

A

TRUE

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16
Q

What are the cautions to observe to prevent fires and burns with electrosurgery?

A

Do not prep skin with alcohol
do not use ethyl chloride as a local anesthetic, eep oxygen away from equipment, be careful with igniting bowel gas when preforming peri-rectal procedures. have a fire extinguisher.

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17
Q

What are cautions when using cryotherapy?

A

remove callous from plantar warts before freezing, unacceptable scarring may occur, scar may be painful, nerves/vessels may be damaged if freezing too deeply, depigmentation or hyper pigmentation may occur.

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18
Q

What type of lighting helps distinguish a macule from a papule?

A

Oblique

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19
Q

Understand the use of diascopy to distinguish a purport from vascular extravasation.

A

Pressing a glass life to a red lesion

If redness remains: purpuric lesion

If redness disappears: vascular dilatation

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20
Q

Confluence of papule leads to the development of larger, usually flat-topped, circumscribed, plateau-like elevations known as:

A

plaques

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21
Q

Plaque results from repeated rubbing of skin and most frequently developed in persons with:

A

atopy

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22
Q

Nodules result from:

A

infiltrates, neoplasms and metabolic deposits in the dermis or subcutaneous tissues

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23
Q

Vesicles and bull arise from a ___ at various levels of the skin, which may be within the ____ or at the _____

A

Vesicles and bull arise from a cleavage at various levels of the skin, which may be within the epidermis or at the epidermal-dermal interface.

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24
Q

_____s develop when serum, blood or purulent exudate dries on the skin surface.

A

crusts

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25
Q

Which layers of the skin are involved in erosion vs. an ulcer vs. a fissure? Which of these lesions typically heals without a scar?

A

Ulcer: loss of epidermis and user papillary layer of the dermis

Erosion: only involved the epidermis, HEALS WO A SCAR

Fissure: involves epidermis and dermis

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26
Q

T/F: When irritated or injured, a skin take may appear as a necrotic, crusted papule that may not be clinically distinctive and may raise concerns regarding malignancy.

A

TRUE

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27
Q

The easiest means of removing a skin tag is:

A

lift and snip, using forceps and scissors

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28
Q

The diagnostic test “dimple sign” suggests:

A

dermatofibroma

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29
Q

_____ is usually sufficient for removal of a dermatofibroma along with a biopsy if indicated.

A

simple excision

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30
Q

Characteristically, on compression, a neurofibroma demonstrates a ______ sign.

A

a “buttonhole” sign

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31
Q

Café-Au-Lait spots (light brown macules) are a cutaneous finding often seen in:

A

Neurofibromatosis type 1

32
Q

Over time moles tend to mature through which types?

A

A, to B and then C types

33
Q

Most nevi are acquired, appearing at age ____ and before are ____.

A

Most nevi appear after the first year of life and before age 35

34
Q

Regular brown color, surface and border are characteristic features of a nevus that differentiates it from a:

A

melanoma

35
Q

A blue nevus is similar in appearance to the more serious diagnosis of:

A

melanoma

36
Q

Weeks to months after incomplete removal of a nevus, brown macular re-pigmentation may appear in the scar and a biopsy specimen takin from the lesion may confused the pathologist with a:

A

melanoma

37
Q

A small percentage of small dark spots within melanocytic nevi are due to:

A

melanoma

38
Q

What are the 4 signs that help distinguish a normal mole from a melanoma?

A

Asymmetry, Irregular border, color and diameter

39
Q

There is a large risk of ____ sin newborns with nevi covering more than 5% of their body surface.

A

Melanoma

40
Q

T/F: Worrisome moles are those that have changed in color, shape, size, have been acquired in adulthood, bleed or are itching

A

TRUE

41
Q

What are the differences between common and atypical moles?

A

Common: sun exposed areas above the waist, #10-40, absent at birth, appear at age 2-6, 5mm (commonly >10mm), irregular border, variable color

42
Q

What are the 3 physical characteristics common to all seborrheic keratoses?

A

well-circumscribed border, stuck-on appearance, variable tan-brown-black color

43
Q

T/F: Common cutaneous warts are rarely linked with HPV-associated carcinomas

A

T

44
Q

T/F: condyloma acuminatum (genital wart) is the most common STI

A

T

45
Q

Cervical cancer is associated with high risk HPV types:

A

16 and 18

46
Q

HPV types __ and __ are associated with 90% of genital wart cases

A

6 and 11

47
Q

What callus over a plantar is pared down with a scalpel, the underlying wart has what two characteristics?

A

interruption of skin lines

black puncta

48
Q

Describe a mosaic wart:

A

warts overlap each other- no distinct, mother-daughter pattern

49
Q

What is traumatic black heel?

A

Dried, dark RBCs deposited in the epidermis after trauma

50
Q

What STI can be confused with genital HPV?

A

Secondary Syphillis

51
Q

What is the goal of wart treatment?

A

to destroy the virus-containing epidermis and preserve as much uninvolved tissue as possible

52
Q

Bicholoracetic acid and Trichloroacetic acid are particularly useful treatment of warts on:

A

Palms and soles

53
Q

Imiquimod (Aldara, Zyclara) 5% cream is useful in the treatment of:

A

anogenital warts

54
Q

T/F: caution must be used when applying podophyllin to extensive lesions because severe systemic reactions may occur from absorption

A

True

55
Q

Cimetidine HD (Tagamet) mechanism of action:

A

blocks H2 receptor present on T-suppressor cells, increasing the cell-mediated immunity and improving the treatment of resistant warts

56
Q

T/F: EDandC is never a first-line therapy on the soles of the feet duet to painful scarring potential

A

TRUE

57
Q

Paring the surface and identifying the presence of skin lines with a translucent core confirms that the lesion is a:

A

corn

58
Q

What is the treatment goal for a corn?

A

to provide immediate relief of painful symptoms and then reduce the friction and pressure that has caused their formation.

59
Q

What are the primary and secondary cause of ingrown toenails?

A

pressure of too tight shoes or cutting the nail too short

60
Q

Understand the concept of packing cotton under the corner of ingrown nails as describes under Conservative Home Health Care slide.

A

Allows the nail to grow out without poking into the skin. Progress it and change daily. If no improvement in 5 days, see doctor

61
Q

When would you use Operative Treatment for an acute ingrown toenail case?

A

Infection persisting with heaping up of granulation tissue

62
Q

How many 30 second applications of 88% liquefied Phenol would you use for attempting to permanently kill a portion of the nail bed?

A

3

63
Q

What is the typical causative organism of chronic paronychia?

A

Candida albicans + bacteria

Acute= staph aureus

64
Q

T/F: you may need to remove the nail in difficult cases of chronic paronychia

A

T

65
Q

In a felon, the unyielding skin of the fingertip, contains the infection and creates tension, resulting in:

A

microvascular compromise, necrosis, access formation, septic arthritis, osteomyelitis, tenosynovitis

66
Q

What is the most common cutaneous cyst?

A

Epidermal inclusion cyst

67
Q

What are 3 causes of epidermal inclusion cysts?

A

traumatic implantation of epidermis into the dermis, spontaneously from hair follicles, giant comedones

68
Q

An epidermal inclusion cyst is a nodule that often feels slightly:

A

malleable

69
Q

An epidermal inclusion cyst is the most common type of cyst located on the:

A

skin

70
Q

Why is it important to remove the complete wall of an epidermal inclusion cyst?

A

to prevent recurrence, must remove all epidermal cells

71
Q

What exam finding indicates that an epidermal inclusion cyst is ripe and ready to drain?

A

fluctuance

72
Q

Wait at lease ___ weeks after inflammation and infection has resolved before attempting excision.

A

4-6 weeks

73
Q

A lipoma may feel ____ but is usually not _____

A

A lipoma may feel rubbery but is usually not malleable

74
Q

Epidermal inclusion cysts and tricholemmal (pilar) cysts are very common and usually called ______ in error

A

sebaceous cysts

75
Q

If the skin moves over the top of a lesion, the lesion is sub-dermal in origin and probably a:

A

lipoma

76
Q

If you believe a lesion is a lipoma but are uncertain of the diagnosis, particularly if the lesion feels quite firm, a ______ must be considered.

A

malignant tumor

Minor Surgery (4 decks)

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