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True Learn Studying 2021 > Skin and soft tissue review > Flashcards

Skin and soft tissue review Flashcards

1
Q

most common nerve injury with anterior shoulder dislocation

A

axillary nerve

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2
Q

most common way to see an ulnar nerve injury from trauma?

A

elbow fracture

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3
Q
  • decreased sensation in 4th and 5th digit of hand
  • reduced grip
  • inability to flex 4th and 5th digit
    what was injured?
A

ulnar nerve injury

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4
Q

most common way to see median nerve injury in trauma?

A

supracondylar humerus fracture

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5
Q

inability to abduct thumb
inability to flex 2nd and 3rd digits of the hand
- what was injured?

A

median nerve injury

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6
Q

inability to extend the wrist, what was injured?

A

radial nerve injury

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7
Q

initial treatment for brown recluse spider bite?

A

rest
compression
elevation

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8
Q

patient on chronic steroids with a chronic wound, what can you supplement to help with wound healing

A

vitamin A

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9
Q

patient with immune thrombocytopenic purpura is post op from splenectomy, still complaining of nose bleeds…next step?

A
  • peripheral smear to look for howell-jolly bodies

- if absent then look for accessory spleen

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10
Q

you see a splenic cyst incidentally on CT scan, what is your next step?

A
  • test for echinococcal species -> if positive patient has hyatid disease
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11
Q

how do you treat hydatid disease?

A
  • can sterilize cyst in spleen with injection of hypertonic saline, alcohol, or silver nitrate
  • then splenectomy trying to make sure no contents are spilled
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12
Q

what is Bowen’s disease

A

squamous carcinoma in situ of the skin

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13
Q

what does actinic keratosis morph into given enough time?

A

Bowen’s disease AKA squamous carcinoma in situ of the skin

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14
Q

What is a Marjolin Ulcer?

A

Squamous cell carcinoma arising from a burn

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15
Q

stage 1 pressure ulcer

A

intact skin, non-blanching erythema

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16
Q

stage 2 pressure ulcer

A

partial thickness skin loss with exposed dermis

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17
Q

stage 3 pressure ulcer

A

full thickness skin loss with exposed fat and granulation tissue

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18
Q

stage 4 pressure ulcer

A

full thickness skin loss with exposed fascia, muscle, bone, cartilage, or bone

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19
Q

first stage of wound healing

A

hemostasis

  • less than 1 day
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20
Q

First stage of wound healing

A

inflammation

1-3 days

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21
Q

third stage of wound healing

A

proliferation

4 days-3 weeks

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22
Q

fourth stage of wound healing

A

remodeling

starts at any time after 5 days and lasts years

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23
Q

mediators of inflammatory phase of wound healing

A

neutrophils (1st to get to wound)

Macrophages

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24
Q

predominant cell during the proliferation phase of wound healing?

A

fibroblast

lay down collagen matrix

25
Q

cells active during proliferation stage of wound healing?

A

fibroblasts and myofibroblasts

26
Q

when do you get 80% of tensile strength from a healing wound?

A

6 weeks

27
Q

predominant method by which negative pressure wound therapy heals wounds?

A

promotes formation of granulation tissue

28
Q

cells needed in a wound to promote proliferation and angiogenesis?

A

Macrophages

29
Q

what is a composite skin graft?

A

small graft with skin and underlying cartilage or other tissue

30
Q

major molecules involved in first phase of wound healing

A

inflammatory phase

TNFa, IL-1, PDGF

31
Q

major molecules involved in second phase of wound healing

A

proliferation stage

PDGF, fibroblast growth factor (FGF), epidermal growth factor (EGF)

32
Q

flesh colored atrophic plaque, biopsy shows spindle cells and stains positive for CD34 and vimentin

A

Dermatofibrosarcoma

33
Q

Treatment for dermatofibrosarcoma?

A

can down stage with imatinib

wide local excision with 2-4 cm margin

34
Q

Fothergill’s sign

A

palpable abdominal mass that remains fixed with abdominal muscle contraction

  • rectus sheet hematoma
35
Q

raised purple subcutaneous lesion, biopsy shows monomorphic large pale cells with whirled appearance

A

Merkel Cell Carcinoma

36
Q

what does Merkel Cell carcinoma stain for traditionally?

A

Cytokeratin-20 (CK-20)

37
Q

what does small cell carcinoma stain for?

A

CK-20 and TTF-1 (thyroid transcription factor 1)

38
Q

first cell to arrive to wound after hemostasis?

A

neutrophil

39
Q

Imbibition

A

diffusion of nutrients into a skin graft without a direct blood supply

40
Q

Insoculation

A

donor and recipient capillaries align

41
Q

When does revascularization happen with a skin graft?

A

typically after POD 5

42
Q

salmon colored fluid coming from midline incision, sign of what?

A

fascial dehiscence

43
Q

margin for basal cell carcinoma

A

0.5 cm

44
Q

patient had resection of a pleomorphic adenoma from their parotid gland, now recurred. how do manage this?

A

-radiation therapy, too difficult to resect in an already operated field

45
Q

thigh mass with biopsy showing atypical spindle cells

A

sarcoma

46
Q

mainstay of treatment for a soft tissue sarcoma

A
  • 1-2 cm margin

- at least one uninvolved fascial plane

47
Q

role of radiotherapy in soft tissue sarcomas

A
  • adjuvant radiation treatment mainly

- used to reduce recurrence: tumor > 5cm, <1cm margin, unable to re-resect positive margin, high grade

48
Q

abdominal wall mass with biopsy showing long, sweeping fascicles containing bland cells and atypia

A
  • Desmoid tumor
49
Q

treatment for Desmoid tumor

A
  • typically self resolve, follow with 3-6 month follow up CT
  • if sx then resect
50
Q

most concerning feature of dermatofirbosarcoma protuberans

A

fibrosarcomatous changes

51
Q

most common form of melanoma in black patients

A

Acral lentiginous melanoma

52
Q

contraindication for transverse rectus myocutaneous flap

A

previous abdominal surgery/compromised superior epigastric artery

53
Q

margin needed for skin squamous cell carcinoma

A

4-6 mm

54
Q

margin needed for 1 cm basal carcinoma

A

2 mm

55
Q

margin needed for 1-2 cm basal cell carcinoma

A

3-5 mm

56
Q

margin needed for > 2 cm basal cell carcinoma

A

1 cm

57
Q

empiric treatment for soft tissue infection

A

penicillin or carbapenem AND clindamycin

58
Q

first line treatment for moderate to severe hydradenitis

A

tetracyclines (eg Doxycycline)

True Learn Studying 2021 (27 decks)

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