Skin / Soft Tissue Flashcards
18 M with double joints in family and h/o early death. What dx? Patho? what test ordered?
Ehlers Danlos
defect in collagen III
Aortic root aneurysm with ruture at 40
CT A of the chest to visualize
what are the antimicrobial properties of silver alginate?
Silver can cause ribosomal toxicity, denaturations of proteins, disruption of bacterial cell membrane
classifications of NSTI and microbes (4)
Type I - polymicrobial - mixed anaerobes
Type II - GAS, S aureus, MRSA, ESBL
Type III - Clostridium and Vibrio
Type IV - Fungal - candida
HS pathophysiology
Due to follicular occlusion
Hurley clinical staging system
Pilonidical cystectomy technique
Should be off midline, as the midline gluteal cleft has bacteria and moisture
radiation ulcer treatment
aggressive radial excision
principle sto follow for soft tissue bx
- Ellipse congruent with langer lines
2. scars oriente d along the long axis
closure of the femoral canal or the abdominal wall following a lymph node dissedction can causes another defect where a hernia can develop. what can be done to address this?
Mesh or sartorius flap
management of melanoma based on breslow depth.
Depth <1mm, 1 cm margin
Depth>1mm, 2cm margin
If nodes are positive, completion LAD should be performed
melanoma work up
stage I and II =H/Pwith skin and lymph node exam
stage III CBC, LDH, CXR and CTs
stage IV = MRI brain and PET/CT
55 yo M with sortic root dilation and long limbs on examination. What is the most likley dx and defect?
Marfan syndrome
Fibrillin 1
Tx for dermal scars?
reconstructive surgery only effective treatment
55 M with 1.5 cm purple raised SQ nodule over the forearm with palpable LAD. Bx shows monomorphic cells with large pale cell, which is true about the dx and w/u?
Dx: Merkel cell carcinoma
+ cytokeratin-20 and negative for TTF immuno stains
post mastectomy pt with Lymphadema and new ulceration. next step?
Stewart Treves is upper extremity lymphangiosarcoma that occurs in postmastectomy pts.
first step is incisional bx then wide local excision
