Skin/Soft Tissue Flashcards
Incision for excisional bx of skin lesion
Longitudinal, elliptical
Diabetic foot ulcer; tx
Debridement, off-loading, tx of PAD and glycemic control
Acute paronychia; initial management
Warm compresses
Purulent paronychia; common bacteria and tx
MSSA, incision and drainage
Predictor used for NSTI
LRNEC: Na<135, WBC>15, CRP>15, Cr>1.6, Glu>180
Split-thickness donor sites
Lateral thigh, buttock, scalp
Full-thickness donor sites
Pre/post-auricular, Supraclvicular, Groin, Medial arm, abdomen
Pilonidal abscess; tx
I&D
Margin for cutaneous SCC
1cm
Firm, flesh colored, red plaques with finger-like projections of spindle cells
Dermatofibrosarcoma protuberans
Indication for SLNB in non-metastatic melanoma
No clinically positive nodes, <0.8mm with ulceration or 0.8-1.0mm with or without ulceration
NSTI bacteria
Polymicrobial
Securing STSG with mild oozing
Fibrin glue, provides some hemostasis
Crucial step for repair fo lip lacerations
Vermillion border reapproximation
Lymphadema management
Massage, ROM, elevation, compression
Pressure wound classification
Stage 1 - Nonblanching erythema
Stage 2 - Dermis
Stage 3 - Exposed subcu
Stage 4 - Exposed muscle/fascia/bone
Locations requiring FTSG
Small wounds, face, joints
Advantages to STSG
Can cover large area
Advantages to FTSG
Less contraction, better cosmesis
Source of re-epithelialization in STSG
Stem cells in the hair follicles
Moh’s surgery indications
Higher-risk BCC/SCC
Drooping of the corner of the mouth after subplatysmal flap carried above inferior border of mandible; dx
Injury to marginal mandibular br of facial nerve
Drooping of the corner of the mouth after subplatysmal flap carried above inferior border of mandible; dx
Injury to marginal mandibular br of facial nerve
Difference between keloid and hypertrophic scars
Both are raised, erythematous and often pyritic but hypertrophic do not exceed boundaries of original scar
Most commonly mutated somatic gene in melanoma
BRAF V600E mutation
Scaly, irregular, dark brown lesions over skin exposed areas
Actinic keratosis
First cells to populate wound and initiate inflammatory reponse
Platelets
Additional workup for melanoma stage I and II
none
Melanoma with clinically pos nodes; next step
FNA or core needle bx
Cut on foot now with streaks of erythema and palpable nodes; dx and tx
Lymphangitis, abxs
Actinic keratosis; precursor to what and tx
SCC, curettage and electrodesiccation, creo Mohs or simple excision
Strawberry hemangioma tx
Observation unless complication, then propranolol
Brown or violet cutaneous lesions in HIV; dx and association
Kaposi sarcoma, HHV8
Refractory Hurley stage III hidradenitis suppurative, tx
Wide excision with reconstruction via STSG or advancement flaps
Empiric tx for NSTI, MOA
Vanc, augmentin, clinda
Gram+, gram-, anaerobic, anti-toxin
Rectal urgency, new bleeding, pain, incontinence after prostate brachytherapy; dx and tx
Radiation proctitis, medical management
Indications for deep inguinal lymph node dissection
4+ pos on sup dissection
Pos cloquet node
Enlarged oleo-obturator LNs on CT
Clinically palpable or extra capsular invasion
Frostbite with erythema, edema, hyperemia; grade and tx
Grade I, rapid rewarming with circulating bath
Frost bite with clear blisters, edema, desquamation; grade and tx
Grade II, active rewarming with circulating bath
Frostbite with hemorrhagic blisters, blue-grey; grade and tx
Garde III, active rewarming with circulating bath
Frostbite with full-thickness, mottled, red, dry, black, mummified skin; grade and tx
Grade IV, active rewarming with circulating bath
Fingertip pad infection; organism and tx
Staph, I&D can start with abx, soaks, elevation
> 50 nevi with first or second degree fam hx of melanoma; dx and tx
Dysplastic nevus syndrome, bx and removal of suspicious lesions and skin surveillance
