Skin/Soft Tissue

Question 1

Incision for excisional bx of skin lesion

Answer 1

Longitudinal, elliptical

Question 2

Diabetic foot ulcer; tx

Answer 2

Debridement, off-loading, tx of PAD and glycemic control

Question 3

Acute paronychia; initial management

Answer 3

Warm compresses

Question 4

Purulent paronychia; common bacteria and tx

Answer 4

MSSA, incision and drainage

Question 5

Predictor used for NSTI

Answer 5

LRNEC: Na<135, WBC>15, CRP>15, Cr>1.6, Glu>180

Question 6

Split-thickness donor sites

Answer 6

Lateral thigh, buttock, scalp

Question 7

Full-thickness donor sites

Answer 7

Pre/post-auricular, Supraclvicular, Groin, Medial arm, abdomen

Question 8

Pilonidal abscess; tx

Answer 8

I&D

Question 9

Margin for cutaneous SCC

Answer 9

1cm

Question 10

Firm, flesh colored, red plaques with finger-like projections of spindle cells

Answer 10

Dermatofibrosarcoma protuberans

Question 11

Indication for SLNB in non-metastatic melanoma

Answer 11

No clinically positive nodes, <0.8mm with ulceration or 0.8-1.0mm with or without ulceration

Question 12

NSTI bacteria

Answer 12

Polymicrobial

Question 13

Securing STSG with mild oozing

Answer 13

Fibrin glue, provides some hemostasis

Question 14

Crucial step for repair fo lip lacerations

Answer 14

Vermillion border reapproximation

Question 15

Lymphadema management

Answer 15

Massage, ROM, elevation, compression

Question 16

Pressure wound classification

Answer 16

Stage 1 - Nonblanching erythema
Stage 2 - Dermis
Stage 3 - Exposed subcu
Stage 4 - Exposed muscle/fascia/bone

Question 17

Locations requiring FTSG

Answer 17

Small wounds, face, joints

Question 18

Advantages to STSG

Answer 18

Can cover large area

Question 19

Advantages to FTSG

Answer 19

Less contraction, better cosmesis

Question 20

Source of re-epithelialization in STSG

Answer 20

Stem cells in the hair follicles

Question 21

Moh’s surgery indications

Answer 21

Higher-risk BCC/SCC

Question 22

Drooping of the corner of the mouth after subplatysmal flap carried above inferior border of mandible; dx

Answer 22

Injury to marginal mandibular br of facial nerve

Question 22

Drooping of the corner of the mouth after subplatysmal flap carried above inferior border of mandible; dx

Answer 22

Injury to marginal mandibular br of facial nerve

Question 23

Difference between keloid and hypertrophic scars

Answer 23

Both are raised, erythematous and often pyritic but hypertrophic do not exceed boundaries of original scar

Question 24

Most commonly mutated somatic gene in melanoma

Answer 24

BRAF V600E mutation

Question 25

Scaly, irregular, dark brown lesions over skin exposed areas

Answer 25

Actinic keratosis

Question 26

First cells to populate wound and initiate inflammatory reponse

Answer 26

Platelets

Question 27

Additional workup for melanoma stage I and II

Answer 27

none

Question 28

Melanoma with clinically pos nodes; next step

Answer 28

FNA or core needle bx

Question 29

Cut on foot now with streaks of erythema and palpable nodes; dx and tx

Answer 29

Lymphangitis, abxs

Question 30

Actinic keratosis; precursor to what and tx

Answer 30

SCC, curettage and electrodesiccation, creo Mohs or simple excision

Question 31

Strawberry hemangioma tx

Answer 31

Observation unless complication, then propranolol

Question 32

Brown or violet cutaneous lesions in HIV; dx and association

Answer 32

Kaposi sarcoma, HHV8

Question 33

Refractory Hurley stage III hidradenitis suppurative, tx

Answer 33

Wide excision with reconstruction via STSG or advancement flaps

Question 34

Empiric tx for NSTI, MOA

Answer 34

Vanc, augmentin, clinda Gram+, gram-, anaerobic, anti-toxin

Question 35

Rectal urgency, new bleeding, pain, incontinence after prostate brachytherapy; dx and tx

Answer 35

Radiation proctitis, medical management

Question 36

Indications for deep inguinal lymph node dissection

Answer 36

4+ pos on sup dissection Pos cloquet node Enlarged oleo-obturator LNs on CT Clinically palpable or extra capsular invasion

Question 37

Frostbite with erythema, edema, hyperemia; grade and tx

Answer 37

Grade I, rapid rewarming with circulating bath

Question 38

Frost bite with clear blisters, edema, desquamation; grade and tx

Answer 38

Grade II, active rewarming with circulating bath

Question 39

Frostbite with hemorrhagic blisters, blue-grey; grade and tx

Answer 39

Garde III, active rewarming with circulating bath

Question 40

Frostbite with full-thickness, mottled, red, dry, black, mummified skin; grade and tx

Answer 40

Grade IV, active rewarming with circulating bath

Question 41

Fingertip pad infection; organism and tx

Answer 41

Staph, I&D can start with abx, soaks, elevation

Question 42

>50 nevi with first or second degree fam hx of melanoma; dx and tx

Answer 42

Dysplastic nevus syndrome, bx and removal of suspicious lesions and skin surveillance