Skin & Soft Tissue Flashcards
What is associated with decreased hernia recurrence: prosthetic or synthetic mesh?
Prosthetic mesh
Which has less immunoreactivity: synthetic or biologic mesh?
Biologic
When to use synthetic mesh for hernias?
Wound class 1-2
When to use biologic mesh for hernias?
Wound class 3-4 if defect is >3cm
At what point does a wound reach 60% of its final tensile strength?
6 weeks
At what time does a wound reach its greatest tensile strength?
8 weeks
What type collagen is initially present in healing wounds?
Type III collagen
What type of collagen provides the final tensile strength of the wound?
Type I collagen
What cells mediate wound contraction?
Myofibroblasts (mainly found at edges)
What factors stimulate wound contraction?
PDGF-AB and BB released by platelets and macrophages
When does wound contraction begin?
After 4-5 days
What factors are released by macrophages in early stages of wound healing?
IL-1, IL-6, IL-8, and TNF-a
When is the maximum collagen accumulation in a wound?
3 weeks after injury
Initial treatment of frostbite grade I
Moist reheating using whirlpool bath
What mediates the release of platelet-aggregating factor from platelets?
Leukotrienes
What virus is associated with merkel cell carcinoma
Polyomavirus
Most common induction agent for immunosuppression after kidney transplant
Thymoglobulin
Diagnosis of a burn infection
10^5 bacteria/gm of tissue from wound culture
Treatment of stretch marks
Reconstructive therapy or laser therapy
Treatment for superficial partial thickness burn of the face
Neomycin or polymyxin B
Treatment of a partial thickness burn
Silver sulfadiazine or silver nitrate
Treatment of a full thickness burn
Mafenide acetate (can penetrate eschar)
Which burn treatment causes metabolic acidosis
Mafenide acetate
Which burn treatment causes nephrotoxicity
Bacitracin
Which burn treatment causes methemoglobinemia
Silver nitrate
Which burn treatment causes hyponatremia
Silver nitrate
Which burn treatment causes transient neutropenia
Silver sulfadiazene
Which transplant med: nephrotoxicity, hypertension, gingival hyperplasia, hirsutism
Cyclosporine
Which transplant med: nephrotoxicity, alopecia, hypertension, diabetogenic
Tacrolimus
Which transplant med: hepatotoxicity, BM suppression, leukopenia
Azathioprine
Which transplant med: nausea, diarrhea, abdominal cramps, hepatotoxicity, leukopenia
Mycophenolate
Which transplant med: anemia, hyperlipidemia, thrombocytopenia, poor wound healing
Sirolimus
Familial atypical multiple mole syndrome - what cancers are they at risk for
Melanoma (100% lifetime risk) and pancreatic cancer
Management of paronychia
I&D, clindamycin
Pathophysiology of GVHD
Activation and differentiation of donor cells into Th1 and Th17 lineages
When do you do a deep inguinal lymphadenectomy for melanoma?
If Cloquet’s node (first of the deep nodes) is positive
What is the most prevalent type of skin cancer
Basal cell carcinoma
Gorlin syndrome
Multiple basal cell carcinomas, spine/jaw anomalies, pitting of palms and soles
What is the endpoint for resuscitation for burn patients
Urine output
Parkland formula
4mL/kg of %BSA
Half in first 8 hrs
Other half in next 16 hrs
What surgical margins are needed for basal cell cancer
4mm
Surgical margins for subungual melanoma at the finger
Amputation at mid proximal phalanx
Surgical margins for subungual melanoma of the toe
Toe amputation including metatarsal head
Melanoma in inguinal region with positive sentinel lymph node biopsy - what is the next step?
US surveillance of inguinal region q3mo
What is the defect in classical type of Ehlers Danlos
Type V collagen
Indications for adjuvant radiation for trunk and extremity soft tissue sarcoma: high grade, large (>5cm), or close margins
