Soft Tissue And Skin Flashcards
Discuss the microbiology of necrotising fasciitis
Type 1- polymicrobial
Aerobic + anaerobic organisms - bactericides, clostridium, peptostreptococcus, enterobactericae, klebsiella, proteus, entrobacter
Strep
Usually in older or comorbid patients type 2 DM, PVD, obesity
Type 2 monomicrobial
Group a strep
B haemolytic strep
Staph Aures
‘M’ protein is important virulence factor
Vibrio
General risk factors
Diabetes, obesity, immune suppression, mucosal breach, penetrating trauma, recent surgery
Clostridial myonecrosis - “gas gangrene”
- secondary to trauma or spread from GIT
- myonecrosis
Discuss the ABCDEFG clinical exam for malenoma
For regular nevi A - asymmetry B - irregular borders C - irregular colour D- diameter greater than 6mm E- elevation
For atypical naevi (nodular, desmoplastic, amalenotic, subungal)
E- elevation
F - firm on palpating
G - growth over a month
Subungal A- African/Asian B- brown/black band C/ change in nail band D- digit - great toe or thumb E- extension of pigment into proximal nail fold F- family history of malenoma
Staging for frostbite
graded 1-4 based on level of cyanosis after rewarming in warm water
1 - none
2- distal phalanx - usually nail loss
3 - intermediate/proximal phalanx - predicts bone amputation
4 - carpal/tarsal bone cyanosis - limb amputation
prognostic factors in sarcoma
size
grade (mitotic count, differentiation, necrosis)
resection margin
IHC for malenoma
HMB 45
MART 1
S100
What is loss of domain with regards to hernia
> 20-30% of abdominal contents reside in the hernia
carpal tunnel syndrome grading
mild - parasthesia + no sleep loss
Moderate - loss of sensation +/- mild nocturnal symptoms
severe - sensory and motor function loss +/- severe nocturnal symptoms
mild - trial conservative treatment - wrist splints +/- steroid inj.
if non responsive mild or mod/severe perform surgery
Generally should perform nerve conductions pre surgery to confirm diagnosis.
