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AliKhan Derm > Surgery Chapter 8 > Flashcards

Surgery Chapter 8 Flashcards

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Dermatology Board Prep flashcards
1
Q

Which of the following is advised to be used in chronic delayed pressure urticarial:
A. Colchicine
B. Sulfasalazine
C. Nifedipine
D. Epinephrine

A

B. Sulfasalazine

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2
Q

Vorinostat, used for a Sezary syndrome, mechanism of action?

A

Inhibition of the histone deacytylase

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3
Q

Merkel cell carcinoma has been linked to Which of the following?
A. Herpes virus
B. CMV
C. Flavi virus
D. Polyoma virus

A

D. Polyoma virus

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4
Q

One of the following inherited disorder with abnormal DNA repair has mismatch DNA repair:
A. XP
B. Cockayne syndrome
C. XP – CS overlap
D. Trichothiodystrophy
E. Muir-Torre syndrome

A

E. Muir-Torre syndrome

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5
Q

Treatment of choicefor delusion of parasitosis A. Doxepin
B. Naltrexone
C. Pramoxetin
D. Pimozide
E. Fexofenadine

A

D. Pimozide

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6
Q

Deuteranopia (green color blindness) is an ocular abnormality seen in:
A. Langerhans cell histiocytosis
B. EED
C. Fabry
D. Pseudoxanthoma elasticum
E. X- linked ichtyosis

A

E. X- linked ichtyosis

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7
Q

Multiple layers of granular cells surrounding sweat ducts in the epidermis is characteristically seen in:
A. KID syndrome
B. Erythrokeratosis variabilis
C. CHILD syndrome
D. Netherton’s syndrome

A

C. CHILD syndrome

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8
Q

S100, CD1, CD68+, Langerin –ve is the immunologic profile of:
A. Benign cephalic histiocytosis
B. Langerhans cell histiocytosis
C. Generalized eruptive histiocytosis
D. Juvenile xanthogranuloma
E. Indeterminate cell histiocytosis

A

E. Indeterminate cell histiocytosis

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9
Q

Microbiology of Hand-foot-mouth?

A

Positive-sense RNA virus

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10
Q

Frey syndrome?

A

Injured parasympathetic nerves erroneously reattach to sweat glands in area resulting in “sweating while eating”

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11
Q

Exceeding > 8 mL per digit causes?

A

Risk of tourniquet effect, limit 2-4 mL total per digit

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12
Q

Gummy smile muscle?

A

Levator labii superioris

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13
Q

Cutaneous danger point, Erb’s point, causes?

A

Winged scapula, inability to abduct arm, and shoulder pain
Erb’s point = site where cervical plexus emerges; located along posterior border of SCM

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14
Q

Mechanism of local anesthetics?

A

Inhibition of sodium ion influx → prevents depolarization → blocks nerve conduction

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15
Q

Where are amide anesthetics metabolized?

A

“two ‘I’s’ = amIde”
Metabolized via CYP 3A4 in liver

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16
Q

How are esters metabolized?

A

via pseudocholinesterases in plasma, renally excreted

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17
Q

Ester anesthetics cross react with?

A

Mnemonic “PPPESTAA”: Paraphenylenediamine (PPD)
PABA
Para-aminosalicylic acid
Ethylenediamine
Sulfonamides
Thiazides
Anesthetics (esters)
Azo dyes

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18
Q

Contraindications to esters?

A

Allergy to PABA or cross-reactors, pseudocholinesterase deficiency

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19
Q

Anesthetic with longest duration of action?

A

Bupivicaine
Highest risk of cardiac toxicity!
Risk of fetal bradycardia

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20
Q

Disadvantages of epinephrine in lidocaine in pregnancy?

A

↓uterine bloodflow, pregnancy category C but diluting to 1:300,000 considered safe

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21
Q

Contraindications to epinephrine in lidocaine?

A

Pheochromocytoma, uncontrolled HTN, digital anesthesia in severe PVD, and uncontrolled hyperthyroidism

22
Q

1% lidocaine is basically?

A

10mg/mL

23
Q

Injection techniques to decrease pain with local anesthesia?

A

■ Buffer w/ bicarbonate
■ Warm anesthetic to body temperature
■ Pretreat w/ topical anesthetics or ice packs
■ Use small diameter needle (30 gauge)
■ Mildly irritate (pinch, rub, Buzzy, ShotBlocker) surrounding skin at the time of injection → decreases transmission of pain signals to brain (“Gate theory” of pain)
■ Inject slowly, starting deep in SQ → gradually move superficial
■ Reintroduce needle at previously anesthetized areas and fan out
■ Music and mental distraction

24
Q

Preservatives in amides and esters?

A

Methylparaben or metabisulfite preservatives in amides
PABA in esters

25
Q

Gold-colored instrument handles indicate?

A

Tungsten carbide, harder and more durable than stainless steel

26
Q

Vertical mattress is for?

A

Vertical = eVert

27
Q

Horizontal mattress is for?

A

Horizontal = Homeostasis
Also, running locked sutures provide homeostasis

28
Q

Purse string suture is for?

A

↓ wound size and ↓ healing time

29
Q

Wounds under high tension, can use?

A

Buried pulley suture
Disadvantage = tissue strangulation

30
Q

Dermabond is?

A

Octyl: 2-octyl cyanoacrylate

31
Q

Liquiband, wound adhesive, is?

A

Butyl: n-butyl cyanoacrylate (dries faster than derma bond) but more rigid

32
Q

Examples of absorbable sutures?

A

Vicryl, chromic gut, PDS, monocryl, plain gut

33
Q

High tissue reactivity is observed with which suture?

A

Plain gut, and second highest is silk
Least inflammation is prolene - best for subcuticular sutures

34
Q

What antiseptic agent is active against spores?

A

Iodine and iodophors, must wait until dry to be effective

35
Q

Which antiseptic agent is teratogenic?

A

Hexachlorophene, causes neurotoxicity too

36
Q

Biterminal means?

A
37
Q

Probe held at a distance (1–2 mm from tissue) → ionized current between probe and tissue “spark gap” is what type?

A

Electrofulguration
Monoterminal device (e.g., hyfrecator)

38
Q

Cell types and their freezing times?

A

○ Melanocytes: –5°C
○ Keratinocytes: –20°C to –30°C
○ Fibroblasts: –35°C to –40°C
○ Benign: –25°C
○ Malignant: –50°C

Nitrogen boiling point: -196

39
Q

M-plasty is used to?

A

To shorten length of excision such that the incision does not extend into an undesired location; common uses: near free margins (perioral and periocular regions)

40
Q

S-plasty is used to?

A

↑ total length of scar, but the linear distance between two apices remains same as linear closure; redistributes tension along different vectors → ↓ tension in central portion of scar → ↓ risk of centrally depressed scar, ↓ dehiscence, and ↓ contraction of scar; common uses: convex surfaces (forearm and shin) and excisions that cross over a joint (elbow and knee)

41
Q

Maximum strength of a scar?

A

80%*
■ 1week = 5%
■ 2 weeks = <10%
■ 1 month = 40%

42
Q

Ectodermosis Pluriorificialis is a type of:
A. Erythema multiforme minor
B. Erythema multiforme major
C. Mucosal erythema multiforme
D. Herpes associated erythema multiforme
E. Drug associated erythema multiforme

A

C. Mucosal erythema multiforme

43
Q

Type of angiokeratoma associated with Cobb syndrome is:
a. Angiokertoma corporis diffusum
b. Angiokeratoma of Fordyce
c. Solitary papularangiokeratoma
d. Angiokeratoma of Mibelli
e. Angiokeratoma circumscriptum

A

e. Angiokeratoma circumscriptum

44
Q

Roseola infant is caused by?

A

HHV-6
“Rose with 6 petals”

45
Q

Primary effect of local anesthetics on never cells is to inhibit or enhance the depolarization phase of the excitation process?

A

INHIBIT the depolarization*

46
Q

Gene for tuberous sclerosis is localized on which chromosomes?

A

9 and 16

47
Q

Final concentration of epinephrine in standard tumescent anesthesia is?

A

1: 1,000,000

48
Q

Herbs and supplements that enhance anticoagulation effects of warfarin?

A

Feverfew, fish oil, garlic, ginger, ginkgo, ginseng, bilberry, chondroitin, vitamin E, licorice, devil’s claw, danshen, dong quai, alcohol

49
Q

Hydorgels used for?

A

Painful wounds

50
Q

Alginates used for?

A

Highly exudative wounds,

AliKhan Derm (13 decks)

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