surgical complications Flashcards

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1
Q

what drugs might give you a morbilliform rash and arthralgias 3 days later if Mono was treated with it.

A

ampicillin, amoxicillin azithromycin (3As)

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2
Q

how long can perichondritis and chondritis last after a wedge excision of the ear.

A

2 months

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3
Q

For a cartilage post op ear infection what two Fluoroquinolones could be chosen for treatment?

A

Cipro ciprofloxacin
levofloxacin

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4
Q

What is this condition called

A

Erosive pustular dermatosis of the scalp

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5
Q

How is erosive pustular dematosis of the scalp treated.

A

High potency topical steroids.

Dapsone and calcineurin inhibitors as well as a second line treatment

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6
Q

what is the main cardiac complication of Bupivacaine

A

Bradycardia

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7
Q

If someone is having an arrythmic reaction to Bupivacaine what can be given to correct it.

A

lipid emulsion

Bupivacaine is highly lipid soluble

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8
Q

increasing Lipid solubility of an anesthetic does what

A

Increases the potency

(penetrates the nerve better)

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9
Q

what are the four branches of the facial artery

A

angular

lateral nasal

superior labial

inferior labial

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10
Q

Should tension vectors be horozontial or perpendicular to a free margin

A

Perpendicular

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11
Q

What is this condition

A

levamisole cut cocaine toxicity

It is an anti helminthic for pets

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12
Q

If prophylactic antibiotic is needed what is most commonly used

A

2 grams Cephalexin 30-60mins prior to keratinized skin surgery.

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13
Q

what is the antibiotic prophylaxis for mucosal surfaces that meet criteria

A

2 grams amoxicillin 30-60min prior to the procedure

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14
Q

What are the four stages of hematoma formation

A

First stage- early development - if not removed later phases occur <48 hours

Second Stage- Gelatinous day2-3

Third stage - Organization hard and rubbery- difficult to get out day 3-5

4th stage- Liquifaction 7-10 days

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15
Q

What is Frey’s Syndrome

A

Gustatory sweating due to auriculotemporal nerve damage.

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16
Q

What four classes of drugs can potentiate side effects of epinephrine?

A

Beta Blockers

MAO inhibitors

Tricyclic antidepressants

Phenothiazines

17
Q

circumoral numbness is associated with what complication during surgery?

A

lidocaine toxcity

18
Q

What is the dtug of choice if you can’t give cephalexin 2gms 30-60mins prior to surgery due to a PCN and possible cross rxn

A

Clindamycin 600mg one hr prior to surgery.

19
Q

which has a higher rate of infections secondary intention healing or first intention healing

A

Secondary intention healing

20
Q

What is the risk for infection primary intention vs secondary intention

A

3.2 % vs 6.8%

21
Q

what is the rate of infection face vs leg

A

2.5% vs 10.5%

22
Q

What are three things to know about intralesional injection of clindamycin to prevent post op infections

A

Lower systemic absorption than oral

No increase in antibiotic resistance

decreased GI effects

23
Q

what areas of the body have a higher rate of surgical infections

A

nose lips ears

lower leg and feet

groin

24
Q

what is the most common cultured bacteria in surgical wound infections

A

Staphlococcus aureus

25
Q

Name three anticoagulants that have more post op bleeding than coumadin aspirin and plavix

A

Apixaban - Eliquis bid

Rivaroxaban - Xarelto qd factor Xa inhibitor

Dabigabtran - Pradaxa bid thombin inhibitor

26
Q

what is the treatment for overdose of apixaban and Rivaroxaban

A

Eliquis & Xerelto

Factor Xa Andexxa

27
Q

what is the treatment for overdose of dabigatran

A

Pradaxa

Idarucizumab (Praxbind)

28
Q

what vascular problem causes the quickest flap necrosis

A

venous congestion can occur in less than 4 hours

order edema-capillary slowing- thrombosus arteries and veins- ischemia- necrosis

29
Q

how to tell veinous congestion from arterial insufficiency

A

11 blade prick will not bleed in arterial insuffieceny and will ooze dark purple blood in venous congestion

Venous congestion will be cyanotic or purple flap

Arterial insufficeny will be pale

30
Q

what is trigeminal trophic syndrome and how is it treated.

A

anesthetic ucler on upper lip or more commonly ala with nasal tip sparing

Multiple treatments exist

anti depressants

bolsters

Steroids

flap

anticonvulants gabapentin and pregbalin

31
Q

what foods do laxtex cross react allergically

A

Bananas

Avocado

chestnut

Kiwi and Passion Fruit

32
Q

What is a serious risk for surgery on the nasal sidewall

A

the opthalmologic veins drain into the cavernous sinus.

Septic thrombosis can occur with meingitis and brain abcesses

33
Q

What is the maxium dose of Lidocaine with epi for tumescent anesthesia?

A

55mg/Kg

34
Q

LAST (Local and Systemic Toxcisity) can occur in over 60 minutes in what % of patient that get it.

A

25%

40% at 10 minutes

35
Q

What are early symptoms of LAST from lidocaine.

A

perioral numbness

paraesthesias

tinnitus

tremor

all signs of CNS stimulation followed by CNS inhibition then cardiac stimulation followed by inhibition

36
Q

antibiotic prohylaxis is reccomended for high risk surgical site infection in all cases

what are the high risks 6

A

lower extremity

Groin

Wedge excisions lip or ear

Flaps on the nose

Grafting

Extensive inflamatory disease.