Common Office Procedures
Help!
|
|
||||
|---|---|---|---|---|---|
| lIdocaine | AmIde (longer half life than esters)
🗑
|
||||
| Procaine | Ester (shorter half life than amides)
🗑
|
||||
| MOA of local anesthetics | block action potentials
🗑
|
||||
| ___ fibers are blocked bfore __ fibers | C (pain) before A (motor). Clinically, loss of pain, temp, touch, then motor
🗑
|
||||
| Procaine, Benzocaine adn Cocaine are | Esters
🗑
|
||||
| Lidocaine, Bupivacaine are | Amides
🗑
|
||||
| What is used for long acting peripheral infiltration | Bupivacine (Marcaine)
🗑
|
||||
| ____ are prone to causing "allergic" rxns (PABA metabolite) | Ester.
🗑
|
||||
| If someone has liver failure, choose an | Ester
🗑
|
||||
| Where are amides metabolized? | In the liver. Don't use in someone who has liver failure or severe compromise
🗑
|
||||
| _______ is a local anesthetic that causes local vasoconstriction | Epinephrine. Increases local duration of action, decreases systemic toxicity.
🗑
|
||||
| If lidocaine burns, what can you add to it to decrease the pain? | SODIUM BICARBONATE; neutralizes pH of anesthetic, decreases timem of onset of conduction blockade
🗑
|
||||
| Which sx occur first neuro or cardio? | Neurologic: early - lightheaded/dizzy, visual disturbance, tinnitus. Late - perioral numbness, muscle twitches/tremors, seizure. Cardiovascule sx - hypotension (vasodilation), cardiac arrhthymia.
🗑
|
||||
| Is slurred speech an early neurological sign? | NO. Early sx: lightheaded/dizzy, visual disturbance and tinnitus
🗑
|
||||
| Safe dose of Lidocaine | 3-5mg/kg.
🗑
|
||||
| Right before injecting, what should you do once you've entered skin? | Pull back on syringe to make sure you haven't entered a vessel
🗑
|
||||
| What should you do to Xylocaine before using it? | Warm it to body temperature (Lecturer has never done this, ideal)
🗑
|
||||
| Buffered Lidocaine is made of | Bicarb:Xylocaine in 1:9 part ratio
🗑
|
||||
| List the types of biopsies | Shave, punch, incisional, excisional
🗑
|
||||
| Downside of Shave biopsy | No architecture, no orientation (anterior, superficial), so can't stage it.
🗑
|
||||
| When should you do shave biopsy? | If you have low suspicion of malignancy. Do not do it in any pigmented thing where you suspect malignancy
🗑
|
||||
| Use this for all pigmented lesions for full-thickness skin and subcutaneous fat | Punch biopsy. Sizes 1-8mm. Usually needs one or two sutures
🗑
|
||||
| When would you do an incisional biopsy? | Large sarcoma.
🗑
|
||||
| What type of incision should you make for an excisional biopsy? | Eliptical;. Length to width ratio of 3:1. Benefits: architecture and margins
🗑
|
||||
| Deep dermal suturing | Deep to superficial on one side, superficial to deep on the opposing side
🗑
|
||||
| treatment for paronychia | I&D
🗑
|
||||
| Felon (infection of terminal phalanx) can cause | tissue necrosis or Osteomyelitis. Treatment is I&D.
🗑
|
||||
| Subungual Hematoma Tx | Drill a hole in the nailbed with a sharp-pointed scalpel blade
🗑
|
||||
| Furuncal Definition | an infection/abscess of the hair follicles caused by obstruction.
🗑
|
||||
| Carbuncle definition | cluster of furuncles
🗑
|
||||
| Tx of Furuncle | I&D, insert scalpel at most fluctuant spot. Make a cross incision.
🗑
|
||||
| Nontender, freely mobile, soft are charactersitcs of | limpomas. Benign fatty tumor. Tx: excision if symptomatic only.
🗑
|
||||
| ______ arise from obstructed follicles and contain cheesy and fetid debris | Epidermal Inclusion Cyst. I&D and remove cyst lining
🗑
|
||||
| Seborrheic Keratosis | "crusty brown sugar appearance". benign
🗑
|
||||
| Actinic Keraotosis | may be pre-cancerous. Appear in sun-exposed areas.
🗑
|
||||
| Basal Cell Cancer | Pearly (less dangerous than Squamous).
🗑
|
||||
| Squamous Cell Cancer | more crusty looking, more dangerous than Squamous.
🗑
|
||||
| Tx for Basal and squamous cell cancer | Excision with at least .3cm radial margins, Mohs micrographic surgery, radiation therapy (after resection depending on staging)
🗑
|
||||
| Most worrisome skin cancer | Melanoma. Rx: punch biopsy or excisional biopsy (NOT SHAVE BX). Need to know depth. Definitive Rx: excise all the way down to fascia.
🗑
|
||||
| Wound with a flap is known as | avulsion
🗑
|
||||
| What is the critical number of bacteria needed to be present to call a wound infected? | > or equal to 10 to the 4th power of bacteria/gram of tissue
🗑
|
||||
| <12 hours old is a | contaminated wound. Infection rate 1-21%
🗑
|
||||
| Definition of dirty wounds | >12 hours, presence of Fb, gross contamination. Infection rate 7-38%
🗑
|
||||
| Most important factor when deciding to close a wound? | Age of the wound. If >24 hours, don't close
🗑
|
||||
| What solution should be used for wet to dry packing? | Saline, not sterile water
🗑
|
||||
| Important points of wet to dry dressings | Wet (not soaked), use saline solution, facilitates mechanical debridement of the wound, DOES NOT prevent bacterial colonization of infection
🗑
|
||||
| Suture for face? | 6-0 prolene
🗑
|
||||
| Thigh wound where you can see muscle? | Absorbable deep, nylon superficial. 2-0 or 3-0. Keep in for two weeks unless DM or on Immunosuppressants (then keep in longer)
🗑
|
||||
| Where is Vicryl (absorbable used)? | utilized below the skin, inside mouth, or where suture removal is difficult. Vicryl lasts 90-120 days
🗑
|
||||
| What will you use for most skin closures? | Non-absorbable
🗑
|
||||
| What may be a good option for scalp, trunk or some extremity wounds? | Staples
🗑
|
||||
| What suture size do you use for trunk and extremities? | 3-0 or 4-0
🗑
|
||||
| Antibiotics are indicated when? | Open fracture where you can see bone
🗑
|
||||
| Clostridium tetani is what type of bacteria? | Gram-positive anaerobe
🗑
|
||||
| Not appropriately immunized people who have a dirty, tetanous prone wound are given | Tetanus toxoid and Tetanus immunoglobulin
🗑
|
||||
| When should tetanus toxoid be given? | patients tetanus immunization unknown or <3 doese, wound >24 hours old, if the pt's last booster dose was >5 yrs (if dirty wound) or >10 years (if clean wound)
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
ltm12