Exam 1 - Benign Lesions, Wound Care, Lab, Antiseptics, Local Anesthetics Flashcards
(119 cards)
1
Q
Name the lesion:
Non-palpable localized change in skin color < 1cm
A
Macule
2
Q
Name the lesion:
Non-palpable localized change in skin color > 1cm
A
Patch
3
Q
Name the lesion:
Solid, elevated lesion in epidermis < 5mm
A
Papule
4
Q
Name the lesion:
Solid, elevated lesion in epidermis > 5mm
A
Plaque
5
Q
Name the lesion:
Solid, elevated lesion extending into the dermis or subcutaneous tissue > 5mm - 2cm
A
Nodule
6
Q
Name the lesion:
Solid, elevated lesion extending into the dermis or subcutaneous tissue > 2cm
A
Tumor
7
Q
Name the lesion:
Localized edema in epidermis causing irregularly shaped lesion
A
Wheal
8
Q
Name the lesion:
Localized accumulation of serous fluid in epidermis < 5mm
A
Vesicle
9
Q
Name the lesion:
Localized accumulation of serous fluid in epidermis > 5mm
A
Bullae
10
Q
Name the lesion:
Localized accumulation of pus < 5mm
A
Pustule
11
Q
Name the lesion:
Fluid-filled or solid mass in skin extending into dermis or subcutaneous tissue
A
Cyst
12
Q
Name the lesion:
A
Seborrheic Keratosis
13
Q
Name the lesion:
A
Seborrheic Keratosis - Rough type
14
Q
Name the lesion:
A
Dermatosis Papulosa Nigra
15
Q
What are the most common benign skin neoplasms (2)?
A
Seborrheic Keratosis
Nevi
16
Q
Tx of Seborrheic Keratosis
A
None
Cryotherapy
Dermabrasion
Punch biopsy
Lasers/Chemical peels
Shave biopsy (if black w/o horn cysts)
17
Q
Name the lesion:
A
Acrochordon (skin tag)
18
Q
Acrochordon DDX
A
Intradermal nevi
Neurofibroma
19
Q
Name the lesion:
A
Dermatofibroma
20
Q
Name the lesion and the diagnostic test
A
Dermatofibroma
“Dimple sign”
21
Q
Tx of dermatofibroma
A
None
Full-thickness excision (will produce a scar)
22
Q
Dermatofibroma DDX
A
Nevi
Malignant Melanoma
Dermatofibrosarcoma Protuberans
23
Q
Name the lesion:
A
Keloid
24
Q
Name the lesion:
Enlargement of the scar within the boundary of the original scar
A
Hypertrophic scarring
25
Name the lesion:
Enlargement of the scar beyond the original scar boundary
Keloid
26
Name the lesion:
Hypertrophic Scar
27
Tx of keloids
Silicone-based therapy (gel, sheets, spray)
Laser therapy
Cryotherapy
Surgery (last option due to recurrence)
28
Name the lesion:
Chondrodermatitis Nodularis Chronica Helicis
29
Risk factors for Chondrodermatitis Nodularis Helicis
Actinic damage, cold exposure, trauma, local ischemia
30
Name the lesion:
Early - central crust at apex
Long standing - dense rolled edges
Chondrodermatitis Nodularis Helicis
31
Chondrodermatitis Nodularis Helicis DDX
SCC
BCC
Actinic Keratosis
32
Name the lesion:
Epidermal Inclusion Cyst
33
Epidermal Inclusion Cysts are filled with "trapped" _______
Keratin
34
Which are more common, epidermal inclusion cysts, or sebaceous cysts?
Epidermal inclusion cysts
35
Pilar cyst DDX
Lipoma
Nasal glioma
Gardner's Syndrome
36
Name the lesion:
Milia (milium)
37
Tx of milia
Infants - Resolve spontaneously
Adults - #11 scalpel and express, retinoid therapy with multiple
38
Name the lesion:
Meibomian Cyst
39
Name the lesion:
Digital Mucous Cyst (myxoid cyst)
40
Name the lesion:
Ganglion Cyst
41
Name the lesion:
Sebaceous Hyperplasia
42
Sebaceous Hyperplasia DDX
BCC
Small keratoacanthoma
Molluscum contagiosum
Syringoma
43
Name the lesion:
Syringoma
44
What is the most common tumor of the intraepidermal sweat glands?
Syringoma
45
Are Syringomas Autosomal Dominant or Recessive?
AD
46
Where can syringomas appear on the body?
Lower lids, forehead, vulva, abdomen, chest
47
Who is she?
Lipoma
48
Lipoma DDX
Liposarcoma
Angiolipoma
Metastatic malignant tumors
49
Name the lesion:
Neurofibroma
50
Name the lesion and the diagnostic sign
Neurofibroma
"Buttonhole" sign
51
Von Recklinghausen's Disease is associated with what lesions?
Neurofibromas
52
Von Recklinghausen's Disease sxs
Multiple neurofibromas
Cafe-au-lait spots
Axillary freckling
53
Neurofibroma DDX
Skin tags
Dermal nevi
54
Name the lesion:
Smooth or slightly elevated, most are hairless
Junctional Nevi
55
Name the lesion:
Slightly elevated, smooth or warty, more elevated with age, hair may be presesnt
Compound Nevi
56
Name the lesion:
Halo Nevi (compound nevi)
57
Name the lesion:
Dermal Nevi
58
(True or False) Symptomatic nevi should always be regarded suspiciously
True chainz
59
Name the lesion:
Atypical Nevi
60
(True or False) Atypical Nevi increase the risk for developing primary melanoma
True
(3-20 fold risk)
61
Who is she??
Lesion with irregular margins, superficial, ruddy granular tissue, painless, exudative, firm edema/woody
Venous Ulcer
62
Who is she??
Lesion on the lateral malleolus, between toes, or phalangeal heads. Pale deep wound bed, painful, pale dry granulation, thin/shiny/dry skin, pallor, cool, deminished pulses.
Arterial Ulcer
63
Who is she??
Lesion on buttocks, perineum, upper thigh, skin folds.
Red, partial thickness (limited to epidermis/dermis), no necrosis, painful and itchy.
Incontinence Associated Dermatitis
64
Who is she??
Lesion that is circumscribed and usually over bony prominences, partial to full thickness deep tissue injury, slough or eschar.
Pressure injury
65
Who is she??
Venous Ulcer
66
Who is she??
Arterial Ulcer
67
Who is she??
Incontinence Associated Dermatitis
68
Who is she??
Lipodermatosclerosis
69
What are the 4 healing stages?
Hemostasis
Inflammatory
Proliferative
Maturation
70
What is the pH of the skin
4-5.5 pH
71
Wound thickness - Superficial
Epidermis only (abrasion, laceration, burn)
72
Wound thickness - Partial thickness
Epidermis and partial dermis only. Pink and painful, no slough. (Partial skin thickness burn, skin tear)
73
Wound thickness - Full thickness
Through dermis and and into the subcutaneous tissue. Possibly to muscle, tendon, or bone. Often develops slough. (Laceration, venous insufficiency)
74
Drainage - Sanguineous
Blood or bleeding
75
Drainage - Serosanguineous
Thin bloody looking or pink
76
Drainage - Serous
Thin yellow, green, tan, or brownish. Can form crusting if dry.
77
Drainage - Purulent
Yellow, greenish, thick
78
What is undermining?
A spot where the skin is no longer connected to the subcutaneous fat/muscle.
79
What is slough?
Yellow fibrinous tissue of fibrin, pus, proteinaceous material. Can be found on the surface of a previously clean wound bed. Thought to be associated with bacterial activity.
80
What are the two types of forceps typically in an NUNM suture pack?
Smooth Adson forceps
Brown-Adson Toothed Forceps
81
Know the difference between the structure and use of needle holders vs. hemostats.
Needle Holders: Straight and short knurled jaws to prevent needle from rolling.
Hemostats: Crosshatched/toothed surface in contrast to needle holders. Used to retrieve foreign bodies in wound, clamp bleeding vessels or tourniquet.
82
What is the most commonly used scalpel blade for minor surgery?
#15 (small lesions)
83
What needle sizes are used: Aspirating a cyst/ganglion
14, 16, 18 - 1.5"
84
What needle sizes are used: Drawing up anesthetics/bicarb
20, 21, 22 - 1" or 1.5"
85
What needle sizes are used: Injecting anesthetics for minor surgery
25-30 gauge
Most common 27 gauge - 1" or 1.5"
86
Which is better for healing: Inversion or eversion of the skin?
Eversion
87
Most common needle size used at NUNM
#19
88
Any process that eliminates or kills all forms of life, including transmissible agents (such as fungi, bacteria, viruses, spore forms, etc). May not destroy prions.
Sterilization
89
Destroy microorganisms (but not endospores and viruses) found on non-living objects by destroying the cell wall or interfering with the cell metabolism.
Disinfection
90
Process of using heat, chemicals, or UV rays to kill most or nearly all microorganisms on skin, in wounds, on mucous membranes, on clothing, and on hard surfaces.
Antisepsis
91
Name the commonly used antiseptics
Alcohol
Iodine
Chlorhexidine gluconate
Hydrogen peroxide
Nonionic surfactants
92
What are the pros/cons of nonionic surfactants?
No adverse effects in wounds, but has no antibacterial actvitiy
93
(True or False) Anesthetics (other than cocaine) are generally vasodilators
True
94
What are the most widely used local anesthetic agents (Esters)
Procaine (Novocaine)
Tetracaine (Pontocaine)
95
What are the most widely used local anesthetic agents (Amides)
Lidocaine (Xylocaine)
Bupivacaine (Marcaine)
96
Which nerve fibers are most sensitive to actions of local anesthetics?
Small nerve fibers
97
What are the benefits of adding epinephrine to injections?
Vasoconstrictive (stops bleeding), longer lasting effects
98
With the administration of local anesthetics, what sensation or function disappears first and which follow in that order?
Sensation of pain, cold/warmth, touch, deep pressure, motor function
99
Into which tissues is it not safe to inject local anesthetics containing epinephrine?
Ears, nose, fingers, toes, penis
100
What is the purpose of adding sodium bicarbonate to local anesthetics?
Reduces pain, decreases the onset and increases the duration of local anesthetics.
101
Allergic reaction is more common with (Esters/Amides)
Esters
102
(Esters/Amides) are hydrolyzed by plasma esterase and excreted via the kidneys
Esters
103
(Esters/Amides) are primarily metabolized by the endoplasmic reticulum in the liver
Amides
104
Ester or Amide?
Procaine (Novocaine)
Ester
105
Ester or Amide?
Tetracaine
Ester
106
Ester or Amide?
TAC Topical
Ester
107
Ester or Amide?
Opthaine (Proparacaine Hydrochloride)
Ester
108
Ester or Amide?
Cetacaine (Rostra Spray)
Ester
109
Ester or Amide?
Lidocaine (Xylocaine)
Amide
110
Ester or Amide?
Bupivacaine (Marcaine)
Amide
111
Ester or Amide?
Mepivacaine
Amide
112
Ester or Amide?
Prilocaine (EMLA cream)
Amide
113
TAC Topical indications
Sutures, pediatric pts
114
Opththaine indications
Topical eye application
Ocular pressure testing
115
Cetacaine (Rostra Spray) indications
Mucous membrane (NOT conjunctiva)
Skin tag in mouth
Overriding gag reflex
116
Lidocaine duration with and without epi
Without 30-60 min
With 120-360 min
117
Buprivacaine (Marcaine) onset and duration
2-3 hour duration
Slow onset 8-12 min
118
(True or False) Mepivacaine can be used with epi
False, it is already slightly vasoconstrictive
119
Prilocaine (EMLA cream) onset and duration
1 hour onset
4 hour duration
