General Flashcards
A patient comes in with a foreign body to the finger. What is your first step?
Evaluate for sensation and circulation
What is the number one cause of FB sensation?
Glass
If it is small, asymptomatic, no need to remove.
Which materials pose the highest risk of infection when it comes to foreign bodies?
Organic splinters
A patient comes in with a horizontal splinter. How do you treat?
Incise/deroof and remove.
Irrigate with NS.
A patient comes in with a vertical splinter. How do you treat?
Elliptical incision, lift cone and undercut.
Irrigate with NS.
A patient comes in with a subungual splinter. How do you treat?
V section, shave, or trephination.
Remove splinter and irrigate with NS.
A patient comes in with sweaty tennis shoe syndrome following a nail puncture to the foot. What criteria must they meet in order to be considered for this dx?
> 4 days of persistent symptoms post puncture.
A patient comes in with a nail puncture. What sequelae are we most concerned about?
Osteomyelitis
What is the causative agent of sweaty tennis shoe syndrome?
Tx?
Pseudomonas aeruginosa
16+: ciprofloxacin
<16: ceftazidime
Define cellulitis
Diffuse skin infection that presents with warmth, edema, and erythema
Define abscess
localized skin infection that contains pus within the dermis or subcutaneous space
Define a furuncle
Boil
Single infection that develops around a hair follicle
Define a carbuncle
a coalescence of several furuncles
Deeper than furuncles and can cause scarring
What are some common areas abscesses tend to grow in?
Back of neck, face, axillae, and buttocks - coarse haired areas
What is the number one infective agent in superficial purulent skin infections?
Stah. aureus
What must you NOT do when working on an abscess that is located on the finger/toe, penis or nose?
DO NOT use epinephrine
A patient presents with an abscess. Are antibiotics needed? How do you treat?
Tx: I&D
PO antibiotics are not needed unless there is surrounding cellulitis. Topical antibiotics are not effective.
A patient presents with an abscess. What criteria must be met for it to be packed?
abscess >5 cm
Pilonidal cyst - on gluteal cleft.
DM patient
Immunocompromised
A patient presents with a pilonidal cyst and cellulitis. Is antibiotic treatment recommended?
Yes - cellulitis and the pilonidal cyst
A patient comes in with a history of recurrent and multiple abscesses. Is antibiotic treatment recommended?
Yes - recurrent and multiple abscesses
A 2 month old patient comes in with an abscess. Is antibiotic treatment recommended?
yes - extremes of age (young infants and elderly)
A patient comes in with purulent cellulitis without signs of systemic infection. What tx is called for?
TMP-Sulfa BID x 7 days
A patient comes in with purulent cellulitis with signs of systemic infection. What tx is called for?
IV vancomycin q 12 hrs - this covers MRSA
A patient comes in for a perirectal abscess. What tx is not recommended?
I&D
