Midterm (not covered in review)

Question 1

What size syringe for irrigation?

Answer 1

20ml

Question 2

Size of suture for Face/Head vs General Body

Answer 2

Face/Head: 5-0, 6-0, 7-0

Gen: 3-0, 4-0, 5-0, 6-0

Question 3

MC synthetic polymer suture material that is ABSORBABLE

Answer 3

Vicryl

Question 4

MC absorbable on skin?

Answer 4

Nylon

Question 5

Most effective method of instrument sterilization?

Answer 5

Chemical

- ethylene oxide or ozone gas

Question 6

Dry and Cold Sterilization?

Answer 6

not very useful.
Cold is Least Effective
Dry - in emergencies

Question 7

what antiseptic is good for mucous membranes like the vagina?

Answer 7

iodine and iodophor solutions

• requires 2min of contact time
• rapidly inactivated
  ex. Betadine

Question 8

MC iodophor for pre-surgical antiseptic use?

Answer 8

Povidone-iodine (Betadine)

Question 9

What is Hibiclens?

Answer 9

good alt to iodophors

• 6+ hrs action on skin
• good on kids

Question 10

nonionic surfactants

• good and bad?

Answer 10

good for eye and cornea
- no antibacterial activity

• it’s a newer type of would cleanser

Question 11

What is the 1st line of defense against invasion of secondary infx?

Answer 11

sterile technique… proper sterile field

Question 12

one of the most important Q’s to ask pt is?

Answer 12

gums bleed?

–> blood dyscrasia

Question 13

What does PARQ stand for?

Answer 13

procedure
alternatives
risk
Q’s

Question 14

in pre-op Dx section of minor surgery report form, put?

Answer 14

reason the lesion was removed

Question 15

Anesthetics other than _____ are generally _______.

Answer 15

cocaine

vasodilators

Question 16

amides metabolized by?

esters by?

Answer 16

amides: LR ER
esters: KD - plasma esterase

Question 17

What may diminish effects of local anesthetics?

Answer 17

hypercalcemia, hypernatremia, hypokalemia

Question 18

actions of local anesthetics:

Answer 18

1. sensation of pain
2. temp
3. touch
4. pressure
5. motor
   * recovered in reverse order

Question 19

side effects of inadvertent intravascular admin… esp if they contain what?

Answer 19

EPI

- LOC, convulsions, CV - hypotension, fatigue, depress contractions of SM, asthma

Question 20

EPI effects

Answer 20

• vasoconstrictor makes surgery easier bc less bleeding
• prolongs duration of anesthesia by retarding absorption
• minimized amt anesthesia needed
• so decreases toxicity

BAD: hypoxic damage - aka no digits, genitalia

Question 21

Red label anesthetic bottles

Answer 21

• contain EPI

- blue dont

Question 22

full vasoconstriction w EPI requires how long?

Answer 22

5-10min

• (commercially premixed: 1:100,000)
• (added to lidocaine 1:200,000)

Question 23

strengths of anesthetics w EPI greater than ______ increase risk for side-effects

Answer 23

1:100,000

Question 24

EPI is labeled “pregnancy category C” bc?

Answer 24

shown to reduce uterine blood flow in animals —> may induce premature labor

Question 25

MAO inhibitors can cause a _________ by creating a pool of endogenous catecholamines

Answer 25

hypertensive crisis | * don't use local anesthetics on pts taking MAO inhibitors

Question 26

Tetracyclics in the presence of exogenous EPI can produce _____?

Answer 26

a prolonged HTN crisis and dysrhythmia

Question 27

less than ____ of pts receiving local anesthetics see a true allergic response

Answer 27

1% | * rarely see outright anaphylactic shock

Question 28

commonly used drugs for topical anesthesia? | effective where?

Answer 28

cocaine, tetracaine, lidocaine | - effective for mucous membranes (nose, mouth, throat, tracheobronchial tree, esoph, GU tract)

Question 29

Infiltration Anesthesia (is local) is when injection into tissue wo considering course of cutaneous nerves - adding epi does what? - procedure?

Answer 29

- doubles duration of action - decreases total amts used by 33% - Procedure: inject around/within skin

Question 30

Strength of anesthesia for field block? | procedure:

Answer 30

- same or higher than infiltration - less drug can be used to provide greater area of anesthesia - Procedure: inverted V - provide anesthesia distal to site of injection

Question 31

if uncertain which anesthetic may cause a drug rxn, use?

Answer 31

methyl paraben preservative-free, single dose ampoules

Question 32

Cocaine - concentration, max dose - onset, duration - mechanism of action

Answer 32

- 4%, 200mg - almost immediate, 120min - prevents uptake of NE at synapses

Question 33

topical opthalmic drop is what?

Answer 33

tetracaine

Question 34

Lidocaine - max dose - duration

Answer 34

- 300mg | - 1.5-2 hrs

Question 35

EMLA - whats so special?

Answer 35

- bridges gap bet topical and infiltration anesthesia - depth of 5mm - safe for genital, mucous membranes - dont apply to broken, inflamed skin

Question 36

ethyl chloride is a? | - duration

Answer 36

vapocoolant | - 15-60 sec

Question 37

early warning signs of ANAPHYLAXIS

Answer 37

- warmth flushing - itching - lightheadedness - sudden fatigue - sense of "something not being right" - -----> STOP, then find EPI, Benadryl, and O2

Question 38

Rapid ANAPHYLAXIS Tx

Answer 38

``` EPI HCL 1:1000 0.3-0.6 cc subQ or IM - repeat every 15-30min as needed - avoid toxicity (scs - HTN, chest pain, tachycardia, HA) - admin. 02 w mask - admin. benadryl TO HOSPITAL ```

Question 39

EPI pen concentration

Answer 39

1: 1000 | - (epipen jr is 1:2000)