Notes in C. Peri-operative Considerations

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Status	Last Update	Fields
Published	08/30/2023	AUC Criteria for MMS scoring system defined as:
Published	08/30/2023	Describe Area H, M, L
Published	08/30/2023	Mohs criteria for Bowenoid AK,AK with focalSCCIS, SCCISAK type
Published	08/30/2023	When is MMS uncertain for melanoma?
Published	08/30/2023	What are Relaxed skin tension lines (RSTL)?
Published	08/30/2023	Anatomical landmarks for nerve blocks
Published	08/30/2023	Anterior border of which muscle is the landmark for the facial artery and Stenson's duct?
Published	08/30/2023	Anatomy/course of parotid gland
Published	08/30/2023	Motor innervation: Facial nerve CN7 does what?
Published	08/30/2023	Where does facial nerve exit? What is it covered by? Name the branches.
Published	08/30/2023	Temporal branch of facial nerve innervates? Danger zone?
Published	08/30/2023	Zygomatic branch innervates?
Published	08/30/2023	Buccal branch?
Published	08/30/2023	Marginal mandibular branch innervates?
Published	08/30/2023	Cervical branch of facial nerve innervates?
Published	08/30/2023	Motor Innervation: Spinal accessory nerve (CN11)
Published	08/30/2023	Erb's point is what?
Published	08/30/2023	SCALP layers include?
Published	08/30/2023	Facial Muscles arise from which branchial arch?
Published	08/30/2023	Muscle of forehead: Frontalis (part of the occiptofrontalis muscle overlyingscalp), what nerve innervates and what happens if nerve is cut?
Published	08/30/2023	what part of orbicularis oculi has both voluntary and involuntary actions?
Published	08/30/2023	Orbicularis oculi innervated by? What happens if injury to the nerve?
Published	08/30/2023	Procerus actions and innervated by?
Published	08/30/2023	Corrugator supercilii actions and innervated by?
Published	08/30/2023	Muscles of the globe, actions and innervation
Published	08/30/2023	Orbicularis oris name the elevators and depressors and innervated by?
Published	08/30/2023	Muscles of mastication innervated by? What muscles move jaw sideways/grind?
Published	08/30/2023	Name the 2 divisions of the SMAS (superior and inferior to zygoma)
Published	08/30/2023	Axial blood vessels and sensory nerves to upper face lay between?
Published	08/30/2023	Axial blood vessels and sensory nerves to lower face lay?
Published	08/30/2023	Motor nerves course along where on the face? (Relative to the SMAS)
Published	08/30/2023	Sensory innervation for posterior scalp and neck?
Published	08/30/2023	Sensory nerves course ? at subcutaenous fat and SMAS junction?
Published	08/30/2023	Sensory nerve damage, does it recover?
Published	08/30/2023	What is Frey’s syndrome?
Published	08/30/2023	What is Trigeminal trophic syndrome?
Published	08/30/2023	Sensory glands also distributes postganglionic secretory fibers to?
Published	08/30/2023	Which nerve is the largest of the 12 cranial nerves?
Published	08/30/2023	Describe V1 of CN5
Published	08/30/2023	Describe V2 of CN 5
Published	08/30/2023	Describe V3 of CN 5
Published	08/30/2023	Auriculotemporal nerve innervates which portions of the ear?
Published	08/30/2023	Lesser occipital nerve innervates?
Published	08/30/2023	Great auricular nerve innervates?
Published	08/30/2023	CN 7, 9, 10: innervate which parts of the ear?
Published	08/30/2023	Vascular supply of the face mainly derives from?
Published	08/30/2023	Facial artery arises from? anastamoses with?
Published	08/30/2023	Superficial temporal artery supplies? Branch of?
Published	08/30/2023	Occipital artery arises from and supplies?
Published	08/30/2023	Posterior auricular artery arises from and supplies?
Published	08/30/2023	Internal maxillary artery anastamose with? What are its branches?
Published	08/30/2023	Branches of internal carotid artery supply? What are the branches?
Published	08/30/2023	Median nerve innervates
Published	08/30/2023	radial nerve innervates
Published	08/30/2023	ulnar nerve innervates?
Published	08/30/2023	Deep peroneal nerve aises from and innervates?
Published	08/30/2023	Posterior tibial nerve arises from and innervates?
Published	08/30/2023	Superficial peroneal nerve arises from and innervates?
Published	08/30/2023	Sural nerve arises from and innervates?
Published	08/30/2023	Saphenous nerve innervates?
Published	08/30/2023	What are the 3 components for anesthetics?
Published	08/30/2023	What component of anesthetic binds to sodium channel?
Published	08/30/2023	Which component determines if ester or amide?
Published	08/30/2023	Which is first to anesthetize? Then what sensation?
Published	08/30/2023	Describe ester anesthetic? Metabolized by? How excreted? What is the issue with PABA metabolite?
Published	08/30/2023	Describe amide anesthetic? Metabolized by? How excreted? Allergy to?
Published	08/30/2023	Pharmacokinetics of anesthetics... effect of pKa, alkalization effect?
Published	08/30/2023	Name pregnancy B category anesthetics? C?
Published	08/30/2023	What does adding Epinephrine 1:100,000 or less to anesthetics do? When do you have to be careful?
Published	08/30/2023	What does adding hyaluronidase to anesthetics do?
Published	08/30/2023	Adding sodium bicarb (8.5%) to anesthetic does what?
Published	08/30/2023	which anesthetic has fastest onset?
Published	08/30/2023	which anesthetic has shortest duration?
Published	08/30/2023	which anesthetic has longest duration with epi?
Published	08/30/2023	which anesthetic has longest duration?
Published	08/30/2023	Name some ophthalmic solutions (anesthetics)
Published	08/30/2023	EMLA is made up of? risks?
Published	08/30/2023	LMX is? How is it used? Risk?
Published	08/30/2023	Tumescent anesthesia dilution? Max dose? Add how much bicarb? Tips to decrease pain?
Published	08/30/2023	Local adverse events from anesthetics?
Published	08/30/2023	What to use to treat vasoconstriction from epinephrine?
Published	08/30/2023	Vasovagal response vitals, symptoms, tx?
Published	08/30/2023	Epinephrine toxicity vitals, symptoms, treatment?
Published	08/30/2023	Anaphylaxis vitals, symptoms, treatment?
Published	08/30/2023	Early anesthetic toxicity symptoms, usually around what dose, tx?
Published	08/30/2023	Intermediate anesthetic toxicity, symptoms, usually at what doses, tx?
Published	08/30/2023	Severe anesthetic toxicity, symptoms, usually at what dose, tx?
Published	08/30/2023	What medications can increase lidocaine levels?
Published	08/30/2023	Digital block with epi? Tips?
Published	08/30/2023	How to treat overdose of anxiolytic?
Published	08/30/2023	Pain is grreatest on which day?
Published	08/30/2023	what healing is less painful post operatively?
Published	08/30/2023	what flaps have highest post op pain scores?
Published	08/30/2023	sites with highest post op pain?
Published	08/30/2023	what combination of pain releif better than tylenol w codeine? What is the regimen?
Published	08/30/2023	What is max dose for acetaminophen and ibuprofen?
Published	08/30/2023	What is pregnancy category for acetaminophen and ibuprofen? Codeine? Aspirin?
Published	08/30/2023	Surgical site infections, clinical symptoms; does a positive culture confirm SSI?
Published	08/30/2023	Risk of SSI w skin surgery?
Published	08/30/2023	highest risk for SSI (areas on body)
Published	08/30/2023	most common culprit organism
Published	08/30/2023	Most rapid onset antiseptic?
Published	08/30/2023	Describe properties of 60-95% alcohol antiseptic
Published	08/30/2023	Describe properties of chlorhexidine antiseptic
Published	08/30/2023	Describe properties of iodine antiseptic
Published	08/30/2023	Describe properties of triclosan antiseptic
Published	08/30/2023	Describe properties of soap and water antiseptic
Published	08/30/2023	longest acting antiseptic agent
Published	08/30/2023	Shaving vs clipping surgical site context of SSI
Published	08/30/2023	Sterilization, steam under pressure (autoclave), describe
Published	08/30/2023	Describe heated chemical vapor sterilization
Published	08/30/2023	Describe dry heat sterilization
Published	08/30/2023	Describe gas sterilization, what chemicals are used
Published	08/30/2023	Describe chemical immersion
Published	08/30/2023	What needle to use for surgery (sutures)
Published	08/30/2023	What are the 3 types of needle tips?
Published	08/30/2023	Suture terms: what is configuration?
Published	08/30/2023	What is tensile strength?
Published	08/30/2023	What is elasticity?
Published	08/30/2023	What is plasticity?
Published	08/30/2023	What is memory
Published	08/30/2023	What is pliability?
Published	08/30/2023	What is coefficient of friction?
Published	08/30/2023	What is reactivity?
Published	08/30/2023	What is size and capillarity with regards to sutures?
Published	08/30/2023	How do natural vs synthetic sutures break down?
Published	08/30/2023	When is a suture considered absorbable?
Published	08/30/2023	Catgut is made from?
Published	08/30/2023	Silk suture properties?
Published	08/30/2023	Staples, describe...
Published	08/30/2023	catgut absorption (fast, plain, chromic)
Published	08/30/2023	which blade is sharper? which maintains sharpness longer?
Published	08/30/2023	Which blade to use in smaller challenging area, which for small delicate areas?
Published	08/30/2023	Risk of bactermia during derm surg vs healthy individuals performing normal activities?
Published	08/30/2023	What is the pathway for bacterial endocarditis and joint infection?
Published	08/30/2023	Risk of SSI?
Published	08/30/2023	Antibiotic ppx recommended for?
Published	08/30/2023	Name some high risk cardiac conditions where abx ppx indicated
Published	08/30/2023	When do you abx ppx in patients with orthopedic pins, plastes, screws and total joint prosthesis?
Published	08/30/2023	What is considered high risk for prosthetic joint infection?
Published	08/30/2023	surgical site ppx non oral: no pcn allegy/pcn allergy, cant take PO, cant take PO w pcn allergy
Published	08/30/2023	SSI ppx oral mucosa breach no pcn allegy/pcn allergy, cant take PO, cant take PO w pcn allergy
Published	08/30/2023	What class of wounds may need SSI ppx?
Published	08/30/2023	Oral cavity site, axilla perineum is considered what wound class?
Published	08/30/2023	Surgical procedures or sites with greater than 5% risk of surgical siteinfection
Published	08/30/2023	Abx ppx for wedge excision lip, ear, flaps on nose, grafts for pts w increased risk of SSI: no pcn allegy/pcn allergy, cant take PO, cant take PO w pc…
Published	08/30/2023	Abx ppx for groin , leg for pts w increased risk of SSI: no pcn allegy/pcn allergy, cant take PO, cant take PO w pcn allergy
Published	08/30/2023	Which has higher infection rate? Secondary intention vs sutured?
Published	08/30/2023	rate of infection is directly proportional to?
Published	08/30/2023	infection usually present at ?-? days post op, but SSI is defined by wound infection within ?? days of surgery? What is criteria?
Published	08/30/2023	Most common pathogen for derm procedures?
Published	08/30/2023	Pathogens by site: skin, mucosa, inguinal/perinemus/ear?
Published	08/30/2023	Most common resdient pathogens?
Published	08/30/2023	Have topical antibiotic creams proven to decrease infection?
Published	08/30/2023	C diff caused by?
Published	08/30/2023	What is risk of peri operative bleeding complications in derm surg?
Published	08/30/2023	Name antiplatelets. MOA aspirin? How long are platelets affected? Which are reverisble vs irreverisble inhibitors of cyclooxygenase? What role does Et…
Published	08/30/2023	Name some anticoagulants. MOA of warfarin? Antidoes? INR in which bleeding risks increase with warfarin? What fold does warfarin increase bleeding vs …
Published	08/30/2023	How to reverse newer anticoagulants?
Published	08/30/2023	What supplements decrease or inhibit platelet aggregation and adhesion?
Published	08/30/2023	What % of general population does von Willebrand disease affect? What needs to be done prior to surgery?
Published	08/30/2023	What class of anticoagulant is unfractionated heparin and LMWH? MOA? How to reverse?
Published	08/30/2023	What class is Dabigatran(Pradaxa)Bivalirudin(Angiomax)Argatroban (Acova)Desirudin (Iprivask)? MOA? Reversal?
Published	08/30/2023	What class is fondaparinux (Arixtra)? MOA? Reversal?
Published	08/30/2023	What class is Rivaroxaban(Xarelto)Apixaban (Eliquis)Edoxaban (Savaysa)Betrixaban(Bevyxxa)? MOA? Reversal?
Published	08/30/2023	How to reverse antiplatelet meds
Published	08/30/2023	If on multiple anticoag or non oral what is recommended?
Published	08/30/2023	Ultrasound can assess which nodes?
Published	08/30/2023	CT scan uses what kind of radiation? imaging improved with? useful for evaluating? Advantages, disadvantages?
Published	08/30/2023	MRI good for? What type of contrast? Advantages? Disadvantages? Contrindication?
Published	08/30/2023	PET-CT used for? what is injceted? limited in? False positives?
Published	08/30/2023	Indications for imaging? Which imaging is best for what?
Published	08/30/2023	Which imaging is best to assess regional lymph nodes?
Published	08/30/2023	Which is imaging of choice for Merkel Cell Carcinoma?
Published	08/30/2023	When is imaging indicated to look for PNI?
Published	08/30/2023	What are the most commonly affected nerves for PNI?
Published	08/30/2023	What are findings for perineural spread on imaging?
Published	08/30/2023	What % of patients with clinically symptomatic PNS had radiologically detectable disease?
Published	08/30/2023	What is electrosurgery?
Published	08/30/2023	Electrosurgery using direct current is called?
Published	08/30/2023	Monopolar or bipolar describe
Published	08/30/2023	Monoterminal vs biterminal describe
Published	08/30/2023	What electro___ is considered monoterminal?
Published	08/30/2023	Cause and treatment of vasovagal syncope
Published	08/30/2023	Describe lidocaine toxicity, what is max dose? Symptoms, treatment?
Published	08/30/2023	Describe hypertensive crisis
Published	08/30/2023	Blood pressure indicating hypertensive urgency
Published	08/30/2023	Hypertensive emergency definition? Management?
Published	08/30/2023	What type of hypersensitivity is anaphylaxis? Presentation? Blood pressure, heart rate? Causative agents in dermatology? How to distinguish from epi s…
Published	08/30/2023	Myocardial infarction risk factors and treatment?
Published	08/30/2023	Air embolism caused by? Who is susceptible? Etiology? How to prevent?
Published	08/30/2023	Review HR & BP of the followng: vasovagal, lido toxicity, epi hypertensive crisis, anaphylaxis
Published	08/30/2023	Review management of the followng: vasovagal, lido toxicity, epi hypertensive crisis, anaphylaxis
Published	08/30/2023	What type of hypersensitivity is contact dermatitis? Timing? Cause?
Published	08/30/2023	Hemorrhage complication, risk highes when? ideal to have what platelet count for surgery?
Published	08/30/2023	Dabigatran (Pradaxa) MOA abd revered by?
Published	08/30/2023	Direct Factor Xa inhibitors?
Published	08/30/2023	Which anticoagulant has no reversal agent?
Published	08/30/2023	treatment for early active bleeding
Published	08/30/2023	treatment for early hematoma?
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