answers
primary treatment for skin and soft tissue abscesses with or without adjunct abx tx - ANS I&D
most common place for cutaneous abscess to form - ANS buttocks, axillary, extremities
localized collections of pus that occur within the dermis and subcutaneous space; erythema,
induration, TTP, and fluctuant are main characteristics - ANS cutaneous abscess
when is wound packing NOT recommended for abscesses - ANS less than 5cm in diameter
where is the incision made when performing an I&D on an abscess - ANS directly over the
center of the abscess
most common causes of skin and soft tissues infections - ANS Staph aureus or MRSA
how often can you give Narcan - ANS every 2-3min
how should patient be positioned to receive nasal Narcan - ANS supine, on their back
local anesthetic which rapid onset of action, but shorter duration for most skin procedures -
ANS Lidocaine (Amides-Xylocaine)
local anesthetic that has a slower onset but a long duration - ANS Bupivacaine (Marcaine)
steps to reduce pain with local anesthetic injection: - ANS stretch skin taut, pressure on skin
surface around the site, 30G needed, enter at 90degrees, aspirate plunger (avoid IV
placement), superficial placement first, allow to "set"
when and where to avoid use of Epi - ANS hx of tachyarrhythmia or vasospastic disease
(Raynauds); distal to wrist, ankle, and male genitalia
ratio when mixing Lido and Epi - ANS 10:1
shave biopsy is used for... - ANS exophytic lesions
punch biopsy is used for.. - ANS rashes and endophytic lesions
when are pre-procedure abx indicated for skin biopsies - ANS prosthetic heart valve, joint
replacement in past 2 yrs, hx of endocarditis, symptomatic valvular heart disease
,pre procedure antibiotic choice for skin biopsy - ANS amoxicillin 2g po 1 hr prior; OR
clindamycin
cryotherapy is used for.. - ANS viral warts and actinic keratosis (precancerous)
contraindications to cyrotherapy - ANS raynauds, pyoderma gangrenosum, cold urticaria,
cryoglobulienemia, cold intolerance, connective tissue disease
skin condition characterized by hives or wheals that results from some trigger - ANS urticaria
acute urticaria lasts.. - ANS less than 6 weeks
most common cause of acute urticaria - ANS viral
most common cause of chronic urticaria - ANS idiopathic
what medication should someone with chronic urticaria avoid - ANS Aspirin
treatment for papular urticaria - ANS topical steroid - low dose
first line treatment for urticaria - ANS non sedating antihistamines (allegra, claritin, zyrtec)
risk factor for anaphylaxis - ANS asthma
"Darrier's sign" is a symptom of what skin condition - ANS dermatographism
LDL normal range - ANS <100
HDL normal range - ANS >60
type of diet to prevent HLD - ANS mediterranean and DASH
therapy indicated if ASCVD preventative measures fail - ANS statins
statins may be started as primary prevention in those with: - ANS diagnosed ASCVD, LDL
>190, diagnosed with DM aged 40-75 and LDL between 70-189, ages 40-75 with LDL between
70-189 and >7.5% 10yr ASCVD risk
MOA of statins - ANS inhibits the enzyme needed for cholesterol synthesis; decreases LDLs
what should be performed before prescribing a statin - ANS baseline fasting lipid profile,
LFTs and pregnancy test
, side effects you should monitor for while someone is taking a statin - and what lab to order if
presenting with symptoms - ANS myopathies and rhabdomyolysis; CK
LDL target goal for those on statin therapy - ANS <70 for secondary prevention; <100 for
primary prevention
when to reassess lipid profile after starting a stain - ANS 4-12 weeks
common side effects of statins - ANS memory loss, increase A1C levels, myopathies
emergent causes of chest pain - ANS ACS, PE, aortic dissection
non emergency causes of chest pain - ANS etiology of musculoskeletal, GI, pulmonary
EKG interpretation of ACS - ANS ST depression (NSTEMI), T wave inversion(NSTEMI), or
ST elevation(STEMI)
treatment for STEMI - ANS emergent PCI within 90min of ED arrival, aspirin, nitro, O2
how often can you give nitro for a STEMI - ANS every 5 minutes up to 3 doses, if BP allows
type of antihypertensive that is used after STEMI event - ANS ACE inhibitors; lisinopril
presents as acute and severe, sharp chest and back pain often described as "tearing" - ANS
aortic dissection
causes/risk factors for aortic dissection - ANS uncontrolled htn, cocaine use, congenital
bicuspid AV, smoking, male >60
presents as sever pleuritic chest discomfort, tachycardia/palpitations, tachypnea, SOB,
dizziness/syncope - ANS PE
3 things EKG helps to identify - ANS ischemic changes, rhythm/rate disturbances, and
electrolyte imbalances
part of the EKG that resembles Atrial depolarization - ANS p wave
normal p wave length - ANS <0.12 seconds
part of the EKG that resembles ventricular depolarization - ANS QRS complex
normal length of QRS complex - ANS 0.08-0.12 seconds
part of EKG that resembles ventricular repolarization - ANS T wave