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1
Q

22y/o WF with subtle double tip break in the columella region is due to what?

A

intermediate crua meet medial crua

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2
Q

What type of patient in the ideal candidate for transconjunctival upper lid blepharoplasty?

A

young patient with no wrinkles

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3
Q

A 22 y/o patient is s/p MVA. C/C pain right shoulder, SOB, and positive Hamman’s sign. What is the diagnosis?

A

Diaphramatic injury

Hamman’s Sign – “mediastinal crunch” produced by the heart beating against air-filled tissues. Associated with pneumomediastinum

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4
Q

Pt. s/p trauma with a tear in the lacrimal duct. How to repair?

A

Silicone nasolacrimal duct intubation x 3-4 month

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5
Q

Which NIDDM med gives rise to lactic acidosis?

A

metformin (glucophage)

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6
Q

Most common benign child salivary gland neoplasm

A

pleomorphic adenoma

Malignant: mucoepidermoid carcinoma

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7
Q

14y/o patient presents with dentoalveolar fracture and loose maxillary incisiors. How do you manage this patient

A

Acrylic splint

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8
Q

Pediatric patient with condyle fracture. What is the most likely cause of disturbed growth?

A

Intracapsular injury more likely to cause growth disturbance, along with immobilization as part of the treatment. Intra-articular hemorrhage

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9
Q

Pt. with pterygomandibular space infection. Where do you drain?

A

Deep to the mandible and superficial to the medial pterygoid

The pterygomandibular space is bounded by the lateral pterygoid muscle superiorly, the pterygomasseteric sling inferiorly, the anterior border of the ramus (where the fascial envelope wraps around the mandible) anteriorly, the posterior border of the ramus posteriorly, the ascending ramus of the mandible laterally, and the anterior layer of the deep cervical fascia medially.

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10
Q

What is the advantage of Versed for use in out patient anesthesia?

A

Lack of active metabolites

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11
Q

Which of the following medications give the most emesis?

A

Ketamine

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12
Q

The potency of a local anesthetic is due to what?

A

Lipid solubility

protein binding - duration of action
pKa - time of onset

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13
Q

What is the difference between hemifacial microsomia type 2a and 2b?

A

Muscle Function
Type I: mini mandible and TMJ. All structures are present, normal in shape and location, but small, Muscle of mastication are consistent with degree of skeletal deformity. Jaw movement (translation, excursions) are present.

Type IIa - the TMJ, ramus and glenoid fossa are hypoplastic, malformed, and malpositioned, but the deformed joint is adequately positioned for symmetric opening, degree of hypoplasia of mandibular musculature is closer to normal.

Type IIb - the joint is malpositioned inferiorly, anteriorly and medially and will not function as a TMJ for adequate symmetric opening, degree of hypoplasia of mandibular musculature is considerably greater.

Type III: Complete absence of the mandibular ramus and TMJ. Lateral pterygoid muscle and articular disk are absent and the temporalis, masseter, and medial pterygoid are moderate to severely hypoplastic. The jaw does not translate on the affected side and does not move medially toward the normal side.

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14
Q

Blood Brain Barrier – what determines what enters?

A

Freely crosses: high lipid solubility and CO2, non ionized

Poorly cross: ions, proteins, and large substances

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15
Q

Attachment of medial canthal ligament?

A

anterior leg: posterolateral surface of the nasal bones

superior leg: junction of the frontal process of the maxilla and the angular process of the frontal bone

The deeper portion (also known as Horner’s muscle or the pars lacrimalis) attaches to the posterior lacrimal crest

The MCT may be subdivided into a superficial portion and a deeper portion with the lacrimal sac between them. The superficial portion has two “legs”.

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16
Q

Beta-2 transferrin is what type of molecule and is found in what two things?

A

Beta-2-transferrin is a carbohydrate free glycoprotein produced by neuraminidase activity in the brain which is uniquely found in the cerebrospinal fluid (CSF) and perilymph.

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17
Q

Tricep reflex out bicep good, injury at?

A 
C7-8
Upper Extremity Reflexes
1. C4: Pectoral
2. C5: Bicep
3. C6: Brachioradialis tendons
4. C7: Triceps tendon

Lower Extremity Reflexes5. L1-2: Cremasteric Muscle6. L2-4: Patellar tendon (Knee)7. L5: Posterior Tibial jerk8. S1: Achilles tendon (Ankle)9. S3-4: Bulbocavernosus10. S3-5: Anal wink

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18
Q

Vancomycin (Red Man Syndrome). The cause of this is what?

A

Histamine release

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19
Q

BP drops after giving versed, what is the next best step?

A

trendelenburg

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20
Q

Pt. elderly male with swelling of the parotid bilaterally at the tail. What condition does he have?

A

Warthins Tumor

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21
Q

A pt. s/p laser resurfacing breaks out in vesicles. What can prevent this?

A

antiviral agents before

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22
Q

Pansystolic murmur is what type of murmur?

A

TR, MR, VSD - Pansystolic murmurs often occur with regurgitant flow across the atrioventricular valves

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23
Q

A patient on 5 Fluorouracil for beast cancer. What should the doctor be worried about?

A

Drug has myelosuppressive effects which can increase rise of infection and bleeding tendency by causing low WBC and platelets counts

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24
Q

Patient with leukemia. Why is there so much bleeding?

A

Decreased amount of megakaryoctes which is the progenitor cell for platelets

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25
What site will offer the best color match for a full thickness flap?
Lateral neck - Any supraclavicular facial graft (from the blush area)matches the facial color better than does any torso or thigh graft.
26
What is the advantage of a full thickness flap over a split thickness flap?
less long term contracture
27
BMP in freeze dried bone provides what?
osteoinduction
28
Inter-arterial injection of diazepam. How to manage next?
Leave the needle in placeAdminister 1% procaine (2-10 cc) serves 4 functions {anesthetic to decrease pain, vasodilator to break arterial spasm and intiate return of blood flow, pH about 5 to counterbalance drugs with alkaline pH, and diluent to decrease the concentrations of previously administered IA drug} Hospitalization of patient for: a. Anesthesiologist to perform sympathetic nerveblock b. Vacular surgeon to perform endarterectomy if needed c. Heparization to prevent further thrombosis
29
Foul smelling odor from socket 1 week s/p extraction, what organism most likely?
Bacteroides
30
What is the dose of Flumazenil?
0.2 mg q1-2min up to 3 mg max
31
What is most common side effect of Flumazenil?
Nausea/vomiting
32
What organisms are found in acute sinusistis?
Streptococcus pneumoniae Haemophilus influenzae Moraxella (Branhamella) catarrhalis
33
What labs are associated with a patient diagnoses with Paget’s disease?
Normal Ca2+, normal PO4, and elevated alkaline phosphatase
34
Bleeding time is increased, PTT increased. What coagulopathy is present?
von Willdebrands
35
Microvascular anastomosis and thrombus formations caused by what?
Collagen exposure
36
Removal of the parathyroid glands leads to what lab changes?
Ca2+ down and PO4 up
37
What is the best way to determine the viability of a superficial graft?
Observation
38
A patient with ESRD preparing for anesthesia, which labs to check?
Potassium – hyperkalemia leading to cardiac issues
39
You are taking out a lone second molar tooth and you notice that the tooth comes out with the buccal plate attached and the tuberosity fractured. What do you do next?
Remove segment and close with palatal flap or buccal fat pad
40
Blood supply to random flaps comes from what?
dermal and subdermal plexus alone and are the most common type of flap used for reconstructing facial defects.
41
Nasolabial flap type and blood supply
axial flap, blood supply is facial artery
42
What type of flap is a z plasty
Rotational (interposition) Interposition flaps differ from transposition flaps in that the incomplete bridge of adjacent skin is also elevated and mobilized. An example of an interposition flap is a Z-plasty Transposition flap refers to one that is mobilized toward an adjacent defect over an incomplete bridge of skin. Examples of transposition flaps include rhombic flaps and bilobed flaps
43
Loosening of implant crown interface. What type of forces can cause?
Eccentric movement Abutment and prosthetic screw loosening can be a recurrent problem seen often with single-tooth restorations. Repeated loosening of screws should bring to mind occlusal overload, heavy contact in lateral excursions, or implant mobility
44
Abbe flap. Based on what blood supply?
labial artery
45
Alveolar osteitis. What type of patient most prone?
>25 yrs old female smoker taking contraceptives
46
EKG strip after starting an IV – rhythm appeared to be regular and roughly 100 beats per minute – next step
Titrate midazolam to effect - (Patient anxious getting IV with basic tachycardia and no arrhythmia on EKG)
47
Patient with a history of malignant hyperthermia. What muscle relaxant to give?
Rocuronium - fast onset and used for rapid sequence induction whensuccinylcholine contraindicated
48
Profuse bleeding noted after tooth pushed into sinus.
PSA
49
Palatal flap based on what artery?
Greater palatine – axial flap
50
After sagittal split osteotomy, what is the last nerve to come back?
Larger myelinated fibers (A-alpha) recovered slower and to a lesser degree at all time intervals up to 2 years when compared with small myelinated and unmyelinated nerve fibers.
51
Delayed complication of pediatric mandible fracture. What is the most common finding?
Growth disturbance (compression fracture of condyle)
52
How to best treat an Aneurysmal bone cyst of posterior mandible?
Curettage and enucleation
53
Harvesting parietal graft. Profuse bleeding from where?
Sagittal sinus and arachnoid granulations
54
Removal of inferior turbinate can lead to what?
Atrophic rhinitis or allergic rhinitis
55
Patient with jaw clicking, photophobia, and intense HA. Biopsy temporal artery shows arteritis. What is the best treatment?
Methylprednisolone: high doses of corticosteroids may be given at 1-2 mg/kg/d until the disease activity is suppressed adequately
56
What is the most common infection associated with diabetes mellitus?
Mucormycosis
57
5 yo w/ URI develops buccal cellulites w/ blue hue, what is cause?
H. influenza
58
What is the most probable cause of gait disturbance following AICBG harvest?
Tensor fascia lata stripping – lateral approach
59
How long does it take for sarcoma to develop after radiation?
14 years
60
Osteoradionecrosis. What percentage of patients develop this condition?
2-6% - Current prevalence rate is less than 4%
61
Placement of cortical ramus graft for small alveolar defect?
Resorb before remodeling
62
Where is the most resistance to transverse expansion of the maxilla?
Zygomaticomaxillary Buttress
63
What eye muscle is not attached to the Annulus of Zinn?
Inferior oblique muscles originate separately from the posterior orbital wall
64
Congenital epulus of the newborn (additional question). How do you treat?
Surgical excision
65
Deficiency with bilateral cleft lip, cleft palate patient?
Anterior/posterior and vertical due to the reflection of tissue from the palate
66
Patient with impacted supernumerary teeth and multiple osteoma?
Gardner syndrome - sebaceous cysts, osteomas, desmoids tumors,gastrointestinal polyps, multiple teeth
67
35 y/o male large lesion right maxilla, right facial swelling, c/c pain, CT shows obliteration of right sinus with sunburst pattern. What is your diagnosis?
Osteosarcoma
68
Young patient with well circumscribed mixed lesion right mandible. Photo shows mass with multiple tooth like structures. What is diagnosis?
Ameloblastic fibro-odomtoma treatment includes enucleation and curettage being curative
69
Radiographic appearance of what tumor is identical to that of unicystic ameloblastoma?
Ameloblastic fibroma
70
What are COC associated with in younger patients?
odontomas Calcifying odontogenic cyst: usually anterior to 1st molars, 65% in incisor-canine area. “ghost cells”, well circumscribed unilocular lesions 50 % of cases contain flecks of indistinct radiopacities. Younger patients, lesions may closely resemble an odontoma or ameloblastic fibro-odontoma
71
Most important with reconstruction of mandibular segmental/continuity defect ?
soft tissue coverage at site
72
Composite graft with the best morphology for implants.
Iliac - limit of 10mm implants with fibula and scapula, 18mm implants can be placed in iliac composite graft
73
Lesion posterior mandible, expanding, no pain. Fistula noted intraoral leaking straw colored cheesy fluid. Young patient. What is your diagnosis?
OKC
74
Mandibular anterior lesion. 22 y/o female. CT scan shows radiolucent lesion that crosses midline. 2 yrs growing. What is diagnosis?
Ameloblastoma
75
Picture red, beefy tongue. Pseudomembranous film wipes off tongue, painful lesion. What is your diagnosis?
Erosive lichen planus
76
Nikolsky sign is NOT associated with which of the following?
Neg. Nikolsky – bullous pemphigoid Pos. Nikolsky – Pemphigoid, pemphigus, scalding skin syndrome(staph infection), toxic epidermal necrolysis(a severe drug reaction).
77
Mechanism of action of cyclosporine?
Inhibits the production of interleukin IL-2 by helper T-cells thereby blocking T cell activation and proliferation
78
Punched out bony lesions refer to what?
Multiple myeloma - Increased calcium, serum electrophoresis “M” spike, Bence Jones proteins, bone pain
79
Older female patient, brown papillary, exophytic lesions on mucosa. History of snuff tobacco. What is your diagnosis?
Verrucous Carcinoma
80
Tinel’s sign is due to what?
Tingling or electric sensations in a nerve upon percussion – Distal tingling to percussion
81
Pt presents with severe pain on swallowing which radiates to the angle of mandible and ear ? Diagnosed with what?
Glossopharyngeal neuralgia
82
Clinical photos. Basal Cell Nevus Syndrome. What else would kids show?
Hypertelorism
83
CT scan. Pt s/p MVA, NOE frx. Large fragment displaced, still attached to medial canthal tendon. Fracture site is comminuted. How do you classify?
II Type I fractures involve a single, noncomminuted, central fragment without medial canthal tendon disruption (left-unilateral, right-bilateral) Type II fractures involve comminution of the central fragment without medial canthal tendon disruption (left-unilateral, right-bilateral) Type III fractures result in severe central fragment comminution with medial canthal tendon disruption (left-unilateral, right-bilateral).
84
Separation of the upper lateral cartilage from the lower lateral cartilage. What does that do to the tip?
Cephalic tip rotation interrupt the ligamentous connections of the upper and lower lateral cartilages. This can result in cephalic tip rotation
85
What muscles not affected when performing a Browpexy?
procerus
86
What are the indications for browpexy?
Pt not undergoing formal brow lift or who have relapsed following brow-lifting and still require brow elevation
87
What muscle opens the Eustachian tube?
Tensor
88
What muscle tenses or closes the soft palate?
levator
89
What are the indications to repair VPI?
good movement of lateral pharyngeal wall
90
Flap for VPI with proper functioning lateral pharyngeal walls?
Superior pharyngeal based flap
91
Monostotic fibro-osseous dysplasia is associated with what?
Found in children
92
What field of vision is the last to improves with a resolving hyphema?
Downward gaze due to gravity
93
What is hyphema caused from?
Caused by rupture of an iris or ciliary body vessel, usually results from blunt trauma
94
Blunt trauma to the eye causing ciliary injection?
Synonym for hyphema
95
Genetic defect of cherubism?
autosomal dominant - chromosome 4p16.3
96
Histologically cherubism most similar to?
Central giant cell granuloma
97
Inferior oblique muscle originates from where?
small depression on the orbital plate of the maxilla just behind the margin and slightly lateral to the bony nasolacrimal canal
98
Elderly man with rapidly growing lesion on sun exposed lower lip. Clinical photo - Sun exposed skin
Keratocanthoma
99
Blood supply for the deltopectoral flap?
internal mammary a
100
Blood supply for the platysma flap?
submental branch of facial a

ABOMS Rapid Fire (4 decks)

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