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ABOMS Rapid Fire > 2 > Flashcards

2 Flashcards

1
Q

Blood supply of the iliac free flap?

A

deep circumflex- branch of external iliac

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2
Q

Blood supply for the nasolabial flap?

A

angular a

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3
Q

Success of submucosous vestibuloplasty based on?

A

Maintenance or prolonged use of a splint

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4
Q

Melanoma is measured in mm from the top of the granular cell layer to the deepest identifiable point but what classification?

A 
Breslow
Breslow’s microstages evals tumor thickness in melanoma. 
Stage Depth
1 <0.76 mm
2 0.76-1.49 mm 
3 1.50-4.00 mm 
4 >4.00 mm
Clark’s levels indicate tumor invasion by relating the most deeply invading tumor cells to surrounding structures
1 Intraepidermal
2 Invasion of papillary dermis 
3 Fill the papillary dermis
4 Invasion of reticular dermis 
5 Invasion of fat
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5
Q

Male patient with elevated acid phosphatase

A

prostate cancer

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6
Q

Clinical slide of a 27 y/o male with large hyperplastic gingival growth in maxilla and mandible. Histology slide – showed thickened epithelial layer. What is the condition (gingival hyperplasia) due to?

A

Calcium channel blocker (verapamil), phenytoin (dilantin)

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7
Q

What is the best radiograph for localizing salivary gland tumors?

A

T2 weighted MRI

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8
Q

Contraindications for flumazenil?

A

Mixed drug OD and chronic benzodiazepine use

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9
Q

Anisocoria is unequal pupils. What situation is this clinical condition associated with?

A

Uncal herniation

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10
Q

Uncal herniation symptoms?

A

Ipsilateral fixed dilated pupil with contralateral hemiparesis

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11
Q

Most common complication of ORIF of mandible.

A

Malocclusion

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12
Q

Most common bleeding in Le Fort surgery that is difficult to control?

A

Internal maxillary artery

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13
Q

Most common bleeding following LeFort surgery?

A

Descending palatine arteries

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14
Q

What contributes most to relapse of the inferior positioned Le Fort I?

A

Occlusion

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15
Q

Dorsal hump removal. What plane of dissection to be in?

A

superior to the lateral cartilages (suprachondrial) and inferior to the nasal bones periosteum (subperiostial)

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16
Q

What layer do you suture in an inferior alveolar nerve repair?

A

Outer epineurium

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17
Q

How many sutures are placed in an anastomosis of a nerve?

A

2-4 placed in the epineurium

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18
Q

Initial sign of cavernous sinus thrombosis?

A

Abducens paresis - Loss of lateral gaze – CN VI

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19
Q

Open bite at the end of a LeFort case. Due to what?

A

Distraction of condyles, unrecognized posterior interferences

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20
Q

Most common complication to TMJ arthroscopy?

A

joint surface scuffing

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21
Q

Young girl with TMJ and progressive open bite. What is diagnosis?

A

RA

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22
Q

Injury to neurovascular bundle with TOVRO?

A

excessive medial dissection

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23
Q

What is the stability of a BSSO advancement mainly due to?

A

fixation

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24
Q

Where is the needle position during a Gow-Gates block?

A

condylar neck

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25
Q

Most important factor with a cortical bone (onlay) graft to the alveolus for future implant is?

A

fixation to stabilize

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26
Q

When to treat retrobulbar hematoma?

A

Pain, increase intraocular pressure, decreased visual acuity

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27
Q

Where do you separate the nasal septum in LeFort III?

A

Through the perpendicular plate of the ethmoid and the vomer at the posterior plate

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28
Q

NF osteotomy during LF III

A

below NF suture

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29
Q

Disinsertion of the levator palpebrae superioris causes what?

A

Loss of tarsal fold and upper lid ptosis

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30
Q

Main etiology of periorbital cellulites?

A

preseptal infection

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31
Q

Proptosis involving orbital cellulitis.

A

post septal infection

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32
Q

Von Willebrand disease. What happens to BT, PT and PTT

A

increased BT and PTT

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33
Q

What process involves the perihilar nodes?

A

Sarcoidosis

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34
Q

MAO inhibitors. Do not use with what medication?

A

meperidine

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35
Q

Pt with JVD and right ventricle and left atrial hypertrophy has what?

A

mitral stenosis

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36
Q

Best monitor for P waves in office anesthesia?

A

Lead II

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37
Q

Aortic Stenosis predisposes to what?

A

Syncope and sudden death

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38
Q

Sudden cardiac death’s etiology usually is of cardiovascular in origin. What rhythm is most seen?

A

ventricular tachycardia or chaotic ventricular fibrillation or both

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39
Q

Patient with angina. What is most ominous sign?

A

Hypotension with bradycardia

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40
Q

Patient with MI, what is the most ominous sign?

A

Diaphoresis and tachycardia

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41
Q

Malignant hyperthermia. What enzyme is elevated?

A

Creatine Kinase

42
Q

Advantage of costochondral graft for TMJ reconstruction.

A

adaptive

43
Q

Characteristic of pt w. OSA?

A

position of hyoid bone, posterior airway space, soft palate length

44
Q

Location of most nasal airway resistance?

A

internal nasal valve

45
Q

Length of screw in ZF region to reach brain?

A

8mm

46
Q

Layers encountered with retroseptal transconjunctival dissection of the lowereyelid

A

Post-septal approach - Conj, retractors, periosteum

47
Q

What is the fluid deficit of a 70kg man NPO for 10 hrs?

A

110cc/hr x 10 hrs = 1100cc

48
Q

At rest the cell membrane is least permeable to?

A

Na. At rest membrane is more permeable to K than Na

49
Q

Minimum blood loss in a 70kg male to alter systolic blood pressure?

A

1500-2000ml Class III shock

50
Q

A 21-year-old female is an unrestrained driver involved in a MVA. She suffers a scalp laceration and is noted to have lost 1000mL of blood at the scene. You would expect her vital signs to be consistent with:

A

Pulse rate >100, normal systolic blood pressure, decreased pulse pressure, respiratory rate of 20-30, urinary output of 20-30mL/hr.These findings are consistent with a Class II hemorrhage, 750-1500ml, The vitals signs or such a blood loss are consistent with those in response A. Response D reflects the vital signs of a Type IV blood loss, Response C a Type III and Response B a Type I.

51
Q

Primary (direct)- callus free- bone healing involves what?

A

Direct contact between the bony segments

52
Q

When do you not use propofol?

A

White soybean oil-egg yolk lecithin emulsion

53
Q

You are uprighting an impacted 2nd molar, you need to do what?

A

Stabilize to 1st molar, avoid occlusal forces

54
Q

How to distinguish between one or two fractures on panorex?

A

One fracture – lines converge at inferior borderTwo fractures –lines diverge and separate at inferior border

55
Q

What is synonymous with an allograft?

A

homologous graft

56
Q

What causes rejection of a facial implant rejection of homograft?

A

Cell mediated – cellular immunity

57
Q

Which repositioning has the greatest increase in alar flare in a Lefort I?

A

superior repositioning of the maxilla causes elevation of the nasal tip,widening the alar bases and decrease the nasolabial angle.

58
Q

Loss of articular cartilage, what most likely causes pain in the joint?

A

Subchondral nociceptive fibers

59
Q

Property of drugs that cross thee BBB?

A

Lipophilic and nonionized

60
Q

What are the papillary signs seen in severe HTN?

A

AV nicking

61
Q

A lab report indicates coagulase positive. This refers to what?

A

Coagulase is an enzyme that coats the bacteria with fibrin and reduces the ability of the host cell to phagocytize it. S. aureus is the only coagulase-positive staphylococci

62
Q

Pt has trismus after injection. Injury to what muscle?

A

Medial ptyerygoid

63
Q

Complications of massive transfusion.

A

Dilutional thrombocytopenia
Complications of massive blood transfusion: thrombocytopenia, coagulation factor depletion, oxygen affinity changes, hypocalcemia, hyperkalemia, acid/base disturbances, hypothermia, and ARDS

64
Q

Where are verocay bodies found?

A

Neurilemoma (Schwannoma)

65
Q

Tzank test used for what?

A

Tzank smear is used in the diagnosis of herpesvirus infections (Tzank cells also seen in pemphigus vulgaris)

66
Q

Aortic stenosis can lead to what

A

syncope and sudden cardiac death

67
Q

Female patient, pano left body of mandible with impacted premolar with radiolucent lesion completely surrounding impacted premolar displace to inferior mandible. What is diagnosis?

A

Adenomatoid Odontogentic Tumor (AOT) - usually associated with anterior maxilla but not always

68
Q

A patient seen in the emergency department presents with: elevated venous pressure, muffled heart sounds, and decreased arterial pressure. What is the most likely diagnosis?

A

Cardiac tamponade

The patient presents with the classic Beck’s triad of increased venous pressure, decreased arterial pressure, distended neck veins and muffled heart sounds indicating cardiac tamponade.

69
Q

What anesthetic gas to avoid with history of atrial fibrillation?

A

Halothane

70
Q

Widen mediastinum on CXR indicates what?

A

Aortic dissection

71
Q

Antibiotics most effective when MIC is what?

A

2-4x
The usual recommended dose of an antibiotic is usually sufficient to provide threefold MIC concentration against the common susceptible organism

72
Q

Resuscitation of kids. What do you do first?

A

Head Tilt

73
Q

What nerve mediates temperature and pain?

A

A delta and C

74
Q

What is associated with Plummer Vinson syndrome?

A

higher incidence of esophageal cancer

Plummer-Vinson syndrome – iron deficiency anemia, esophageal webs, seen in conjunction with glossitis and dysphagia, has been associated with a high frequency of both oral, hypopharyngeal and esophageal squamous cell carcinoma

75
Q

What is a poor prognosis sign of patient with squamous cell carcinoma of maxillary sinus?

A

pain

76
Q

Neurogenic shock is due to what?

A

Neurogenic shock is shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls.

77
Q

Where is mucosa sutured during Vestibuloplasty procedure?

A

Mucosa is sutured to the vestibular depth at the area of the periosteal attachment

78
Q

What is the most common cause of impacted second molar?

A

Impacted 3rd molar

79
Q

What is the advantage of the osteotomy over medpor implant to augment chin?

A

Less resorption

80
Q

What post operative complication is the most difficult to correct after laser skin resurfacing?

A

hypopigmentation

81
Q

What subnucleus of the trigeminal brainstem nucleus is primarily involved in the receiving and processing of facial pain?

A

Subnucleus caudalis of CN 5

82
Q

What is the most common type of condyle fracture in children?

A

compressive

83
Q

What concerns the anesthesiologist about a patient with rheumatoid arthritis?

A

Restricted neck mobility and the possibility of dislocation of cervical vertebrae

84
Q

Most common complication associated with compression osteosynthesis?

A

Necrosis at bone interface

85
Q

When does the blood supply to the STSG begin:

A

Survives 48 hours by plasmatic imbibition

Revascularization complete in 4-7 days.

86
Q

What percentage of lingual nerve rises above the level of the alveolar crest in the area of the third molar?

A

10-15%

87
Q

What is the conventional wisdom regarding the maximum time that the tooth has before reimplantation to have a shot at viability?

A

120 minutes, periodontal ligament fibers become irreversibly necrotic after this time frame

88
Q

Treatment of avulsed tooth, out 3 hrs, but patient kept in mouth. How to treat?

A

Root canal first before reimplantation

89
Q

Best way to close an oro-antral fistula from a 1st molar of 8 mm?

A

Openings greater than 6 mm require primary closure

Openings less than 2mm, no surgical treatment is necessary providing adequate hemostasis

Openings 2-6 mm conservative treatment is indicated including placement of figure of eight suture over the socket, gelfoam and sinus precautions.

90
Q

Indications for Buccal Fat pad closure of O-A fistula?

A

Defects greater than 6 mm

91
Q

A pediatric patient presents to our office 2 weeks following trauma to a primary central incisor. The tooth is now discolored, but otherwise asymptomatic. What is your treatment?

A

observation

92
Q

What type of mandibular fracture poses the greatest risk of airway obstruction?

A

Bilateral angle fracture

93
Q

Child bitten by a dog 3 days ago, now infected, what is the most likely organism?

A

Pasturella multicedins

Augmentin is the antibiotic choice because it is bacteriocidal for the range and spectrum of human and animal bite pathogens including Staphylococcus species and Pasteurella multocida.

94
Q

When you bite on your anterior teeth describe the forces applied over an angle fracture?

A

Tension at the alveolus, compression at the inferior border

95
Q

Patient has flaccid elbow & wrist reflex, but normal triceps reflex following MVA, what is the level of C-spine injury?

A

C 5-6 (triceps is C 7)

96
Q

Primary bone healing requires?

A

Bone-bone contact & compression across the fracture site

97
Q

Bone-bone contact & compression across the fracture site

A

Neutral zone

However, this is not possible in the mandible, since the neutral zone is in direct line w/ the IAN

98
Q

What is the thickness of the superior tarsal plate

A

1 mm, (length 25mm, height upper 10mm, height lower 4mm)

99
Q

What is the position of the upper eyelid, at primary gaze, in relation to the limbus?

A

2-3mm inferior

100
Q

Which fracture would you NOT use a compression plate for?

A

Oblique fractures are contraindication to compression plate

ABOMS Rapid Fire (4 decks)

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