4 Flashcards

1
Q

Delayed complication of pediatric mandible fracture. What is the most common finding?

A

Growth disturbance (compression fracture of condyle)

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2
Q

Masticatory dysfunction related to:

A

parafunctional habits

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3
Q

Which tooth fracture has the worse prognosis?

A

Intrusion with middle root fracture

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4
Q

Lady with marble-like swelling in upper lip - freely movable

A

Canalicular adenoma

Type of benign salivary gland tumor that occurs most often in minor salivary glands. In addition to pleomorphic adenoma, the two are the most common tumors of the upper lipIn 95% of cases, canalicular adenoma occurs on the upper lip. The next most common location is the buccal mucosa (inner cheek).

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5
Q

Pulmonary capillary wedge pressure best to evaluate:

A

Left heart failure

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6
Q

Positioning of incision to harvest cranial bone graft in child:

A

parietal

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7
Q

Medical finding in Langerhans cell disease:

A

diabetes insipidus

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8
Q

Elderly man with acute onset of right facial weakness - remainder of body is intact with good strength - hyperacusis and loss of taste on the right:

A

bells palsy

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9
Q

Avoid with seizure history:

A

ketamine

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10
Q

Bimaxillary protrusive without skeletal excess (dental origin) – management:

A

Anterior segmental osteotomies of the dentition

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11
Q

Relapse following mandibular setback:

A

Proximal segment overrotation (aligning superior border)

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12
Q

Complications with completion of IAN lateralization for implants:

A

Incising the incisive branch

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13
Q

Female with large lesion in posterior mandible - radiograph showed a localized lesion – CT scan illustrated an oval shape lesion with an intact cortical border:

A

Ossifying fibroma

Ossifying fibroma, also known as osteofibrous dysplasia, is a benign fibrous tumor with local aggressive behavior. The most common site in adults is the mandible. The most common site in children is the tibia, followed by other long bones. Ossifying fibroma occurs during the first decade of life and presents clinically as a painless, enlarging mass.

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14
Q

Width to Length ratio for a flap:

A

1:3

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15
Q

Murmur of mitral stenosis best heard:

A

Fifth rib at midclavicular line

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16
Q

Sign of right vs left HF

A

right: JVD
left: dyspnea

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17
Q

Displacement of the condyle in a child alters the functional extracellular matrix via loss of:

A

lateral capsular ligament

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18
Q

Separating junction between the upper and lower lateral cartilages results in change of nasal tip:

A

Decreased projection and rotation

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19
Q

Nasal tip changes with maxillary advancement:

A

Increased tip projection and rotation

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20
Q

Potential limitation regarding the utilization of a temporalis flap:

A

trismus and contour defect

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21
Q

Etiology of apertognathia:

A

nasal obstruction

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22
Q

Best means for ensuring success of revised microvascular free flap:

A

aspirin

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23
Q

Which medicine in combination with midazolam is going to lengthen the sedative effects:

A

cimetidine

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24
Q

Refractory AV node transmission is based on:

A

potassium conductance

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25
Q

Effect of Aortic stenosis in MAP?

A

decrease

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26
Q

Why is Versed the quickest acting benzo?

A

most lipid soluble

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27
Q

Muscle relaxant used in renal pts?

A

atracurium

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28
Q

Lethal rhythm most commonly seen in cardiac arrest pts?

A

v fib

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29
Q

Drugs that cause Methemoglobinemia?

A

> 600mg prilocaine

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30
Q

The blood supply to the inferior turbinates:

A

Segment supplied by ethmoidal artery off ophthalmic artery.

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31
Q

Cerebral Perfusion Pressure is the difference between?

A

MAP and ICP.

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32
Q

Diazepam exerts a synergistic effect when administered concurrently with

A

cimetidin, erythromycin, diltiazem, verapamil, ketoconazole and itraconazole

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33
Q

Tooth in the infratemporal fossa after cautious attempt at removal what next?

A

close, ABX, Wait 4-6 weeks and attempt again after triangulating with radiographs

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34
Q

Fixed unilateral pupil LEAST likely cause:

A

CN II injury

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35
Q

Which muscle protrudes the tongue?

A

Genioglossus

Styloglossus: retracts and elevates tongue

Hyoglossus: depresses and retracts tongue
Palatoglossus: elevates tongue

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36
Q

A patient with a bleeding disorder is given desmopressin, what will this cause?

A

Decreased urine volume and increased urine osmolality

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37
Q

Which bones comprise the external nasal vault?

A

paired nasal bones
frontal bone
frontal/nasal process of the maxilla

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38
Q

Which muscle is not dealt with by a brow lift?

A

orbicularis oculi

Frontalis: deep transverse forehead lines

Corrugator: vertical glabellar creases

Procerus: transverse wrinkles at root of nose

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39
Q

What are the most common bacteria involved with human bites?

A

staph and strep

Human bites: 25% Staph aureus, 10% alpha hemolytic strep, 50% anaerobic gm + cocci, fusobacteria, bacteriodes; and 15% eikenella corrodens in severe infections. Treatment: augmentin and rabies prophy

Animal bites: 25% pasteurella, 10% staph, 40% alpha hemolytic strep, and 20% bacteroides and fusobacteria

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40
Q

What is the blood supply of a pedicled buccal fat graft for closing an OA fistula?

A

blood supply from branches of Imax

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41
Q

Which is the antibiotic treatment for mucormycosis infections?

A

amphotericin b

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42
Q

The difference between a thermal burn and an electrical burn in a child is which of the following?

A

deep underlying tissue destruction with possibility of late bleedingElectrical burns have may cause distant organ damage and necrosis due to conduction of current and density; bones>skin>muscle; electrical burns occur more commonly in early childhood due to exploration and adulthood due to work

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43
Q

What is the best medical treatment for post-herpetic neuralgia?

A

tricyclic antidepressants

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44
Q

Pt with a vitek implant and bony changes on MRI, what is best treatment?

A

remove prosthesis and reconstruct with total joint

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45
Q

Which patient is best to have hylauronate injected into the TMJ?

A

patients with large MIO, acute closed lock and steep posterior slope ofeminence

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46
Q

What are the indications for arthrocentesis?

A

Persistant closed lock, previous invasive procedure, point tenderness, internal derangement associated with hypomobility due to adhesions, disk immobility and disk displacements, degenerative disease, synovial disease and hypermobility

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47
Q

21 y.o. patient with bilateral TMJ pain and a progressive open bite, what is diagnosis?

A

Rheumatoid ArthritisChronic inflammatory synovium- B lymphocytes infiltration and expansion, macrophages and T cell invasion release cytokines which lead to synoviocyte proliferationdiagnosis: atleast 1 joint with arthritis > 6 wks, age <16 yrs excluding other causes; labs reveal increased ESR, possible lymphopenia, thrombocytopenia, anemia; articular- girls>boys, systemic- girls=boys, polyarticular- >5 joints, pauciarticular- arthritis affecting 4 or fewer joints

48
Q

A patient has sympathetically mediated pain what is best treatment?

A

clonidine and phentolamine

49
Q

Why are more impacted 3rd molars seen today than previously?

A

change in diet resulting in less attrition of fewer permanent teeth

50
Q

What is the test performed before doing a free radial forearm flap?

A

allens test

51
Q

One child is born with a cleft to normal parents, what is the chance of having a second child with a cleft?

A

4%-Normal parents with 1 cleft child= 4%-1cleft parent with 1 cleft child= 13%-1 cleft parent and no children= 2-7%-Normal parents with 2 cleft children=19%-1 cleft parent and 2 normal children=3.5%

52
Q

Frey’s syndrome is?

A

para and sympathetic innervation of sweat glandsCross innervation of auriculotemporal nerve (branch of V3) with otic ganglion and glossopharyngeal nerve (parasympathetic) causing gustatory sweating; aka auriculotemporal syndrome

53
Q

What is the most common side effect of romazicon?

A

> 10% nausea and vomiting

54
Q

Which drug is most likely to cause an arrhythmia?

A

terbutaline

55
Q

During submental liposuction, which direction should the opening of the cannula face?

A

towards the platysma

56
Q

What happens to the level of potassium in a patient in DKA who is given insulin?

A

extracellular level decreases

57
Q

A patient with rheumatoid arthritis may have which of the following respiratory problems?

A

restrictive lung disease

58
Q

How would you treat a patient that had an alveolar ridge augmentation with HA 3 months ago and now has infraorbital dysesthesia?

A

remove implant

59
Q

The best reason to place an implant above the osteotomy site of a genioplasty is?

A

decrease the labiomental fold

60
Q

Which tumor spreads via perineural invasion?

A

adenoid cystic

61
Q

Which structure lies in the most inferior aspect of the lingual space?

A

hypoglossal nerve

62
Q

Mandibular setback of 6mm or less, what makes it unstable?

A

clockwise rotation of proximal segment

63
Q

How can you de-rotate the tip in a rhinoplasty?

A

resect medial crura

64
Q

What is the advantage of putting a semi-occlusive bandage on a STSG donor site

A

faster healing

65
Q

Which is characteristic of synovial fluid in a patient with RA?

A

increase proteins
The synovial fluid has reduced viscosity, exhibiting the “mucous-string sign”. WBC (PMNS) ( up to 50,000/mm3 ) are also seen in the synovial fluid. The granulomatous synovial tissue, or pannus, grows over the joint surface into the subchondral bone which then destroys the joint and will result in hypomobility

66
Q

What is the vascular supply to the inferior turbinate?

A

Internal max

Sphenopalatine artery/terminal branches of Imax

67
Q

How does a post-septal cellulitis result in decreasing vision?

A

obstruction of venous flow

68
Q

How does aortic stenosis affect BP

A

decreased bp, decreased pulse pressure

69
Q

Compression of which part of the brain cause anisacoria?

A

upper midbrain

70
Q

What type of flap is the temporalis flap?

A

Temporalis muscle flap is an axial flap based on the anterior and posterior deep temporal arteries.

71
Q

What is the max number of carpules of 3% mepivicaine a 35kg, 7 y.o. childcan receive?

A

4 carpules

72
Q

What is the max dose of 2% lido w/1:100,000 epi?

A

500 mg

73
Q

What muscle relaxant is contraindicated in renal failure patients?

A

vecuronium

74
Q

What is the most common complication of a radial forearm free flap?

A

exposure of the flexor carpi radialis tendon.

75
Q

What is the benefit of an Estlander flap?

A

abundance of mucosa

76
Q

Which graft will integrate or become vascularized the fastest?

A

corticocancellous block

77
Q

How should a tooth with an open apex be treated?

A

RCT w/CaOH, stabilize for 7 days

78
Q

Where is the brow fat found?

A

Below muscle The brow fat lies just deep to the orbicularis oculi muscle and superficial to the periosteum

79
Q

A browpexy is indicated for which of the following?

A

Incipient or mild lateral brow ptosis or minor brow asymmetryPossible to achieve a 1-3 mm increase in brow height.

80
Q

What is the nerve that was injured after lipo resulting in paresthesia below the ear, on the neck and preauricular region?

A

Greater auricular

81
Q

Which head of the buccal fat pad is most important from a cosmetic standpoint?

A

buccal

82
Q

A STSG takes which layers?

A

Dermis and part of the adnexal structures

83
Q

How much of the tongue can you take without negatively affecting speech, swallowing, etc when doing a tongue flap?

A

50%

84
Q

When can a tongue flap be divided postop?

A

10-14 days

85
Q

What is the etiology of hand-foot-mouth disease?

A

enterovirus (coxsackievirus)

86
Q

A patient has loss of the upper lid crease several weeks after orbital trauma (swelling has resolved) what is cause?

A

The levator has been disinserted or transected

87
Q

What muscles are responsible for supporting the proximal segment of a VRO?

A

masseter and medial pterygoid

The masseter, medial pterygoid m and lateral pterygoid m are responsible for supporting the proximal segment of a VRO. The greater the amount of medial pterygoid that is stripped, the greater the amount of condylar sag that will result

88
Q

What stage of anesthesia does nitrous ideally promote?

A

stage 2 level 1`

89
Q

Race with highest incidence of Cleft lip/palate:

A

Native American > Asian > Caucasian > African

90
Q

Which lamellae includes the obiculari and overlying skin:

A

anterior lamella

The lower eyelid is composed of 3 lamellae.At the level of the tarsus, the posterior lamella consists of the conjunctiva and the tarsus.

Inferior to the tarsus, the posterior lamella is composed of conjunctiva, the retractor muscle, and the capsulopalpebral fascia

The middle lamella fuses with the posterior lamella at the tarsalplate and is composed of the orbital septum

The anterior lamella is the orbicularis oculi muscle andoverlying skin.

91
Q

Factors affecting nerve sensory after BSSO except:

A

gender

92
Q

All the following cause of intra operative hemorrhage during IVRO except:

A

lingual artery

93
Q

Infectious DNA Virus choices

A

Mono – EBV (DNA)Scrofula – TB (Bact)AIDs – HIV (RNA)Herpangina – Coxsackie (RNA)

94
Q

Splenectomy patients susceptible to which infections:

A

Encapsulated bacteria: S. pneumoniaeH. influenzaN. meningitides

95
Q

Gram stain from neck wound shows Gram positive in clusters:

A

Staph species in clusters, treat with Bactrim because penicillinase

96
Q

Severe cervicofacial infection (necrotizing fascitis) with tea colored urine:

A

rhabdomyolysis

97
Q

FEV1/FVC ratio is best indicator to assess this disease?

A

irreversible obstructive

98
Q

CT of large contrasting enhancing fluid collection at the medial posterior the mandible, what is the location:

A

lateral pharyngeal

99
Q

What is the most ominous sign of a patient with angina pectoris?

A

Bradycardia and hypotension

100
Q

Pulmonary hypertension, right ventricular hypertrophy, left atrial enlargement, what is cause?

A

mitral stenosis

101
Q

What inhalational agent is irritating to the airway in pediatrics?

A

desflurane

102
Q

What is a cause of PEA?

A

H’s:Hypovolemia, Hypoxia, Hydrogen ions (acidosis) Hypo/hyperkalemia, Hypothermia

T’s: Toxins, Tamponade (cardiac) Tension pneumothorax, Thrombosis, Tablets

103
Q

Pericardial tamponade resembles?

A

hemothorax

104
Q

Most likely reason for thrombus after microvascular anastomosis?

A

incresaed collagen

105
Q

Cannulation of the nasolacrimal duct in a pediatric patient, how long does the tube stay in place?

A

8-12 weeks

106
Q

Glucose content of CSF, nasal and bloody secretions.

A

Nasal < CSF < Blood

Nasal 30 mg/dl
CSF 45 mg/dl
Blood 80 mg/dl

107
Q

How does bronchogenic carcinoma met to mandible?

A

Batsons plexus

108
Q

Worst prognostic osteosarcoma

A

Small cell

109
Q

Mc areas of lichen planus

A

Flexor surfaces

110
Q

Solitary plasmacytoma tx

A

Radiation

111
Q

Thumbnail melanoma

A

Acral lentiginous

112
Q

Osteosarcoma tx

A

Wide excision with chemo

113
Q

Pustules on buccal mucosa and hard palate are signs of what

A

Crohns

114
Q

how does alveolar bone form

A

1st arch, ectomesenchyme

115
Q

how do mandible and maxilla form?

A

first arch with mesoderm