4 Flashcards
1
Q
Delayed complication of pediatric mandible fracture. What is the most common finding?
A
Growth disturbance (compression fracture of condyle)
2
Q
Masticatory dysfunction related to:
A
parafunctional habits
3
Q
Which tooth fracture has the worse prognosis?
A
Intrusion with middle root fracture
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).
5
Q
Pulmonary capillary wedge pressure best to evaluate:
A
Left heart failure
6
Q
Positioning of incision to harvest cranial bone graft in child:
A
parietal
7
Q
Medical finding in Langerhans cell disease:
A
diabetes insipidus
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
9
Q
Avoid with seizure history:
A
ketamine
10
Q
Bimaxillary protrusive without skeletal excess (dental origin) – management:
A
Anterior segmental osteotomies of the dentition
11
Q
Relapse following mandibular setback:
A
Proximal segment overrotation (aligning superior border)
12
Q
Complications with completion of IAN lateralization for implants:
A
Incising the incisive branch
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.
14
Q
Width to Length ratio for a flap:
A
1:3
15
Q
Murmur of mitral stenosis best heard:
A
Fifth rib at midclavicular line
16
Q
Sign of right vs left HF
A
right: JVD
left: dyspnea
17
Q
Displacement of the condyle in a child alters the functional extracellular matrix via loss of:
A
lateral capsular ligament
18
Q
Separating junction between the upper and lower lateral cartilages results in change of nasal tip:
A
Decreased projection and rotation
19
Q
Nasal tip changes with maxillary advancement:
A
Increased tip projection and rotation
20
Q
Potential limitation regarding the utilization of a temporalis flap:
A
trismus and contour defect
21
Q
Etiology of apertognathia:
A
nasal obstruction
22
Q
Best means for ensuring success of revised microvascular free flap:
A
aspirin
23
Q
Which medicine in combination with midazolam is going to lengthen the sedative effects:
A
cimetidine
24
Q
Refractory AV node transmission is based on:
A
potassium conductance
25
Effect of Aortic stenosis in MAP?
decrease
26
Why is Versed the quickest acting benzo?
most lipid soluble
27
Muscle relaxant used in renal pts?
atracurium
28
Lethal rhythm most commonly seen in cardiac arrest pts?
v fib
29
Drugs that cause Methemoglobinemia?
>600mg prilocaine
30
The blood supply to the inferior turbinates:
Segment supplied by ethmoidal artery off ophthalmic artery.
31
Cerebral Perfusion Pressure is the difference between?
MAP and ICP.
32
Diazepam exerts a synergistic effect when administered concurrently with
cimetidin, erythromycin, diltiazem, verapamil, ketoconazole and itraconazole
33
Tooth in the infratemporal fossa after cautious attempt at removal what next?
close, ABX, Wait 4-6 weeks and attempt again after triangulating with radiographs
34
Fixed unilateral pupil LEAST likely cause:
CN II injury
35
Which muscle protrudes the tongue?
Genioglossus
Styloglossus: retracts and elevates tongue
Hyoglossus: depresses and retracts tongue
Palatoglossus: elevates tongue
36
A patient with a bleeding disorder is given desmopressin, what will this cause?
Decreased urine volume and increased urine osmolality
37
Which bones comprise the external nasal vault?
paired nasal bones
frontal bone
frontal/nasal process of the maxilla
38
Which muscle is not dealt with by a brow lift?
orbicularis oculi
Frontalis: deep transverse forehead lines
Corrugator: vertical glabellar creases
Procerus: transverse wrinkles at root of nose
39
What are the most common bacteria involved with human bites?
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
40
What is the blood supply of a pedicled buccal fat graft for closing an OA fistula?
blood supply from branches of Imax
41
Which is the antibiotic treatment for mucormycosis infections?
amphotericin b
42
The difference between a thermal burn and an electrical burn in a child is which of the following?
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
43
What is the best medical treatment for post-herpetic neuralgia?
tricyclic antidepressants
44
Pt with a vitek implant and bony changes on MRI, what is best treatment?
remove prosthesis and reconstruct with total joint
45
Which patient is best to have hylauronate injected into the TMJ?
patients with large MIO, acute closed lock and steep posterior slope ofeminence
46
What are the indications for arthrocentesis?
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
47
21 y.o. patient with bilateral TMJ pain and a progressive open bite, what is diagnosis?
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
A patient has sympathetically mediated pain what is best treatment?
clonidine and phentolamine
49
Why are more impacted 3rd molars seen today than previously?
change in diet resulting in less attrition of fewer permanent teeth
50
What is the test performed before doing a free radial forearm flap?
allens test
51
One child is born with a cleft to normal parents, what is the chance of having a second child with a cleft?
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
Frey’s syndrome is?
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
What is the most common side effect of romazicon?
>10% nausea and vomiting
54
Which drug is most likely to cause an arrhythmia?
terbutaline
55
During submental liposuction, which direction should the opening of the cannula face?
towards the platysma
56
What happens to the level of potassium in a patient in DKA who is given insulin?
extracellular level decreases
57
A patient with rheumatoid arthritis may have which of the following respiratory problems?
restrictive lung disease
58
How would you treat a patient that had an alveolar ridge augmentation with HA 3 months ago and now has infraorbital dysesthesia?
remove implant
59
The best reason to place an implant above the osteotomy site of a genioplasty is?
decrease the labiomental fold
60
Which tumor spreads via perineural invasion?
adenoid cystic
61
Which structure lies in the most inferior aspect of the lingual space?
hypoglossal nerve
62
Mandibular setback of 6mm or less, what makes it unstable?
clockwise rotation of proximal segment
63
How can you de-rotate the tip in a rhinoplasty?
resect medial crura
64
What is the advantage of putting a semi-occlusive bandage on a STSG donor site
faster healing
65
Which is characteristic of synovial fluid in a patient with RA?
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
What is the vascular supply to the inferior turbinate?
Internal max
| Sphenopalatine artery/terminal branches of Imax
67
How does a post-septal cellulitis result in decreasing vision?
obstruction of venous flow
68
How does aortic stenosis affect BP
decreased bp, decreased pulse pressure
69
Compression of which part of the brain cause anisacoria?
upper midbrain
70
What type of flap is the temporalis flap?
Temporalis muscle flap is an axial flap based on the anterior and posterior deep temporal arteries.
71
What is the max number of carpules of 3% mepivicaine a 35kg, 7 y.o. childcan receive?
4 carpules
72
What is the max dose of 2% lido w/1:100,000 epi?
500 mg
73
What muscle relaxant is contraindicated in renal failure patients?
vecuronium
74
What is the most common complication of a radial forearm free flap?
exposure of the flexor carpi radialis tendon.
75
What is the benefit of an Estlander flap?
abundance of mucosa
76
Which graft will integrate or become vascularized the fastest?
corticocancellous block
77
How should a tooth with an open apex be treated?
RCT w/CaOH, stabilize for 7 days
78
Where is the brow fat found?
Below muscle The brow fat lies just deep to the orbicularis oculi muscle and superficial to the periosteum
79
A browpexy is indicated for which of the following?
Incipient or mild lateral brow ptosis or minor brow asymmetryPossible to achieve a 1-3 mm increase in brow height.
80
What is the nerve that was injured after lipo resulting in paresthesia below the ear, on the neck and preauricular region?
Greater auricular
81
Which head of the buccal fat pad is most important from a cosmetic standpoint?
buccal
82
A STSG takes which layers?
Dermis and part of the adnexal structures
83
How much of the tongue can you take without negatively affecting speech, swallowing, etc when doing a tongue flap?
50%
84
When can a tongue flap be divided postop?
10-14 days
85
What is the etiology of hand-foot-mouth disease?
enterovirus (coxsackievirus)
86
A patient has loss of the upper lid crease several weeks after orbital trauma (swelling has resolved) what is cause?
The levator has been disinserted or transected
87
What muscles are responsible for supporting the proximal segment of a VRO?
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
What stage of anesthesia does nitrous ideally promote?
stage 2 level 1`
89
Race with highest incidence of Cleft lip/palate:
Native American > Asian > Caucasian > African
90
Which lamellae includes the obiculari and overlying skin:
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
Factors affecting nerve sensory after BSSO except:
gender
92
All the following cause of intra operative hemorrhage during IVRO except:
lingual artery
93
Infectious DNA Virus choices
Mono – EBV (DNA)Scrofula – TB (Bact)AIDs – HIV (RNA)Herpangina – Coxsackie (RNA)
94
Splenectomy patients susceptible to which infections:
Encapsulated bacteria: S. pneumoniaeH. influenzaN. meningitides
95
Gram stain from neck wound shows Gram positive in clusters:
Staph species in clusters, treat with Bactrim because penicillinase
96
Severe cervicofacial infection (necrotizing fascitis) with tea colored urine:
rhabdomyolysis
97
FEV1/FVC ratio is best indicator to assess this disease?
irreversible obstructive
98
CT of large contrasting enhancing fluid collection at the medial posterior the mandible, what is the location:
lateral pharyngeal
99
What is the most ominous sign of a patient with angina pectoris?
Bradycardia and hypotension
100
Pulmonary hypertension, right ventricular hypertrophy, left atrial enlargement, what is cause?
mitral stenosis
101
What inhalational agent is irritating to the airway in pediatrics?
desflurane
102
What is a cause of PEA?
H’s:Hypovolemia, Hypoxia, Hydrogen ions (acidosis) Hypo/hyperkalemia, Hypothermia
T’s: Toxins, Tamponade (cardiac) Tension pneumothorax, Thrombosis, Tablets
103
Pericardial tamponade resembles?
hemothorax
104
Most likely reason for thrombus after microvascular anastomosis?
incresaed collagen
105
Cannulation of the nasolacrimal duct in a pediatric patient, how long does the tube stay in place?
8-12 weeks
106
Glucose content of CSF, nasal and bloody secretions.
Nasal < CSF < Blood
Nasal 30 mg/dl
CSF 45 mg/dl
Blood 80 mg/dl
107
How does bronchogenic carcinoma met to mandible?
Batsons plexus
108
Worst prognostic osteosarcoma
Small cell
109
Mc areas of lichen planus
Flexor surfaces
110
Solitary plasmacytoma tx
Radiation
111
Thumbnail melanoma
Acral lentiginous
112
Osteosarcoma tx
Wide excision with chemo
113
Pustules on buccal mucosa and hard palate are signs of what
Crohns
114
how does alveolar bone form
1st arch, ectomesenchyme
115
how do mandible and maxilla form?
first arch with mesoderm
