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APBS Flashcards

1
Q

Screening guidelines for implant rupture FDA?

A

MRI or ultrasound
5-6 years post op, q2-3 years

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2
Q
  1. A 70-year-old woman who is obese and has type 2 diabetes is evaluated because of a very painful violaceous plaque on the abdomen that has developed into a black eschar. History also includes end-stage renal disease. Examination of a specimen obtained on biopsy at the border of the lesion shows calcification of small- and medium-sized vessels, microvascular thromboses, extravascular soft-tissue calcification, and panniculitis. Administration of which of the following is the most appropriate management for this condition?

A) Calcium carbonate B) Corticosteroids
C) Iron infusion
D) Sodium thiosulfate
E) Warfarin

A

This is calciphylaxis

D

All others are risk factors or pre-disposing factors

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3
Q

Which of these schlerotherapy treatments for lymphatic malformations has the highest complication rate ?
A) Bleomycin
B) Doxycycline
C ) Ethanol
D ) OK-432
E) Sodium tetradecyl sulfate

A

C

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4
Q

Risk factors for neurocutaneous melanosis

A

> 20 satelite lesions
midline lesions
giant

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5
Q

Which of the following cytokines is most likely to foster reperfusion injury?
A) Fibroblast growth factor 3 B) Interleukin-2
C) Transforming growth factor beta D) Tumor necrosis factor alpha
E) Vascular endothelial growth factor

A

The correct response is Option D.

Tumor necrosis factor alpha is a key cytokine in reperfusion injury. This cytokine is proinflammatory and plays a role in mediating vasodilation, edema, and oxidative stress after restoration of perfusion.
Interleukin-2 is also proinflammatory, but it is not central to reperfusion injury. The other cytokines are growth-mediating cytokines.
Transforming growth factor beta and vascular endothelial growth factor are involved with vascular growth. Fibroblast growth factor 3 is involved with cellular growth and wound- healing.

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6
Q

Effect on hematoma and opioid use of ketorolac

A

No change hematoma
Less opioids

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7
Q

Timing of masquelet technique

A

4 weeks ideal
6-8 weeks if complicated `

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8
Q
  1. A 35-year-old transgender man (assigned female at birth) meets World Professional Association for Transgender Health guidelines for gender-affirming genital surgery. He chooses to undergo radial forearm flap phalloplasty. During flap harvest, the plastic surgeon identifies the cutaneous nerve near the cephalic vein; the nerve is later coapted to the ilioinguinal and dorsal clitoral nerves for sensory reconstruction. This cutaneous nerve originated from which of the following more proximal nerves?
    A ) Axillary
    B ) Median
    C)Musculocutaneous
    D) Radial
    E) Ulnar
A

c

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9
Q

HS is caused by which glands ?

A

inflammation of the apocrine glands

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10
Q

Bacteria and treatment for aquarium

A

Mycobacterium marinium, doxy x 3 months

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11
Q

She is started on a pharmacologic agent with indirect inhibition of factor Xa
as the primary mechanism of action. Which of the following agents did she most
likely receive?
A) Apixaban
B) Dabigatran
C) Enoxaparin
D) Fondaparinux
E) Warfarin

A

D

Fondaparinux is an indirect factor Xa (thrombin) inhibitor that is administered by
subcutaneous injection. It has been demonstrated to be efficacious for prophylaxis or
treatment of venous thromboembolisms.
Dabigatran and apixaban are direct thrombin inhibitors. Warfarin is a vitamin K antagonist.
Enoxaparin is a direct factor Xa inhibitor.

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12
Q

Calciphylaxis treatment

A

sodium thiosulfate

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13
Q

Parry-rhomberg treatment

A

MTX

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14
Q

Innervation of the rectus muscles

A

intercostals

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15
Q

DO mechanism of bone formation ?

A

Intramembranous ossification

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16
Q

Define :
A) Endochondral ossification
B) Intramembranous ossification
C) Osteoconduction
D) Osteogenesis
E) Osteoinduction

A

New bone is formed during distraction osteogenesis via the process of intramembranous ossification. The key is that the new bone is spontaneously formed without a cartilaginous intermediate. In addition to distraction osteogenesis, intramembranous ossification occurs during fetal development with the formation of the flat bones. It also occurs with primary bone healing.

Osteogenesis is the primary mechanism for healing of a vascularized bone graft. Osteoblasts that survive the bone graft transfer procedure and osteoblasts at the native recipient bone both participate in the formation of new bone to heal the bony interface.

Osteoconduction is the primary process for healing of cortical bone grafts. Blood vessels and cells from the recipient wound bed grow into the cortical bone graft, which functions as a template for the deposition of new bone.

Endochondral ossification involves formation of new bone via a cartilaginous intermediate. This process is seen during fetal long bone development and during bony fracture healing via a cartilaginous callus.

Osteoinduction, which is seen in healing of cancellous bone grafts, involves bone morphogenetic protein stimulating mesenchymal cells at the recipient site to differentiate into osteoprogenitor cells.

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17
Q

2 arteries to anastomose in penile amputation

A

internal pudendal artery (deep structures)
inferior external pudendal artery (skin)

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18
Q

What is glut 1 positive ?

A

infantile hemangioma

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19
Q

Best views to determine ulnar variance

A

1) lateral
2) PA

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20
Q

How to make toe syndactyly dorsal skin scars better

A

Use plantar flaps for web space surfacing

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21
Q
  1. The superolateral border of the popliteal fossa is formed by which of the following
    muscles?
    A ) Biceps femoris
    B ) Lateral head of the gastrocnemius
    C ) Medial head of the gastrocnemius
    D ) Plantaris
    E ) Semimembranosus
A

A

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22
Q

What type of agar for mycobacterium marinum

A

Löwenstein-Jensen medium

Acid fase zeilh neelson stain

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23
Q

What time does the femur and clavicle ossify ?

A

8 weeks

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24
Q

Chances of having an absent EIP

A

5%

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25
Q

A 6-year-old boy with right congenital corneal anesthesia and a history of multiple
corneal abrasions and ulcerations is scheduled to undergo donor sural nerve
grafting. Which of the following graft targets is most likely to provide the greatest
improvement in corneal sensation?
A ) Left supraorbital nerve to right corneal nerve
B ) Left supraorbital nerve to right supraorbital nerve
C ) Left supratrochlear nerve to right scleral limbus
D ) Right frontal branch of facial (VII) nerve to right supratrochlear nerve
E ) Right infraorbital nerve to right corneal nerve

A

The correct response is Option C.
The ipsilateral, supraorbital, and supratrochlear nerves provide sensation to the cornea. There
are many causes for insensate cornea, including congenital and acquired conditions. Herpes
infection is one of the leading causes. Chronic ulceration and injury can lead to corneal
scarring that can lead to blindness. Corneal sensation is critical for protection of the cornea
and sight. Reinnervation of the cornea may be possible with donor nerve grafts from the
contralateral side to the sclera at the limbus. The fascicles can be divided and the individual
fascicles distributed in a subconjunctival fashion to be sutures to the sclera at the edge of the cornea. Use of the ipsilateral, trochlear, or supraorbital nerve is not expected to regain
innervation since these nerves themselves are involved

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26
Q

A 2-year-old girl presents to the clinic preoperatively with an unrepaired cleft
palate. The patient is meeting developmental milestones. Compared with a similar
patient undergoing surgery at 1 year of age, this patient has an increased risk for
which of the following?
A ) Feeding difficulty
B ) Fistula formation
C ) Maxillary growth restriction
D ) Postoperative airway complications
E ) Velopharyngeal insufficiency

A

E

Sooner = maxillary growth restriction
Later = speech issues

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27
Q

A 44-year-old woman is evaluated because of pain and clicking anterior to the
tragus with mouth opening. In the more common form of internal derangement of
the temporomandibular joint, the disc is most often located in which of the
following positions?
A ) Anterior and medial
B ) Inferior and lateral
C ) Posterior and lateral
D ) Posterior and medial
E ) Superior and medial

A

A

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28
Q

Highest risk of dermal cyst intracranial extension?/

A

anterior fontanelle

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29
Q

Syndrome associated with lower lid coloboma

A

TC

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30
Q
  1. A 40-year-old man presents with acute left facial nerve paralysis that began 24
    hours ago. In addition to a loss of facial expression on the left side of the face, the
    patient is most likely to report which of the following symptoms?
    A ) Crocodile tears
    B ) Excessive salivation
    C ) Gustatory sweating
    D ) Hyperacusis
    E ) Tongue numbness
A

D

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31
Q

The pathology report describes the lesion as having Kamino
bodies present with no nuclear atypia or increased mitoses. Results of
fluorescence in situ hybridization studies are negative for melanoma markers.

What is this and what it the management

A

spitz nevus
expectantMos

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32
Q

Most common complication of lefort 1 + BSSO

A

permanent nerve damage (10%)

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33
Q

Safe for black people tattoo laser type and wavelength

A

q switched Nd-Yag 1064

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34
Q

Gland most likely to cause dry eye?

A

Mebomian

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35
Q

Most commonly associated complication to circumareolar mastopexy?

A

flattened projection

36
Q

Last step in rhinoplasty?

A

Alar flair reduction

37
Q

Jessner solution depth and response
35% TCA d+r
50% TCA d+r

A

superficial- no frosting
papillary dermis- frosting with erythema
reticular dermis - frosting with no erythema

38
Q

MOA cryolipolysisq

A

apoptosis

39
Q

MOA minoxidyl and finasteride

A

Minoxidil is believed to work primarily by increasing blood flow by opening potassium
channels leading to vasodilation at the follicular level,

Finasteride inhibits 5-alpha reductase type II, leading to decreased circulating levels of
dihydrotestosterone,

40
Q

Amastia
Amazia
Athelia

A

No breast or NAC
No breast, present NAC
No NAC

41
Q

MOA TXA

A

The binding of this receptor prevents plasmin (the activated form of
plasminogen) from binding to and ultimately stabilizing the fibrin matrix.A 46-year-old woman who has moderate acne scars on her face is interested in
improving the appearance of the scars. She has Fitzpatrick Type IV skin. The
patient is very concerned about possible postprocedure dyspigmentation. Which
of the following is the most appropriate technique that would address the patient’s
concerns?

42
Q

A 46-year-old woman who has moderate acne scars on her face is interested in
improving the appearance of the scars. She has Fitzpatrick Type IV skin. The
patient is very concerned about possible postprocedure dyspigmentation. Which
of the following is the most appropriate technique that would address the patient’s
concerns?

A

microneedling

43
Q

Parotid duct travels through which part of the buccal fat pad ?

A

Anterior lobe (posterior part)

44
Q
A
44
Q

Mustarde and furnas

A

Mustarde = chonco-scaphal

furnas = scapho-mastoid

45
Q

frailty index score 5`

A
  • Functional status before surgery
  • Diabetes mellitus
  • Chronic obstructive pulmonary disease
  • Congestive heart failure
  • Hypertension requiring medication
46
Q
  1. Which of the following healthcare reform laws guarantees the transferability of a
    patient’s health insurance coverage from one employer to another?
    A ) 21st Century Cures Act
    B ) Health Information Technology for Economic and Clinical Health Act
    C ) Health Insurance Portability and Accountability Act
    D ) Patient Safety and Quality Improvement Act
    E ) Women’s Health and Cancer Rights Act
A

c

47
Q

relative stability vs absolute

A

relative = external splinting, intramed nail, external fixation

absolute - compression, tension band, lag screw

48
Q

Complication of phentermine (weight loss drug) pre-op

A

Non-responsive hypotension

49
Q

Risk of getting breast cancer BRCA 1 and 2

A

60 and 50%

50
Q

MOA 5-fu

A

The
mechanism of action is inhibition of fibroblast proliferation with a decrease in collagen
synthesis

51
Q

Which of
the following ventilatory maneuvers is most appropriate immediately prior to
cinching the stitch for pleural closure after a pneumothorax

A

modified valsalva, maximum inspiration

52
Q

Treatment of benign phylloides tumor

A

excision with margins

53
Q

Lab complications of oxandrolone and does it affect mortality ?

A

AST ALT elevation

Non

54
Q

what can you mix with liposomal bupi?

A

normal bupi
not lido

55
Q

A ) Expired
B ) Probation
C ) Retired
D ) Revoked
E ) Suspended

A
  • Expired – Certification has lapsed; the diplomate has not met the requirements to
    renew certification.
  • Retired – No longer in active practice of plastic surgery.
  • Revoked – Certification is no longer valid due to a failure to maintain required ethical
    or professionalism standards.
  • Suspended – Certification is suspended due to action on a medical license by a state
    medical board.
  • Probation – Certification is placed on probation due to action on a medical license by
    a state medical board.
56
Q

MOA papaverine

A

phosphodiesterase inhibitors

57
Q

How long to hold tamoxifen and anastrazole

A

tamoxifen is debatable, 2-4 weeks

anastrazole not at all

58
Q

CPT codes for
benign
malignant
soft tissue sarcomas

A

14xxx
16xxx

these only include simple closure

21-25xxx

this includes all closure types

59
Q

Best treatment for microcystic lymphatic malformation

A

sirolimus

60
Q

subcutaneous abdominal tumor with familial adenomatous polyposis (FAP) syndrome

A

desmoid

61
Q

Primary mechanism for bone healing free fib

A

osteogenesis

conduction = cortical
induction = cancellous
endochondral ossification = fracutre

62
Q

MOA TPA

A

converts plasminogen to plasmin

63
Q

CPT code for cure pectus excavatum

A

A ) 21740 (reconstructive repair of pectus excavatum or carinatum, open)

64
Q

Where is the plantaris tendon at the ankle?

A

medial to the achilles tendond

65
Q

Reduction for bennet fracture

A

abduction
pronation
traction
volar pressure

66
Q

What is the significance of a myoarterial unit under the nail?

A

glomus tumor

67
Q

Minimum of bone distal to a joint for elective amputation

A

5 cm

68
Q

Cast treatment for minimally displaced radius fracture. 2 weeks later cannot retropulse thumb. What do you do ?

A

EPL rupture, tendon transfer

69
Q

Initial cause of thumb boutonniere in RA

A

E ) Metacarpophalangeal joint synovitis

70
Q

P-16 protein expression test is significant for ?

A

HPV

71
Q

Worse strabisme with fronto-orbital advancement or endoscopic ?

A

FOA

72
Q

Lower voice post tracheal shave injured thing

A

anterior commissure ligament

recurrent laryneal - horeseness

73
Q

Replacement of an avulsed tooth quickly lessens the damage to what structure ?

A

Periodontal ligamenet

74
Q

Do you need imaging for a child <2 years old for a lateral brow dermoid cyst?

A

no, older than this MRI and anything central MRI

75
Q

Most common complication for discectomy for TMJ

A

Condylar remodeling

76
Q

Normal MRD 1

A

4-5mm

77
Q

HOw long do you wait after injectivng lidocaine before injecting liposomal buip?

A

20 mins

78
Q

Mucosal vs bony hypertrophy of the inferior turbniate treatment

A

Bony = submuosal resection
mucosal = outfracture

79
Q

How to decrease risk of hypopigmentation for fitz v and c02 laser ?

A

decrease dwell time

80
Q

Inferior oblique, what movements

A

medial and superior

81
Q

Chemotherapy contra-indication for HBOC

A

Doxyrubicin

82
Q

Timing of excision post paradoxical adipose hyperplasia cryolipolysis

A

6-9 months

83
Q

Dry
wet
Superwet
TUmescent

A

Dry= nothing
Wet = 200-300 per anatomic area
superwet 1:1
Tumescent 2-3:1

84
Q

Chance of having contralateral BIA-ALCL

A

4.6%

85
Q
A

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