APBS Flashcards
Screening guidelines for implant rupture FDA?
MRI or ultrasound
5-6 years post op, q2-3 years
- 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
This is calciphylaxis
D
All others are risk factors or pre-disposing factors
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
C
Risk factors for neurocutaneous melanosis
> 20 satelite lesions
midline lesions
giant
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
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.
Effect on hematoma and opioid use of ketorolac
No change hematoma
Less opioids
Timing of masquelet technique
4 weeks ideal
6-8 weeks if complicated `
- 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
c
HS is caused by which glands ?
inflammation of the apocrine glands
Bacteria and treatment for aquarium
Mycobacterium marinium, doxy x 3 months
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
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.
Calciphylaxis treatment
sodium thiosulfate
Parry-rhomberg treatment
MTX
Innervation of the rectus muscles
intercostals
DO mechanism of bone formation ?
Intramembranous ossification
Define :
A) Endochondral ossification
B) Intramembranous ossification
C) Osteoconduction
D) Osteogenesis
E) Osteoinduction
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.
2 arteries to anastomose in penile amputation
internal pudendal artery (deep structures)
inferior external pudendal artery (skin)
What is glut 1 positive ?
infantile hemangioma
Best views to determine ulnar variance
1) lateral
2) PA
How to make toe syndactyly dorsal skin scars better
Use plantar flaps for web space surfacing
- 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
What type of agar for mycobacterium marinum
Löwenstein-Jensen medium
Acid fase zeilh neelson stain
What time does the femur and clavicle ossify ?
8 weeks
Chances of having an absent EIP
5%
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
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
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
E
Sooner = maxillary growth restriction
Later = speech issues
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
Highest risk of dermal cyst intracranial extension?/
anterior fontanelle
Syndrome associated with lower lid coloboma
TC
- 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
D
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
spitz nevus
expectantMos
Most common complication of lefort 1 + BSSO
permanent nerve damage (10%)
Safe for black people tattoo laser type and wavelength
q switched Nd-Yag 1064
Gland most likely to cause dry eye?
Mebomian
Most commonly associated complication to circumareolar mastopexy?
flattened projection
Last step in rhinoplasty?
Alar flair reduction
Jessner solution depth and response
35% TCA d+r
50% TCA d+r
superficial- no frosting
papillary dermis- frosting with erythema
reticular dermis - frosting with no erythema
MOA cryolipolysisq
apoptosis
MOA minoxidyl and finasteride
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,
Amastia
Amazia
Athelia
No breast or NAC
No breast, present NAC
No NAC
MOA TXA
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?
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?
microneedling
Parotid duct travels through which part of the buccal fat pad ?
Anterior lobe (posterior part)
Mustarde and furnas
Mustarde = chonco-scaphal
furnas = scapho-mastoid
frailty index score 5`
- Functional status before surgery
- Diabetes mellitus
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Hypertension requiring medication
- 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
c
relative stability vs absolute
relative = external splinting, intramed nail, external fixation
absolute - compression, tension band, lag screw
Complication of phentermine (weight loss drug) pre-op
Non-responsive hypotension
Risk of getting breast cancer BRCA 1 and 2
60 and 50%
MOA 5-fu
The
mechanism of action is inhibition of fibroblast proliferation with a decrease in collagen
synthesis
Which of
the following ventilatory maneuvers is most appropriate immediately prior to
cinching the stitch for pleural closure after a pneumothorax
modified valsalva, maximum inspiration
Treatment of benign phylloides tumor
excision with margins
Lab complications of oxandrolone and does it affect mortality ?
AST ALT elevation
Non
what can you mix with liposomal bupi?
normal bupi
not lido
A ) Expired
B ) Probation
C ) Retired
D ) Revoked
E ) Suspended
- 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.
MOA papaverine
phosphodiesterase inhibitors
How long to hold tamoxifen and anastrazole
tamoxifen is debatable, 2-4 weeks
anastrazole not at all
CPT codes for
benign
malignant
soft tissue sarcomas
14xxx
16xxx
these only include simple closure
21-25xxx
this includes all closure types
Best treatment for microcystic lymphatic malformation
sirolimus
subcutaneous abdominal tumor with familial adenomatous polyposis (FAP) syndrome
desmoid
Primary mechanism for bone healing free fib
osteogenesis
conduction = cortical
induction = cancellous
endochondral ossification = fracutre
MOA TPA
converts plasminogen to plasmin
CPT code for cure pectus excavatum
A ) 21740 (reconstructive repair of pectus excavatum or carinatum, open)
Where is the plantaris tendon at the ankle?
medial to the achilles tendond
Reduction for bennet fracture
abduction
pronation
traction
volar pressure
What is the significance of a myoarterial unit under the nail?
glomus tumor
Minimum of bone distal to a joint for elective amputation
5 cm
Cast treatment for minimally displaced radius fracture. 2 weeks later cannot retropulse thumb. What do you do ?
EPL rupture, tendon transfer
Initial cause of thumb boutonniere in RA
E ) Metacarpophalangeal joint synovitis
P-16 protein expression test is significant for ?
HPV
Worse strabisme with fronto-orbital advancement or endoscopic ?
FOA
Lower voice post tracheal shave injured thing
anterior commissure ligament
recurrent laryneal - horeseness
Replacement of an avulsed tooth quickly lessens the damage to what structure ?
Periodontal ligamenet
Do you need imaging for a child <2 years old for a lateral brow dermoid cyst?
no, older than this MRI and anything central MRI
Most common complication for discectomy for TMJ
Condylar remodeling
Normal MRD 1
4-5mm
HOw long do you wait after injectivng lidocaine before injecting liposomal buip?
20 mins
Mucosal vs bony hypertrophy of the inferior turbniate treatment
Bony = submuosal resection
mucosal = outfracture
How to decrease risk of hypopigmentation for fitz v and c02 laser ?
decrease dwell time
Inferior oblique, what movements
medial and superior
Chemotherapy contra-indication for HBOC
Doxyrubicin
Timing of excision post paradoxical adipose hyperplasia cryolipolysis
6-9 months
Dry
wet
Superwet
TUmescent
Dry= nothing
Wet = 200-300 per anatomic area
superwet 1:1
Tumescent 2-3:1
Chance of having contralateral BIA-ALCL
4.6%
