Board Cases

Question 1

CTS

Question 2

Pressure Sore

Answer 2

Hx:
Continent?
PMH: DM / PVD?
Spinal cord injury / ambulatory / sensation / spasticity?
Current wound care regimen

W/U:
Imaging - MRI
Bx - tissue path (marjolins
ulcer / micro / bone bx)

Consults: IM, PT, SW, ID (+/- ortho /gen surg /uro)

______
1. educate
2. spasticity (baclofen/diazepam)
3. prevent contractures (PT/tenotomy)
4. Stage 3/4 –> debride /changes. Close only if social fixed, Bx negative

Ischial - inf glut rot (FC or MC- IGA), Hamstring V-Y (MC-profunda),Post thigh V-Y (based medially - profunda)

Sacral - Sup glut rot (FC or MC - SGA), BL V-Y (SGA), SGAP (FC)

Troch - TFL (MC - transv LFCA), ALT (Desc LFCA), girdlestone (with vastus lateralis interpsoition)

**Bx for Marjolins

Question 3

Lip

Answer 3

partial thickness: mucosal advancement for red lip, FTSG cutaneous lip

Hx: XP, Gorlin syn, rads, organ transplant
PE: full skin exam, LN
Dx: Bx (not shave)
Palpable LN –> medical oncology / CT / PET

Question 4

Nose

Answer 4

Subunits (dorsum,sidewall,tip,ala, soft triangle,columella)
Layers (mucosa,cartilage,skin)

Question 5

Eyelid

Answer 5

Question 6

Ear

Answer 6

Question 7

ZMC fx

Answer 7