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Oral Board Review Textbook > Focused Review > Flashcards

Focused Review Flashcards

1
Q

What is better for posterior expansion, 2-piece lefort or SARPE?

A

2-piece lefort, more relapse

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2
Q

What is the max expansion you can get with a SARPE?

A

For around 7 mm

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3
Q

What is your SARPE protocol?

A

-5-7 days latency
-0.5 mm / day within 4 weeks
-4 months consolidation

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4
Q

What do you do if you have a dusky maxilla?

A

-Concerned for avascular necrosis
-Remove any splints/IMF
-Consider OR to return maxilla back to original position

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5
Q

What is the normal intercanthal and interpupillary distance?

A

-Intercanthal: 32 mm
-Interpupillary: 60 mm

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6
Q

What is the goal MIO s/p ankylosis?

A

35 mm

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7
Q

What is the Kaban protocol?

A

-Resect bony ankylosis
-Ipsilateral coronoidectomy
-Contralateral coronoidectomy prn
-Temporalis flap
-Mobilization after 10 days
-Aggressive PT

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8
Q

What imaging do you obtain for a TMJ ankylosis?

A

CT Face with contrast (see pterygoid plexus and other vasculature

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9
Q

What are your landmarks for a TMJ arthrocentesis?

A

-Holmund-Hellsing line.
-10 mm ahead and 2 mm below
-20 mm ahead and 10 mm below

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10
Q

What do you use for your arthrocentesis?

A

-LR 300 mL
-Kenalog 40 mg/mL

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11
Q

What inflammatory mediators are you attempting to reduce in TMJ?

A

TNF-a
IL1
IL6

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12
Q

Describe your costochondral graft approach?

A

-Rib 6 on right side
-5 cm incision along inframammary crease
-Skin, subQ, fascia, plane between pectoralis major and rectus abdominus
-Harvest 1-3 cm of cartilaginous cap
-Check for PTX

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13
Q

Where is most likely bleeding during TMJ surgery?

A

-Middle meningial: 31 mm medial to zygomatic arch and 2.4 mm anterior to height of glenoid fossa
-Masseteric
-Pterygoid plexus

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14
Q

What is the course of the facial nerve?

A

-Branch 1.5-2.8 cm anterior to EAC
-Crosses zygomatic arch 8-35 mm anterior to EAC in temporoparietal fascia layer

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15
Q

Describe steps of carotid cutdown.

A

-Neck incision 5 cm in length, 2 cm below inferior border of mandible over SCM
-Retract SCM posteriorly
-Identify carotid sheath
-Retract IJV posteriorly
-Dissect to carotid bifurcation (ID hypoglossal nerve)
-Ligate above facial (third anterior branch)

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16
Q

What is TMJ concepts made out of?

A

-Fossa: High molecular weight polyethylene, unalloyed titanium mesh
-Condyle: Cobalt/chronium/molybendum, titanium alloy body

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17
Q

What is Frey’s syndrome, how is it treated?

A

-Aberrent innervation of parasympathetic and sympathetic fibers of auriculotemporal and glossophrayngeal nerves
-Demarcate area with starch iodine test
-Scopolamine patch or botox 16 units

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18
Q

How is OSA classified?

A

AHI:
Normal: 0-4
Mild: 5-15
Moderate: 15-30
Severe: 30+

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19
Q

What is apnea?

A

-Cessation of airflow x10 seconds

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20
Q

What is hypopnea?

A

-Reduction of airflow resulting in O2 reduction of 3-4%

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21
Q

What is RERA?

A

-Respiratory event related arousal

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22
Q

What is STOP BANG and how is it interpreted?

A

-Snoring, tiredness, observed apnea, pressure, BMI, age, neck, gender
-High risk 5-8, intermediate 3-4

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23
Q

What is Epworth sleepiness scale and how is it interpreted?

A

-Questions likelihood of dozing off during specific tasks
-11-24 excessive, 6-10 higher than normal daytime sleepiness

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24
Q

What is PAS?

A

Posterior airway space (measured along line B to angle of mandible)
-Less than 11 may indicate base of tongue obstruction

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25
Q

What is P-PNS?

A

-Length of soft palate
-Over 37 indicated increased risk of OSA

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26
Q

What is H-MP?

A

Hyoid to mandibular plane
-Longer than 15 mm indicative of longer airway/OSA

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27
Q

What is COVID?

A

-A viral disease that can cause severe acute respiratory syndrome due to virus attaching to ACE2 receptors in lungs activating inflammatory mediators that can lead to a cytokine storm.
-Spread via direct contact or droplets

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28
Q

What is the rood criteria?

A

-Darkening, deflection, narrowing or bifid roots
-Diversion, narrowing or interruption of white line of canal

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29
Q

Describe the pupillary reflex.

A

Afferent CN II
Efferent CN III
Parasympathetic CN III, ciliary ganglion
Sympathetic: Superior cervical ganglion

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30
Q

What are the levels of nerve testing?

A

A: Aa/Ab: Brush stroke/2 pt discrimination. Normal 2-point 6 mm
B: Ab: Static touch
C: Ad/C: Pain

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31
Q

How is a neuroma managed?

A

Resect 3 mm each side

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32
Q

How is direct neurorrhaphy completed?

A

-7/0 nylon (can repair 5 mm primarily)

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33
Q

What is Axogen, how does it work?

A

-Processed allograft, scaffold for nerve tissue to grow
-Use with entubulation (polyglycolic acid conduit)

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34
Q

What is the failure rate with coronectomy?

A

30% (root migration)

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35
Q

What are the borders of the pterygomandibular space?

A

-Buccal to parotid
-Lateral pterygoid to inferior border of mandible
-Medial pterygoid to Ascending ramus

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36
Q

What divides the superficial and deep temporal space?

A

-Temporalis muscle

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37
Q

What is the route of an infection to the mediastinum?

A

-Danger space
-Alar and prevertebral fascia
-Enters C6-T4

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38
Q

What is an implant made out of?

A

-Grade 4 titanium
-Titanium, aluminum, vanadium

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39
Q

What are fast, short and long acting insulin?

A

-Fast: Lispro, aspart
-Short: Regular
-Long: Glargine, Levemir

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40
Q

What are biguanides and how do they work?

A

-Metformin
-Decrease hepatic gluconeogenesis

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41
Q

What are sulfonylureas and how do they work?

A

-Glipizide
-Stimulates beta cells to produce insulin

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42
Q

How does ozempic work?

A

-GLP-1 agonist
-Stimulates insulin secretion and decreases glucagon secretion

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43
Q

What are the borders of the submasseteric space?

A

-Buccal-parotid
-Lateral pterygoid to inferior border of mandible
-Ascending ramus to masseter

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44
Q

How is a bowstring test preformed?

A

-Grab eyelid with fingers or forceps and pull laterally
-Palpate tendon area and detect movement

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45
Q

What are the zones of the neck?

A

Zone 1: Thoracic inlet to cricothyroid membrane
Zone 2: Cricothyroid membrane to angle of mandible
Zone 3: Above angle of mandible

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46
Q

What is PIerre Robin Sequence?

A

A congenital birth defect characterized by underdeveloped jaw, backward displacement of tongue and upper airway obstruction. Associated with cleft palate

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47
Q

What is the Cincinnati stroke scale?

A

-Facial droop, arm drift, abnormal/slurred speech

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48
Q

What is the management of stroke?

A

-CT within 20 min of ED
-TPA within 60 minutes of ED (within 3 hours of stroke)

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49
Q

What are requirements for TPA in stroke patient?

A

-Ischemic stroke
-No anticoagulants/antiplatelets x24h

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50
Q

What is T2DM?

A

-Endocrine disorder characterized by increased blood glucose secondary to insulin resistance

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51
Q

What is HTN?

A

-Increased arterial pressure diagnosed with 2 elevated readings on 2 occassions

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52
Q

What is CAD?

A

-Plaque build-up in the wall of the arteries that supply blood to the heart

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53
Q

What is IHD?

A

-HEart damage caused by reduced blood flow to the heart, inability to match oxygen demand of the heart?

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54
Q

What is MRD1 and MRD2 and measurements?

A

-MRD1: Corneal reflex to upper eyelid 4 mm
-MRD2: Corneal reflex to lower eyelid, 5 mm

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55
Q

How is botox reconstituted and what is the shelf life?

A

-50 U vial in 1.25 mL of sterile saline
-4U/0.1 mL
-Use within 4 hours

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56
Q

Pleomorphic Adenoma

A

-Most common salivary gland neoplasm, benign
-Ductal and myoepithelial cells common
-Resection with 1 cm margins (up to superficial parotidectomy, known to have extracapsular spread)

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57
Q

Carcinoma ex-pleomorphic adenoma

A

-Malignant transformation of pleomorphic adenoma
-Extent and grading drive treatment
-Wide local excision, neck dissection, consider radiation

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58
Q

Polymorphous adenocarcinoma

A

-Previously PLGA
-Second most common intraoral malignancy
-Good prognosis
-Surgical resection with 1.5 cm margins

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59
Q

Mucoepidermoid carcinoma

A

-Most common malignant salivary gland tumor
-Low-high grade affects treatment
-1.5 cm margins (hemimaxillectomy if high grade), consider radiation for high grade

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60
Q

Adenoid Cystic carcinoma

A

-Salivary gland malignancy
-Perineural invasion and skip lesiosn
-10% 15 year survival
-3 cm margins

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61
Q

Acinic Cell Carcinoma

A

-Low grade salivary malignancy
->90% survival
-1 cm margins

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62
Q

Neurofibroma

A

-Most common peripheral nerve sheath tumor
-Consider NF-1 (AD) if cafe au lait spots
-Conservative excision

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63
Q

Schwannoma

A

-Peripheral nerve sheath tumor with Antoni A&B
-Conservative excision

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64
Q

Osteosarcoma

A

-Male>female, mean age 30-40
-Swelling with pain, loosening of teeth, paresthesia
-Loss of p53 and Rb tumor suppresor genes
-Pre-op Chemo (doxorubicin, vincristine, cyclophosphamide, prednisone)
-Allow 1 month for marrow recovery
-3 cm bony margin, 2 cm soft tissue margin
-Post-op chemo 6 weeks after resection
-Low grade survivability >80%, high grade <30%

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65
Q

What are the variants of osteosarcoma?

A

-Chondroblastic (high grade)
-Osteoblastic
-Fibroblastic
-Telangiectatic
-Osteoclast-rich

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66
Q

How is osteosarcoma staged?

A

-T1 <8cm, T2 >8cm
-G1 (well differentiated, low grade), G2 (moderately differentiated, high grade), G3 (poorly differentiated, high grade)
-T3G1 still IB

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67
Q

Obturator timing

A

9 months to become dimensionally stable

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68
Q

Describe soft tissue sarcomas and treatment

A

-Angiosarcoma, rhabdomyosarcoma, leiomyosarcoma, karposi sarcoma
-Wide local excision

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68
Q

Zygomatic Implants

A

-Straumann 30-60 mm length, 3.3-4.3 mm diameter, 55 degree platform
-ZAGA 0-4 (concavity of maxillary anterior wall)
-Crestal incision, releasing incision at second molar and midline
-Expose infraorbital nerve, body of zygoma and zygomatic arch, palatal flap raised
-Small sinus window cut on lateral aspect of maxillary sinus, reflect sinus membrane if possible
-Entry point located at first premolar-first molar region
-Drill speed 1-1.5k
-Twist drill 2.9 mm, possibly 3.5 mm
-15 rpm on insertion, 50 Ncm max

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69
Q

PA opioid lookup

A

PDMP (prescription drug monitoring program)

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70
Q

Erythema multiforme

A

-Acute self-limiting immunological disorder
-Often idiopathic or secondary to a trigger (HSV, medication
-Spectrum and can progress to EM minor/major, SJS, TEN
-Topical/systemic steroids for mild cases
-Hospitalization and supportive care for SJS/TEN

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71
Q

Papillary Cystadenoma Lymphomatosum

A

-Warthins tumor
-10% bilateral
-Smokers, older males
-Superficial paroticecotmy, 5 mm cuff

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72
Q

Verrucous Carcinoma

A

-Malignant epithelial neoplasm, exophytic papillary growth
-Locally aggressive
-1 cm margins, 85% survival

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73
Q

Pemphigoid

A

-Autoimmune destruction at basement membrane zone (hemidesmosome destruction)
-Need ophthalmology consult
-Dexamethasone elixir 0.5 mg/5cc

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74
Q

Pemphigus

A

-Autoimmune intra-epithelial destruction
-Systemic

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75
Q

Central Giant Cell granuloma

A

-Multinucleated giant cells
-Non-aggressive <5 cm
-Aggressive >5 cm (adjunct triamcinolone 10 mg/mL for each 1 cm x6 weeks)

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76
Q

Fibrous dysplasia

A

-Congenital Fibro-osseous disease in GNAS1 gene
-Associated with osteosarcoma
-Mono-ostotic/poly-ostotic

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77
Q

Cemento-osseous dysplasia

A

-Reactive fibro-osseous disease
-PA, focal, florid presentations

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78
Q

OKC

A

-Benign neoplasm from dental lamina
-PATCH gene

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79
Q

Odontogenic Myxoma

A

-Ectomessenchymal tumor
-Benign, locally aggressive
-1 cm border with 1 anatomic barrier

80
Q

CEOT

A

Benign odontogenic tumor, asymptomatic expansile lesion
-1 cm margin with uninvolved anatomic barrier

81
Q

Ameloblastoma

A

-Benign, locally aggressive odontogenic tumor of inner enamel epithelium
-BRAF mutation
-1 cm with uninvolved anatomic barrier

82
Q

Aneurysmal bone cyst

A

-Excision eo en bloc resection

83
Q

Calcifying odontogenic cyst

A

-Benign odontogenic cyst
-Common anteiror maxilla
-E&C/excision

84
Q

Traumatic bone cyst

A

Curettage

85
Q

-Ossifying fibroma

A

-Conservative excision
-Wide local excision, 30-50% recurrence with juvenile

86
Q

Langerhans Cell histiocytosis

A

-Surgical curettage
-Low dose radiation, may need chemo if widespread

87
Q

Vascular malformation

A

-High flow vascular malformation
-Pre-op embolization, 2 cm margins)

88
Q

Adenomatoid odontogenic tumor

A

-Benign odontogenic tumor
-2/3 female, 2/3 maxilla, 2/3 imapcted
-Encapsulated, E&C

89
Q

Indications for chemo and rad with SCCa

A

-Radiaiton: Positive margins, T3/T4, ECS, Perineural spread, N2+
-Chemo: ECS, +margins, recurrence, mets

90
Q

Levels of Neck

A

-1: Submental/submandibular
-2: Sternohyoid-SCM (divided by CN XI)
-3: SCM Hyoid-cricoid cartilage
-4: SCM Cricoid cartilage to clavicle
-5: Posterior (SCM-Trap), cricoid divides
-6: Hyoid to suprasternal notch, carotid

91
Q

Radical neck dissectio

A

-Levels 1-5
-CN XI
-IJV
-SCM

92
Q

Importance of SCM and XI

A

SCM Head turning
CM XI: Shoulder use

93
Q

Elective neck dissection in an N0 neck?

A

-Occult lympho node metastasis greater than 15-20%

94
Q

Ideal malar eminence location

A

10-15 lateral
15-20 inferior to lateral canthus

95
Q

Ideal nasolabial angle

A

85-105 degrees

96
Q

Wits appraisal

A

-Maxilla and mandible relationship not influenced by cranium
-AO, BO (A and B to occlusal plane)
-Females: AO and BO coincide
-Males: BO 1 mm ahead of AO

97
Q

Mandibular plane angle

A

Angle >39 is high
Angle <28 low angle

98
Q

Whats the ideal occlusal plane angle

A

-Angle between occlusal plane and anterior cranial base
-14 degrees idea

99
Q

Holdaway ratio

A

-Extend NB line to inferior border
-Compare L1 to pogonion
-Ideal ratio is 1:1 in males, 0.5:1 in females

100
Q

What is in PRF, what is your protocol to make?

A

-10 mL blood
-Centrifuge 12 min at 2700 rpm
-In middle of tube
-Contains FGF, VEGF, PDGF, IGF1

101
Q

What is a medrol dose pack?

A

-Methylprednisone 4 mg tabs
-6 day taper (6, 5, 4, 3, 2, 1): 21 tabs
-1 mg methylprednisone=5 hydrocortisone

102
Q

Xrays in pregnant patients

A

-Less than 10 Gy (5 in 1st trimester)
-Pan=0.00001 Gy

103
Q

TMJ evaluation with tongue depressor

A

-Mahan’s sign
-Bite on tongue depressor
-Pain on same side: Muscular
-Pain on opposide side: TMJ internal derangement

104
Q

Radiation in CBCT and pan

A

CS 9300
-CBCT: 70-100 mSv (9 days background equivalency)
-Pan: 20 mSv
-Flight NY-LA 500 mSv
-Medical grade 7k mSV

105
Q

DM Criteria

A

Fasting glucose >126
Non-fasting glucose >200
A1c >6.5

106
Q

What is the Zurich classification for osteomyelitis?

A

-Acute osteomyelitis (less than 4 weeks)
-Secondary Chronic Osteomyelitis (more than 4 weeks, cause known)
-Primary Chronic osteomyelitis (more than 4 weeks, cause unknown)

107
Q

Temporoparietal Fascia Flap

A

-Supplied by superficial temporal artery and vein
-Map superficial temporal artery via doppler
-Incision through preauricular crease in front of tragus and extends superficially into hemi-coronal incision
-Skin, subcutaneous, fat/fascia
-Incision keeps in mind facial nerve, extend superiorly to scalp
-Check arc of rotation
-Release fascia with desired pedicle from underlying temporalis muscle
-Galea seperated from TP fascia
-Release completed in the subgaleal areolar tissue down to zygomatic arch
-Subcutaneous tunnel formed to allow flap to extend to defect

108
Q

Botox injections

A

Frontalis 4 U/site: 2 cm above eyebrow to prevent ptotic brow
Procerus/corrugator: 5U/site
Crows feet: Lateral orbicularis 3 U/site: 5mm from orbital rim and 5 mm medial and lateral to the suprorbital nerve
-Avoid forehead injections lateral to the lateral canthus to prevent inhibition of temporalis

109
Q

Inability to close eye after botox

A

Paralysis of orbicularis oculi
Tape eye shut and lubricant

110
Q

Misch bone classification

A

Types I-4, 4 being softest. Related to hounsfield units

111
Q

Cawood ridge classification

A

1-Dentate
2-Immediate post-extraction
3-Well healed, adequate height/width
4-Knife edged, inadequate width
5-Inadequate height and width
6-depressed ridge, loss of basal bone

112
Q

What is propofol and how do you use it?

A

-Sedative-hypnotic
-Potentiation of GABA
-1 mg/kg for induction (3mg/kg children)
-25-100 mcg/kg/min infusion
-Intermittent bolus of 20-50

113
Q

What is ketamine and how do you use it?

A

-Dissociative anesthetic with analgesic effects
-NMDA receptor antagonist
-Sympamimetic
-0.5 mg/kg intermittent bolus
-IM 3-5 mg/kg

114
Q

What is midazolam and how do you use it?

A

-Sedative-hypnotic
-Potentiates GABA
-0.1-0.2 mg/kg IV
-Oral premed: 1 mg/kg

115
Q

How is midazolam reversed?

A

-Flumazenil 0.2 mg over 15 seconds.
-Repeat until max dose 1 mg
-Pediatric: 0.01 mg/kg

116
Q

What is fentanyl and how is it used?

A

-Narcotic mostly mu receptor agonist
-1 mcg/kg

117
Q

How is fentanyl reversed?

A

-Naloxone (competitive antagonist
-0.4 mg q2 min up to 10 mg
-Pediatric 0.01 mg/kg up to 0.1 mg/kg

118
Q

Dose of succinycholine/rocuronium

A

-Sux: 1 mg/kg (20% for laryngospasm)
-Rocuronium: 0.5 mg/kg

119
Q

ACLS Cardiac arrest algorithm

A

-Start CPR, give O2, attach monitors/defebrilator
-VF/pVT: Shock, shock, 1 mg epi, shock, 300 amio, shock, 150 amio, shock, 1 mg/kg lido (shock 120-200J)
-Asystole/PEA: CPR, Epi q3-5 min, reversible causes (hypovolemia, hypoxia, acidosis, hypo/hyperkalemia, hypothermia, tension PTX, tamponade, toxins, thrombosis)

120
Q

Adult Bradycardia algorithm

A

-HR <50/min. Check for hypotension, AMS, signs of shock, chest discomfort
-Atropine 1 mg q 3-5 min max 3 mg
-Transcutaneous pacing
-Epi 2-10 mcg/min

121
Q

Adult tachycardia algorithm

A

-HR >150/min. Check for hypotension, AMS< signs of shock
-Synchronized cardioversion 50-200 J
-Adenosine if narrow complex: 6 mg first dose, 12 mg second dose
-If wide and stable: Adenosine if regular/monomorphic
-If narrow and stable: Vagal maneuvers, beta blocker
-Antiarrhtymic infusions for stable wide QRS: Amiodarone 150 mg over 10 minutes

122
Q

PALS Cardiac arrest

A

-Start CPR, attach monitors/defibrillator
-VF/pVT: Shock (2 J/kg), shock (4J/kg), epi 0.01 mg/kg, shock, amio (5 mg/kg), shock, lidocaine 1 mg/kg
-Asystole/PEA: CPR< epi q3-5 min
-Reversible causes: Hypovolemia, hypoxia, acidosis, hypoglycemia, hyper/hypokalemia, hypothermia, PTX, tamponode, toxins, thrombosis

123
Q

Pediatric bradycardia

A

-Start CPR at HR <60/min
-Epi: 0.01 mg/kg q3-5 min
-Atropine 0.02 mg/kg max 0.5 per single dose, can repeat once
-Transthoracic pacing
-Treat underlying causes (hypoxia, hypothermia, medications)

124
Q

Pediatric tachycardia

A

-Unstable narrow: Adenosine 0.1 mg/kg first dose, 0.2 mg/kg second dose. Synchronized cardioversion 0.5-1 J/kg, increase to 2 J/kg for second dose
-Unstable wide: Synchronized cardioversion
-Stable narrow: Vagal maneuvers, adenosine 0.1 mg/kg
-Stable wide: Adenosine if monomorphic, expert consult

125
Q

Pediatric airway

A

Large occiput
Large tongue
Narrowest part is cricothyroid
Superior and anterior larynx
Floppy epiglottis

126
Q

Age cricothyroidotomy is contraindicated

A

-Age 6 and less

127
Q

ZMC fracture classification

A

Zingg
-A1 isolated arch, A2 Isolated lateral wall, A3 isolated inferior orbital rim
-B: Monogragment with all 4 buttresses
C: Comminution

Knight and north: Direction of displacement

128
Q

Condylar fracture classifications

A

Wassmud Scheme
AO: high/low based on sigmoid notch and lateral pole line

129
Q

Zide condylar fracture criteria

A

-Middle cranial fossa involvement
-Unable to achieve occlusion
-Invasion of joint space by foreign body
-Lateral capsule violation and displacement

Relative: Bilateral when height needs restored, early/immediate function, medical conditions, delayed tx with misalignment

130
Q

NOE classification

A

Markowitz
1-No comminution, tendon intact
2-Central fragment largest with tendon
3-severe comminution with avulsed tendon

131
Q

Frontal sinus classification

A

Gontys
1-Isoalted anterior
2-anterior and posterior fractures
3-Posterior only
4-comminuted

132
Q

TMJ ankylosis classification

A

Topazian
1-only condyle
2-Condyle/sigmoid notch
3-Condyle/sigmoid notch/coronoid

133
Q

Osteoradionecrosis classification

A

Notani
1-alveolar bone
2-Above IAN
3-Below IAN

134
Q

How does Unasyn work and what is the adult/pediatric dosage?

A

-Ampicillin/sulbactam
-Beta lactam: Inhibits cell wall synthesis via inhibition of PCN binding proteins
-Beta lactamase inhibitors: Inhibitor of beta lactamase to prevent breakdown of the beta lactam
-3g q6hr.
-300 mg/kg/day

135
Q

PCN, Augmentin MOA, adult/ped dosage

A

-PCN: Beta lactam: Inhibits cell wall synthesis
-Augmentin: Amoxicillin/clavulanate (adds beta lactaumase inhibitor)
-Amoxicillin 500 mg q8h. Pediatric: 40 mg/kg/day
-Augmentin 875/125 mg q12h. 45 mg/kg/day

135
Q

Clindamycin MOA, adult/ped dosage

A

-50S inhibitor
-300 mg QID
-10 mg/kg/day Peds

135
Q

Moxifloxacin MOA/adult dosage

A

-DNA gyrase inhibitor
-400 mg/day

136
Q

Types of nec fasc

A

-Type I: Mixed
-Type II: Group A strep
-Type III: Staph
-Type IV: Clostridium
-Type V: Klebsiella

137
Q

Antibiotics for nec fasc

A

-Broad spectrum
-Cabapenem (beta lactam), Vanc

138
Q

Treatment of Torsades

A

-50 mg/kg (max dose 2g) rapid push if pulseless
-1-2 g over 10-20 minutes if pulse

139
Q

Antibiotics for cavernous sinus thrombosis

A

-Rocephin (crosses BBB)
-Flagyl
-Vanc (high likelihood of S. aureus)
-Steroids

140
Q

Treatment of mucor

A

Amphotericin B (5 mg/kg)
-Renal toxicity, shake and bake
-Inhibits ergosterol on fungal membrane

141
Q

Allergic reaction management

A

-IM Epi 1:1000 0.3 mg (0.15 mg if 10-25 kg) q15 min
-IV Epi: 10 mcg-1 mg q2 min (1-10 mcg/kg peds)
-Albuterol inhaler prn bronchospasm
-Diphenhydramine 0.5 mg/kg IV peds or 50 mg adults
-Dexamethasone 4 mg IV 0.1 mg/kg pediatrics

142
Q

Submandibular space

A

-Anteiror to posterior belly of digastric
-Inferior and medial aspect of mandible- digastric tendon
-Platysma to mylohyoid

143
Q

Lateral pharyngeal space

A

-Constrictor msucles to alar fascia
-Skull base to hyoid
-Retropharyngeal to medial pterygoid

144
Q

Implant material?

A

85% titanium 15% zirconium

145
Q

Fill technique and types

A

-Subdermal plane, aspirate
15-25 mg/mL
-Higher G’ more firm
-Juvederm voluma (cheeks/chin)
-Volbella (lips)
-Volux (jawline)

146
Q

How is filler dissolved?

A

Hyluronidase 1500 units (dissolve in 5 mL)

147
Q

Treatment of ectropion/entropion

A

-Ectropion: Tarsal strip
-Entropion (quickert suture or grafting)

148
Q

Scar/wound management

A

-Antibiotic ointment day 2-7
-Petroleum jelly after first week
-Silicone gels/sheets
-Avoid sun exposure

149
Q

Skin prep for peels/laser

A

-Tretinoin (allows penetration)
-Glycolic acid (allows penetration)
-Hydroquinone (reduces melanocytic production)
-Sunscreen
-Acyclovir 3 days before, 10 days after

150
Q

Chemical peel depth

A

0.45 mm (TCA 35%)
-Medium depth, papillary dermis

151
Q

Acid base deficit in PD

A

Respiratory alkolosis

152
Q

Asthma

A

-Reversible obstructive respiratory disease characterized by bronchiolar inflammation and hyperresponsiveness

153
Q

CHF

A

-Cardiovascular disease characterized by the inability of the heart to pump enough blood to meet the body’s metabolic demands.
-Can see dyspnea, peripheral edema, S3/S4 sounds

154
Q

IDDM

A

-Endocrine disordre of autoimmune destruction of beta islet cells in the pancreas that produce insulin

155
Q

HTN

A

-Persistently elevated arterial blood pressure of 130/80 in adults. 2 elevated readings on 2 or more visits

156
Q

ESRD

A

-Chronic renal disease leading to kidney failure
GFR <15

157
Q

CAD

A

Disease of the vasculature of the heart, atherosclerotic plaque causing hardening and stenosis of the vessels supplying blood to the heart

158
Q

Down Syndrome

A

Genetic disorder trisomy 21. Characterized by intellectual disability, developmental delay, CV problems

159
Q

Fibromyalgia

A

Chronic disorder that causes pain and tenderness throughout the body. Heightened sensitivity to pain

160
Q

Von Willebrand disease

A

Hematologic disorder caused by quantitative or qualitative defect of von Willebrand factor

161
Q

Sickle cell disease

A

AR hematologic disorder causing structural sickling of RBCs. Crisis treated with bed rest, analgesics, and hydration

162
Q

Pernicious anemia

A

Macrocytic anemia caused by B12 deficiency due to autoimmune mediated decrease in intrinsic factor

163
Q

Congenital Heart Defect

A

Abnormality of the heart that develops before birth, can be from defective vessels, leaky valves or septal defects

164
Q

Cystic fibrosis

A

AR disease resulting in altered chloride and water transport via the CFTR gene, pt with thickened secretions

165
Q

Myasthenia Gravis

A

Autoimmune disorder affecting the ACh receptor causing weakness and fatigue

166
Q

HIV/AIDS

A

-RNA retrovirus that targets CD4 cells leading to immunodeficiency. AIDS less than 200 CD4 count

167
Q

Multiple Sclerosis

A

Inflammatory demyelinating disease of the CNS causing neurological dysfunction, relapses and periods of remission

168
Q

Transfusion Reaction

A

Fever, chills, hives, and itching from a transfusion
-Stop transfusion, supportive care, possible neph consult for kidney support

169
Q

Serotonin syndrome

A

Excessive serotonin causing diarrhea, flushing, muscle rigidity and seizures
-Treat with lorazepam, labetolol, cyporheptadine, methysergide

170
Q

Digoxin toxicity

A

-Nausea, vomiting and visual disturbance
-Treat with digoxin specific antibody

171
Q

Changes in transplanted heart

A

-Denervated heart
-Does not respond to indirect acting medications (glycopyrolate, atropine, digoxin, physostigmine)

172
Q

Allergic rhinitis

A

IgE mediated inflammatory process of nasopharynx/oropharynx associated with allergen exposure

173
Q

What is Humate P

A

-vWF, Factor VIII

174
Q

What is cryoprecipitate?

A

-Factors 8, 9, vWF, fibrinogen, fibronectin

175
Q

ALS

A

Neurodegenerative disorder of upper and lower motor neurons leading to muscle failure

176
Q

Alzheimer’s

A

Neurodegenerative disorder of amyloid plaque and neurofibrillary tangles causing decreased cognition

177
Q

Parkinsons

A

Neurodegenerative disorder caused by loss of dopaminergic neurons causing rigidity and resting tremor

178
Q

Physiologic changes in pregnancy

A

Increased CO and workload, hypercoagulable, decreased FRC
Can use fentanyl and propofol

179
Q

TMJ Wilkes

A

1-Painless clicking
2-intermitent locking/occasional pain
3-Frequent pain
4-Restricted ROM, chronic pain/crepitus
5-Joint pain/crepitus

180
Q

TMJ ankylosis

A

Sawhney: 1-flat condyle, decreased joint space, 2-bony fusion on outer aspect of articular surface, 3-bony block ramus-zygomatic arch, 4-wider bony block and change of architecture

Topazian: 1-Condyle only, 2-sigmoid notch, 3-Coronoid

181
Q

House brackmann

A

1-Normal
2-Mild
3-Moderate (complete closure with effort)
4-Moderate-severe (incomplete eye closure)
5-Barely perceptible motion
6-Total paralysis, no movement

182
Q

Classification of frontal sinus fracture

A

Gontys
1-Anterior table
2-Posterior table
3-Both anterior and posterior
4-Comminuted

183
Q

Classification of bone quality

A

Misch (relates to hounsfield units)
D1 Hardest
D4 Softest

184
Q

Classification of bone quantity

A

Cawood
1-Dentate
2-Immediate post extraction
3-Well rounded, adequate height/width
4-Knife edge, adequate height, inadequate width
5-Flat- inadequate height/width
6-Depressed ridge, basilar loss

185
Q

Classification of edentulous mandible

A

Class 1: 16-20 mm
Class 2: 11-15 mm
Class 3: <10 mm

186
Q

Nerve injury classification

A

Seddon: Neuropraxia, axonotmesis, neurotmesis, neuroma

Sunderland:
1-temporary
2-possible recovery, endo/perineurium intact
3-perinuerium intact
4-only epineurium intact
5-Complete transection
6-Neuroma

187
Q

Orbital infection classification

A

Chandlers
1-Preseptal cellulitis
2-Postseptal cellulitis
3-Subperiosteal abscess
4-Orbital Abscess
5-Cavernous sinus thrombosis

188
Q

Nec fascitis classification

A

1-mixed aerobe/anaerobe
2-Strep pyogens
3-Staph aureus
4-Clostridial
5-Klebsiella

189
Q

Glogau classification

A

1-Early, minimal wrinkles
2-Moderate, dynamic wrinkles
3-Advanced, static wrinkles
4-Wrinkles everywhere/photoaging

190
Q

Fitzpatrick classification

A

1-White/very fair
2-White/fair
3-White/olive, sometimes burns
4-Light brown, rarely burns
5-Dark brown
6-Black

191
Q

Dedo classification

A

1-Normal
2-Excess skin
3-Excess fat
4-Platysmal banding
5-Migrognathia
6-Low hyoid

192
Q

BUN/Creat ratio
CT contrast in AKI

A

BUN/Creat 20:1 shows dehydration
Pre-treat with Sodium bicarbonate

193
Q

Types of brow lift

A

Trichophytic (lowers hairline): In hairline. Galea/loose areolar tissue/deep temporal fascia

Endoscopic: Raises hairline. 5 incisions, subperiosteal, deep temporal fascia

194
Q

Upper lid bleph

A

-MRD1 4 mm
-Eyelid crease ~8 mm
-Pinch test
-Leave 20 mm between margin and eyelid-brow junction
-Skin only dissection. Medial obicularis dissection.

195
Q

How does an MRI work?

A

-MRI applies a strong magnetic field to allign protons along a single axis
-RF pulse emitted and knocks proton off axis, magnet ligns up agin. RF waves form an image

196
Q
A

Oral Board Review Textbook (26 decks)

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