OMSITE 2022 Flashcards
innervation to:
tensor veli palatini
tensor tympani
V3 motor
Pfeiffer syndrome
midface hypoplasia, craniosynostosis, tracheal fusion or narrowing, syndactyly, broad thumb and great toe
may have CP
Sathre-Chotzen syndrome
TWIST gene
hypertelorism, +/- craniosynostosis, syndactyly
may have CP
Stickler syndrome
collagen type II and XI syndrome, AD
CP, mandibular hypoplasia (Pierre Robin sequence– CP)
Crouzon syndrome
craniosynostosis (most common syndromic type), midface hypoplasia, narrow palate +/- CP, NO HAND abnormalities
Apert syndrome
same as Crouzone + syndactyly (craniosynostosis, midface hypoplasia, narrow palate +/- CP)
ketamine effect on CV system
direct negative inotropic effect but has central sympathetic-stimulating activity
Purpose of direct pulp cap
prevent needing RCT or extraction when pulp is already exposed (maintain pulp vitality)
best solution for avulsed tooth
cow’s milk
man with 3 month eye issue and fatigue when chewing
myasthenia gravis
young pt with trigeminal neuralgia: what other condition should you test for
MS
Restorative space required for different implant-retained prostheses
Minimum amount of vertical space required for implant prostheses:
fixed screw-retained (implant level): 4-5 mm
fixed screw-retained (abutment level): 7.5 mm
fixed cement-retained: 7-8 mm
unsplinted overdenture: 7mm
bar overdenture: 11 mm
fixed screw-retained hybrid: 15mm.
how long does it take for toradol antiplatelet effects to wear off
1-2 days (5-6 half lives)
interferes with platelet aggregation
mechanism of respiratory depression from morphine
morphine-6-glucoronide
TCA mechanism
block the reuptake of serotonin and norepinephrine in presynaptic terminals, act as competitive antagonists on post-synaptic alpha cholinergic (alpha1 and alpha2), muscarinic, and histaminergic receptors (H1).
how does osseodensification work
counter clockwise drilling
brachial plexus
- C4-pec/deltoid
- C5-bicep
- C6-brachioradialis
- C7-tricep
PFTs in MG
- dec FEV1, increased RV:FRC ratio
2. muscular weakness causes RV to be higher
desmoplastic ameloblastoma histology
epithelial tumour islands surrounded by a zone of loose-structured connective tissue
plexiform ameloblastoma
basal cells arranged in anastomosing strands, inconspicuous stellate reticulum
follicular ameloblastoma
peripheral palisading and central reticulum stellate pattern
ameloblastoma classifications
1) solid/multicystic
- follicular: spindle cell, acanthomatous, granular, basal cell
- plexiform
2) extra-osseous/peripheral
- luminal
- mural
3) desmoplastic
4) unicystic
ameloblastoma histology
reverse polarization, peripheral palisading, and stellate reticulum-like cells
plasmacytoma
Monoclonal plasma cells, no associated clonal B cell population
mucoepidermoid carcinoma histology
Mucous cells embedded in epidermoid cell nests or lining cystic spaces
Intermediate cells found within epidermoid cell nests or forming separate nests
solid, cystic, or mixed growth patterns
schwannoma histology
well-differentiated schwann cells Encapsulated, well circumscribed Most cases have a zonal pattern composed of cellular areas (Antoni A) with nuclear palisading (Verocay bodies) and a hypocellular component (Antoni B)
pyogenic granuloma
Highly vascularized proliferation of granulation tissue. Often demonstrates surface ulceration and a subacute inflammatory cell infiltrate comprised of neutrophils, lymphocytes and plasma cells.
local anesthetic maxes
prilocaine: 600 mg
lidocaine: 500 mg or 7 mg/kg
articaine: 500 mg
mepivacaine: 400 mg
marcaine: 90 mg
cavernous sinus thrombosis
unilateral periorbital edema, headache, photophobia, proptosis
CN 3, 4, V1, V2, 6
Wilkes Classification
- early reducing, painless clicking
- late reducing, pain and intermittent locking
- non reducing, limited opening, closed lock
- non reducing, chronic pain, bony changes
- non reducing, crepitation, less pain
Number of fascicles in lingual and IAN
lingual: 10-25 fascicles
IAN 12-18 fascicles
Nerve classifications / which last to come back
A alpha is last to come back (large myelinated)
Nerve Characteristic Function
A Alpha large/myelinated position/fine touch
A Beta small/myelinated proprioception
A Delta large/unmyelin. superficial (sharp) pain
C small/unmyelinated deep (dull) pain
pediatric airway differences
anterior/superior larynx, narrow cricoid, narrow/rigid trachea, larger tongue, smaller pharynx, larger/floppier epiglottis
pro-inflammatory mediators
leukotriene B4 PGE2 TNF NO IL-1B
length of tooth splinting
- subluxation: 2 weeks
- extrusive luxation: 4 weeks
- intrusive luxation: 4-8 weeks
- avulsion: 2-4 weeks
tibial incision
gerdy’s tubercle (anterolateral approach)
myxoma
- more common in mandible, more aggressive in maxilla
2. anti-apoptotic protein: BCL-2
T2 tongue primary, no nodal involvement
ipsilateral neck dissection and resection
adenosine dosing (PALS)
0.1 mg/kg, max 6 mg
distraction implant time
4 weeks
melanoma under finger nail
acral lentiginous
shark fin EtCO2 slope
COPD
sick sinus syndrome EKG
paced (treated with pacemaker)
wide complex tachycardia (peds)
synchronized cardioversion (0.5-1 J/kg followed by 2 J/kg)
rate of malignancy transformation lichen planus
0-6%
ACLS SVT treatment
adenosine 6 mg (followed by 12 if ineffective)
virus responsible for mononucleosis
EBV (DNA virus)
amount of lagophthalmos that can be tolerated
2 mm
rate of paresthesia after nerve lateralization
5%
retinal detachment
monocular diplopia
isoproteronol
Isoproterenol is a beta-1 and beta-2 adrenergic receptor agonist
used for bradycardia or torsades
scopolamine / atropine vs. glycopyrrolate (robinul)
scopolamine and atropine: central antimuscarinic
robinul: peripheral antimuscarinic
probabilities for cleft
- 1 parent OR child-
- 2 children
- 1 parent AND 1 child
- 4%
- 9%
- 17%
formation of primary palate
fusion of lateral and medial nasal process and maxillary process
Lemierre’s syndrome
Fusobacterium necrophorum, typically occurs in healthy teenagers and young adults. The infection originates in the throat and spreads via a septic thrombophlebitis of the tonsillar vein and internal jugular vein.
Frey’s syndrome
gustatory sweating and facial flushing
post-ganglionic (otic ganglion) after injury to auriculotemporal nerve during parotid dissection
tx of recurrent cutaneous melanoma
VEGF infusion
children have lower MAC, why?
higher alveolar ventilation rate, lower FRC
thickness of schneiderian membrane
0.3-0.8 mm
modiolus- 5 muscles
buccinator, levator and depressor anguli oris, zygomaticus, risorius
what happens when you orthodontically extrude a tooth?
MG junction stays same, crestal gingiva migrates
how long after radiation should you wait for implants?
6 months
thickness of staple implant
12 mm
obesity ventilation
- PaO2 is decreased representing a ventilation/perfusion mismatch
- PaCO2 remains normal
demineralized freeze-dried bone graft
osteoinductive
maxillary canine eruption
- 22mm
- 80% palatal
- vertical then buccal
what increases APAP toxicity
phenytoin
pediatric IAN compared to adult?
more inferior, lateral, and posterior
increased risk of ankylosis in intracapsular fracture in the…
contralateral ramus
stahl’s ear
extra crease, pointed ear
peridex reduces nosocomial PNA by?
52%
ossifying fibroma resection margins
5 mm
massive blood transfusion effects
dilutional coagulopathy, metabolic alkalosis, hypocalcemic hypothermia, hyperkalemia, cardiogenic pulmonary edema
staining for chondrosarcoma?
CKD4
mechanism of cetuximab
binds to EGF to inhibit tyrosine kinase
connective tissue graft
- red colored side to recipient bed
2. white BM side to abutment
rate of bone loss around an implant
0.2 mm / year, should not exceed 1.5 mm in 12-18 months
thick STSG 0.01-0.025 in (0.3-0.45 mm)
- 0-48: imbibition
- 48-72: inoculation
- 3-5 days: neovascularization
- 7 days: adequate blood supply
posterior hip neurovasculature
- superior and gluteal a
- superior cluneal nerve L1-3
- middle cluneal nerve S1-3
AICBG
- subcostal T12-L1
- iliohypogastric L1-L2
- femoral cutaneous L2-L3
Burkitt’s lymphoma
- endemic form 2x more freq in maxilla, EBV
- “starry sky”
- chemo gives 90% remission
stage I/II tongue SCC
- 1-1.5cm margin
2. elective neck disseciton unless <2mm invasion
FOM SCC
- 50% met
2. <2mm 7.5% nodal, >2mm 38% nodal
treatment of rhabdomyosarcoma
surgical excision followed by chemo
eye symptom in SLE
keratoconjunctivitis
what is argon laser absorbed by?
Hgb
autonomic innervation of eye muscles
levator palpebrae oris: parasympathetic
superior tarsal muscle (Mueller’s): sympathetic
what is remifentanil metabolized by?
plasma esterase
direct thrombin inhibitors
dabigatran, argatroban, hirudin, bivalirudin
best skin match for nose
posterior auricular skin
dantrolene MOA
inhibits Ca release
what is verapamil used to treat?
vasospastic angina
ballistics
penetration and size are most important factor
which nerve is most commonly injured during local anesthesia administration?
lingual nerve
osteomyelitis
increased intramedullary pressure
can spread hematogenously in peds
mitral regurg intraop management
blowing holosystolic apex…
normal to increased heart rate, increase preload, decrease afterload
hypertrophic cardiomyopathy intraop management
preload normal or increase (expand volume)
afterload increase (avoid vasodilation),
minimize sympathetic stimulation
treat hypotension with phenylephrine
obese pt lung volumes
normal FEV1
decr FRC
restrictive defect
V-Q mismatch
absolute contraindication in MAO-i use
ephedrine
what can’t you use in mitral valve prolapse with regurg
ketamine
most important part of coronectomy
remove enamel
contraindicated in MG
non-depolarizing muscle relaxants
erythromycin + versed increases versed concentration via what mechanism
inhibits P450 3A4 system
where is ADH released
posterior pituitary
max amount of time prior to re-implantation of avulsed tooth can survive
120 min
how long should subluxed permanent teeth be treated with a flexible splint?
7-10 days
