Past Proc Derm Questions Flashcards
Sharp dissection is performed in the chin
2019 - True - Blunt dissection is often hampered by presence of vertically and diagonally inserting muscle fibres and minimal SC space to dissect within. By contrast, skin of lateral cheek has no direct muscle insertions
Brigham and Women’s Hospital Tumour Classification system for SCC
- based on a total number of criteria
- the following are part of the scale: perineural invasion >0.1mm is equivalent to T3
- invades into SC
- invades into bone in T2b
- larger than 2 cm
- T
- F - bone invasion is equivalent to T3
- T
- F - T3
- T
Desmoplastic SCC is less aggressive than normal cutaneous SCC
F - increased risk of local recurrence and metastasis
Flaps on chin are widely undermined
F - undermining is often difficult and associated with increased bleeding
Chin flaps cross two cosmetic units
?F
Sensory innervation of the ear:
- auricular temple nerve supplies lower part of auricle
- greater auricular supplies conchal bowl
- greater auricular and lesser occipital supplies lower aspect of ear
- the apical triangle exists on the ear
- F —> greater auricular nerve
- F —> auricular branch (Arnold’s nerve) of vagus nerve (CN X)
- T
- F —> refers to superior portion of cutaneous upper lip between medial cheek and ala margin (where crescent in ala crescentic adv flap is taken)
Regarding the nose:
- nasojugal fold is perpendicular to bunny lines
- nasal sill is on the glabella
- soft triangle is inferior to the nose
- False -
- False -
- True -
Cosmetic units
- are anatomical junctions
- anterior hair line is an anatomical junction
- temple and forehead are in same cosmetic unit
- same cosmetic units have the same amount of hair
- F
- F
- T
- F - texture, pigment, pore size, sebaceous quality and hair quality same in a given cosmetic unit
Sebaceous skin
- leaves inverted scars
- is more elastic
- is more compliant
- T
- F
- F
Staples
- cause more skin necrosis than suture
- have more infection
- evert the wound
- can be used for full thickness skin grafts
- true - cause more partial necrosis (Robinson p.200)
- F
- T
- T
- Chalazion clamp is used as a haemostat over the lip
- Local anaesthetic is required for a chalazion clamp to the eyelid for a chalazion clamp to the eyelid
- 0.5% lignocaine is used for the eye
- eye ops for more than 1 hour need drops every 10 min
- True p.230 Robinson
- True
- False, Benoxinate, Tetracaine or Properacaine are used
- True
Tourniquet times:
- arm >60min
- leg >60min
- you should exsanguinate the arm after applying the tourniquet
- F arm 60 min or less p.231
- T leg 1.5-2 hours
- F limb is exsanguinated with a bandage or elastic wrap before tourniquet inflation
Lateral cheek should not be left for secondary intention healing
True
Upper eyelid can be used as FTSG
True
Flaps over the eyelid should be undermined to mid fat
False - above muscle. Layers on eyelid go from dermis to muscle
The dermis of the upper eyelid is attached to orbicularis oculi
True
Rhombic flap used to treat medial canthal areas
True
Banner flap can be used as a lower eyelid repair and causes pincushioning
True
Corrugator supercilii lies superficial to the supratrochlear artery
True
PROCERUS causes inferior movement of the forehead
True
Platysma contributes to lip depression
True - draws corners of mouth inferiorly
Incobotulinumtoxin :
- more potent than onabotulinumtoxin
- does not contain human albumin
- does not need refrigeration
- shelf life >36mo
- equal efficacy when stored in freezer or refrigerator
- F
- F. Does have albumin
- T . Robinson’s states store at <25C ~room temp
- F. 36mo Table 27.1 when unopened
- T
LN2 of face and limbs:
- which causes more swelling?
- LN2 over neck heals faster than on hand
- DFTC is recommended for Kaposi sarcoma
- suitable for KS lesion >1.5cm
- touch LN2 can be used for KS
- face p.163 - post LN2 oedema on face is most obvious
- T
- T
- ?F ?for small lesions of KS
- T
Keratoacanthomas in subungal location are not associated with bony destruction
False - they are