Plastic Surgery Flashcards
Domestic radiator is an example of …………..
Contact burns
Account for 70% of children burns
Scalds
………. Accounts for 3-4% of all admissions to burn units
Electrical injury (burns)
Hydrofluoric acid causes burn by…………
leeching calcium from the body
In the zone of stasis there is diminished tissue perfusion due to………….
Platelet microthrombus formation
Neutrophils adherence
Fibrin deposition
………….. can convert the zone of stasis to complete tissue loss
Prolonged hypotension
Infection
Edema
Increase tissue perfusion in the zone of hyperemia results from ……..
Heat injury
Release of histamine
Prostaglandins
Interleukins
Free O2 radicals
Degradation products of bunrt tissue as myoglobin and hematochromagen may lead to………..
Acute tubular necrosis (ATN)
What are the effects of hypothermia?
-may lead to acidosis and coagulopathy
-causes peripheral vasoconstriction and impairs O2 delivery to tissues
-metabolism changes from aerobic to anaerobic
Tropical anitmicrobial agent of choice is …………….
Silver sulfadiazine
Acute phase of burn management begins with mobilization of………………..
ECF and subsequent diuresis
Fluid replacement continues from the ……….. phase to the ……… phase
Emergent
Acute
For eye care use …….
Saline rinses
Artificial tears
Neck burns don’t use………… to reduce wound contraction
Pillows
rehabilitation phase can occur……………..
2 weeks or up to 2-3 months after burn injury
The major factors contributing to systemic complications of burns are……….
Breakdown of skin integrity
Fluid loss
Direct injury doesn’t normally occur below the level of bronchus because……
Of the cooling effect of rapid vaporization in the pulmonary tract
Rhabdomyolysis and hemolysis can occur in burnt patients due to ……………..
-Deep thermal or electrical burns of muscles
-muscle ischemia due to constricting eschars
Hydrogen cyanide gas is a metabolic poison, which acts by inhibiting the final stages of…………..
Oxidative phosphorylation(cytochrome oxidase) at the mitochondria level and hence causes cellular death
Hydrogen cyanide poisoning is treated by……………
IV sodium thiosulphate
Hydroxocobalamin
100% O2
Full thickness graft is also called…..
Wolfe graft
Split skin graft is also called ……….
Tiersch’s graft
Flaps is used to cover an area with poor vascularity such as …………..
Post-mastectomy irradiation ulcers
Bedsores
Ulcers over the lower 1/3 of the tibia
Flaps are used in Full thickness loss of tissue in ………….
Lid
Nose
Cheek
(To cover bony prominence)
Sensation of the flap returns within………
6weeks - 3years
(The sweating returns with sensation)
Any island is considered as ……….
An axial flap
The classical donor sites of double pedicle flap(tube pedicle flap) are …………
Neck
Antero-medial aspect of the thigh
Anterior abdominal wall (AAW)
Acromial-pectoral region
The drawback of advancement flaps is …………..
May cause devascularization of the skin and creation of a dead space with a possibility of hematoma formation
Rhomboid flap is used in ………
BCC in the face
The Z plasty is used for……..
-lengthen a scar contracture line
-change the scar direction
-to rotate the axis of tissues
-to overcome a depressed scar
The most useful free flaps are the …………
TRAM flaps
Groin flap
Dorsalis pedis flap
Latissimus dorsi flap
Tensor fascia lata myocutaneous flap
A myocutaneous flap is used to cover a surface, which is unsuitable for skin graft as…………
Cortical bone
Opened joint
Latissimus dorsi myocutaneous flap is supplied by………
Thoracodorsal artery
A branch of the sub scapular artery
Pectoralis major myocutaneous flap is supplied by ………. , and used to cover………..
-Thoraco-acromial artery
-head and neck defects
Chest wall
Sternum
Esophagus (after thinning it out)
Gastrocnemius flap is supplied by ……………… , is used to cover………….
- sural branches of popliteal artery and vena comitantes
- defects of the shin of tibia(upper 2/3)
Knee
In cross leg flap
Transverse rectus abdominis myocutaneous (TRAM) flap is supplied by ………….. , is used to reconstruct…………
-Deep superior epigastric vessels
-breast and chest wall defects, can also be used as a free flaps to cover remote defects
Tensor fascia lam is used for reconstruction of ………………..
Bedsores of the greater trochanter
Vulva
Abdomen
Used in the past for hernioplasty of recurrent inguinal hernias
The sequestration type of dermoid cyst is typically found in……….
Pre auricular (temporal) region
Post auricular region
Inner and outer canthus
Midline of the scalp
Chin
Supra-sternal
Pre-sternal
Pilonidal
Sub-lingual
Epidermal cyst (sebaceous cyst) is common in the…………
Scalp
Ears
Retro auricular region
Face
Scrotum
Thorax
Most lipomas are painless but may be multiple and painful as……..
neurolipomatosis
The melanocytes are derived from……………
The neural crest
There are several formulas for IV replacement like……….
ABA consensus formula
Parkland formula
Brooke formula
Evan’s formula
……… is another crystalloid solution which is even more closely physiological to human body more than Ringer lactate
Plasmylate
………. It’s the main killer of burnt patients
Septicemia
Suppurative thrombophlebitis is the source of ……………….
Septicemia
Hematogenous pneumonia
…….. is the leading cause of death in fire victims
Inhalational injury
The graft can be fixed with…………
Sutures
Staples
Free bandage
Embryologically blood vessels are …………….
Segmental ( like lumber )
Anastomotic ( like internal mammary )
Axial ( limb vessels )
What’s the methods of reliable monitoring of skin flab blood flow?
-Laser doppler (one of the best)
-Injection of fluorocin at the time of operation (early stages)
-Temperature probes
-trans cutaneous O2 estimation
-radioisotope clearance (not easily used)
-prick the skin with sterile needle (bright red blood is good)
Papilloma is mostly on …………
Face
Neck
Trunk
Intertriginous zones
Treatment of keloid
-low voltage x ray therapy
-in long standing cases: excision and resuturing preceded and followed by radiation
-intradermal injection of steroids
-shaving the keloid with resurfacing of the area by a thin split graft
Keloid is common in ………
Face
Neck
Ears
Over the sternum
Infront of the abdomen
Keratocanthoma usually affects……….
Face
Nose
Keratocanthoma is also called…………..
Adenoma sebaceum
Molluscum sebaceum
Molluscum pseduo carcinomatosum
40% of marjolin’s ulcer occur on ……
Lower limb
Acitinc (UV) rays cause……..
DNA damage
T-helper cell suppression
Risk factors of infantile hemangioma (IH)
-White race
-Premature infants (low birth weight) ———> up to 30%
-maternal factors:
Advanced maternal age
Multiple gestation pregnancy
Placenta brevia
Preeclampsia
-in utero diagnostic procedures (chorionic villus sampling and amniocentesis)
-use of fertility drugs
-erythropoietin
-breech presentation
-being first born
Common side effects of oral propranolol are…………..
Sleep disturbances
Night terrors
Adverse effects of intra-lesional steroids in IH
-central retinal artery occlusion (periorbital lesions)
-eyelid necrosis (periorbital lesions)
-Atrophy
-Hematoma
-skin depigmentation
-possible significant systemic delivery
The thenar eminence is innervated by ……………..
The recurrent branch of the median nerve
The adductor pollicis is innervated by ……………..
Ulnar nerve
Lumbricals originate from ……………..
The FDP distal to the carpal tunnel
The epitenon (epithelial) suture of the tendon add additional support and ……………
Prevent locking of tendon during flexion
Sub-ungual hematoma should be evacuated if it is more than 25% of the size of the nail by ……………….
Terphination
Or
Removal of the nail plate
SCC is also called………..
Epithelioma
Epidermoid carcinoma
Multiple melanomas are very rare (……….% of all melanomas)
, in familial cases it can reach……..
1-4 %
20%
Lentigo maligna melanoma is also called……………
Hutchinson’s melatonic freckle
If paronychia or eponychia is chronic so the causative organism is ………….
Candida
……….. is the most common infection in the hand
Paronychia or eponychia
Distal pulp is subdivided into ……. Compartments
16
Infection of the web space of the thumb occurs secondary to………….
Infection of palmar blisters
Human saliva has demonstrated 42+ species such as ………
Strept
Staph
E.corrodens (30%)
Bacteroides (the most common anaerobe
