Plastic Surgery Flashcards
what are the features of rhinoplasty procedure?
o incisions are made to access bones + cartilage
o bone may be removed, or grafts/synthetic filler added
o after reshaping the skin is redraped over structure of nose
o stents may be used to support
what are the features of mentoplasty procedure?
o Reduction of addition of material to a patients chin
o Chin rounding = osteotomy
o Chin augmentation = implants (intraoral or submental, alloplastic implants)
what are the features of otoplasty procedure?
o Cartilage splitting – incisions + repositioning of cartilage
o Cartilage sparing – avoid full thickness attempting to create more effective angles + curls
what is botulin toxins use in plastic surgery?
injected into muscles under facial wrinkles
what are facial fillers?
hydoronic acid, synthetic, collagen – fill up lines + hollows
what is blepharoplasty?
upper lid (take ellipse of skin), lower lid (more complicated)
what is skin rejuvenation?
use fat from patient = on NHS acnes scarring, hyaluronic acid
what is a face lift?
removal of excess skin, tightening of underlying tissues
how are wounds reconstructed?
o Primary closure – clean, simple cut
o Healing by secondary intention = treat infection, clean, debride
o Skin grafts and skin flaps
what are is the cause of acute tonsillitis?
Majority viral
B lactamase producing bacteria
what are the viral causes of acute tonsiliitis?
EBV, also rhinovirus, influenza, parainfluenza, enterovirus, adenovirus
what are the bacterial causes of acute tonsillitis?
streptococcus pyognes, H influenza, S aureus, streptococcus pneumoniae
what is the histology of the tonsils?
specialised squamous, deep crypts, lymphoid follicles and posterior capsule
what is the pathophysiology of acute tonsillitis?
- Local inflammatory pathways result in oropharyngeal swelling, oedema, erythema and pain
- Rarely swelling may progress to the soft palate and uvula or inferiorly to supraglottitis
what are the types of acute tonsillitis?
- Acute parenchymatous
- Acute Follicular
- Acute Catarrhal Tonsillitis
what are the features of Acute parenchymatous tonsillitis?
swelling and erythema and whole tonsil
what are the features of Acute follicular tonsillitis?
crypts filled with infected fibrin and often spotted appearance
what are the clinical features of viral tonsillitis?
malaise, sore throat, temperature, able to undertake normal activity, possible lymphadenopathy
what are the clinical features of bacterial tonsillitis?
systemic upset, fever, odynophagia, halitosis, unable to work/school, lymphadenopathy, tonsillar exudates
how is tonsillitis diagnosed?
Centor Criteria
what are the features of the centor criteria?
o 1 point for each – absence of cough, fever, tonsil exudates, anterior cervical adenopathy, age <15
o Subtract point for >44
how do centor scores determine
o 0 or 1 point = no antibiotic
o 2 or 3 points = should receive antibiotic if symptom progress
o 4 or 5 points = treat empirically with antibiotic
what is the management of tonsillitis?
- Supportive – eat&drink, rest, ibuprofen +/- paracetamol analgesia
- 1st Line – antibiotics
- 2nd Line – steroids
- Hospital – IV fluid, IV antibiotic, steroid
- Surgery - adenotonsillectomy
what is the antibiotics given in tonsillitis?
penicillin 500mg qd for 10 days (clarithromycin if allergic)