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ASPS Inservice Review 2024 > Review > Flashcards

Review Flashcards

1
Q

What is the timing and treatment for prehabilitation of the abdominal with Botox? What is the affect of treatment?

A

2-4 weeks prior

Higher rates of primary closure

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2
Q

What is the treatment of HIV associated lipodystrophy?

A

ploy-l-lactic acid (Sculptra)

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3
Q

What percentage of infections are accounted for by Biofilms? What is the most common organisms for breast implants?

A

80%

Staph epidermadis (coag negative staph)

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4
Q

Where is the lumbar artery perforator flap found?

A

Between erector spinae and the quadratus lumborum

Lumber is found in the quad by the ER

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5
Q

What is the mechanism of action for papavarine? What is the usual concentration? Mechanism?

A

Phosphodiesterase inhibitors

30mg/dL

Inhibit phosphodiesterase which Inhibit cGMP

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6
Q

What is the management of aromatase inhibitors and tamoxifen for preop, micro cases?

A

Aromatase inhibitors continue
Tamoxifen stop (data inconclusive, 28 days prior)

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7
Q

What is a viable option for Poland syndrome? What vessel if IMA is not available?

A

Diep flap reconstruction

Thoacodorsal artery may be an option for anastomosis

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8
Q

What is the cause of osteogenesis imperfecta?

A

Type I collagen production

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9
Q

What is the first sign of scleroderma? What is the progression in the fingers? What is the leading cause of death?

A

Systemic sclerosis disease

Raynaud’s phenomena

Progresses from distal to proximal in the finger

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10
Q

What is xeroderma pigmentosa?

A

Autosomal recessive disorder affecting the DNA repair, nucleotide excision repair

Early skin cancer development, sensitivity to light

Non melanoma skin cancer by 8-9 years old

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11
Q

What is the defect in Marfans syndrome?

A

Fibrilin 1

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12
Q

What is the enzyme necessary for collagen cross linking and what viatamin is needed?

A

Lysyl oxidase and requires

vitamin C

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13
Q

What is implicated in Menke’s disease?

A

Defect in copper transport

Leads to poor muscle tone, failure to thrive, brittle hair

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14
Q

Where is the defect on the abdominal wall in omphalocele and gastroischesis?

A

Omphalocele: central abdomen

Gastroischisis: right of the umbilicus

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15
Q

Why does omphalocele happen? When does the intestines herniate and return to the abdomen?

A

Failure of intestines to return to the abdominal cavity

Herniate week 6 return week 10

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16
Q

What are eccrine glands classified as and what are they important in?

A

Exocrine sweat glands

Implicated in thermoregulation

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17
Q

What is silver nitrate effective against adverse reactions and what is the most common use? Side effect?

A

Effective against staph and pseudomonas

Toxic epidermal necrolysis

Electrolyte disturbances

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18
Q

What is a side effect of silver sulfadiazine? What to do

A

Transient leukopenia

Switching to a different topical for a few days will return the count to normal

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19
Q

What are the intraoperatice factors contributing to flap thrombosis?

A

Anastomosing irradiated vessels

Intraop hypotension and large volume fluid administration

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20
Q

What is the treatment for melanoma of the nail bed? In situ etc

A

Wide local excision based on depth with local flap

No need for amputation

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21
Q

What is the most effective technique to minimize costal cartilage warping?

A

Harvesting the central portion of the rib

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22
Q

What is the defect in Mayer Rotinsky Hauser syndrome? What is present?

A

Congenital disorder of Mullarien duct aplasia

Ovaries and normal external genitalia

Can be abscence of vagina or abscence of both vagina and uterus

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23
Q

What is PAIS and CAIS syndrome? What are they genetically and what do they all have?

A

Complete or partial androgen insensitivity syndrome

All have undescended testes and testosterone in the male range

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24
Q

What is Klienfelter syndrome? What do they present with?

A

47 XXY small testes and testicular insufficiency

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25
Q

What is McKusik Kaufman syndrome?

A

Present with hydrometricolpos (distal vaginal obstruction

Postaxial polydactyl

Congenital cardiac defects

Four types ranging from imperforate hymen to vaginal atresia with cloacal abnormalities

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26
Q

What is the flap of choice for a type IB posterior vaginal wall defects when abdominoplasty and bilateral medial thigh lift was done?

A

Free ALT flap

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27
Q

What are the effects of tretinoin? What is the main pharmaceutical mechanism of action?

A

Increased epidermal and dermal thickness

Thinning of the stratum corneum

MOA inhibition of AP1 transcription factor binding to DNA decreasing protease activity

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28
Q

How does vitamin A help in corticosteroid wound healing issues?

A

Promotes re epithelialization

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29
Q

What are the effects of long term corticosteroid use on the three phases of wound healing?

A

1: inflammatory: decrease the expression of cytokines

2: proliferatice: decrease keratinocyte growth factor (driver of re epithelialization)

3: remodeling: decreased macrophages no conversion of type 3 collagen to type I leading to less tensile strength

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30
Q

What type of fluid is TPN in terms of tonicity? What can be helpful in extrav injuries?

A

Hypertonic

Hyluronidase

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31
Q

Where is the plane of dissection for a transversus abdominis release? Above and below the arcuate line

A

Between transversus abdominis and transversalis fascia above

Between peritoneum and transversus abdominis below

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32
Q

What is the plan for a tap block?

A

Between transversus abdominis and internal oblique

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33
Q

Where are morel levalle lesions and what is the treatment?

A

Located between the deep fat and the deep fascia

Lesions with 400ccs or less would be considered for drain and doxycycline

Larger treat with open surgery and quilting

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34
Q

What are the skin layers from superficial to deep?

A

Dermis, subq fat, superficial fascia, deep fat, deep fascia, muscle, bone

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35
Q

What is the primary indication for closure of a neural tube defect?

A

Risk of infection, close within 48hrs

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36
Q

What is the effect of venous repair for venous outflow of the ear?

A

No change in survival rates

Decreases postoperative need for transfusion

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37
Q

What is the treatment for distal third of the leg defects in patients with severe PVD?

A

ALT free flap, can be flow through

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38
Q

What are the advantages of prepec placement for breast reconstruction vs sub pec?

A

Medial placement of implant
Less animation deformity

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39
Q

What is the basic design of the keystone flap?

A

V to y flaps at the opposing poles at 90 degrees

1:1 flap to defect length

Relies on central random perforators

Ok to release deep fascia surrounding the defect

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40
Q

What is the Gibson principle for cartilage grafting?

A

Cartilage warps to the opposite side of scoring. Based on the principle of releasing internal self locked stress

Ex a concave piece of cartilage is scored at the concave portion will make it straight

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41
Q

What are the three main flaps to fill pelvic dead space?

A

VRAM
Gracilis
Omental flaps

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42
Q

What is the blood supply of the para scapular flap and what does it branch off of?

A

Circumflex scapular artery

Branches off of the sub scapular artery of the axillary artery

Transverse scapular (Supra scapular) and dorsal scapular artery(transverse cervicle)

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43
Q

What is a flap used for vaginal reconstruction that can provide a sensation?

A

Pudendal fasciocutaneous flaps

Based on the terminal branches of the internal pudendal ateries (superficial perineal arteries)

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44
Q

What is the antibiotic duration for breast reconstruction?

A

Less than 24 hrs, ancef

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45
Q

What is the affect of vein grafting on digital reimplantation?

A

Does not decrease success

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46
Q

What are positive predictors of digital replant?

A

High volume centers

Warm ischemia time less than 12hrs
Cold ischemia time 24hrs

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47
Q

In RFFF penile reconstruction what nerves are coapted for erogenous sensation?

A

LABC to dorsal nerve of the penis

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48
Q

What is type 1 and type 2 nec fasc?

A

Type I: polymicrobial

Type II: monomicrobial

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49
Q

What is the treatment for strep pyogenes? What aesthetic procedure may be associated?

A

Gram positive cocci in chains, Group A strep, beta hemolytic

Treat with Clindamycin and PCN

Liposuction

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50
Q

What is another indication for chest wall reconstruction besides rib space and number?

A

Paralyzed diaphragm and herniation of abdominal contents below the level of the defect

Need to reconstruct with rigid or semirigid approach

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51
Q

What is the flap of choice for trochanteric defects?

A

TFL flap

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52
Q

What are flap options for ischial injury reconstruction?

A

Gracilis and biceps femoris

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53
Q

What is the treatment of choice for lower eternal defects?

A

Omental flap and skin graft or vram flap

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54
Q

What is the suture of choice for closure of oral mucosal lacerations?

A

Chromic gut suture

Loses tensile strength in 10-14 days

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55
Q

What is the prophylaxis for leech therapy? What is the organism?

A

Ciprofloxacin

Aeromonas

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56
Q

What is the best laser for hypervascular burn scar management? What wavelength?

A

PDL 585nm

Targets hemoglobin at 585nm

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57
Q

What is the hernia working group classification of hernias?

A

Grade 1 low risk no infection
Grade 2 comorbidities present that increase the risk of complications
Grade 3 discontinuity of the GI tract or wound infection
Grade 4 mesh infection

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58
Q

What is the transformation rate to SCC for leukoplakia of the mouth?

A

10%

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59
Q

What are the nerve transfers for C5-6 brachial plexus injuries? What time frame?

A

12-18 months

Spinal accessory to suprascapular nerve for shoulder abduction

Triceps branch of the radial nerve to axillary nerve transfer

Ulnar nerve to biceps transfer

Median nerve to to brachialis muscle branch

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60
Q

What are options for nerve transfer if total plexus injury?

A

Phrenic to musculocutaneous

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61
Q

What distal nerve transfer can be used for high ulnar nerve injuries?

A

Ain to ulnar motor branch

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62
Q

What percentage of patients undergoing lower extremity amputation walk when related to critical limb ischemia?

A

Less than 50%

Compared to post traumatic patients which is over 90%

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63
Q

How much of preserved proximal tibia is needed for the best functional outcome of below the amputation?

A

At least 10 cm

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64
Q

What is the path of dissection for free fibula flap?

A

Posterior septum

Peroneus Longus and brevis dissected off the fibula

Anterior septum is identified and divided

EDL muscle encountered first then EHL

Interosseous septum divided and Tibialis posterior identified and dissected off posterior trunk

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65
Q

What is the treatment for arterial thrombosis of the hand for example in ulnar hammer syndrome?

A

Catheter based arteriogrophy first

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66
Q

What is the management of dupuytrens flare?

A

NSAIDS rest elevation

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67
Q

What is the Budapest criteria for CPRS?

A

1 Continued pain out of proportion to original event

  1. Three of the following (history):
    A: numbness or increased pain
    B: temperature asymmetry skin color changes
    C: edema or sweating
    D: decreased motor function or changes in hair or nail growth

(Physical) one symptom needs to be seen at time of evaluation in two of the categories

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68
Q

What is a tendon transfer for foot drop?

A

Tibialis posterior to foot

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69
Q

What is the treatment of choice for slac wrist?

A

Scaphoidectomy and four corner arthodesis

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70
Q

What is the Paneva Holevich technique for tendon repair?

A

Two stage technique where distal ends of the FDS and FDP, sutured to each other, lumbrical sutured over and a silicone rod is left in place for tendon sheath reconstruction.

Second stage the myotendenous junction is then released and pulled through the reconstructed sheath

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71
Q

What is the nerve transfer for foot drop?

A

Tibial nerve from FHL, FDL to tibialis anterior

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72
Q

What length is nerve grafts not successful?

A

Over 6cm

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73
Q

What is Olliers syndrome?

A

Both have Multiple endochondromas

Mafucci has multiple venous malformations

Olliers: no venous malformations

Both can transform to chondrosarcoma

Mutations in IDH 1 and 2

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74
Q

What is the receptor that is overactive in raynauds?

A

Alpha 2

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75
Q

What causes nail plate deformity from mucous cyst and where?

A

Eminates from the dip joint and presses on the germinal matrix causing the deformation of the nail

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76
Q

What is the treatment for Marjolins ulcer?

A

Squamous cell from chronic wounds, very aggressive

Need to treat with resection down to fascia, 2cm margins

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77
Q

What prevents the dorsal dislocations from re locating?

A

Volar plate, can divide and no need to repair

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78
Q

What is the cause of claw toe?

A

Injury to the FHL causing contraction and shortening after free fibula

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79
Q

What is the most common primary malignant bone tumor of the hand?

A

Chondrosarcoma

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80
Q

What is the treatment after volar dislocation of the pip joint?

A

Extension splinting with the DIp joint free for 4-6 weeks, due to central slip injury

81
Q

How does thumb hypoplasia differ from thumb brachydactyl?

A

Distal phalanx is only affected in thumb brachydactyl

Proximal phalanx is affected in thumb hypoplasia

82
Q

What is the most common injury mechanism for fingertip injuries in children?

A

Door or window crush injuries

83
Q

What is epithelioid sarcoma and how is it treated?

A

Mimics infection diagnosed on biopsy as spindle cells or squamous cells

Treat with wide local excision

84
Q

What is the blood supply of the rectus femoris muscle flap?

A

Descending branch of the lateral circumflex femoral artery

85
Q

What is an ultrasound finding for carpal tunnel syndrome?

A

Increased cross sectional area of the nerve signifying edema

86
Q

What are the changes in EMG and nerve conduction studies in carpal tunnel?

A

NCS: mild cases may be normal, or unchanged, increased latency in advanced disease

EMG: earliest sign of denervation: spontaneous muscle activity with fibrillation (seen after changes in NSC), abductor pollicis brevis muscle denervation on emg in late stage

87
Q

What is the most common hand infection organism and what antibiotics used?

A

MRSA and vancomycin especially in IVDU since they are usually clinda resistant

88
Q

What is the treatment of mallet finger and what is an absolute indication for surgery?

A

Splinting

Volar subluxation can be seen with v sign of the joint on x ray is an absolute indication for operative treatment

Relative indication: more than 50 percent of the count involved

89
Q

When is congenital trigger thumb released?

A

After 1 year in fixed deformities

90
Q

What tendon is most often ruptured in hook of hamate fracture?

A

FDP of the small finger

91
Q

How is a Bennett fracture of the thumb cmc joint reduced?

A

Axial traction

Pronation and abduction of the thumb in extension while volar pressure is applied to the metacarpal base

92
Q

What is the dominant pedicle of the trimmed great toe flap?

A

First plantar metatarsal artery

93
Q

What is the pedicle for trimmed second toe flaps?

A

Medial plantar digital artery

94
Q

What is the elsons test for the finger and what does it check for?

A

PIP joint is flexed over a table and patient is asked to extend against resistance, extension can be seen at DIP joint which is from the lateral bands

Checks for central slip injury

95
Q

How long of a boney defect can a medial femoral condyle flap cover?

A

7 cm defects

Can have sensory changes in the saphenous nerve distribution, decrease in ROM

Femur fracture is rare

96
Q

What is the difference in location of Captodactyly vs Clinodactyl vs Kronstadt deformity?

A

Kriner: radial and volar deviation of distal phalanx

Camptodactyly: flexion contracture of the PIP joint

Clinodactyly: small finger is radially displaced

97
Q

What are the characteristics of stsg that contribute to secondary contracture?

A

Thickness: thicker less contraction

Meshed: higher secondary contracture

Placement on fascia have higher contracture

98
Q

What tooth has a higher risk for agenesis in cleft lip and palate?

A

Lateral incisor

99
Q

What is the treatment method of choice for lefort one distraction?

A

External distraction has better speech outcomes and more predictable

100
Q

What is the FDA ages for helmet therapy of plagiocephaly?

A

3-18 months

101
Q

What depth is the marginal mandibular artery in relation to platysma and facial vessels? Posterior belly of digastric

A

Below the platysma

Above the facial vein, facial artery is deep to the facial vein

Posterior belly of digastric runs between the facial artery and vein, the muscle is superficial to the hypoglossal nerve

102
Q

When is bone grafting of the alveolus performed?

A

Between 8-12 years old in mixed dentition before rupture of the canine

Later times of grafting is associated with higher rates of graft failure

103
Q

What is the treatment of infected thyroglossal duct cyst?

A

Antibiotics

I&D avoided due to possible fistula formation

104
Q

What is the imaging for Masseter hypertrophy?

A

CT MRI

105
Q

What are the seven bones that make up the orbit?

A
  1. Sphenoid
  2. Maxilla
  3. Palatine
  4. Zygoma
  5. Ethmoid
  6. Lacrimal
  7. Frontal
106
Q

What is the recommendation for the length of latency, activation and consolidation phase for mandibular distraction?

A

Latency: length of time for callus bone formation: 1 day

Activation: rate of expansion 2-4 times a day with 1-1.5 mm per day about 3-4 weeks

Consolidation: immobilization to allow for bone healing. Twice as long as activation phase about 8 weeks

107
Q

What is the palpable structure superior to the thyroid cartilage?

A

Hyoid bone

108
Q

What is the palpable ring below the thyroid cartilage?

A

Cricoid cartilage: isthmus of the thyroid lies just below the

109
Q

Heat is the best approach for sagital synostosis?

A

Modified pi procedure or strip crani

110
Q

What decreases infection risk of mandibular fractures?

A

Smoking

Antibiotics prior to fixation

External approach

111
Q

What is the ideal coverage for superior anterior aspect areas auricular defect coverage?

A

Temporal parietal fascia flap

112
Q

When is MRI ordered for neurocutaneous melanosis?

A

Before 6 months old

113
Q

What does the mental nerve innervate?

A

Mentalis
Depressor Anguli oris
Depressor labii inferioris

114
Q

What is the management of a stable zone 3 injury?

A

Ct angio or angiogram

115
Q

What are the most commonly injured teeth with mandible distraction

A

First and second molars

116
Q

What is the course of the nerve to the masseter muscle?

A

From foramen ovale. Obliquely below the zygomatic arch, through the sigmoid notch

Target branch is found between the deep and middle lobes of the masseter

117
Q

In the furlow procedure what flaps are composed of muscle/ mucosa?

A

Flap that is created from anterior soft palate is transposed posteriorly and composed of LVP

Flap that starts posteriorly is mucosa only

118
Q

What does the sistrunk procedure consist of?

A

Excision of cyst, middle part of the hyoid bone and surrounding tissue

119
Q

What is the function of the inferior rectus muscle?

A

Raises and abducts the eye

120
Q

What is the treatment for medium to small sized defects of the upper helical rim?

A

Anita Buch flap: chondrocutaneous advancement flap

121
Q

Where does the thoracic duct terminate? What lab to diagnose chyle leak?

A

At the junction of the left subclavian and internal jugular

More than 110 mg/dL chylomycrons and triglycerides

122
Q

What is the treatment for forehead feminization with thin frontal sinus bone?

A

Frontal sinus setback

123
Q

What is possibly medialized in degeorge syndrome?

A

Internal carotid arteries

124
Q

What is the pedicle for the submental flap? Where is it and what muscles can be included?

A

Runs between the ramus of the mandible and the submandibular gland

Can be taken with mylohyoid, platysma, anterior belly of digastric

125
Q

What does the posterior belly of digastric receive its blood supply from?

A

Posterior auricular and occipital

126
Q

What is the Markowitz Manson classification of NoE fractures? How to treat?

A

Type I: large bony fragment attached to canthal tendon- ORIF of fragment

Type II: canthal tendon attached and comminuted fracture, needs ORIF and wire fixation

Type III: avulsion of the medial canthal tendon trans nasal wiring

127
Q

What is the effect of microneedling? When to perform?

A

Increase collagen and elastin

3-4 months after initial surgery

128
Q

What is a useful graft in correcting the lateral cural collapse?

A

Lateral crural strut graft

129
Q

What muscle is included in the TUG flap?

A

Gracilis muscle

130
Q

What is a way to reduce post inflammatory hyperpigmentation during laser?

A

Reducing fluence

131
Q

How to manage full thickness necrosis after face lift?

A

Allow to demarcate and local wound care

132
Q

What are ways to decrease contour deformities in liposuction?

A

Cross cross pattern
Under correction and deeper tissue planes

133
Q

What is a way to tell if a patient is a good candidate for Botox to platysma for jaw contouring?

A

Tell them to contract the platysma if jawline appears would be a good candidate

134
Q

What is the treatment for hypoestheisa of the abdominal skin after abdominoplasty?

A

Observation

135
Q

What nerves in innervate the sensory portion of the breast?

A

Anterior 2-5 for medial breast

Lateral 3-5 for lateral 5th also contributes to lower medial portion

136
Q

What are causes of malignant hyperthermia?

A

Volitile anesthetics: iso sevo and desflurane

Succinylcholine

137
Q

What happens if clitoral frenulum is divided? What is divided in the clitoral hood reduction?

A

Anterior rotation of the clitoris causing chafing

Lateral clitoral hood superficial skin only

138
Q

What is the treatment for reactive hyperpigmentation?

A

Hydroquinone with glycolic acid cream or retinol

Hydroquinone works by inhibiting tyrosinase

139
Q

What is the mechanism of TXA?

A

Amino acid lysine derivative: binds to sites on plasminogen preventing conversion to plasmin

140
Q

What are the branches that supply the orbicularis muscle?

A

Zygomatic: innervates the lateral

Buccal: innervates the medial as well as the lacrimal pump mechanism

141
Q

What is the consequence of over resection of the lower lateral cartilage?

A

Narrow the nasal tip

Alar retraction and external lasso valve dysfunction

142
Q

What is a consequence of over resection of the upper lateral cartilage?

A

Inverted V deformity

143
Q

What is the preferred incision for nipples sparing mastectomy with ptotic vs non ptotic breasts?

A

Lateral IMF non ptotic
Vertical radial ptotic

144
Q

What is the advantage of long scar vs short scar technique?

A

Long scar: addresses neck

145
Q

What is the efficacy of vaginal laser treatment?

A

It is not effective when compared to sham treatment

146
Q

Where are the lymphatics located in the femoral triangle?

A

Medial to the femoral vein

147
Q

What is a subdomal graft and what is it used for?

A

Strip of cartilage 8-10mm long 1.5 wide placed under the domes of the lower lateral cartilage

Used to control interdomal distance position and genu angle

148
Q

What is the sequence of facial fat pad deflation?

A

Deep compartment deflation in early 40s: medial and lateral SOOF, deep medial cheek, medial portion of the buccal fat pad

Then superficial

Forehead is last in the 70s

149
Q

What is the angle of divergence and what can be done to correct it?

A

Angle when looked at the worms eye view of the two domes of the nose should be 30 degrees

Interdomal sutures are used to correct

150
Q

What are retractors of the lower lid?

A

Capsulopalpebral fascia and interior tarsal muscle(analogus to the muller muscle)

151
Q

What are the markers for breast implant associated squamous cell carcinoma?

A

CK5/6 positive and p63 positive

152
Q

What are signs of microscopic fat embolism from gluteal fat grafts?

A

Pulmonary edema: treatment is supportive no heparin

153
Q

What cancers are Poland syndrome patients at risk for?

A

Hodgkin’s disease, leukemia, renal tumors lung tumors

Same risk as general population for breast cancer

154
Q

What laser helps with hyperpigmentation, small blood vessels and fine rhytids?

A

IPL

Er yag has no effect on small blood vessels

155
Q

What stain can be used to confirm milk discharge from galactocele?

A

Sudan 4 stain

156
Q

How do you differentiate cervical vs marginal mandibular nerve branch injury?

A

If able to every the lip it is cervicle since marginal mandibular branch innervates the mentalis muscle

157
Q

What is the treatment for bia alcl if found in One breast?

A

Bilateral total capsulectomy and removal of implants since 5% of the time can be in contralateral breast

158
Q

How is female hair loss graded?

A

Ludwig classification

Vertex thinning

159
Q

What is the lidocaine dosing for tumescent solution?

A

35 mg/kg

160
Q

What is the effect of pull on the ptyragoid muscle on the maxilla in lefort I injuries?

A

Inferior and posterior

161
Q

Tooth numbering system

A
162
Q

What is the management of white clot in micro?

A

Compromised platelet/ vessel damage

Treat with Excision and vein graft

Also postop platelets would help

163
Q

What are bone biopsies sent for when evaluating for osteo?

A

Sent for histopathology

164
Q

What is the CME standards for ASPS?

A

25 category 1 cme credits in patient safety activity every 5 years when in the continuous certification program

Overall 125 category 1 cme credits every 5 years including the patient safety component

165
Q

What is the treatment for midazolam overdose?

A

Flumazenil 3mg over 30 seconds

166
Q

What is a consequence of spinal accessory nerve injury in the posterior neck?

A

Shoulder drooping decreased mobility GH joint capsulitis

No neck range of motion issues

167
Q

What is the standard ancef intraop dosing

A

Every 4hrs

168
Q

What is the diagnosis for pericardial tamponade?

A

Auscultation first if not emergent ultrasound

169
Q

What are the different levels of evidence based on study

A

I prospective cohort or systematic reviews of these studies

II: lesser quality prospective cohort

Iii: case control

IV case series

V expert opinion

170
Q

What is the patient safety and quality improvement act protect?

A

Healthcare workers who report medical malpractice

171
Q

What does the 21st century cures act help define?

A

Helps define the electronic health record interoperability and allows patients to view their medical record

172
Q

What is the mechanism of action for semaglutide?

A

Glp1 analogue: stimulates insulin production inhibits glucagon release and delays gastric emptying

Leads to 15 percent weight loss

173
Q

What is the active ingredient in manuka honey?

A

Methyl glyoxal: alters the bacterial fimbria and flagella

High osmolality: draws water out

174
Q

What is the innervation to the anterior hard palate?

A

Nasopalatine nerve a branch of v2

175
Q

What supplies the sensation of the nasal roof and anterior nasal septum?

A

Anterior ethmoidal nerve branch of V2

176
Q

What nerve supplies the hard palate?

A

Greater palatine nerve

177
Q

What nerve supplies the soft palate?

A

Lesser palatine nerve branch of V2

178
Q

What is the nerve supply of the buccal mucosa?

A

Buccal nerve branch of v3

179
Q

After calcium gluconate given for hyperkalemia what is next step?

A

Insulin, albuterol then bicarbonate

180
Q

What causes csf leak in rhinoplasty?

A

Injury to the cribriform plate

181
Q

What must be included in the sistrunk procedure?

A

Resection of the suprahyoid region

182
Q

What is the rule of 80s for salivary gland tumors?

A

80 percent in the parotid
80% are benign
80% of benign tumors are pleomorphic adenomas

183
Q

What does vitamin A do in wound healing?

A

Increases collagen cross linking

184
Q

What does vitamin c do?

A

Hydroxilation of proline

185
Q

What is zinc used for in wound healing?

A

Promotes immune response and lymphocyte activation

186
Q

What are symptoms of zinc deficiency?

A

Rash acne loss of taste increased infection infertility

Alopecia night blindness delayed wound healing

High in post bariatric surgery

187
Q

How does b12 deficiency present?

A

Megaloblastic anemia
Glossitis
Ataxia
Altered mental status

188
Q

What is klippel trenaunay syndrome?

A

Patchy port wine stain on an extremity overlying a lymphatic malformation with skeletal hypertrophy

189
Q

What is parkes Weber syndrome?

A

Same as Klippel Trenauay syndrome but with AVF on MRI

190
Q

What is osler Weber rendu syndrome?

A

Telengetsias of the skin and mucus membranes with nose bleeds and positive family history

191
Q

What is a concern with SGLT2 inhibitors such as dapagliflozen?

A

Diabetic keto acidosis need to stop 3 days before

192
Q

What is the birads classification?

A

1: normal
2: benign
3: probably benign less than 2%malignancy
4: suspicious features
5 probably malignant

193
Q

What drugs cause AKI?

A

NSAIDs aminoglycosides and amphoteracin

Metformin is metabolized in the kidneys but an accumulation may lead to lactic acidosis and AKI

194
Q

What are contraindications to lumpectomy and radiation?

A

Early pregnancy
Multi focal disease
Diffuse microcalcifications
Inflammatory breast cancer
Persistent positive margins

195
Q

What is associated with accessory auricle tissue?

A

Risk of renal, cardiac anomalies and hearing loss

196
Q

Who should a physician inform of a health info breach over 500 patients?

A

Affected individuals
US health and human services
Prominent media outlet within 60 days

If it’s fewer than 500 then hhs and patients

197
Q

What decreases the risk of postoperative nausea and vomiting when administered on induction?

A

Propofol

198
Q

What drugs are associated with a risk for postoperative nausea and vomiting?

A

Thiopental, halothane, remifentanil, nitrous

ASPS Inservice Review 2024 (1 decks)

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