Skin & Soft Tissue

Question 1

What is associated with decreased hernia recurrence: prosthetic or synthetic mesh?

Answer 1

Prosthetic mesh

Question 2

Which has less immunoreactivity: synthetic or biologic mesh?

Answer 2

Biologic

Question 3

When to use synthetic mesh for hernias?

Answer 3

Wound class 1-2

Question 4

When to use biologic mesh for hernias?

Answer 4

Wound class 3-4 if defect is >3cm

Question 5

At what point does a wound reach 60% of its final tensile strength?

Answer 5

6 weeks

Question 6

At what time does a wound reach its greatest tensile strength?

Answer 6

8 weeks

Question 7

What type collagen is initially present in healing wounds?

Answer 7

Type III collagen

Question 8

What type of collagen provides the final tensile strength of the wound?

Answer 8

Type I collagen

Question 9

What cells mediate wound contraction?

Answer 9

Myofibroblasts (mainly found at edges)

Question 10

What factors stimulate wound contraction?

Answer 10

PDGF-AB and BB released by platelets and macrophages

Question 11

When does wound contraction begin?

Answer 11

After 4-5 days

Question 12

What factors are released by macrophages in early stages of wound healing?

Answer 12

IL-1, IL-6, IL-8, and TNF-a

Question 13

When is the maximum collagen accumulation in a wound?

Answer 13

3 weeks after injury

Question 14

Initial treatment of frostbite grade I

Answer 14

Moist reheating using whirlpool bath

Question 15

What mediates the release of platelet-aggregating factor from platelets?

Answer 15

Leukotrienes

Question 16

What virus is associated with merkel cell carcinoma

Answer 16

Polyomavirus

Question 17

Most common induction agent for immunosuppression after kidney transplant

Answer 17

Thymoglobulin

Question 18

Diagnosis of a burn infection

Answer 18

10^5 bacteria/gm of tissue from wound culture

Question 19

Treatment of stretch marks

Answer 19

Reconstructive therapy or laser therapy

Question 20

Treatment for superficial partial thickness burn of the face

Answer 20

Neomycin or polymyxin B

Question 21

Treatment of a partial thickness burn

Answer 21

Silver sulfadiazine or silver nitrate

Question 21

Treatment of a full thickness burn

Answer 21

Mafenide acetate (can penetrate eschar)

Question 22

Which burn treatment causes metabolic acidosis

Answer 22

Mafenide acetate

Question 23

Which burn treatment causes nephrotoxicity

Answer 23

Bacitracin

Question 24

Which burn treatment causes methemoglobinemia

Answer 24

Silver nitrate

Question 25

Which burn treatment causes hyponatremia

Answer 25

Silver nitrate

Question 26

Which burn treatment causes transient neutropenia

Answer 26

Silver sulfadiazene

Question 27

Which transplant med: nephrotoxicity, hypertension, gingival hyperplasia, hirsutism

Answer 27

Cyclosporine

Question 28

Which transplant med: nephrotoxicity, alopecia, hypertension, diabetogenic

Answer 28

Tacrolimus

Question 29

Which transplant med: hepatotoxicity, BM suppression, leukopenia

Answer 29

Azathioprine

Question 30

Which transplant med: nausea, diarrhea, abdominal cramps, hepatotoxicity, leukopenia

Answer 30

Mycophenolate

Question 31

Which transplant med: anemia, hyperlipidemia, thrombocytopenia, poor wound healing

Answer 31

Sirolimus

Question 32

Familial atypical multiple mole syndrome - what cancers are they at risk for

Answer 32

Melanoma (100% lifetime risk) and pancreatic cancer

Question 33

Management of paronychia

Answer 33

I&D, clindamycin

Question 34

Pathophysiology of GVHD

Answer 34

Activation and differentiation of donor cells into Th1 and Th17 lineages

Question 35

When do you do a deep inguinal lymphadenectomy for melanoma?

Answer 35

If Cloquet's node (first of the deep nodes) is positive

Question 36

What is the most prevalent type of skin cancer

Answer 36

Basal cell carcinoma

Question 37

Gorlin syndrome

Answer 37

Multiple basal cell carcinomas, spine/jaw anomalies, pitting of palms and soles

Question 38

What is the endpoint for resuscitation for burn patients

Answer 38

Urine output

Question 39

Parkland formula

Answer 39

4mL/kg of %BSA Half in first 8 hrs Other half in next 16 hrs

Question 40

What surgical margins are needed for basal cell cancer

Answer 40

4mm

Question 41

Surgical margins for subungual melanoma at the finger

Answer 41

Amputation at mid proximal phalanx

Question 42

Surgical margins for subungual melanoma of the toe

Answer 42

Toe amputation including metatarsal head

Question 43

Melanoma in inguinal region with positive sentinel lymph node biopsy - what is the next step?

Answer 43

US surveillance of inguinal region q3mo

Question 44

What is the defect in classical type of Ehlers Danlos

Answer 44

Type V collagen

Question 45

Indications for adjuvant radiation for trunk and extremity soft tissue sarcoma: high grade, large (>5cm), or close margins