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Part II > Surgery > Flashcards

Surgery Flashcards

1
Q

The most commonly involved muscle in trismus is …..

The muscle pierced by the needle in IANB is …..

A

medial pterygoid

buccinator

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2
Q

The path of lingual artery is …….

A

from the ant. of ECA, it loops upward, passes posterior to hyoglossus muscle, to enter the submandibular space. There, CN XII passes superficially to it

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3
Q

Warthin’s duct is crossed twice by ………

A

lingual N.

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4
Q

Blood/Gas partition coefficient for N2O is ……

A
  1. 47
    * The less, the faster the onset and the emergence
    * The more, the more dissolved in blood and slower onset
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5
Q

The deep tendon of the temporalis and superior pharyngeal constrictor form …….

A

V shaped landmark (for IANB)

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6
Q

LIdocaine and procaine differ from other L.A in that ….

A

they produce initial mild sedation/drowsiness

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7
Q

To induce dissociative anesthesia, use …….

A

ketamine IV 2 mg/kg

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8
Q

Respiratory complications after surgery include

A

atelectasias, aspiration pneumonia, pulmonary embolus

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9
Q

Hemophilia will cause ……., While VWD will cause ……

A

increased PTT (everything else is normal)

Increased PTT & BT

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10
Q

Midazolam is water …….

A

soluble (no need for propelyne glycol). It is most commonly used due to fast onset
* Diazepam & Lorazepam are water insolube (Longer action, but slower onset)

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11
Q

Chloral hydrate is …….

A

hypnotic and sedative used for pedos

* Note: emotional stress reduce the rate of absorption of PO drugs

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12
Q

Tylenol is ……

A

weak cox inhibitor in periphery (and the reason for lack of anti inflammatory effects), but strong cox inhibitor centrally
* Note: avoid nsaids, tylenol, meperidine and morphine in dialysis patients

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13
Q

…….. is contraindicated in patients with respiratory disease

A

barbs

  • also in pregnancy (fetal damage)
  • barbs are weak analgesics even at high doses
  • Has small therapeutic window (lethal dose is close to effective dose)
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14
Q

Benzons action is ……, while Barbs action is …..

A

potentiate the action of GABA
enhance the transmission of Cl ions, preventing depolarization
* Note: Benzos are potent cerebral vasoconstirctors

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15
Q

…. is contraindicated for patients taking MAOI and dilantin

A

meperidine

  • the mix results in life threatening hyperpyrexic reactions
  • Meperidine is taken for pain 50 mg every 4 hours
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16
Q

Pentazocine is …..

A

a mixed opioid agonist-antagonist

* no euphoria

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17
Q

Primary Max. molars are luxated palatally because ……..

A

they are palataly positioned, and the palatal root is strong

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18
Q

Impacted molars are best removed when the root is …….

A

2/3 formed

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19
Q

Darvon 65 is a mix of ……..

A

phenoxyphene (opioid), caffiene, aspirin

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20
Q

What are the effects of glucocorticoids on wound healing?

A

interfere with the migration of neutrophils and inhibiting their phagocytic ability. Also, retards capillary formation

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21
Q

Pseudoarthrosis is produced by …..

A

excessive mobility of fractured segments

* Note: normal healing time for fractures is 6 weeks

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22
Q

Types of semirigid fixation include

A

miniplate fixation and wire fixation

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23
Q

Types of non rigid fixation include

A

MMF with ivy loops, arch bars, tranalveolar screw, gunning & lingual splints

24
Q

The standard time for MMF is …….

A

4-6 weeks

25
Q

Tunneling resorption is ……

A

formation of new haversian systems in the fractured segment, to allow for formation of new BV

26
Q

Compartment syndrome is …..

A

the pressure applied to BV in area of fracture from the severe swelling. Leads to muscle necrosis and long term disability

27
Q

EMS should be notified ……. for less than 8 yr old patient, or ……. for adult patient

A

1-5 min
immediately
* Note: for best results, CPR should begin within 4 mins

28
Q

Normal BUN value is ………

Creatinine value is ……

A

7-18 mg/dL

0.6 - 1.2 mg/dL

29
Q

ASA classes are ……..

A 
I - normal patient
II -  mild systemic disease
III - moderates systemic disease
IV - severe & constant threat to life
V - morbid
VI - organ donor
30
Q

Autogenous grafts are two types

A

Cortical (good strength, high BMP content)

Cancellous (high cell content, lacks strength)

31
Q

When constochondral rib graft is used for ridge aug., there will be ….

A

shrinkage

32
Q

Problems with alloplastic grafts when used for genial deficiency are …….

A

erosion of bone adjacent to implant, migration of graft, and unpleasant sensation
* alloplastic = synthetic

33
Q

The advantage of hydroxyapatite graft is …..

A

it binds physically and chemically to bone, and doesn’t resorb

34
Q

The disadvantage of hydroxyapatite is ……..

A

nerve neuropathy, may migrate, and poor color under mucosa, and no osteogenesis

35
Q

Minimum bone height for endosseous implant is ……

A

10 mm

* Implant length ranges from 8 - 18 mm

36
Q

Blade shaped implants are used in case of ……

A

insufficient width but good good depth of bone

37
Q

The most important structure to prevent spread of infection is …….

A

hyoid bone

38
Q

Cavernous sinus thrombosis results from ……

A

spread of infection from deep temporal space and canine space (via ophthalmic veins)

39
Q

The masticator space contains the content of ……

A

pterygomandibular space and is continuous with the temporal space
* Infection of masticator space causes trismus

40
Q

The least accurate method for obtaining body temp is ……

A

axillary

* The best is rectally and aurally

41
Q

What are the types of frenectomy

A
  1. for wide based frenum: V-Y advancement flap

2. for narrow frenum: Z-plasty or diamond excision

42
Q

The bacteria in cellulitis is ……

A

aerobic

* cellulitis is more serious than abscess

43
Q

Epidermoid carcinoma is another name for ……

A

SCC

44
Q

Patients at risk of osteoradionecrosis are treated with hyperbaric oxygen. T/F??

A

true

* 20 sessions before surgery, 10 sessions after

45
Q

Dissociative anesthesia is produced by

A

ketamine

* used to produce short term anesthesia for short procedures (e.g changing a bandage)

46
Q

Neuroleptanesthesia is produced by ……

A

neuroleptic (droperidol)
narcotic (fentanyl)
N2O + O2
* Induction is slow, but recovery is fast after N2O is removed
* Used for short term procedures (colonoscopy, endoscopy etc…)

47
Q

INR represents ……

A

a standardized reading for PT score, no matter how that score is acquired

  • Different PT is due to different reagents used for its determination on the same patient
  • Normal INR for patient not on anticoagulants is 1
  • Normal INR for anticoagulant patient is 2-4
  • INR of 5 is contraindicated for surgery
48
Q

Platelet count below …… is contraindicated for elective surgery

A

50,000

  • Emergency procedures can be done with as few as 30,000 (with hematologist & good technique)
  • Causes of thrombocytopenia include: cirrhosis, transfusion, infectious mononucleosis
49
Q

Ramsay hunt syndrome is ……

A

herpes zoster infection of the sensory and motor branches of VII & VIII
* Tx is antidepressants, anticonvulsants, or sympathetic blockers

50
Q

Crepitations of TMJ is associated with …….

A

osteoarthritis

51
Q

TMJ arthrocentesis is …..

A

injection of saline in superior joint space for the treatment of internal derangement

52
Q

The sign of internal derangement of TMJ is ……

A

reciprocal clicking

53
Q

The origin of superior lateral pterygoid is ……..

and the inferior head is ………

A

infratemporal crest of the greater wing

lateral pterygoid plate

54
Q

Flumazenil is used for treatment of ……..

A

diazepam overdose

55
Q

Analeptics are ………..

Ataraxics are …..

A

CnS stimulants

tranquilizers

56
Q

L.A with epi is contraindicated in patients with ….

A

hyperthyroidism, uncontrolled hypertension, bisulfate allergy, angina, recent MI, or taking non specific beta blockers

Part II (6 decks)

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