surgery Flashcards
1
Q
Nasolabial flap artery
A
angular artery
2
Q
LA onset determined by which compoenent
A
aromatic ring
3
Q
LA amine determines
A
duration action
4
Q
LA no epi duration of action
A
30-60 min
5
Q
max LA without epi
A
max 4.5mg/kg
6
Q
max LA with epi
A
+epi 7 mg/kg
7
Q
how b-blockers affect LA levels
A
increase
8
Q
maximum vasoconstriction epinephrine time
A
15 min
9
Q
commonest cause Allergy in LA
A
paraben
10
Q
which LA should, not be use in children
A
prilocaine
11
Q
LA with vasoconstrictor( no epine) effect
A
cocaine
12
Q
is epinephrine in nerve block vasoconstricitve
A
not
13
Q
sodium bicarb : 1% lidocaine ratio
A
1:10( reduce sting/but shelf life),
14
Q
Max dose of lidocaine+ epi in tumescent anesthesia
A
50mg/kg,
15
Q
ESLD appropriate anesthetic
A
use benzocaine- renal metabolis
16
Q
cosmetic unit :Cutaneous lip- chin
A
mental crease;
17
Q
is nasal tip cosmetic unit
A
NOT
18
Q
FTSG Not on
A
cartilage!,
19
Q
FTSG size must be
A
• 25% larger
20
Q
FTSG contract by% from donor site
A
15%
21
Q
Alopecia neoplastica-
A
breast CA
22
Q
Imiquimod fda indications
A
FDA AK sBCC < 2cm body NOT face scalp anogenital)
23
Q
SCC prognosis- worst –
A
depth invasion> 4mm, size > 2cm
24
Q
Wound healing collagen first deposited
A
type 3
25
Botox A pain worsened by
preservative free saline
26
Avoid Facial nerve injury byundermining which plane
undermine subQ fat
27
vertical skin tension lines
Scapula
28
avoid benzocaine, parabens sulphonamide thiazide diuretic
PPD allergy-
29
post surgery Dermabrasion
6w
30
IE prophylaxis
60 min before
31
NO need IE prophylaxis
for ASD
32
lateral canthus infraorbital rotation
Mustarde flap
33
Lip defects-
primary closure
34
Eyelid defect- - wound contraction
2 intention CI
35
MCW melanoma cocktail –
monclonal ab MART1 melan A tyrosine , SLN bx, micromets detection
36
Trapdoor deformity-
nasolabial flap
37
Acne scarring – laser ro use
ND yag( 1064 nm) greatest depth penetration
38
dorsal nasal rotation flap
Riger –
39
glabellar mid forehead
Supratrochlear-
40
1st absorbed- what suture
catgut 7-14d
41
Polyglactin type of suture
vicryl
42
polyglycolic acid –absorption
90 days
43
absorbable monofilament 180d
Polydioxanone PDS-
44
Antiptosis subdermal suspension- type of thread
polypropylene thread
45
periorbital fat pad
Phosphatidylcholine
46
Procerus-
inferomedial
47
alpha tocopherol
Major antioxidant
48
- cd4 lymphocytopenia
Skin cancer risk
49
salicylic acid lactic ethanol resorcinol no neutralisation
Jessner peel-
50
supf temporal facial artery-labial angular, maxillary posterior auricular occipitalare branches of ?
ECA-
51
ICA branches EXCEPT
angular artery
52
Baker Gordon
phenol
53
phenol
arrhythmia liver/renal failure
54
phenol *epidermolytic penetration
deep peel croton oil
55
Erbium yag/co2( 10600nm) which part ocular damage
aqueous- cornea
56
PDL(585nm)ndyag alexandrite ruby ocular damage
retinal pigment,
57
Alexandrite KTP ruby Ndyag diode - what medium
solid medium
58
which laser has liq medium
PDL
59
argon co2 krypton cu vapour all require what type media?
Gas media –
60
Erbium- post- Cx
milia
61
Reticulate erythema
diod laser
62
Organ transplant chemoprotective agent
rapamycin
63
shorten length excision
M plasty
64
no inflammatory response , show up on dental xrays
Radiesse- hydroxyhapatite
65
Infraorbital botox- adverse event
festooning
66
Thermage complication –
lipoatrophy
67
HIV lipoatrophy,longest DOA, FDA
Sculptra
68
blue nodules caused by which filler
Restylane- hyaluronic acid-
69
CI in anaphylaxis low allergic , duration 6-12 m
Restylane- hyaluronic acid-
70
Fibroblast harvestomh – dermal augmentation
Isolagen-
71
electrocautery, • Electrosurgery
NOT
72
scalpel form of electrocautery
shaw
73
Follicular unit hair transplantation
2-3 months post implantation
74
EMPD- mohs-
CK7
75
Which Tattoo pigment allergic eczematous granulomatous pseudolymphomatous- lichenoid ,
mercuric sulphide
76
cadmium sulphide causes phototoxic reaction.
phototoxic reaction –
77
Strength wound- 2w
-5%,
78
Strength wound- • 1m
-50%
79
Strength wound- 6m
70%,
80
Iodine/benzakonium chloride-
ACD
81
Z plasty bilobed rhombic nasolabial flap
Transposition flaps
82
AT type of flap
Advancement-
83
What flap can decrease wound tension
Z plasty –
84
helix lobule innervation
Greater auricular nerve
85
tragus innervation
Auriculotemporal( mandibular branch trigeminal
86
PWS- which laser
586 nm PDL
87
ALA PDT
protoporphyrin IX
88
Serotonin action in wound healing
Cross link collagen molecules
| Stimulate fibroblast prolifration
89
Histamine kinin prostaglandin complement common action in wound healing
Increase vascular permeability
90
Which chemical mediator also sensitise pain receptor and increase synthesis GAGS
Prostaglandin
91
Which chemical mediator increases phagocytosis enhance bacterial lysis mast cell and basophil activation in wound healing
Complement
92
Partial thickness wounds difference full thickness wound via mechanism of wound healing
PT- re epitheliazation from both wound edges and adnexal structures
Vs FT- only from wound edges
93
Defeciency nidogen 1, TGFb, superoxide dismurase IL6, TLR3 all cause
Delayed wound healing
94
Mice lacking MMP demonstrate
Accelerated wound healing
95
For what wound size does primary intention healing deonstrate superior result
For wounds >8 mm
96
3 phases of wound healing are
Inflammatory
Prolifeerative
Remodeling
97
Components of the provisional matrix ?
Vitronectin, thrombospondin 1/2, tenascin, GAG, proteoglycans, collagen 3/6
98
Compenents of remodelled collagenous scar
Collagen 1
99
First extracellular matrix deposited in wound space
Fibrin clot
100
Name of transmembrane receptors that recognise and bind to ECM proteins
Integrin
101
Migration of keratinocytes over wound bed regulated by
Keratinocyte growth factor and hepatocyte growth factor
102
Classic marker of activated keratinocytes
K6 k16
103
What event marks irreversible terminal differentiation of keratinocytes
Process profilaggrin into filaggrin
104
Location of multipotent stem cells
Stem cells in bulge region of outer follicular root sheath
105
What causes fibroblasts to differentiate into protomyofibroblast
Mechanical stress
106
What causes protomyofibroblasts into myofibroblast
TGFb1
107
Protomyofibroblasts characterised by expression of
Fibronectin variant ED-A
108
Recombinant growth factor approved for topical treatment of diabetic foot ulcer
PDGF -BB
109
What dressing for highly exudative wound
Alginate
110
Part of nail that forms dorsal superficial surface
Proximal nail matrix
111
What is o2 requirement for optimal fibroblast proliferation
Hypoxia
112
What part of nail matrix is responsible for ventral deep surface of nail ?
Distal nail matrix
113
Part of nail matrix responsible for lunula?
Distal 1/3 matrix
114
Nail bed sits directly over
Periosteum
115
Orientation of nail matrix biopsy ?
Horizontal
116
Orientation of nail bed biopsy
Vertical
117
Depth of nail biopsy
Down to periosteum
118
Location of biopsy of melanonychia
Distal nail matrix
119
Nail matrix excision results in what changes to nail plate?
Thinner nail plate, thickness proprtional to length of matrix
120
Ideal excision of nail matrix orientation and location? For minimal nail dystrophy?
Horizontal orientation in distal nail matrix
121
TCA 30% is a ? Peel
Superficial
122
antiviral prophylaxis given for which chemical peels
medium and deep
123
TCA 30% is what level of peel?
supeficial
124
jessner's solution consist of ?
salicylic/lactic acid, resorcinol, ethanol
125
88% phenol is an e.g. of ?
medium chemical peel
126
2 e.g. of deep chemical peel
bakergordon, TCA > 50%
127
glycolic acid 70% alone is what level peel??
superficial
128
1)anything containing 35% TCA
| or 2) 88% phenol are what level chemical peel
medium level
129
content of baker gordon
phenol, croton oil. liq hexachlorophene, distilled water
130
medium depth peel at what level ?
papillary dermis
131
MOA of BTX inhibit Ach release?
cleave SNARE complex
132
BTX type A light chain cleaves what protein?
snAp25
133
BTX type B light chain cleaves what protein?
synaptoBrevin, VAMP protein
134
Botox effective for what type facial lines?
dynamic not static
135
which type botox FDA approved for labellar rhytides and hyperhidrosis
A
136
pregnancy category of Botox
C
137
How to prevent eyelid ptosis when injecting botox ?
1 cm above orbital rim
138
adverse effect of injecting orbicularis oculi for crows feet when patient is smiling?
ptosis of upper lip--> ipsilateral zygomaticus complex
139
Monsel’s solution should be avoided
| in the setting of
biopsy specimens of pigmented
| lesions
140
split thickness skin graft ooze
What is an ideal agent to place in the wound before
the nonstick dressing?
gelatin ,hygroscopic, hemostasis by
a 3-dimensional meshwork within which
platelets can aggregate to form a clot
141
ideal for patients who are undergoing
| long-term anticoagulation therapy to obtain hemostasis between stages that is easily removed
Hydrophilic polymer, efficacy of WoundSeal does not depend on the body’s clotting
142
TGFb1 and TGFb2 expression leads to ? scarring
TGFb1 and TGFb2 expression leads to in-creased scarring
143
TGFb3 expression leads to ?scarring
reduced scarring
144
Proinflammatory cytokines such as? enhance scarring
interleukin-6 IL-6 and IL-8 enhance scarring
145
antiinflammatory cytokine
| ? decreases the amount of scar tissue
IL-10
146
In wound healing , Homeobox b13, the Wnt signaling pathway, early growth response-1, and platelet-derived growth factor all favor
fibroplasia
147
onychomatricoma coexistingprocess?
Onychomycosis
148
Co2 laser Potential disadvantages
includerisk of burns to the face and exaggerated removal oftissue with cartilage exposure.
149
The Shaw knife has been particularly useful
b. debulking large tumors
150
Lymphatic drainage of the eyelids is by the
.preauricular and submandibular nodes
151
In performing operation on the lower eyelid,which branch greatest
risk of trigeminal injury?
d. Lacrimal
