Trauma

Question 1

A patient provides a history of having recent blunt trauma to the left zygoma. Regarding the clinical condition exhibited:
(A) recurrent hemorrhage may occur in 0-38% of the cases.
(B) there may be decreased intraocular pressure and optic ischemia.
(C) topical cycloplegics are contraindicated for this condition.
(D) topical steroids may result in scaring of the cornea.

Answer 1

(A) recurrent hemorrhage may occur in 0-38% of the cases.

COMSSAT: 2019
Explanation:
Source: Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.

Question 2

The child shown in the photograph suffered a dog bite with soft-tissue involvement. Twenty-four hours after primary closure the patient develops a wound infection. Which of the following is the most likely primary cause of the infection?
(A) Pasteurella multocida 
(B) Streptococcus viridians 
(C) Staphylococcus aureus 
(D) Eikenella corrodens

Answer 2

(A) Pasteurella multocida

COMSSAT: 2019
Explanation:
Source: Kristinson, G. (2007). Pasteurella multocida infections. Pediatrics in review (vol. 28) (pp. 472-473).

Question 3

An avulsive upper lip injury involving approximately one fourth of the transverse length of the lip should be treatment planned for a/an:
(A) Abbe-Estlander flap.
(B) Gilles fan flap.
(C) full-thickness wedge resection and primary closure. (D) Karapandzic flap.

Answer 3

(C) full-thickness wedge resection and primary closure.

COMSSAT: 2019
Explanation:
Source: Lee, P. & Mountain, R. (2000). Lip reconstruction. Current opinion otolaryngology & head and neck, (vol. 8) (pp. 300-304). Lippincott Williams & Wilkins, Inc.

Question 4

The most specific reliable marker of perfusion in a multiple trauma patient is:
(A) urine output.
(B) Doppler blood pressure. 
(C) capillary refill time.
(D) tachycardia.

Answer 4

(A) urine output.

COMSSAT: 2019
Explanation:
Source: Cocchi, M., Kimlin, E. & Walsh, M. et. al. (2007). Identification and resuscitation of the trauma patient in shock. Emergency medicine clinics of north America, (vol. 25), (pp. 623-642).

Question 5

Diffuse axonal injuries are thought to arise from which of the following mechanism?
(A) Acceleration and deceleration 
(B) Blunt object trauma
(C) High velocity missle penetration 
(D) Low velocity missle penetration

Answer 5

(A) Acceleration and deceleration

COMSSAT: 2019
Explanation:
Source: Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.

Question 6

Severe ocular pain, decreased vision, increased intraocular pressure and proptosis after facial injury most likely is due to:
(A) retrobulbar hematoma.
(B) fracture of the optic canal.
(C) hemorrhage from the maxillary sinus.
(D) superior orbital fissure syndrome.

Answer 6

(A) retrobulbar hematoma.

COMSSAT: 2019
Explanation:
Source:
Walton, W., Von Hagen, S., Grigorian, R. & Zarbin, M. (2003). Management of traumatic hyphema. Survey of Ophthalmology, (pp. 242-243).
Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.
Ochs, M.W. & Johns, F.R. (1998). Evaluation and management of periorbital and ocular injuries, 2, 45-60.
Wether, J.R. (1999). Reconstruction of internal orbital fractures. Oral and maxillofacial surgery clinics of north America, 11, 211-223.

Question 7

Traumatic telecanthus is caused by:
(A) lateral displacement of a zygomatic fracture.
(B) orbital rim fracture.
(C) orbital roof “blow-in” fracture.
(D) medial orbital wall “blow-out” fracture.

Answer 7

(D) medial orbital wall “blow-out” fracture.

COMSSAT: 2019
Explanation:
Source: Walton, W., Von Hagen, S., Grigorian, R. & Zarbin, M. (2003). Management of traumatic hyphema. Survey of Ophthalmology, (pp. 242-243).
Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.
Ochs, M.W. & Johns, F.R. (1998). Evaluation and management of periorbital and ocular injuries, 2, 45-60.
Wether, J.R. (1999). Reconstruction of internal orbital fractures. Oral and maxillofacial surgery clinics of north America, 11, 211-223.

Question 8

With respect to mandibular fractures, a “favorable” fracture is one in which:
(A) there are teeth on each side of the fracture.
(B) there is no displacement of the fragments.
(C) the displacing muscles are countered by the interlocking of fragments.
(D) a repeatable occlusion is present without treatment.

Answer 8

(C) the displacing muscles are countered by the interlocking of fragments.

COMSSAT: 2019
Explanation:
Source:
Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.

Question 9

The site of mandibular fracture associated with the highest incidence of complication, whether treated open or closed, is the:
(A) condylar process. 
(B) angle.
(C) body.
(D) symphysis.

Answer 9

(B) angle

COMSSAT: 2019
Explanation:
Source: Sorel, B. (1998). Open versus closed reduction of mandible fractures. Oral and maxillofacial surgery clinics of north America, 10, 541.
Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.

Question 10

Which of the following is the best image for assessing the orbit for fractures?
(A) Axial CT
(B) Direct Coronal CT
(C) 3-D CT Reconstructions 
(D) MRI

Answer 10

(B) Direct Coronal CT

COMSSAT: 2019
Explanation:
Source:
Walton, W., Von Hagen, S., Grigorian, R. & Zarbin, M. (2003). Management of traumatic hyphema. Survey of Ophthalmology, (pp. 242-243).
Fonceca, Marciani & Turvey (2009). Oral and maxillofacial surgery, 2 (2), 62.
Ochs, M.W. & Johns, F.R. (1998). Evaluation and management of periorbital and ocular injuries, 2, 45-60.
Wether, J.R. (1999). Reconstruction of internal orbital fractures. Oral and maxillofacial surgery clinics of north America, 11, 211-223.