Wednesday, March 24, 2010

611-620 MCQ in Facial Plastic and Reconstructive Surgery

611-620

611) Which TECHNIQUE to close a surgical defect of the lower lip is demonstrated in the drawing below?


A. Gillies
B. Unilateral Karapandzic flap
C. Parallel Abbé flap
D. Webster flap
E. Johanson flap

612) Which of the following statements about the FIBULAR OSTEOCUTANEOUS FLAP is FALSE?

A. The peroneal artery and vein provide the primary blood supply to this flap.
B. The sensory input to the flap is provided by the direct innervation of the common peroneal nerve.
C. Flap elevation is usually done with a thigh tourniquet inflated to 350 mm Hg.
D. A segment of 8 cm of fibula is preserved proximally and distally.
E. A posterior splint is left in place for 10 days.

613) When will FAST ABSORBING SURGICAL GUT LOOSE virtually ALL TENSILE STRENGTH?

A. 48 hours
B. 72 hours
C. 5 days
D. 7 days
E. 10 days

614) Which of the following flaps is the ONE in which the base of the flap is not adjacent to the recipient defect and a second stage is required?

A. Rotation
B. Advancement
C. Interposition
D. Interpolation
E. Island

615) In which of the following facial areas are SILK SUTURES INDICATED?

A. Nose
B. Cheek
C. Forehead
D. Ear
E. Eyelid margin

616) A patient had botulinum A exotoxin (BTX-A) injected into the forehead. After 3 days there was still no response. Which of the following is TRUE?

A. Reinjection in 3 months
B. Reinjection with a half dose at day 4
C. Reinjection at 2 weeks
D. No for further injections
E. Reinjection increasing the initial dose at 2 weeks

617) Which of the following represents the EARLIEST SYMPTOM of LOCAL ANESTHETIC TOXICITY?

A. Visual disturbance
B. Convulsions
C. Muscular twitching
D. Respiratory system depression
E. Numbness of tongue

618) Which of the following statements about split-thickness skin grafts (STSG) is INCORRECT?

A. STSG contain a portion of the epidermis.
B. STSG are easy to harvest.
C. STSG have a different texture and lighter color than the neighboring tissue.
D. STSG are cosmetically inferior to full-thickness skin grafts.
E. STSG are less durable to than full-thickness skin grafts.

619) Which is of the following tissues IS LESS TOLERANT of EXPANSION?

A. Epidermis
B. Adipose tissue
C. Blood vessels
D. Muscular tissue
E. Neural tissue

620) Which of the following statements about the RADIAL FOREARM FLAP is TRUE?

A. It is a fascial or a fasciocutaneous flap.
B. The flap is very reliable, but is thick , non-pliable and without sensation.
C. Pathologic fracture is possible, but is not frequently occurring.
D. Primary closure of the donor site is always possible.
E. Magnetic resonance angiography is mandatory preoperatively to assess adequate blood flow


ANSWERS & REFERENCES


611) E     Johanson flap

Ellis D. A.F., Gullane P. J.: Cosmetic and Reconstructive Lip Surgery, chapter 23 in Instructional Courses, American Academy of Otolaryngology Head and Neck Surgery, (Johnson, Blitzer, Ossoff, Thomas, editors) , Volume 1, pp.269-271, 1988

612) B     The sensory input to the flap is provided by the direct innervation of the common peroneal nerve.

Burkey B. B., Coleman Jr., J. R.: Microvascular Flaps, in Chapter 47, Facial Plastic and Reconstructive Surgery, Second Edition, Thieme (Papel, I., editor), 2002, pp. 578-581

Burkey B. B., Schmalbach C. E., Coleman Jr., J. R.: Microvascular Flaps, in Chapter 57, Facial Plastic and Reconstructive Surgery, Third Edition, Thieme (Papel, I., editor), 2009, pp. 578-581

613) C     5 days

Maas C. S.: Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, pp. 28-29, 2001

Cheney M. L.: Soft Tissue Techniques, Chapter 3 in Facial Surgery, Plastic and Reconstructive, Williams & Wilkins, pp. 53-55, 1997

614) D     Interpolation

Shumrick D.A., Savoury L. W.: Local Flaps in chapter 3, Otolaryngology, (Paparella, Schumrick, Gluckman, Meyerhoff, editors), Saunders, Vol. IV, Plastic and Reconstructive Surgery and Interrelated Disciplines, Third Edition, pp. 2647-2652, 1991

Triana Jr. R. J., Murakami C. S., Larrabee Jr. W. F.: Skin Grafts and Local Flaps, in Chapter 4, Facial Plastic and Reconstructive Surgery, Third Edition, Thieme (Papel, I., editor), 2009, pp. 41-57

Park S. S.: Local and Regional Cutaneous Flaps, in Chapter 54, Facial Plastic and Reconstructive Surgery, Third Edition, Thieme (Papel, I., editor), 2009, pp. 721-743

615) E     Eyelid margin

Holt G. R.: Aesthetic primary wound treatment to improve scars chapter 6 in Facial Scars, Incision, Revision and Camouflage (Thomas, Holt, editors), Mosby, p. 67, 1989

616) C     Reinjection at 2 weeks

Blitzer A., Binder W. J., Brin M. F.: Botulinum Exotoxin A (Botox) for Facial Wrinkles, Chapter 23 in Facial Plastic and Reconstructive Surgery, Second Edition, Thieme, (Papel, editor), 2002, p. 262-268

Meyer T. K., Blitzer A.: Botulinum Toxin for Facial Wrinkles, Chapter 30 in Facial Plastic and Reconstructive Surgery, Third Edition, Thieme, (Papel, editor), 2009, p. 369-377

617) E     Numbness of tongue

Feinstein R., Nielsen H. C.: Local anesthetics chapter 4 in Facial Scars, Incision, Revision and Camouflage (Thomas, Holt, editors), Mosby, pp. 37-38, 1989

618) A     STSG contain a portion of the epidermis.

Levine H. L.: Skin, Dermal and Mucosal grafting, Chapter 2, Otolaryngology, (Paparella, Schumrick, Gluckman, Meyerhoff, editors), Saunders, Vol. IV, Plastic and Reconstructive Surgery and Interrelated Disciplines, Third Edition, pp. 2639-2645, 1991

Triana Jr. R. J., Larrabee Jr. W. F.: Skin Grafts and Local Flaps, Chapter 4 in Facial Plastic and Reconstructive Surgery, Third Edition, Thieme, (Papel, editor), 2009, pp. 41-58

619) B     Adipose tissue

Hoffmann J. F.: Tissue Expansion in Reconstruction of the Head and Neck, Chapter 45 in Facial Plastic and Reconstructive Surgery, (Papel, I, editor), Thieme,2002, pp. 549-551

Hoffmann J. F.: Tissue Expansion in Reconstruction of the Head and Neck, Chapter 55 in Facial Plastic and Reconstructive Surgery, (Papel, I, editor), Thieme, 2009, pp. 549-551

620) A     It is a fascial or a fasciocutaneous flap.

Burkey B. B., Coleman Jr., J. R.: Microvascular Flaps, in Chapter 47, Facial Plastic and Reconstructive Surgery, Second Edition, Thieme (Papel, I., editor), pp. 567-571, 2002

Burkey B. B., Schmalbach C. E., Coleman Jr., J. R.: Microvascular Flaps, in Chapter 57, Facial Plastic and Reconstructive Surgery, Third Edition, Thieme (Papel, I., editor), 2009, pp. 578-581


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Updated: June 1, 2017

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