801-810 MCQ in Facial Plastic and Reconstructive Surgery

801-810

801) Which of the following arteries is the one indicated by the black arrow in the drawing below?

A. Thoracoacromial Artery
B. Lateral Thoracic Artery
C. Transverse Cervical Artery
D. Mammary Artery Perforators
E. Dorsal Scapular Artery

802) Which of the following managements is the IDEAL for treatment of Dermatofibrosarcoma Protuberans localized in the head and neck area?

A. Currettage followed by electrosurgery
B. Wide surgical excision
C. Mohs surgery
D. Radiation therapy
E. Radiation therapy and chemotherapy

803) In the normal Human Scalp, what is the percentage of Hair Follicules in the TELOGEN PHASE?

A. 1%
B. 5%
C. 10%
D. 20%
E. 30%

804) Which of the following statements about skin graft vascularization is FALSE?

A. Skin grafts initially adhere to the recipient bed by fibrin.
B. Skin grafts receive fluid during the first 48 hours by plasmatic imbibition.
C. Skin grafts will create, after 48 hours, connections between preexisting blood vessels and their bed (inosculation).
D. Skin grafts are firmly attached to their new blood supply by the ninth day.
E. Skin grafts usually attain normal sensory innervation after healing is complete.

805) Which of the following statements regarding normal periocular anatomic relationships is FALSE?

A. Brow at or above Superior Orbital Rim
B. Vertical Palpebral Aperture (10 mm)
C. Horizontal Palpebral Aperture (34 mm)
D. Lateral Canthal Angle (Acute)
E. Lower Lid Margin Below Inferior Limbus

806) Which of the following statements about orbital anatomy is TRUE?

A. The Orbital Walls are formed by 6 bones.
B. The Frontal Bone forms the entire Orbital Roof.
C. The Optic Foramen is located in the Greater Wing of the Sphenoid.
D. The Anterior Ethmoidal Foramina is located 18 mm from the Frontoehtmoidal Suture.
E. The Posterior Ethmoidal Foramina is located 36 mm from the Frontoehtmoidal Suture.

807) Which of the following statements about Eyelid Ptosis evaluation is TRUE?

A. The normal measurement of the Palpebral Fissure is usually less than 10 mm.
B. The normal Eyelid Crease measurement in females is usually less 10 mm.
C. Normal Levator Function is usually greater than 11 mm.
D. Margin Reflex Distance-1 (MRD1) is the distance between the Center of the Pupil in primary position and the Central Margin of the Lower Eyelid.
E. Margin Reflex Distance-2 (MRD2) is the distance between the Center of the Pupil in primary position and the Central Margin of the Upper Eyelid.

808) Which of the following is the BEST management for a Dorsal Nasal Cyst noted one year postrhinoplasty?

A. Conservative and gentle daily massage
B. Needle aspiration
C. Incision and drainage
D. Corticoid injections
E. Surgical excision

809) Which of the following is THE MOST RELIABLE indicator for identifying a patient at risk of developing postblepharoplasty Dry Eye Syndrome?

A. History.
B. Schirmer’s test
C. Tear Film Break-up Time
D. Quantitative Tear Lysozyme Level
E. Corneal Staining with Rose Bengal Solution

810) Which of the following statements about Corneal Abrasion postblepharoplasty is FALSE?

A. A sterile corneal shield coated with a bland ophthalmologic ointment is useful for prevention.
B. A temporary Frost Traction Suture can help to protect the eye during Lower Lid Blepharoplasty.
C. The use of ophthalmologic ointment is helpful to avoid drying and Corneal Ulcer Formation.
D. Rose Bengal Solution staining and the Slit Lamp will made the diagnosis.
E. The treatment of Corneal Abrasion is to close the eye, use antibacterial ointment and patch for 48 hours.


ANSWERS & REFERENCES


801) B     Lateral Thoracic Artery

Annino Jr., D. J, Shu R. S: Musculocutaneous Flaps, Chapter 46 in Facial Plastic and Reconstructive Surgery (Papel I, editor), second edition, 2002, pp. 560-566

Annino Jr., D. J, Shu R. S: Musculocutaneous Flaps, Chapter 56 in Facial Plastic and Reconstructive Surgery (Papel I, editor), Third edition, 2009, pp. 757-764

802) B     Wide surgical excision

Hendrix J. D. Jr., Slingluff C. L.: Cutaneous Malignancies Diagnosis and Treatment, Chapter 42 in Facial Plastic and Reconstructive Surgery (Papel I, editor), second edition, 2002, pp. 485-507

Hendrix J. D. Jr., Slingluff C. L.: Cutaneous Malignancies Diagnosis and Treatment, Chapter 42 in Facial Plastic and Reconstructive Surgery (Papel I, editor), Third edition, 2009, pp. 675-702

803) C     10%

Bennett R.G.: Anatomy anf Physiology of the Skin, Chapter 1, in Facial Plastic and Reconstructive Surgery, Second Edition, 2002, pp. 10-12

http://emedicine.medscape.com/article/835470-overview

804) E     Skin grafts usually attain normal sensory innervation after healing is complete.

Angel M.F., Giesswein P., Hawner P.: Skin Grafting, chapter 7 in Operative Plastic Surgery, (Evans G. R.D., editor), McGraw-Hill, 2000, pp.59-65

Triana Jr. R. J., Murakami C. S., Larrabee Jr. W. F.: Skin Grafts and Local Flaps, Chapter 4, Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Second Edition, 2002, pp. 38-54

Hom D. B., Tope W. D.: Minimally Invasive Options and Skin Grafts for Cutaneous Reconstruction, Chapter 53, Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 703-719

805) E     Lower Lid Margin Below Inferior Limbus

Zdinak L. A.: Patient Evalualtion in Otolaryngologic Clinics of North America (Bosniak S. L., editor), Vol. 38, No. 5, October 2005, pp.857-869

Ridley M. B., VanHook S. M.: Aesthetic Facial Proportions, Chapter 11, Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Third Edition, 2009, pp. 119-133

806) E     The Posterior Ethmoidal Foramina is located 36 mm from the Frontoehtmoidal Suture.

Burkat C. N., Lemke B. N.: Anatomy of the Orbit and its related structures in Otolaryngologic Clinics of North America (Bosniak S. L., editor), Vol. 38, No. 5, October 2005, pp.825-856

807) C     Normal Levator Function is usually greater than 11 mm.

Edmonson B. C., Wulc A. E.: Ptosis Evaluation and Management in Otolaryngologic Clinics of North America (Bosniak S. L., editor), Vol. 38, No. 5, October 2005, pp.921-946

808) E     Surgical excision

Quatela V. C., Russell Ries W.: Aesthetic Facial Surgery, chapter 24 in Complications in Head and Neck Surgery (Krespi and Ossoff, editors), 1993, pp.385-435

809) A     History

Quatela V. C., Russell Ries W.: Aesthetic Facial Surgery, chapter 24 in Complications in Head and Neck Surgery (Krespi and Ossoff, editors), 1993, pp.385-435

Gilbard J. P.: The Diagnosis and Management of Dry Eyes, in Otolaryngologic Clinics of North America (Bosniak S. L., editor), Vol. 38, No. 5, October 2005, pp.871-885

810) D     Rose Bengal Solution staining and the Slit Lamp will made the diagnosis.

Quatela V. C., Russell Ries W.: Aesthetic Facial Surgery, chapter 24 in Complications in Head and Neck Surgery (Krespi and Ossoff, editors), 1993, pp.385-435


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Updated: June 25, 2017

811-820 MCQ in Facial Plastic and Reconstructive Surgery

811-820

811) Which of the following eyelid structures (cross sectioned drawing below) is the ONE represented by the arrow?

A. Meibomian glands
B. Sweat glands
C. Gray line
D. Tarsus
E. Orbicularis muscle

812) Which of the following is the MOST COMMON cause of permanent Lagophthalmos?

A. Eyelid Laxity not corrected
B. Orbital Septum trauma with scarring
C. Eyelid incision healing with scarring and contracture
D. Excessive resection of upper eyelid skin
E. Suturing the Orbital Septum with skin closure sutures

813) A 15 year old boy suffered blunt neck trauma due to a bicycle handle bar injury. The physical examination and work up revealed massive endolaryngeal edema with airway obstruction, mucosal lacerations with exposed cartilage and an immobile left vocal cord. In which of the following classifications of laryngotracheal injury, according to the Schaeffer and Fuhrman, is the injury mentioned above included.?

A. I
B. II
C. III
D. IV
E. V

814) Which of the following facial scars is BETTER NOT revised

A. 4 cm linear scar within the common border of two aesthetic units
B. 4 cm linear scar perpendicular to the RSTLs
C. 4 cm scar, curved an pin-cushioned
D. 4 cm scar interrupting and crossing an aesthetic unit of the face
E. 4 cm linear scar causing distortion of the Lower Eyelid

815) Which of the following statements about Mohs Micrographic Surgery for Basal Cell Carcinoma is FALSE?

A. Mohs Technique is the ideal for treatment of initial Basal Cell Carcinoma.
B. Mohs Technique is ideal for treatment of Recurrent Basal Cell Carcinoma
C. Mohs technique sectioning allows to check 100% of the lateral and deep margins of the each specimen
D. Mohs Technique gives a high five year Cure Rate of 90%.
E. Mohs Technique removes the narrowest margin of tissue that is technically feasible.

816) Which of the following forehead and eyebrow lifting procedures will afford THE MOST ACCURATE AND THE GREATEST ELEVATION per millimeter of tissue excised?

A. Direct Eyebrow Lift
B. Midforehead Lift
C. Temporal Eyebrow Lift
D. Open Coronal Eyebrow and Forehead Lift
E. Pretichial Open Forehead Lift

817) Which of the following is NOT a characteristic of the Asian Nose?

A. Wide with strong Nasal Bones
B. Broad and flat Nasal Dorsum
C. Wide and flat Tip Cartilages
D. Limited Tip Projection
E. Wide Alar Base

818) Which of the following wait periods is APPROPRIATE prior to reconstruction of complex cutaneous facial defects after oncologic resection?

A. 3 months
B. 6 months
C. 8 months
D. 10 months
E. 12 months

819) Which of the following treatment options for the management of Facial Cutaneous Basal Cell Carcinoma is INCORRECT?

A. Electrodessication and curettage
B. Cryotherapy
C. Radiotherapy
D. Laser vaporization
E. Topical Imiquimod

820) Which of the following statements about Congenital Melanocytic Nevi is TRUE?

A. Congenital melanocytic nevi are present at birth in 3% of neonates.
B. Congenital melanocytic nevi are dark brown, round or oval in shape and always hairless.
C. Congenital melanocytic nevi from 10 to 15 cm. are considered large.
D. Congenital melanocitic nevi of large size will transform into melanoma in 30% of cases.
E. Congenital melanocytic nevi carry a risk of melanoma related to the age of the child.


ANSWERS & REFERENCES


811) A     Meibomian glands

Burkat C. N., Lemke B. N.: Anatomy of the Orbit and its related structures in Otolaryngologic Clinics of North America (Bosniak S. L., editor), Vol. 38, No. 5, October 2005, pp.825-856

Bersani T. A. , Courchesne M. C.: Post-traumatic Eyelid Deformities, Facial Trauma: Primary and Secondary Repair (Kellman R. M., Tatum III S. A., Marentette L. J., Guest Editors), Facial Plastic Surgery Clinics of North America, Nov. 1998, pp. 511-525

812) D     Excessive resection of upper eyelid skin

Quatela V. C., Russell Ries W.: Aesthetic Facial Surgery, chapter 24 in Complications in Head and Neck Surgery (Krespi and Ossoff, editors), 1993, pp.385-435

Pastorek N. J., Bustillo A.: Blepharoplasty, chapter 176 in Head and Neck Surgery-Otolaryngology, (Bailey, B.J., editor), 4th edition, Lippincott Williams & Wilkins, 2006, pp. 2611-2625

813) C     III

Link D. T., Cotton R. T.: The Laryngotracheal Complex in Pediatric Head and Neck Trauma, Facial Plastic Surgery Clinics of North America, Pediatric Head and Neck Trauma, (Rothschild M.A, editor) Vol. 7, No. 2, May 1999, pp. 133-144

814) A     4 cm linear scar within the common border of two aesthetic units

Jones M. E., Costantino P.: Pediatric Scar Revision, Facial Plastic Surgery Clinics of North America, Pediatric Head and Neck Trauma, (Rothschild M.A, editor) Vol. 7, No. 2, May 1999, pp. 243-252

815) D      Mohs Technique gives a high five year Cure Rate of 90%.

Lang, Jr. P.G.: Mohs Micrographic Surgery for Basal Cell Carcinoma , Advances in Mohs Surgery, (Dzubow, L. M., editor) , Facial Plastic Surgery Clinics of North America, August 1998, Vol.6, No.3, pp.275-295

Hendrix Jr. J.D., Slingluff C. L: Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52 in Facial Plastic and Reconstructive Surgery (Papel, I. D. , editor), Third edition, Thieme, 2009, pp. 675-702

816) A        Direct Eyebrow Lift 

Hoenig J. A.: Comprehensive Management of Eyebrow and Forehead Ptosis, in Otolaryngologic Clinics of North America (Bosniak S. L., editor), Vol. 38, No. 5, October 2005, pp.947-984

817) A     Wide with strong Nasal Bones

Strahan R. W., Perrott D. H.: Rhinoplasty of the Asian Nose using autogenous cartilage augmentation techniques (McCurdy Jr. J. A.., editor) , Facial Plastic Surgery Clinics of North America, February 1996, Vol.4, No.1, pp.63-73

Jang Y. J.: Asian Rhinoplasty, Chapter 48 in Facial Plastic and Reconstructive Surgery (Papel, I. D. , editor), Third edition, Thieme, 2009, pp. 619-637

http://emedicine.medscape.com/article/1293426-overview

818) E     12 months

Cordoro K. M., Russell M. A.: Minimally Invasive Options for Cutaneous Defects: Secondary Intention Healing, Partial Closure and Skin Grafts in Local Cutaneous Flaps ( Park S. S., editor) , Facial Plastic Surgery Clinics of North America, May 2005, Vol.13, No.2, pp.215-230


819) D     Laser vaporization

Padgett J. K.: Cutaneous Lesions: Benign and Malignant in Local Cutaneous Flaps ( Park S. S., editor) , Facial Plastic Surgery Clinics of North America, May 2005, Vol.13, No.2, pp.195-202

Hendrix Jr. J.D., Slingluff C. L: Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52 in Facial Plastic and Reconstructive Surgery (Papel, I. D. , editor), Third edition, Thieme, 2009, pp. 675-702

820) E     Congenital melanocytic nevi carry a risk of melanoma related to the age of the child.

Padgett J. K.: Cutaneous Lesions: Benign and Malignant in Local Cutaneous Flaps ( Park S. S., editor) , Facial Plastic Surgery Clinics of North America, May 2005, Vol.13, No.2, pp.195-202

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Updated: June 25, 2017

821-830 MCQ in Facial Plastic and Reconstructive Surgery

821-830

821) What is the LEAST amount of bone required to be left in place when harvesting the Osteocutaneous Free Flap represented in the drawing below?

A. 4 cm
B. 8 cm
C. 12 cm
D. 14 cm
E. 18 cm

822) Which of the following ear structures give sensory innervation the auriculotemporal nerve (V)?

A. Lobule
B. Conchal Bowl
C. Inferior aspect of the Auricle
D. Anterior aspect of the Helix and Tragus
E. Posteromedial surface of the Auricle

823) Which of the following reconstruction methods is the LEAST useful for a medium (not possible to use primary closure) midcheek defect ?

A. Secondary Intention
B. Rhombic Flap
C. Bilobed Flap
D. Cheek Advancement Flap
E. Cervicofacial Rotation Flap

824) Which of the following statements about Merkel Cell Carcinoma is TRUE?

A. Merkel Cell Carcinoma is a malignant tumor derived from neuroendocrine cells of Neural Crest origin.
B. Most of the lesions are localized on the trunk.
C. They are most commonly seen in childhood age.
D. Local recurrence rate is below 5%.
E. Wide local excision is the only effective treatment.

825) Which of the following suture materials has the MOST tensile strength?

A. Polypropylene (Prolene)
B. Silk
C. Polyglactin (Vicryl)
D. Polyester (Mersilene)
E. Nylon

826) Which of the following statements about postoperative care after hair restoration surgery is FALSE?

A. A gentle pressure head dressing is used for 48 hours.
B. Head elevation and no bending for 48 hours is mandatory.
C. Shampoo and shower are allowed at 48 hours.
D. Saline spray and aloe gel are applied to the grafts at night.
E. Initial postoperative follow up is at 2 weeks.

827) Which of the following statements about hairline design is FALSE?

A. The design should be high.
B. The design should be symmetrical.
C. The design should include a temporal recesion.
D. The most anterior point of hairline is placed at 7.0 cm from the midglabella point.
E. The temporal points linking frontal hair with temporal hair should be located at the intersection of a line drawn from the Lateral Canthus to the Temporal Fringe.

828) When is it USUALLY recommended to remove the auricle dressing after otoplastic surgery?

A. 1 day
B. 2 days
C. 3 days
D. 4 days
E. 5 days

829) Which of the following statements about nasal reconstruction is TRUE?

A. The skin of the nasal dorsum and sidewall is thick , non-pliable and fixed to underlying tissues.
B. The Paramedian Forehead Flap is a random flap.
C. The Paramedian Forehead Flap will improve results if delay is used.
D. The Nasolabial Flap is a "workhorse" for lower nasal defects.
E. The Nasolabial Flap is an Axial Flap with the main blood supply from the Labial Artery.

830) Which of the following statements about Alloderm is FALSE?

A. Alloderm is fabricated from cadaveric skin.
B. Alloderm has an acelular dermis matrix.
C. Alloderm does not contain epidermis.
D. Alloderm carries the complication of migration.
E. Alloderm is used as a soft tissue filler and camouflage of grafts.


ANSWERS & REFERENCES


821) B     8 cm

Burkey B. B., Coleman, Jr., J. R.: Microvascular Flaps, chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Facial Plastic and Reconstructive Surgery, Second Edition, 2002, pp.567-590

Burkey B. B., Schmalbach C. E., Coleman, Jr., J. R.: Microvascular Flaps, chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Facial Plastic and Reconstructive Surgery, Third Edition, 2009, pp. 765-793

Chepeha D. B., Teknos T. N.: Microvascular Free Flaps in Head and Neck Reconstrucion, chapter 162 in Head and Neck - Otolaryngology, (Bailey, B. J., editor), 4th edition, 2006, pp. 2369-2391

822) D     Anterior aspect of the Helix and Tragus

Calhoun K. H., Chase S.P.: Reconstruction of the Auricle, Local Cutaneous Flaps (Park, S.S.,editor), Facial Plastic Surgery Clinics of North America, May 2005, Vol. 13, No. 2, pp. 231-241

Nachlas N. E.: Otoplasty, chapter 27 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Facial Plastic and Reconstructive Surgery, Second Edition, 2002, pp. 309-321

Nachlas N. E.: Otoplasty, chapter 34 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Facial Plastic and Reconstructive Surgery, Third Edition, 2009, pp. 421-433

823) A     Secondary Intention

Pletcher S. D., Kim D. W.: Current Concepts in Cheek Reconstruction, (Park, S.S.,editor), Facial Plastic Surgery Clinics of North America, May 2005, Vol. 13, No. 2, pp. 267-281

824) A     Merkel Cell Carcinoma is a malignant tumor derived from neuroendocrine cells of Neural Crest origin.

Padgett J. K.: Cutanenous Lesions: Benign and Malignant in Local Cutaneous Flaps ( Park S. S., editor) , Facial Plastic Surgery Clinics of North America, May 2005, Vol.13, No.2, pp.195-202

Hendrix Jr. J. D., Slingluff C. L.: Diagnosis and Treatment of Cutaneous Malignancies, Chapter 52 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 675-702

825) D     Polyester (Mersilene)

Frideman J., Mosser S. W.: Closure Material, chapter 4 in Operative Plastic Surgery, (Evans G. R.D., editor), McGraw-Hill, 2000, pp.26-32

826) A     A gentle pressure head dressing is used for 48 hours.

Vogel J. E.: Hair Restoration, Chapter 21 in Operative Plastic Surgery (Evans G. R.D., editor), 2000, pp.208-224

827) D     The most anterior point of hairline is placed at 7.0 cm from the midglabella point.

Vogel J. E.: Hair Restoration, Chapter 21 in Operative Plastic Surgery (Evans G. R.D., editor), 2000, pp.208-224

Stough III D. B., Stough IV D. B.:Hair Replacement Techniques, Hair Replacement Techniques, chapter 25 in Facial Plastic and Reconstructive Surgery, (Papel I.D., & Nachlas N.E., editor, editors), Mosby Year Book, 1992, pp. 169-178

828) A     1 day

Furnas D. W.: Otoplasty for Protruding Ears, Cryptotia, or Stahl’s Ear, Chapter 40 in Operative Plastic Surgery (Evans G. R.D., editor), 2000, pp.417-448

Nachlas N. E.: Otoplasty, Chapter 27 in Facial Plastic and Reconstructive Surgery, (Papel, I. D., editor), Second Edition, 2002, pp.309-321

Nachlas N. E.: Otoplasty, chapter 34 in Facial Plastic and Reconstructive Surgery, (Papel I. D., editor), Facial Plastic and Reconstructive Surgery, Third Edition, 2009, pp. 421-433

829) D     The Nasolabial Flap is a "workhorse" for lower nasal defects.

Menick F. J.: Forehead Flap for Nasal Reconstruction, Chapter 24 in Operative Plastic Surgery (Evans G. R.D., editor), 2000, pp.255-268

Mayer M. H.: Nasolabial Flap, Chapter 25 in Operative Plastic Surgery (Evans G. R.D., editor), 2000, pp. 269-277

830) D     Alloderm carries the complication of migration.

Romo III T., Kwak E. S.: Nasal Grafts and Implants in Revision Rhinoplasty, Facial Plastic Surgery Clinics of North America, (Kridel R. W.H., editor), Nov. 2006, Vol. 14, No. 4, pp.373-387

Stucker F. J.. Shaw G., Ephrat M.: Biologic Tissue Implants, Chapter 7 in Facial Plastic and Reconstructive Surgery, (Papel I.D., editor), Second Edition, Thieme, 2002, pp.73-78

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Updated: June 25, 2017

831-840 MCQ in Facial Plastic and Reconstructive Surgery

831-840

831) Which of the following Reconstruction Techniques represents the one used for the Ear Avulsion (with near total loss) shown below?

A. The Baudet
B. The Dieffenbach
C. The Tunnel Technique of Converse
D. The Davis
E. The Antia

832) Which of the following nasal features is the one characterizing a Pinocchio Tip Deformity?

A. Long nose
B. Supratip Deformity
C. Hanging Columella
D. Excesive nasal tip projection
E. Broad nasal tip

833) Which of the following Columellar Incisions is NOT used in Open Rhinoplasty?

A. V-shape incision
B. Inverted V-shape incision
C. Stair-step incision
D. Slightly curvilinear incision
E. Z-shape incision

834) Which of the following factors is the GREATEST contributor to skin necrosis after facelift surgery?

A. Smoking
B. Diabetes mellitus
C. Arteriosclerosis
D. Raynaud’s disease
E. Previous radiation therapy to the head and neck

835) Which of the following statements about toxicity in Chemical Face Peeling is FALSE?

A. Phenol toxicity will be enhanced by the presence of kidney or liver disease
B. Phenol is cardiotoxic, hepatotoxic and nephrotoxic.
C. Phenol absorption and toxicity is directly proportional to the total area of skin treated.
D. Phenol toxicity is directly proportional to the concentration of free phenol in the blood and tissues.
E. Phenol absorption and toxicity is directly proportional to the concentration of the solution.

836) Which of the following facial areas is MOST COMMONLY scarred after Chemical Peeling?

A. The forehead
B. The periorbital area
C. The nose
D. The cheek
E. The lip

837) Which of the following statements in the evaluation and management of patients for facial plastic surgery is FALSE?

A. If a patient expects perfection should not have surgery.
B. Every patient is not a good candidate for surgery.
C. Most faces are symmetrical.
D. The goals of a patient who seeks surgical aid should be realistic.
E. It is unethical for a plastic surgeon to guarantee the surgical results.

838) Post-rhinoplasty, when should the protective splint of the nose be removed?

A. 2 days
B. 4 days
C. 7 days
D. 12 days
E. 14 days

839) Which of the following IS NOT a characteristics of local facial flaps?

A. Similar color and texture
B. Good survival rate
C. Less contracture
D. Good in younger patients
E. Direct closure of secondary defects

840) Which of the following statements about superficial eyelid topography is FALSE?

A. Interpalpebral distance is 12 mm approximately.
B. Mean Reflex Distance 1 (MRD1) is the distance from the center of the pupil up to the inferior edge of the upper eyelid.
C. Mean Reflex Distance 2 (MRD2) is the distance from the center of the pupil down to the superior edge of the lower eyelid.
D. Eyelid ptosis will decreased the MRD1 measurement.
E. Ectropion of the lower lid will decreased the MRD2 measurement.


ANSWERS & REFERENCES


831) A     The Baudet

Baudet J, Tramond P, Goumain A. A propos d'un procede original de reimplantation pavillon de reille totalement separe [A new technic for the reimplantation of a completely severed auricle]. Ann Chir Plast. 1972;17:67–72.

Traumatic Total or Partial Ear Loss, Chapter 29 in Operative Plastic Surgery (Evans G. R.D., editor), 2000, pp. 308-313

Converse J. M.: Reconstructive of the Ear, Chapter 14 in Operative Plastic and Reconstructive Surgery, (Barron and Saad, editors), 1980, Vol. 1, pp.283-320

832) D     Excesive nasal tip projection

Peck G. C., Peck Jr., G.C.: Rhinoplasty: Classic Problems and Complications, Chapter 1, in Complications and Problems in Aesthetic Plastic Surgery, (Peck G. C., editor), 1992, pp. 1.2-1.21

833) E     Z-shape incision

Gruber R.: Rhinoplasty and Open Rhinoplasty, Chapter 2, in Complications and Problems in Aesthetic Plastic Surgery, (Peck G. C., editor), 1992, pp. 2.2-2.29

834) A     Smoking

Kaye B. L.: Facelift Surgery, Chapter 3, in Complications and Problems in Aesthetic Plastic Surgery, (Peck G. C., editor), 1992, pp. 3.2-3.15

Perkins S. W., Naderi S.: Rhytidectomy, Chapter 19 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 207-225

835) E     Phenol absorption and toxicity is directly proportional to the concentration of the solution.

Litton C., Szachowicz II E. H.: Chemical Face Peels, Chapter 7, in Complications and Problems in Aesthetic Plastic Surgery, (Peck G. C., editor), 1992, pp. 7.2-7.16

836) C     The nose

Litton C., Szachowicz II E. H.: Chemical Face Peels, Chapter 7, in Complications and Problems in Aesthetic Plastic Surgery, (Peck G. C., editor), 1992, pp. 7.2-7.16

837) C     Most faces are symmetrical.

McCollough E. G.: Effective Communication with the patient, Chapter 2 in Nasal Plastic Surgery, 1994, pp.17-29

838) C     7 days

Philosophy and Principles of Rhinoplasty, Chapter 40 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 507--528

http://emedicine.medscape.com/article/881443-treatment

839) D     Good in younger patients

Rousso D. E., Fedok F. G.: Nasal Reconstruction, chapter 22 in Nasal Plastic Surgery (McCollough E. G. , editor), 1994, pp. 321-343

840) E     Ectropion of the lower lid will decreased the MRD2 measurement.

Most S. P. , Mobley S. R., Larrabee Jr.: Anatomy of the Eyelids in Facial Plastic Surgery Clinics of North America, Blepharoplasty (Nassif P.S., editor), November 2005, Vol. 13, No. 4, pp.487-492

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Updated: June 25, 2017

841-850 MCQ in Facial Plastic and Reconstructive Surgery

841-850

841) A 7 year old child suffered a round traumatic skin avulsion which is localized at the tip of the nose (see drawing below).Which of the following reconstructive technique is the IDEAL in this particular case?

A. Second Intention
B. Post-auricular Full Thickness Skin Graft
C. Pre-auricular Split Thickness Skin Graft
D. Bilobe Flap
E. Romboid Flap

842) Which of the following anatomic statements about the anatomy of the eyelid is TRUE?

A. The Müller Muscle is innervated by the Third Cranial Nerve.
B. The Capsulopalpebral Fascia is a primary retractor of the Lower Eyelid.
C. The Levator Palpebrae Superioris is innervated by the Sympathetic Nervous System.
D. The arterial supply to the eyelid comes totally from branches of the External Carotid Artery.
E. The Inferior Oblique Muscle separates the Central and Lateral Fat Compartments of the Lower Eyelid.

843) Which of the following statements about Osteocutaneous Flaps is TRUE?

A. Fibular Flaps allow a maximal 20 cm. bone length availability.
B. Fibular Flaps require that an 10 cm segment of fibular bone be left superiorly and inferiorly.
C. Scapular Flaps allow a maximal 10 cm. bone length availability.
D. Iliac Crest Flaps allow a maximal 10 cm. bone length availability.
E. Radial Forearm Flaps allow a maximal 7 cm. bone length availability.

844) Which of the following statements about Microvascular Reconstruction is FALSE?

A. Vessels in the Vascular Pedicle are skeletonized, freeing the artery from the vein.
B. Vessels are transected and irrigated intermittently with dilute heparinized saline solution.
C. Vessels should be handled by the intima.
D. End-to-End Technique is the most commonly used is arterial anastomosis.
E. Anastomosis involves the use of Monofilament Suture (9-0, nylon).

845) Post Microvascular Arterial Anastomosis, when does failure MOST commonly occur?

A. 6 hours
B. 24 hours
C. 36 hours
D. 48 hours
E. 72 hours

846) Which of the following statements about the Radial Forearm Free Flap is FALSE?

A. It is a fascial flap.
B. It is a fasciocutaneous flap.
C. It can be harvested with a bone.
D. It can be harvested without a bone.
E. It does not carry sensory innervation.

847) Which of the following statements about the Radial Forearm Free Flap is TRUE?

A. It is a thick , non-pliable flap
B. It is based on the Posterior Radial Collateral Artery.
C. The Medial and Lateral Antebrachial Nerves can be incorporated into the flap.
D. The donor site can be closed primarily
E. An arm splint is not required.

848) Which of the following clinical applications for Microvascular Free-Tissue Flaps is INCORRECT?

A. Radial Forearm-Oral cavity Defects
B. Gracilis-Facial Reanimation
C. Latissimus Dorsi-Skull Base Reconstruction
D. Ileac Crest-Orbital Defect
E. Fibula-Mandibular Defects

849) Which of following statements about the Rectus Myocutaneous Free Flap is TRUE?

A. The Rectus Abdominal Muscle has a dual blood supply from the deep inferior and superior epigastric arteries.
B. The deep inferior and superior Epigastric Arteries are branches of the Internal Iliac Artery.
C. The Rectus Myocutaneous Free Flap is based in the Superior Epigastric Artery and Vein.
D. The Rectus Myocutaneous Free Flap should be designed below the Arcuate Line.
E. The Rectus Myocutaneous Free Flap has a low potential for abdominal wall hernia.

850) Which of the following statements about Microvascular Reconstruction is TRUE?

A. The vessels should be handled by the intima
B. The most common arterial anastomosis is End-to-Side.
C. Microvascular anastomosis involves the use of 9-0, interrupted or continuous stitches, with slow absorbing sutures.
D. The advantage of the Continuous Suture Technique is the lack of leakage at the anastomosis site.
E. The disadvantage of the Continuous Suture Technique is narrowing at the anastomosis of the vessel lumen.


ANSWERS & REFERENCES


841) B     Post-auricular Full Thickness Skin Graft

Rousso D. E., Fedok F. G.: Nasal Reconstruction, chapter 22 in Nasal Plastic Surgery (McCollough E. G. , editor), 1994, pp. 321-343

842) B     The Capsulopalpebral Fascia is a primary retractor of the Lower Eyelid.

Most S. P. , Mobley S. R., Larrabee Jr.: Anatomy of the Eyelids in Facial Plastic Surgery Clinics of North America, Blepharoplasty (Nassif P.S., editor), November 2005, Vol. 13, No. 4, pp.487-492


843) C     Scapular Flaps allow a maximal 10 cm. bone length availability.

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

844) C     Vessels should be handled by the intima.

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

845) B     24 hours

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

846) E     It does not carry sensory innervation.

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

847) C     The Medial and Lateral Antebrachial Nerves can be incorporated into the flap.

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

848) C     Latissimus Dorsi-Skull Base Reconstruction

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

849) A     The Rectus Abdominal Muscle has a dual blood supply from the deep inferior and superior epigastric arteries.

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

850) E     The disadvantage of the Continuous Suture Technique is narrowing at the anastomosis of the vessel lumen.

Burkey B. B., Coleman Jr, J.R.: Microvascular Flaps, Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Second Edition, 2002, pp. 567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J.R.: Microvascular Flaps, Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I. D. , editor), Third Edition, 2009, pp. 765-793

---------------------------------------
Updated: June 25, 2017

851-860 MCQ in Facial Plastic and Reconstructive Surgery

851-860

851) According to Female Esthetics, what is the ideal Pretarsal Eyelid/Eyebrow Ratio?. Refer to the drawing of the Female Eye below.


A. 2.5X
B. 3.0X
C. 3.5X
D. 4.0X
E. 4.5X

852) When does PEAK Wound Contraction occur?

A. 2 days
B. 5 days
C. 7 days
D. 14 days
E. 21 days

853) Which of the following cellular components in wound healing is responsible for the CONTRACTION PHASE?

A. Macrophages
B. Fibroblasts
C. Myofibroblasts
D. Endothelial cells
E. Lymphocytes

854) When in the healing process does a wound achieve the Tensile Strength of pre-injured tissue?

A. 1 month
B. 6 months
C. 1 year
D. 2 years
E. Never

855) Which of the following statements is the appropriate maximal timing to close primarily facial wounds?

A. 6 hours
B. 24 hours
C. 36 hours
D. 48 hours
E. 72 hours

856) Which of the following properties enables this condition, related to the skin: "the ability to retain the shape obtained by stretching when the deforming force is gone"?

A. Tensile strength
B. Elasticity
C. Plasticity
D. Memory
E. Reactivity

857) Which of the following statements about the Fibular Osteomyocutaneous Free Flap is FALSE?

A. The arterial supply is based on the Peroneal Artery.
B. The Skin Paddle is supplied by Septocutaneous Perforators from the Intermuscular Septum.
C. The sensory input to the flap is based on the Lateral Sural Cutaneous Nerve.
D. This flap offers the longest length of available revascularized bone (30 cm.)
E. The donor site can be closed primarily or with a skin graft

858) Which of the following flaps is the most USEFUL in Anterior Skull Base Reconstruction?

A. Rectus Myocutaneous
B. Radial Forearm
C. Lateral Arm
D. Lateral Thigh
E. Temporoparietal Fascia

859) Which of the following eyelid conditions is treated effectively using the Feldstein Suture Procedure?

A. Ptosis
B. Ectropion
C. Entropion
D. Laxity
E. Lagophthalmos

860) Which of the following adult percentages in burn assessment is INCORRECT?

A. Each arm constitutes 9% of the Total Body Surface Area.
B. Each leg constitutes 18% of the Total Body Surface Area.
C. The head and neck 18% of the total body surface area
D. The anterior portion of the trunk constitutes 18% of the Total Body Surface Area.
E. The posterior portion of the trunk constitutes 18% of the Total Body Surface Area.


ANSWERS & REFERENCES


851) C     3.5X

Gentile R. D.: Upper Lid Blepharoplasty in Facial Plastic Surgery Clinics of North America, Blepharoplasty (Nassif P.S., editor), November 2005, Vol.13, No. 4, 2005, pp.511-524

852) D     14 days

Maas C. S.: Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, 2001, pp. 4-13

Fisher E. , Frodel Jr. J. L.: Wound Healing, Chapter 2, in Facial Plastic and Reconstructive Surgery, Third Edition (Papel I. D., editor) 2009, pp. 15-25

853) C     Myofibroblasts

Fisher E. , Frodel Jr, J. L.: Wound Healing in Chapter 2 in Facial Plastic and Reconstructive Surgery (Papel I. D., editor), 2002, pp. 15-25

Fisher E. , Frodel Jr. J. L.: Wound Healing, Chapter 2, in Facial Plastic and Reconstructive Surgery, Third Edition (Papel I. D., editor) 2009, pp. 15-25

854) E     Never

Maas C. S.: Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, 2001, pp. 4-13

Fisher E. , Frodel Jr. J. L.: Wound Healing, Chapter 2, in Facial Plastic and Reconstructive Surgery, Third Edition (Papel I. D., editor) 2009, pp. 15-25

855) C     36 hours

Maas C. S.: Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, 2001, pp.16-24

856) C     Plasticity

Maas C. S.: Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, 2001, pp. 26-36

857) D     This flap offers the longest length of available revascularized bone (30 cm.)

Burkey B. B., Coleman Jr, J. R.:Microvascular Flaps in Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I.D. , editor), Second Edition, 2002, pp.567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J. R.:Microvascular Flaps in Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I.D. , editor), Third Edition, 2009, pp.765-793

Chepeha D. B. , Teknos T. N.:Microvascular Free Flaps in Head and Neck Reconstruction, Chapter 162 in Head & Neck Surgery-Otolaryngology, (Bailey, B.J., editor), 4th Edition, Lippincott Williams & Wilkins, 2006, pp. 2369-2391

858) A     Rectus Myocutaneous

Burkey B. B., Coleman Jr, J. R.:Microvascular Flaps in Chapter 47 in Facial Plastic and Reconstructive Surgery, (Papel I.D. , editor), 2002, pp.567-590

Burkey B. B., Schmalbach C. E., Coleman Jr, J. R.:Microvascular Flaps in Chapter 57 in Facial Plastic and Reconstructive Surgery, (Papel I.D. , editor), Third Edition, 2009, pp.765-793

859) C     Entropion

Eliasoph I.: Current Techniques of Entropion and Ectropion Correction, Otolaryngologic Clinics of North America, Advances in Oculo-facial Surgery (Bosniak S. L., editor), October 2005, Vol. 38, No. 5, pp.903-919

860) C     The head and neck 18% of the total body surface area

Kucan J. O.: Burns and Trauma, Chapter 12 in Plastic Surgery, A Core Curriculum (Ruberg R.L., Smith D. J., editors) 1994, pp. 207-237

http://emedicine.medscape.com/article/879183-overview

---------------------------------------
Updated: June 25, 2017

861-870 MCQ in Facial Plastic and Reconstructive Surgery

861-870

861) The drawing below represents a local flap used to close a circular defect located just below the mid lower eyelid margin. Which of the following statements regarding the flap is TRUE?

A. It is a Webster Flap.
B. It is an improper flap.
C. Most of the scars violate the direction of the RSTLs.
D. The vectors of tension are parallel to the eyelid margin.
E. Eyelid margin distortion is very unlikely.

862) Which of the following nonabsorbable sutures has the MOST tissue reaction?

A. Silk
B. Nylon
C. Polypropylene (Prolene)
D. Polyester (Mersilene)
E. Stainless steel

863) Which of the following microsurgical suture materials is the MOST commonly used?

A. Nylon with a taper curved needle
B. Nylon with a cutting curved needle
C. Nylon with a cutting reversed curved needle
D. Polypropylene (Prolene) with a taper curved needle
E. Polypropylene (Prolene) with a cutting reversed curved needle

864) Which of the following statements about the suture material PLAIN CATGUT is FALSE?

A. It is derived from the submucosal layer of sheep intestine.
B. It elicits a low inflammatory response.
C. It loses its tensile strength by 7 days.
D. It increases its tensile strength up to 14 days by treating the catgut with chromium salts (chromic gut).
E. It ideal for subcutaneous closure.

865) Which of the following complications is MOST commonly seen after using costal cartilage for nasal dorsal augmentation?

A. Infection
B. Extrusion
C. Warping
D. Displacement
E. Resorption

866) Which of the following techniques to repair Unilateral Cleft Lip involves Upper and Lower Lip Z-plasties?

A. Millard
B. Tennison-Randall
C. Rose-Thompson
D. Skoog
E. Le Mesurier

867) Which of the following statements about the topical antibacterial agent Sulfamylon (Mafenide) is FALSE?

A. It will penetrate the eschar
B. No hypersensitivity is known
C. It is painful at application.
D. It produces metabolic acidosis with a compensatory respiratory alkalosis.
E. It accentuates post-burn hyperventilation.

868) Which of the following characteristics of congenital melanocytic nevi is related to the risk of development of melanoma?

A. Color
B. Size
C. Shape
D. Border
E. Hairy

869) Which of following statements about Scalp Reconstruction is FALSE?

A. Skin grafting provides a suboptimal cosmetic result
B. Skin grafts will take in pericranium or drilled calvarial bone
C. Local flaps must be designed larger and longer than those in other areas
D. Local flaps will cause donor site very difficult to close
E. The local flaps used are rotation in design only due to the lack of elasticity.

870) Which is of the following anatomical sites is the BEST donor site for Split-Thickness Skin Grafts for the Upper Eyelids?

A. Preauricular
B. Postauricular
C. Supraclavicular
D. Inner aspect of the arm
E. Inner aspect of the thigh


ANSWERS & REFERENCES


861) B     It is an improper flap.

Pletcher S. D., Kim D. W.: Current Concepts in Cheek Reconstruction, Facial Plastic Surgery Clinics of North America, Local Cuteneous Flaps, (Park S.S., editor), May 2005, Vol.13, No. 2, pp. 267-281

862) A     Silk

Maas C. S.: Sutures and Needles, Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, pp.25-36

863) E     Polypropylene (Prolene) with a cutting reversed curved needle

Lineaweaver W.: Microsurgery, Chapter 3 in Plastic Surgery, A Core Curriculum (Ruberg R.L, Smith D. J., editors) , 1994, pp. 65-78

864) B     It elicits a low inflammatory response

Maas C. S.: Sutures and Needles, Wound Management and Suturing Manual, Facial Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, pp.25-36

865) C     Warping

Kim D. W., Toriumi D. M: Management of posttraumatic nasal deformities the crooked nose and the saddle nose, in Rhinoplasty Update, ( Perking S. W., editor), Facial Plastic Surgery Clinics of North America, February 2004, Vol. 12, No. 1, pp.111-132

Stal S., Spira M.: Cartilage Grafting in Current Therapy in Plastic and Reconstructive Surgery, Head and Neck, (Marsh J.L., editor), 1989, pp.63-70

866) D        Skoog                                                                                                                                            
Stark R. B., Tomljanovich P.I.: The Cleft Lip, Chapter 6 in Operative Plastic and Reconstructive Surgery (Barron J. N., & Saad M. N., editors), Churchill Livingstone, Volume 1, 1980, pp.149-173

http://emedicine.medscape.com/article/1279641-overview

867) B     No hypersensitivity is known

Kucan J. O.: Burns and Trauma, Chapter 12 in Plastic Surgery, A Core Curriculum, (Ruberg R.L. and Smith D.J., editors), 1994, pp.207-237

868) B     Size

Padgett J.K.: Cutaneous Lesions: Benign and Malignant, Local Cutaneous Flaps, (Park S. S., editor), Facial Plastic Surgery Clinics of North America, May 2005, Vol.13, No.2, pp.195-202

869) E     The local flaps used are rotation in design only due to the lack of elasticity.

Earnest L. M., Byrne P. J.: Scalp Reconstruction, Local Cutaneous Flaps, (Park S.S., editor), Facial Plastic Surgery Clinics of North America, May 2005, Vol. 13, No 2, pp.345-353

870) D     Inner aspect of the arm

Cassisi N. J.: Cervical Trauma, Chapter 27 in Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsbury III H. C., Goldsmith III M. M., editors), 1990, pp.497-504

---------------------------------------
Updated: June 25, 2017

871-880 MCQ in Facial Plastic and Reconstructive Surgery

871-880

871) Which of the following facial plating systems is the ONE represented in the drawing below?

A. DCP (Dynamic Compression Plate) System
B. EDCP (Eccentric Dynamic Compression Plate) System
C. Mandibular Reconstructive System
D. Lag Screw System
E. Emergency Screw System

872) Which of the following recommendations is the KEY to the PROPER management of human and animal penetrating wounds?

A. Copious irrigation
B. Debridement
C. Amoxicilin-clavulanate IV
D. Primary closure
E. Delayed primary closure

873) What is the minimal size of Congenital Hairy Nevus clinically significant for development of melanoma?

A. 5 cm
B. 10 cm
C. 15 cm
D. 20 cm
E. 25 cm

874) Which of the following statements about oral commisure electrical burns is FALSE?

A. The timing of management is controversial.
B. The controversy is related to immediate excision versus delayed excision.
C. Immediate excision and repair will produce excision of normal tissue.
D. Delayed excision and repair carries the risk of Labial Artery Bleeding.
E. 90% of cases will require late flaps for Commissure Reconstruction.

875) Which of the following statements about oral commisure electrical burns is FALSE?

A. The degree of tissue destruction is very difficult to determine in the initial period.
B. 2 weeks after the burn it is necessary to distinguish between vital and nonvital tissue.
C. Usually the amount of tissue destruction is less than expected at the initial evaluation.
D. The reconstruction stage can start 2-weeks postinjury.
E. The Acrylic Obturator with Commisure Splint is useful in preventing contracture.

876) Which of the following Cleft Lip Deformities is the one that can be successfully repaired by the MANCHESTER Technique?

A. Complete Unilateral Cleft Lip
B. Incomplete Unilateral Cleft Lip
C. Bilateral Cleft Lip
D. Bilateral Cleft of the soft and the hard palate
E. Cleft Nasal Deformities

877) Which of the following statement about the Sphincter Pharyngoplasty designed by Orticochea is FALSE?

A. Flaps are raised from the posterior tonsillar pillars.
B. Each flap contains a portion of the Palatopharyngeus muscle.
C. Patients who demonstrate poor velar elevation but good lateral wall motion are good candidates for Sphincter Pharyngoplasty.
D. The flaps are transposed medially and interdigitated on the posterior pharyngeal wall.
E. The flaps are not sutured to the posterior Pharyngeal Wall laterally.

878) Which of the following cranial nerves DOES NOT pass through the Superior Orbital Fissure?

A. III
B. IV
C. VI
D. V1
E. V2

879) Which of the following statements about the Arc of Rotation in the SCALP is TRUE?

A. The arc of rotation in the scalp should be 2 times the wound diameter
B. The arc of rotation in the scalp should be 3 times the wound diameter
C. The arc of rotation in the scalp should be 4 times the wound diameter
D. The arc of rotation in the scalp should be 5 times the wound diameter
E. The arc of rotation in the scalp should be 6 times the wound diameter

880) Which of the following is NOT characteristic of aging lips?

A. Blunting of the philtrum
B. Flattening of the white roll of the upper and lower lips
C. Lip projection is unchanged
D. Decreased vermillion show
E. Perioral rhytids


ANSWERS & REFERENCES


871) D     Lag Screw System

Schwimmer A.: Lag Screw Technique and Advanced Applications, Chapter 6 in Craniomaxillofacial Fractures, Principles of Internal Fixation Using the AO/ASIF Technique, (Creenberg A.M., editor), 1993, pp. 69-76

Costantino P. D., Tadros M., Wolpoe M.:Principles of Facial Plating Systems, Chapter 67 in Facial Plastic and Reconstructive Surgery, (Papel I.D. , editor), 2009, pp.929-944

872) A     Copious irrigation

Holt G. R.: Acute Soft Tissue Injuries of the Face, Chapter 54 in Facial Plastic and Reconstructive Surgery, Second Edition (Papel, Ira), 2002, pp. 689-696

Stallworth C. L., Holt G. R.: Acute Soft Tissue Injuries of the Face, Chapter 65 in Facial Plastic and Reconstructive Surgery, Second Edition (Papel, Ira), 2009, pp. 907-918

873) D     20 cm

Casuccio J. R.: Pediatric Issues in Facial Plastic and Reconstructive Surgery, Chapter 28 in Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsbury III H. C., Goldsmith III M. M., editors), 1990, pp.515-526

874) E     90% of cases will require late flaps for Commissure Reconstruction.

Cassisi N. J.: Cervical Trauma, Chapter 27 in Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsbury III H. C., Goldsmith III M. M., editors), 1990, pp.497-504

875) C     Usually the amount of tissue destruction is less than expected at the initial evaluation.

Cassisi N. J.: Cervical Trauma, Chapter 27 in Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsbury III H. C., Goldsmith III M. M., editors), 1990, pp.497-504

876) C     Bilateral Cleft Lip

Richards A. M.: Key Notes on Plastic Surgery, 2002, pp.93-106

http://emedicine.medscape.com/article/1279040-overview

877) C     Patients who demonstrate poor velar elevation but good lateral wall motion are good candidates for Sphincter Pharyngoplasty.

Richards A. M.: Key Notes on Plastic Surgery, 2002, pp.93-106

http://emedicine.medscape.com/article/1281032-overview

878) E     V2

Ricciardelli E., Persing J. A.: Anatomy/Physiology/Embryology, chapter 14 in Plastic Surgery, A Core Curriculum (Ruberg R. L., and Smith D. J., editors), 1994, p.252

879) E     The arc of rotation in the scalp should be 6 times the wound diameter

Park S. S.: Local and Regional Cutaneous Flaps, Chapter 44, in Facial Plastic and Reconstructive Surgery, Second Edition (Papel I. D., editor) 2002, pp. 528-548

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

880) C     Lip projection is unchanged

Maloney B. P.: Aesthetic Surgery of the Lip, Chapter 29 in Facial Plastic and Reconstructive Surgery, Second Edition, (Papel I. D., editor), 2002, pp.344-352

Maloney B. P.: Aesthetic Surgery of the Lip, Chapter 36 in Facial Plastic and Reconstructive Surgery, Third Edition, (Papel I. D., editor), 2009, pp.459-468

---------------------------------------
Updated: June 25, 2017

881-890 MCQ in Facial Plastic and Reconstructive Surgery

881-890

881) Which of the following statements about the Musculocutaneous Flap Technique shown below is TRUE?

A. Its blood supply is based on the transverse cervical and dorsal scapular arteries.
B. It is the most reliable of the three flap designs.
C. Its blood supply can be compromised by a previous neck dissection.
D. It is usually designed as an island musculocutenous Flap.
E. It is always closed primarily, but will require wide undermining.

882) In a preoperative computer analysis a patient has a LEGAN angle of 20 degrees. Which of the following statements is TRUE?

A. There is poor Nasal Tip Projection
B. There is adequate Nasal Tip Projection
C. There is poor Chin Projection
D. There is adequate Chin Projection
E. There is poor Nasal Tip Rotation

883) Which of the following hair colors is the LEAST suited for hair transplantation procedures in patients with light skin and straight hair?

A. Blonde
B. Red
C. Gray
D. Salt-and-pepper
E. Dark brown

884) Which of the following complications is the one created by combining large excisions of Lateral Crura with Vertical Dome Divisions (Goldman Technique)?

A. Tent-Pole Appearance
B. Nasal Valve Collapse
C. Alar Retraction
D. Bossa Deformity
E. Tip Ptosis

885) Which of the following statements about Frontal Sinus Fracture is FALSE?

A. Extreme force is required to fracture the Anterior Table of the Frontal Sinus.
B. Associated serious injuries are common in 2/3 of the patients.
C. Isolated fracture of the Anterior Table occurs in 1/3 of the patients.
D. Combined fractures involving Anterior Table , Posterior Table and Nasofrontal Recess occur in 2/3 of patients
E. Follow up is limited to 1 year.

886) Which of the following is NOT a "red flag" when evaluating patients for cosmetic plastic surgery?

A. Overconcern with a minor deformity
B. Inability to describe problem
C. Disapproving family
D. Female rhinoplasty patient
E. Surgiholic patients

887) Which of the following statements about lidocaine (Xylocaine) as used in local anesthesia is TRUE?

A. It is an amine local anesthetic.
B. It produces local anesthesia by selectively blocking the sodium ions of the axon.
C. It is totally metabolized by the liver.
D. Its plasma half-life is 1.5 hours.
E. Its recommended total dosage in an adult is 500 mg without Epinephrine.

888) Which of the following statements is TRUE regarding the execution of the Rotation-Advancement Flap Technique for the repair of a Cleft Lip?

A. The A flap is the Advancement Flap
B. The B flap is the Rotation Flap
C. The c flap is the Columellar Flap, noncleft side
D. The D flap is the Simonart’s band
E. The m flap is the Lateral Mucosal Flap

889) What percentage of Asian Eyelids have an Epicanthal fold?

A. 5 %
B. 25%
C. 50%
D. 75%
E. 90%

890) For which of the following nasal deformities is the TONGUE-IN-GROOVE Technique indicated?

A. Alar Flare
B. Nasal Valve Collapse
C. Hanging Ala
D. Hanging Columella
E. Retracted Ala


ANSWERS & REFERENCES


881) B     It is the most reliable of three flap designs.

Annino Jr. D. J. , Shu R. S.: Musculocutaneous Flaps, Chapter 46 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, 2002, p. 560-566

Annino Jr. D. J. , Shu R. S. Gold D. R.: Musculocutaneous Flaps, Chapter 56 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, 2009, p. 757-764

882) C     There is poor Chin Projection

Papel I.D: Computer Imaging for Facial Plastic Surgery, Chapter 10 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, 2002, p. 110-124

Papel I.D: Computer Imaging for Facial Plastic Surgery, Chapter 12 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, 2009, p. 135-141

883) E     Dark brown

Stough D. , Whitworth J.M.: Hair Replacement Techniques, Chapter 26, Facial Plastic and Reconstructive Surgery), Second edition, (Papel I.D., editor), 2002, pp.299-308

Rousso D. E., Sule S. Stough D., , Whitworth J.M.: Hair Replacement Techniques, Chapter 33, Facial Plastic and Reconstructive Surgery), Third edition, (Papel I.D., editor), 2009, pp.
409-420

884) A     Tent-Pole Appearance

Simons R.L., Rhee J.S.: Surgery of the Nasal Tip: Vertical Dome Division, chapter 37 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Second Edition, pp. 429-438, 2002

Simons R.L., Rhee J.S.: Surgery of the Nasal Tip: Vertical Dome Division, chapter 45 in Facial Plastic and Reconstructive Surgery (Papel, editor), Thieme, Third Edition, pp. 577-587 , 2009

885) E     Follow up is limited to 1 year.

Strong E. B., Sykes J. M.: Frontal Sinus and Nasoorbitoethmoid Complex Fractures, Chapter 59 in Facial Plastic and Reconstructive Surgery, Second Edition, 2002, pp. 747-758

Strong E. B., Sykes J. M.: Frontal Sinus and Nasoorbitoethmoid Complex Fractures, Chapter 69 in Facial Plastic and Reconstructive Surgery, Second Edition, 2009, pp. 965-990

886) D     Female rhinoplasty patient

Foster C. A.: A Plastic Surgeon's Perspective, Chapter 2 in Aesthetic Facial Plastic Surgery, A Multidisciplinary Approach (Romo III,T., Millman A.L., editors), 2000, pp.17-26

887) B     It produces local anesthesia by selectively blocking the sodium ions of the axon.

Norfleet E. A.: Toxic Effects of Anesthetic, Chapter 45 in Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsbury III H. C. and Goldsmith III M.M, editors), 1990, pp. 832-842

Fletcher M. V.: Anesthesia in Facial Plastic Surgery, Chapter 17, in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Third Edition, 2009, pp.189-197

888) C     The c flap is the Columellar Flap, noncleft side

Sykes J. M., Tollefson T.T.: Management of the cleft lip deformity, Facial Plastic Surgery Clinics of North America, (Regan Thomas J.,editor), Seminal Review Issue, February 2005, Vol.13, No. 1, pp.157-167

Capone R. B., Sykes J. M.: Evaluation and Management of Cleft Lip and Palate Disorders, Chapter 76, in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Third Edition, 2009, pp.1059-1078

889) E     90%

McCurdy Jr., J. A.: Upper blepharoplaty in the Asian patient: the “double eyelid” operation, Facial Plastic Surgery Clinics of North America, Seminal Review Issue, (Regan Thomas, J., editor), February 2005, Vol. 13, No. 1, pp.47-64

McCurdy Jr. J. A.: Cosmetic Surgery of the Asian Face, Chapter 35, in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Third Edition, 2009, pp.435-458

890) D     Hanging Columella

Skridel R. W. H., Chiu R. J.: The Management of Alar Columellar Disproportion in Revision Rhinoplasty, Facial Plastic Surgery Clinics of North America, Vol. 14, N0. 4., November 2006, pp. 313-329

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Updated: July 25, 2017

891-900 MCQ in Facial Plastic and Reconstructive Surgery

891-900
891) Which ot the following statements about the local flap designed below is FALSE?

A. It is based on the principles of the Limberg Flap
B. It will allow designs in 2 different ways.
C. It will close large circular defects.
D. It is ideal for closing scalp vertex defects.
E. Its main disadvantage is "Trap-Door" Contracture.

892) Which one of the following complications related to the Deep-Plane Rhytidectomy has been found in higher frequency than that found with more superficial Rhytidectomy?

A. Hematoma
B. Infection
C. Skin necrosis
D. Facial nerve injury
E. Alopecia

893) Which of the following statements about unstable, potentially violent patients is TRUE?

A. They occupy approximately 20% of the patient base.
B. Men are less prone to instability than women.
C. Older patients have greater frequency of abnormal behavior than younger patients.
D. Use and abuse of alcohol is related to unstable and violent behavior.
E. Rhinoplasty patients are at greater risk than facial scar patients for unstable or violent acts.

894) Which of the following is NOT a facial characteristic typical of a 70-year-old man?

A. Drooping, elongated nasal tip complex
B. Dorsal nasal hump
C. Skin and subcutaneous tissues thickened
D. Stretching and migration downward of the lateral cruras
E. Facial proportions (three equal third) unchanged

895) Which of the following features is NOT characteristic of a problematic rhinoplastic patient?

A. Married
B. Immature
C. Male
D. Overly expectant
E. Narcissistic

896) Which of the following facial analysis is related to a female rather than a male patient?

A. Wider, straighter and less concave dorsal aesthetic lines
B. Dorsum 2 mm behind a line drawn from the radix to the tip-defining points
C. No supratip break
D. Decreased Tip Rotation
E. Chin tangential to a plumb line from the vermilion of the upper lip

897) Which of the following congenital syndromes is an inherited multisystemic disorder that includes multiple Basal Cell Carcinomas, palmar and plantar pitting, calcification of the dura, jaw cysts and skeletal abnormalities?

A. Xeroderma Pigmentosum
B. Epidermolysplasia Verruciformis
C. Nevoid Basal Cell Carcinoma Syndrome
D. Muir-Tore Syndrome
E. Rombo Syndrome

898) Which of the following complications is the MOST COMMON after Epicanthoplasty in the Asian patient?

A. Keloid Formation
B. Hypertrophic Scar
C. Skin Necrosis
D. Asymmetry
E. Infection

899) Which of the following synthetic implants has micropores of 30 μm, allows tissue ingrowth, is biocompatible, is soft/pliable, is sculptable, has poor structural support and generally is used for onlay augmentation of the Nasal Dorsum.?

A. Medpor
B. Silastic
C. Mersilene
D. Gore-tex
E. Supramid

900) Which of the following doses is the total recommended dosage of lidocaine without epinephrine in an adult patient?

A. 300 mg
B. 400 mg
C. 500 mg
D. 600 mg
E. 700 mg


ANSWERS & REFERENCES


891) E     Its main disadvantage is "Trap-Door" Contracture.

Bailey B.J., Calhoun K.H., Coffey A.R., Neely J.G.: Atlas of Head & Neck Surgery-Otolaryngology, Lippinctoot-Raven, First Edition, pp. 628-629

892) D     Facial nerve injury

Kridel R. W. H., Covello L. V.: The Aging face (Rhytidectomy), Chapter 180 in Head and Neck Surgery- Otolaryngology, (Bailey B.J., editor), Third Edition, 2001, Lippincott Williams & Wilkins, pp.2317-2338

Kridel R. W. H., Soliemanzadeh P..: The Aging Face (Rhytidectomy), Chapter 177, in Head and Neck Surgery- Otolaryngology, (Bailey B.J., editor), Fourth Edition, 2006, Lippincott Williams & Wilkins, pp. 2627-2650

893) E     Rhinoplasty patients are at greater risk than facial scar patients for unstable or violent acts.

Powell D., Hobgood T.: Detection and Management of the unstable patient, Facial Plastic Surgery Clinics of North America, (Regan Thomas J.,editor), Seminal Review Issue, February 2005, Vol.13, No. 1, pp.169-180

894) E    Facial proportions (three equal third) unchanged

Rohrich R. J., Hollier L. H.: Rhinoplasty with Advancing Age, Characteristcs and Management, Rhinoplasty, Current Concepts, (Guyuron B, editor), Clinics in Plastic Surgery, April 1996, Vol. 23, No. 2, pp. 281-296

895) A     Married

Rohrich R.J., Janis J.E., Kenkel J. M.: Male Rhinoplasty, Plastic and Reconstructive Surgery, Sept. 2003, Vol.112, no. 4, pp.1071-1885

896) B     Dorsum 2 mm behind a line drawn from the radix to the tip-defining points

Rohrich R.J., Janis J.E., Kenkel J. M.: Male Rhinoplasty, Plastic and Reconstructive Surgery, Sept. 2003, Vol.112, no. 4, pp.1071-1885

897) C     Nevoid Basal Cell Carcinoma Syndrome

Gherardini G., Bhatia N., Stal S.: Congenital Syndromes Associated with Nonmelanoma Skin Cancer, Nonmelanoma Skin Cancer, Clinics in Plastic Surgery, (Schusterman M.A, editor), Clinics in Plastic Surgery, October 1997, Vol. 24, No. 4, pp. 649-661

898) B     Hypertrophic Scar

McCurdy Jr. J.A.: Upper Blepharoplasty in the Asian patient: the “double eyelid” Operation, Facial Plastic Surgery Clinics of North America, (Regan Thomas J.,editor), Seminal Review Issue, February 2005, Vol.13, No. 1, pp 47-64

899) D     Gore-tex

Romo III T., KwaK E. S.: Nasal Grafts and Implants in Revision Rhinoplasty, in Facial Plastic Surgery Clinics of Noth America, Vol. 14, N0. 4., November 2006, pp. 373-387

900) A     300 mg

Norfleet E. A.: Toxic Effects of Anesthetic, Chapter 45 in Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsbury III H. C. and Goldsmith III M.M, editors), 1990, pp. 832-842

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Updated: July 25, 2017