1251-1260 MCQ in Facial Plastic and Reconstructive Surgery

1251-1260

1251) Which of the following percentage of the hair cycle is in the ANAGEN phase?

A. 10%
B. 30%
C. 50%
D. 70%
E. 90%

1252) Which of the following statements regarding hair patho-physiology is FALSE?

A. The hair cycle has three phases:  anagen, catagen and  telogen
B. Approximately 5% of the hair follicles are in the catagen phase
C. Scalp hair grows approximately 1 mm every 3 days. 
C. Most of the hair loss conditions are due to the hereditary male pattern baldness
D. The follicular unit transplantation is the gold standard in surgical hair transplantation

1253) Which of the following is NOT a typical characteristic of the Asian Nose, considering a rhinoplasty?

A. Planning: augmentation rhinoplasty
B. Tip: bulbous, poor defined, underprojected
C. Ala: flared with a short columella
D. Skin: Thin
E. Nasal septum: small anterior nasal spine

1254) Which of the following statements regarding Hair Restoration is FALSE?

A. Hair loss although progressive is always predictable at any age.
B. Hair color that matches the skin color has an advantage.
C. Do not make the hairline too low (higher better than lower).
D. The frontal temporal angle lies on the lateral epicanthal line as hair loss progresses.
E. The frontal hairline consists of micro-irregularity and macro-irregularity.

1255) Which of the following scalp zones is ideal for scalp reduction?

A. Crown
B. Mid-scalp
C. Anterior-scalp
D. Occipital scalp
E. Temporal scalp

1256) What is the proper classification of the cleft palate presented? (See drawing below)

A. Bilateral complete cleft of the secondary palate.
B. Bilateral complete cleft of the primary and secondary palate
C. Bilateral incomplete cleft of the primary palate
D. Bilateral incomplete cleft of the secondary palate
E. Bilateral complete cleft of the primary and incomplete secondary palate

1257) Which of the following statements is considered the most common drawback in the use of a single-stage melolabial flap for nasal alar reconstruction?

A. Trap-door deformity
B. Alar retraction
C. Necrosis
C. Dehiscence
D. Stenosis

1258) Which of the following cutaneous lasers is the BEST in the removal of GREEN tattoo pigments?

A. Q-switched Ruby (694 nm) Laser.
B. Alexandrite (755 nm) Laser
C. Nd:YAG (1064 nm) Laser.
D. Pulse dye (585-595 nm) Laser
E. Ruby laser

1259) Which of the following alopecia areas is ideal for the use of scalp flaps?

A. Crown
B. Frontal
C. Mid-Scalp
C. Occipital scalp
D. Temporal scalp

1260) What is the percentage of hair loss necessary before alopecia becomes noticeable?

A. 20%
B  30%
C. 50%
D. 60%
E. 70%

ANSWERS & REFERENCES

1251) E     90%

Ende K. H., Kabaker S.S.: Hair Restoration: Medical and Surgical Techniques, chapter 26 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, 2010, pp. 371-389


1252) B     Approximately 5% of the hair follicles are in the catagen phase

Ende K. H., Kabaker S.S.: Hair Restoration: Medical and Surgical Techniques, chapter 26 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, 2010, pp. 371-389


1253) C     Skin: Thin

Park S. S., Jin H.: Noncaucasian Rhinoplasty, chapter 38 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, 2010, pp. 568-579


1254) A     Hair loss although progressive is always predictable at any age.

Shapiro R., Shapiro P.: Hairline Design and Frontal Hairline Restoration, Facial Plastic Surgery Clinics of North America, Hair Restoration (Konior and Gabel, editors), August 2013, Vol. 21, No. 3, pp. 351-362

1255) A     Crown

Devroye J.: Management of the Crown, , Facial Plastic Surgery Clinics of North America, Hair Restoration (Konior and Gabel, editors), August 2013, Vol. 21, No. 3, pp. 397-406

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

1256) B    Bilateral complete cleft of the primary and secondary palate

Smith H.W.: Comprehensive Surgical Atlases in Otolaryngology-Head and Neck Surgery, the Atlas of Cleft lip and Cleft palate surgery (K.J. Lee, editor-in-chief), 1983, pp. 131-142

1257) A     Trap-door deformity

Eskiizmir G. , Baker S., Cingi C.: Nonmelanoma Skin Cancer of the Head and Neck, (Thomas J. R, editor), Facial Plastic Surgery Clinics of North America, Nov. 2012, Vol. 20, No. 4,  pp. 493-513

1258) A     Q-switched Ruby (694 nm) Laser

Fedok F. G., Carritano F., Portela A.: Cutaneous Lasers (Thomas J. R, editor), Facial Plastic Surgery Clinics of North America, Feb. 2013, Vol. 21, No. 1,  pp. 95-110

1259) B     Frontal

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

1260) C     50%

Ende K. H., Kabaker S.S.: Hair Restoration: Medical and Surgical Techniques, chapter 26 in Cummings Otolaryngology-Head and Neck Surgery, Fifth Edition, Volume one, 2010, pp. -371-389


-----------------------------------------
Updated: August 5, 2017

1241-1250 MCQ in Facial Plastic and Reconstructive Surgery

1241-1250

1241) The treatment of CHOICE of dermatofibrosarcoma protuberans of the head and neck is?

A. Surgery
B. Curettage
C. Radiation therapy
D. Chemotherapy
E. Chemo-radiation therapy

1242) Which of the following skin neoplasms is associated with the Laser-Trelat sign?

A. Seborrheic keratosis
B. Syringoma
C. Pilomatricoma
D. Sebaceous adenoma
E. Neurofibroma

1243) Which of the following laser is the BEST for treatment of port-wine stain vascular malformations?

A. CO2
B. KTP
C. PDL
D. Nd:YAG
E. Er:YAG

1244) Microdermabrasion is intended to remove which of the following?

A. Stratum basale of the epidermis
B. Stratum spinosum of the epidermis
C. Stratum granulosum of the epidermis
D. Stratum lucidum of the epidermis
E. Stratum corneum of the epidermis

1245) Which of the following lasers is THE BEST or the removal of GREEN tattoo pigments?

A. CO2
B. Nd:YAG
C. Q-switched ruby.
D. Pulse dye laser
E. KTP

1246) Which of the following surgical techniques is the one represented in the drawing and used in the repair of a bilateral cleft lip? (See drawing below)

A. Tennison flap technique
B. Millard flap technique.
C. Manchester technique
D. Bilateral lip adhesion
E. Skoog technique

1247) Which of the following brow lift techniques is performed in the subcutaneous plane?

A. Coronal
B. Petrichial
C. Midforehead
D. Lateral Endoscopic forehead approach
E. Medial Endoscopic forehead approach

1248) Which of the following statements is FALSE with respect to the management of bilateral cleft lip repair?

A. The primary lip repair is performed when the patient is 3 months old.
B. In asymmetric clefts, the side to be closed first is the most narrow.
C. In symmetrical clefts, it makes no difference which side is closed first.
D. Growth of the prolabium can be stimulated by circular massage and gentle pressure.
E. In the two-stage lip closure, the second operation is performed 7 weeks after the first.

1249) Which of the following lasers is the one used in the treatment of rhinophyma?

A. Alexandrite
B. CO2
C. Erbium
D. Ruby
E. KTP

1250) The FDA has approved Radio Frequency in the treatment of which of the following?

A. Telangiectasias
B. Acne
C  Dyschromias
D. Rhytids
E. Hypertrophic scars

ANSWERS & REFERENCES

1241) A     Surgery

Reinstadler D. R.,  Sinha U. K.: Uncommon Cutaneous Neoplasm of the Head and Neck, Nonmelanoma Skin Cancer of the Head and Neck, Surgical treatment, Facial Plastic Surgery Clinics of North America; Nonmelanoma Skin Cancer of the Head and Neck (Gingi C, Regan Thomas J., editors), Nov. 2012, pp. 483-491

1242) A     Seborrheic keratosis

Reinstadler D. R.,  Sinha U. K.: Uncommon Cutaneous Neoplasm of the Head and Neck, Nonmelanoma Skin Cancer of the Head and Neck, Surgical treatment, Facial Plastic Surgery Clinics of North America; Nonmelanoma Skin Cancer of the Head and Neck (Gingi C, Regan Thomas J., editors), Nov. 2012, pp. 483-491

1243) C     PDL

Ingraffea A.: Benign Skin Neoplasms, Facial Skin: Contemporary Topics for the Surgeon, (Thomas J. R, editor), Facial Plastic Surgery Clinics of North America, Feb. 2013, Vol. 21, No. 1, pp. 21-32

1244) E     Stratum corneum of the epidermis

Visscher M. O., Pan B. S., Kitzmiller W. J.: Photodamage Treatments and Topicals for Facial Skin, Facial Skin: Contemporary Topics for the Surgeon, (Thomas J. R, editor), Facial Plastic Surgery Clinics of North America, Feb. 2013, Vol. 21, No. 1, pp. 61-75

1245) C     Q-switched ruby

Fedok F. G., Garritano F., Portela A.: Cutaneous Laser, Facial Skin: Contemporary Topics for the Surgeon, (Thomas J. R, editor), Facial Plastic Surgery Clinics of North America, Feb. 2013, Vol. 21, No. 1, pp. 95-110

1246) C     Manchester technique

Bardach J., Salyer K., Noordhoff M. S.: Bilateral Cleft Lip Repair, Chapter 4 in Surgical Techniques in Cleft Lip and Palate, (Bardach, Salyer, editors), Second Edition, Mosby Year Book, 1991, pp. 113-172

1247) C     Midforehead

Javidnia H., Sykes J.: Endoscopic Brow Lifts. Have they replaced Coronal Lifts, Minimally Invasive Procedures in Facial Plastic Surgery, (Thomas J. R, editor), Facial Plastic Surgery Clinics of North America, May. 2013, Vol. 21, No. 2, pp. 191-199

1248) B     In asymmetric clefts, the side to be closed first is the most narrow.

Bardach J., Salyer K., Noordhoff M. S.: Bilateral Cleft Lip Repair, Chapter 4 in Surgical Techniques in Cleft Lip and Palate, (Bardach, Salyer, editors), Second Edition, Mosby Year Book, 1991, pp.
113-172

1249) B     CO2

Ries W. R. , Wittkopf M.: Lasers in Facial Plastic Surgery, Chapter 10 in Facial Plastic and Reconstructive Surgery, (Papel. I, editor), Thieme, Third edition, 2009, pp. 99-118

1250) D     Rhytids

Koch R. J.: Nonablative Facial Skin Rejuvenation, Chapter 27 in Facial Plastic and Reconstructive Surgery, (Papel. I, editor), Thieme, Third edition, 2009, pp. 331-336

---------------------------------------
Updated: June 15, 2017

1231-1240 MCQ in Facial Plastic and Reconstructive Surgery

1231-1240

1231) Which of the following statements regarding CYANOACRYLATE tissue adhesives is FALSE?

A. Cyanoacrylate tissue adhesives are solely recommended for superficial skin closure.

B. Cyanoacrylate tissue adhesives are contraindicated in children.

C. Cyanoacrylate tissue adhesive most commonly used is the Octyl-2-Cyanoacrylate.

D. Cyanoacrylate tissue adhesives can be used in wound/incision closure for blepharoplasty and facelift.

E. Cyanoacrylate tissue adhesives breakdown products can produce a histotoxic reaction.

1232) Which of the following tissue adhesives is commonly used primarily for VASCULAR ANASTOMOSIS?

A. Tisseel

B. BioGlue

C. Bytyl-cyanocrylate

D. 2-Octyl cyanoacrylate

E. Platelet-rich plasma compounds

1233) Which of the following tissue adhesives is the ONE used for superficial tissue closure?

A. Tisseel

B. BioGlue

C. Bytyl-cyanocrylate

D. 2-Octyl cyanoacrylate

E. Platelet-rich plasma compounds

1234) Which of the following is the MOST common complication of suction-assisted lipectomy in the Head and Neck?

A. Hematoma

B. Infection

C. Skin irregularities

D. Seroma

E. Nerve paresia

1235) Which of the following statements regarding Suction-assisted Lipectomy in the head and neck is FALSE?

A. The patient should be marked in the sitting position.

B. Local anesthesia with IV sedation is ideal in this surgical procedure

C. Lipectomy in the lower aspect of the neck is done utilizing an incision behind the ear lobule.

D. Lipectomy dissection should be done deep to the platysma muscle.

E. The surgeon should never turn the opening of the cannula toward the skin.

1236) Which of the following statement regarding the mandibular plating system presented below is FALSE? (See drawing below)

A. This plate is  a Eccentric Dynamic Compression plate system (EDCP).

B. This plate will require bicortical fixation.

C. This plate will require that four screws be used on each side of the injury.

D. This plate is indicated in mandibular fractures related to shotgun wounds.

E. This plate is used also in atrophic mandibles.

1237) Which of the following statements regarding Suction-assisted Liposuction  in the face and neck is FALSE?

A. Good elasticity in the skin  is ideal for the efficacy of liposuction

B. Lack of wrinkled skin will improve the outcome of liposuction

C. Platysmal banding can be significant improved by neck liposuction

D. Dimpling, depressions or scarring will not improved by liposuction.

E. A high, posteriorly placed hyoid bone will produce a more favorable cosmetic result.

1238) What is the approximately recommended  NEGATIVE pressure necessary for the proper execution of neck and face liposuction?

A. 1 atm of negative pressure

B. 2 atm of negative pressure

C. 3 atm of negative pressure

D. 4 atm of negative pressure

E. 5 atm of negative pressure.

1239)Which of the following statements regarding Eccentric Dynamic Compression Plates (EDCP) is FALSE?

A. Eccentric Dynamic Compression Plates  (EDCP) contain two sets of dynamic drill holes.

B. Eccentric Dynamic Compression Plates  (EDCP)  have outside screws holes with incline ramps set obliquely at 45-90 degrees to the long axis of the plate.

C. The outer set of screw holes glides superiorly to produce compression at the level of the alveolus.

D. The inner set of screw holes glides toward the fracture, providing compression at the inferior mandibular border.

E. Eccentric Dynamic Compression Plates  (EDCP) need additional hardware to insure compression at the alveolus.

1240) What is the following statements IS related to a "Vertical Post Deformity"?

A. An overly corrected superior antihelix

B. An overly corrected inferior antihelix

C  An overly corrected concha cavum

D. An overly corrected concha cymba

E. An overly corrected lobule

ANSWERS & REFERENCES

1231) B     Cyanoacrylate tissue adhesives are contraindicated in children.

Egan K.K., Kim D. W., Toriumi D. M.: Tissue Adhesives, chapter 9 in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp.91-97

1232) B     BioGlue

Egan K.K., Kim D. W., Toriumi D. M.: Tissue Adhesives, chapter 9 in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp.91-97

1233) D     2-Octyl cyanoacrylate

Egan K.K., Kim D. W., Toriumi D. M.: Tissue Adhesives, chapter 9 in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp.91-97

1234) C     Skin irregularities

Colton J. J.: Suction-Assisteed Lipectomy in the Head and Neck, chapter 17 in Instructional Courses, (Johnson, Blitzer, Ossoff, Regan Thomas, editors), Vol, 2, 1989, pp.207-222

1235) D     Lipectomy dissection should be done deep to the platysma muscle.

Colton J. J.: Suction-Assisteed Lipectomy in the Head and Neck, chapter 17 in Instructional Courses, (Johnson, Blitzer, Ossoff, Regan Thomas, editors), Vol, 2, 1989, pp.207-222

1236) A      This plate is  a Eccentric Dynamic Compression plate system (EDCP).

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

1237) C     Platysmal banding can be significant improved by neck liposuction

Kridel R. W. H., Kelly P. E., Castellano R. D; Liposuction of the Face and Neck, chapter 24 Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp.286-300

1238) A     1 atm of negative pressure

Kridel R. W. H., Kelly P. E., Castellano R. D; Liposuction of the Face and Neck, chapter 24 Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp.286-300

 http://emedicine.medscape.com/article/842367-treatment#a1133

Newman J., Nambiar M.: Cervicofacial Liposuction, Operative Challenges in Otolaryngology-Head and Neck Surgery, (Pillsburry III H. C., Goldsmith III M.M., editors), Year Book Medical Publishers, Inc. 1990, 604- 629

1239) E     Eccentric Dynamic Compression Plates  (EDCP) need additional hardware to insure compression at the alveolus.

Clark W. D.: Stabilization and Fixation of the Mandible, chapter 4 in Surgery of the Mandibule (Bailey B. J., Holt G. R., editors), Thieme,pp. 25-37

1240) A     An overly corrected superior antihelix

Otoplasty in  Renewal of Certification Study Guide in Otolaryngology-Head and Neck Surgery (Gluckman J. L., editor), American Academy of Otolaryngology-Head and Neck Surgery Foundation, 1998, pp. 679-683

-----------------------------------------
Updated: August 5, 2017

1221-1230 MCQ in Facial Plastic and Reconstructive Surgery

1221-1230

1221) The Furlow double-opposing Z-plasty technique used to repair a cleft of the soft palate will have the following advantage

A. Less incidence of palatal fistula
B. Less incidence of bleeding
C. Less incidence of airway compromise
D. Less incidence of velopalatal insufficiency
E. Less technical difficulties, easy to perform

1222) Which of the following statements regarding CO2 laser resurfacing is FALSE?

A. Topical anesthetic is adequate for a facial CO2 laser resurfacing.
B. Prophylactic  antivirals medications for all patients undergoing C02 laser resurfacing are mandatory.
C. The use of prophylactic antibiotics in C02 laser resurfacing in not universally used.
D. A typical "yellow chamois" is seen when the laser enters the reticular dermis.
E. Viral and bacterial infections are heralded by intense postoperative pain.

1223) The proper design of an Scalp Rotation Flap WILL REQUIRE

A. An arc 2 times the diameter of the defect
B. An arc 3 times the diameter of the defect
C. An arc 4 times the diameter of the defect
D. An arc 5 times the diameter of the defect
E. An arc 6 times the diameter of the defect

1224) Which of the following laser is considered an ABLATIVE facial laser?

A. Er:YAG laser
B. 532 nm laser
C. 1320 nm Nd:YAG laser
D. 1450 nm Diode laser
E. Fraxel laser

1225) Which of the following statements is TRUE regarding Sculptra?

A. It is an injectable form dimethylpolysiloxane.
B. It is immunologically active.
C. Skin testing is necessary prior to treatment.
D. It is approved  for treatment of facial lipo-atrophy associated with HIV disease.
E. One injection is usually necessary for significant improvement

1226) Which of the following statements regarding the "STAIRCASE" method presented below used for lip reconstruction is FALSE?

A. It is used for defects up to two-thirds of the lower lip.
B. This flap can be used only unilaterally - not bilaterally - or in combination with other flaps.
C. Each horizontal "step" used in the reconstruction measures half the defect.
D. The orbicularis muscle fibres are not altered and the lip innervation is preserved.
E. This technique is based on the advancement principle of local soft tissue.

1227) Which of the following statements regarding tissue expansion devices is FALSE?

A. The standard tissue expander is composed of a silastic reservoir, and injection port and connecting tubing.
B. The rectangular shape device will achieve the least gain in surface area.
C. The size of the expander base should be 2.5-3 times the size of the defect to be closed.
D. The donor site should be an area adjacent to the defect with tissue similar to that being replaced.
E. Tissue expander will stimulate proliferation of blood vessels in the expanded area.

1228) Which of the following statements regarding tissue adhesives is TRUE?

A. Cyanoacrylate tissue adhesives are designed for superficial and deep tissue use.
B. Butyl-cyanoacrylate is a long-chained derivatives with a slow breakdown rate of degradation.
C. Cyanoacrylate tissue adhesives breakdown are not toxic to the tissues.
D. Fibrin tissue adhesives are contraindicated in facelift surgery
E. BioGlue is a tissue adhesive primarily use for vascular anastomosis.

1229) The RECOMMENDED management of a giant congenital hairy nevus is

A. Conservative management
B. Laser coagulation
C. Chemical peeling
D. Photodynamic therapy
E. Surgical excision

1230) Which of the following tissue adhesives is composed of purified bovine serum albumin and glutaraldehyde?

A. BioGlue
B. Tisseel
C  Bytyl-cyanocrylate
D. 2-Octyl cyanoacrylate
E. Platelet-rich plasma compounds

ANSWERS & REFERENCES

1221) D     Less incidence of velopalatal insufficiency

Bower C. M., Seibert R. W.,  Muntz H. R.: Cleft Lip and Palate, chapter 33 Complications in Pediatric Otolaryngology (Josephson G.D. & Wohl D. L., editors, Taylor & Francis, 2005,  pp. 539-552

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, Thieme, 2009, pp.1059-1078

1222) A     Topical anesthetic is adequate for a facial CO2 laser resurfacing.

Carniol P. J., Harmon C. B., Hamilton M. M.: Ablative Laser Facial Skin Rejuvenation, Chapter 26 in Facial Plastic and Reconstructive Surgery, (Papel I.D, editor), Third Edition, Thieme, 2009, pp.321-330

1223) E     An arc 6 times the diameter of the defect

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

1224) A     Er:YAG laser

Carniol P. J., Harmon C. B., Hamilton M. M.: Ablative Laser Facial Skin Rejuvenation, Chapter 26 in Facial Plastic and Reconstructive Surgery, (Papel I.D, editor), Third Edition, Thieme, 2009, pp.321-330

1225) D     It is approved  for treatment of facial lipo-atrophy associated with HIV disease.

Maas C. S., Yu K. C. Y., Egan K. K.: Neuromodulators and Injectable Soft Tissue Substitutes, Chapter 28 in Facial Plastic and Reconstructive Surgery, (Papel I.D, editor), Third Edition, Thieme, 2009, pp. 337-353

1226) B    This flap can be used only unilaterally - not bilaterally - or in combination with other flaps.

Rowe N. M., Zide B.Z: Lip and Oral Commissure Reconstruction, Current Therapy in Plastic Surgery (McCarthy, Galiano, Boutros, editors), 2006, pp. 129-134

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, Regan Thomas, editors), Vol. 1, 1988, pp. 261-274

1227) B     The rectangular shape device will achieve the least gain in surface area.

Swenson R. W.: Tissue Expansion, chapter 20  in Highlights of the Instructional Courses. Vol. 7, 1994, (Lucentet F.E., editor), Mosby, 1995, 223-235

1228) E     BioGlue is a tissue adhesive primarily use for vascular anastomosis.

Egan K.K., Kim D. W., Toriumi D. M.: Tissue Adhesives, chapter 9 in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp. 91-97

1229) E     Surgical excision

http://emedicine.medscape.com/article/1295033-overview

1230) A     BioGlue

Egan K.K., Kim D. W., Toriumi D. M.: Tissue Adhesives, chapter 9 in Facial Plastic and Reconstructive Surgery (Papel I.D., editor), Thieme, 2009, pp.91-97

-----------------------------------------
Updated: August 5, 2017

1211-1220 MCQ in Facial Plastic and Reconstructive Surgery

1211-1220

1211) Which of the following characteristics of the Unilateral Cleft Lip Nose is FALSE?

A. The nasal tip is deflected toward the non-cleft side.
B. The length of the lower lateral cartilage on the cleft side is shorter compared to the non-cleft side.
C. The nasal floor and sill are often absent on the cleft side.
D. The caudal septum deflects toward the non-cleft side.
E. The internal nasal valve is usually compromised by the weak upper lateral cartilages.

1212) Which of the following grafts are used to increase an inadequate nasofrontal angle?

A. Dorsal onlay grafts
B. Spreader grafts
C. Radix grafts
D. Dorsal sidewall onlay grafts
E. Septal extension grafts

1213) Which of the following midface muscles is critical in the effective rejuvenation/reposition of the mid-face?

A. Orbicularis oculi muscle
B. Zygomatic major muscle
C. Levator labii superioris muscle
D. Masseter muscle
E. Orbicularis oris muscle

1214) Which of the following nasal areas  IS NOT indicated to implant GORE-TEX  in Rhinoplasty?

A. Nasal dorsum
B. Supratip dorsum
C. Nasal tip
D. Lateral nasal wall
E. Premaxilla

1215) A 55-year-old woman is consulting you for  a possible blepharoplasty. She has had a recent LASIK surgery. What is the proper timing to perform a blepharoplasty in this patient?

A. There is no time contraindication for blepharoplasty and LASIK surgery.
B. The patient should wait 1 month after her LASIK surgery.
C. The patient should wait 2 months after her LASIK surgery.
D. The patient should wait 4 months after her LASIK surgery.
E. The patient should wait 6 months after her LASIK surgery.

1216) Which of the following statement is FALSE regarding the drawing presented below?.  A forceps elevates the alar complex and a transdomal suture is placed. The alar complex is excised.

A. The delivery approach is used in conjunction with a transfixion incision.
B. The excision involves the resection of the dome and the adjacent lateral crura.
C. The presented resection will deproject the nasal profile.
D. Alar flaring can occur using  this  technique.
E. Alar base reduction is contraindicated associated with this technique.

1217) Which of the following medical conditions is NOT related to an increased risk for lower eyelid retraction in the execution of a lower eyelid blepharoplasty?

A. Globe prostosis
B. High myopia
C. Hypoplasia of the malar eminence
D. Diabetes
E. Thyroid ophthalmopathy

1218) Which of the following statements regarding GORE-TEX is TRUE?

A. Gore-Tex is a Porous High-density Polyethylene.
B. Gore-Tex has pore sizes ranging from 125-250 µm
C. Gore-Tex can be used for columellar graft augmentation.
D. Gore-Tex most common complication is infection.
E. Gore-Tex implant extrusion rate is high

1219) Which of the following statements regarding PORT WINE STAINS is FALSE?

A. Port Wine Stains are present at birth.
B. Port Wine Stains grow in proportion to child's growth.
C. Port Wine Stains will not regress spontaneously.
D. PDL is the most accepted laser used in the treatment of Port Wine Stains.
E. 60% of patients will require treatment

1220) Which of the following  muscle that exerts a force on the mandible is considered a depressor-retractor?

A. Temporalis
B. Masseter
C  Median pterygoid
D. Lateral pterygoid
E. Mylohyoid

ANSWERS & REFERENCES

1211) B      The length of the lower lateral cartilage on the cleft side is shorter compared to the non-cleft side.

Coleman Jr J. R., Sykes J. M.: Cleft Lip Rhinoplasty, Chapter 66 in Facial Plastic and Reconstructive Surgery, Second Edition (Papel, Ira), 2002, pp. 830-843

1212) C     Radix grafts

 Gunter J. P., Landecker A., Cochran C. S.: Frequently Used Grafts in Rhinoplasty Nomenclature and Analysis, Plast Reconstr Surg 2006; 118(1):14e-29e

1213) A     Orbicularis oculi muscle

Paul M. D., Calvert J. W., Evans G. R. D.: The Evolution of the Midface Lift in Aesthetic Plastic Surgery, Plast Reconstr Surg. 2006; 117(6):1809-182

1214) C      Nasal tip

Conrad K., Torgerson C. S., Gillman G. S.: Applications of GORE-TEX implants in Rhinoplasty Reexamined After 17 years, Arch Facial Plast Surg. 2008; 10(4); 224-231

1215) E      The patient should wait 6 months after her LASIK surgery.

Friendland J. A., Lalonde D. H., Rohrich R. J.: An evidence-Based Approach to Blepharoplasty, Plast Reconstr Surg. 2010; 126 (6); 2222-2229

1216) E      Alar base reduction is contraindicated associated with this technique.

Papel I. D., Mabrie D. C.: Deprojecting the Nasal Profile, Rhinoplasty and Septoplasty, Part I, in Otolaryngolocic Clinics of North America, Vol. 32, No. 1, February 1999, pp.65-87

Kridel RW, Konior RJ.: Dome truncation for management of the overprojected nasal tip, Ann Plast Surg. 1990 May;24(5):385-96.

1217) D       Diabetes

Lelli Jr G. J., Lisman R. D.: Blepharoplasty Complications, Plast. Reconstr Surg. 2010; 125(3);1007-1017

1218) D     Gore-Tex most common complication is infection.

Peled Z. M., Warren A. G., Johnston P. , Yaremchuk M. J.: The Use of Alloplastic Materials in Rhinoplasty Surgery; A Meta-Analysis, Plast Reconstr Surg. 2008; 121(30; 85e-92e

1219) E       60% of patients will require treatment

Stier M. F., Glick S. A., Hirsch R. J.: Laser Treatment of Pediatric Vascular Lesions: Port Wine Stains and Hemangiomas, J. Am. Acad. Dermatol. 2008; 58:261-285

1220) E        Mylohyoid

Stanley Jr., R. B.: Maxillofacial Trauma, chapter 24  Otolaryngology Head and Neck Surgery, (Cummings, Fredrickson, Harker, Krause, Richardson, Schuller, editors), Third Edition, 1998, pp.453-485

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Updated: August 5, 2017

1201-1210 MCQ in Facial Plastic and Reconstructive Surgery

1201-1210

1201)The use of retinoid treatments for the face, such as a isotretinoin (Accutane), will induce atrophy of the

A. Keratinocytes cells
B. Adipose cells
C. Sebaceous glands
D. Hair follicles
E. Melanocytes cells

1202) Which of the following components is CRITICAL in the hemostatic phase of wound healing?

A. Neutrophils
B. Macrophages
C. Platelets
D. Lymphocytes
E. Red blood cells

1203) Which of the following components is CRITICAL in the synthesis of collagen?

A. Vitamin A
B. Vitamin C
C. Zinc
D. Vitamin E
E. Vitamin K

1204) Which of the following treatment modalities is THE MOST accepted in the treatment and prevention of an hypertrophic scar?

A. Massage therapy
B. Onion extract
C. Vitamin E
D. Silicone gel sheeting
E. Topical imiquimod 5% cream

1205) Which is the MOST common adverse effect of Pulse Dye Laser (PDL)?

A. Permanent purpura
B. Transient purpura
C. Hyperpigmentation
D. Hypopigmentation
E. Edema

1206) What is the name of the surgical technique used in the repair of the left forehead defect?

A. Jury flap
B. Worthen flap
C. Island flap
D. Orticochea flap
E.  Hatchet flap

1207) Which of the following laser is considered "the gold standard" for the treatment of hypertrophic scars and keloids?

A.CO2 laser
B. Nd:YAG laser
C. Er:YAG laser
D. PDL laser
E. Argon laser

1208) Which of the following topical prevention/treatment for post-surgical scars have NOT been shown to improve scar appearance?

A. Vitamin E
B. Pressure garment
C. Silicone Gel Sheeting (SGS)
D. Petrolatum ointment
E. Imiquimod cream

1209) Which of the following statements regarding dermabrasion for facial scars is FALSE?

A. Timing for dermabrasion is usually within the first month of the wound production.
B. Penetration into the papillary dermis will produce a diffuse pinpoint bleeding.
C. Penetration into the reticular dermis will produce a yellow chamois color appearance.
D. Reepithelization usually occurs within 10 days after dermabrasion
E. Erythema is expected, persisting for weeks to months, generally resolves with time.

1210) Which of the following vitamins or trace elements in high doses has been associated with delayed wound healing ?

A. Vitamin A
B. Vitamin C
C  Vitamin E
D. Zinc
E. Iron

ANSWERS & REFERENCES

1201) C      Sebaceous glands

Gantwerker E. A., Horn D. B.: Skin: Histology and Physiology of Wound Healing, (Steven Ross Mobley, Guest editor), Facial Plastic Clinic of North America, Vol.19, No. 3, Aug. 2011, pp. 441-453

1202) C      Platelets

Gantwerker E. A., Horn D. B.: Skin: Histology and Physiology of Wound Healing, (Steven Ross Mobley, Guest editor), Facial Plastic Clinic of North America, Vol.19, No. 3, Aug. 2011, pp. 441-453

1203) B       Vitamin C

Gantwerker E. A., Horn D. B.: Skin: Histology and Physiology of Wound Healing, (Steven Ross Mobley, Guest editor), Facial Plastic Clinic of North America, Vol.19, No. 3, Aug. 2011, pp. 441-453

1204) D      Silicone gel sheeting

Foo C. W. , Tristani-Firouzi P.: Skin: Topical Modalities for Treatment and Prevention of Postsurgical Hypertrophic Scars, Scars: Prevention, Correction, and Reduction, (Mobley S. R., Guest editor), Facial Plastic Clinic of North America, Vol.19, No. 3, Aug. 2011, pp. 543-550

1205) B        Transient purpura

 Alster T., Zaulyanov-Scanlon L.: Laser Scar Revision: A review, Dermatol. Surg.; 33:131-140
Sobanko J. F, Alster T. S.: Laser Treatment for Improvement and Minimization of Facial Scars,  Scars: Prevention, Correction, and Reduction, (Mobley S. R., Guest editor), Facial Plastic Clinic of North America, Vol.19, No. 3, Aug. 2011, pp. 527-542

1206) B         Worthen flap

http://emedicine.medscape.com/article/876972-treatment#a1133

1207) D        PDL laser

Sobanko J. F., Alster T. S.: Laser Treatment for Improvement and Minimization of Facial Scars, Scars: Prevention, Correction and Reduction, (Mobley S.R., Guest Editor), August 2011, Vol. 19, No. 3, pp. 527-542

1208) A       Vitamin E 

Sidle D. M., Decker J. R.: Use of Makeup, Hairstyles, Glasses, and Prosthetics as Adjuncts to Scar Camouflage,  Scars: Prevention, Correction and Reduction, (Mobley S.R., Guest Editor), August 2011, Vol. 19, No. 3, pp. 481-489

1209) A       Timing for dermabrasion is usually within the first month of the wound production.

Surowitz J. B., Schockley W. W.: Enhancement of Facial Scars with Dermabrasion,  Scars: Prevention, Correction and Reduction, (Mobley S.R., Guest Editor), August 2011, Vol. 19, No. 3, pp. 517-525

1210) C       Vitamin E

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

Burns J. L., Mancoll J. S., Phillips, L. G.: Impairments to Wound Healing, Clin Plastic Surgery 30, 2003, pp. 47-56


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Updated: August 5, 2017