6. A 70-year-old woman who is obese and has type 2 diabetes is evaluated because of a very painful violaceous plaque on the abdomen that has developed into a black eschar. History also includes end-stage renal disease. Examination of a specimen obtained on biopsy at the border of the lesion shows calcification of small- and medium-sized vessels, microvascular thromboses, extravascular soft-tissue calcification, and panniculitis. Administration of which of the following is the most appropriate management for this condition? A) Calcium carbonate B) Corticosteroids C) Iron infusion D) Sodium thiosulfate E) Warfarin

This is calciphylaxis D All others are risk factors or pre-disposing factors

APBS Flashcards by Pauline Navals

Screening guidelines for implant rupture FDA?

MRI or ultrasound
5-6 years post op, q2-3 years

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A 70-year-old woman who is obese and has type 2 diabetes is evaluated because of a very painful violaceous plaque on the abdomen that has developed into a black eschar. History also includes end-stage renal disease. Examination of a specimen obtained on biopsy at the border of the lesion shows calcification of small- and medium-sized vessels, microvascular thromboses, extravascular soft-tissue calcification, and panniculitis. Administration of which of the following is the most appropriate management for this condition?

A) Calcium carbonate B) Corticosteroids
C) Iron infusion
D) Sodium thiosulfate
E) Warfarin

This is calciphylaxis

All others are risk factors or pre-disposing factors

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Which of these schlerotherapy treatments for lymphatic malformations has the highest complication rate ?
A) Bleomycin
B) Doxycycline
C ) Ethanol
D ) OK-432
E) Sodium tetradecyl sulfate

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Risk factors for neurocutaneous melanosis

> 20 satelite lesions
midline lesions
giant

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Which of the following cytokines is most likely to foster reperfusion injury?
A) Fibroblast growth factor 3 B) Interleukin-2
C) Transforming growth factor beta D) Tumor necrosis factor alpha
E) Vascular endothelial growth factor

The correct response is Option D.

Tumor necrosis factor alpha is a key cytokine in reperfusion injury. This cytokine is proinflammatory and plays a role in mediating vasodilation, edema, and oxidative stress after restoration of perfusion.
Interleukin-2 is also proinflammatory, but it is not central to reperfusion injury. The other cytokines are growth-mediating cytokines.
Transforming growth factor beta and vascular endothelial growth factor are involved with vascular growth. Fibroblast growth factor 3 is involved with cellular growth and wound- healing.

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Effect on hematoma and opioid use of ketorolac

No change hematoma
Less opioids

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Timing of masquelet technique

4 weeks ideal
6-8 weeks if complicated `

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A 35-year-old transgender man (assigned female at birth) meets World Professional Association for Transgender Health guidelines for gender-affirming genital surgery. He chooses to undergo radial forearm flap phalloplasty. During flap harvest, the plastic surgeon identifies the cutaneous nerve near the cephalic vein; the nerve is later coapted to the ilioinguinal and dorsal clitoral nerves for sensory reconstruction. This cutaneous nerve originated from which of the following more proximal nerves?
A ) Axillary
B ) Median
C)Musculocutaneous
D) Radial
E) Ulnar

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HS is caused by which glands ?

inflammation of the apocrine glands

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Bacteria and treatment for aquarium

Mycobacterium marinium, doxy x 3 months

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She is started on a pharmacologic agent with indirect inhibition of factor Xa
as the primary mechanism of action. Which of the following agents did she most
likely receive?
A) Apixaban
B) Dabigatran
C) Enoxaparin
D) Fondaparinux
E) Warfarin

Fondaparinux is an indirect factor Xa (thrombin) inhibitor that is administered by
subcutaneous injection. It has been demonstrated to be efficacious for prophylaxis or
treatment of venous thromboembolisms.
Dabigatran and apixaban are direct thrombin inhibitors. Warfarin is a vitamin K antagonist.
Enoxaparin is a direct factor Xa inhibitor.

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Calciphylaxis treatment

sodium thiosulfate

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Parry-rhomberg treatment

MTX

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Innervation of the rectus muscles

intercostals

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DO mechanism of bone formation ?

Intramembranous ossification

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Define :
A) Endochondral ossification
B) Intramembranous ossification
C) Osteoconduction
D) Osteogenesis
E) Osteoinduction

New bone is formed during distraction osteogenesis via the process of intramembranous ossification. The key is that the new bone is spontaneously formed without a cartilaginous intermediate. In addition to distraction osteogenesis, intramembranous ossification occurs during fetal development with the formation of the flat bones. It also occurs with primary bone healing.

Osteogenesis is the primary mechanism for healing of a vascularized bone graft. Osteoblasts that survive the bone graft transfer procedure and osteoblasts at the native recipient bone both participate in the formation of new bone to heal the bony interface.

Osteoconduction is the primary process for healing of cortical bone grafts. Blood vessels and cells from the recipient wound bed grow into the cortical bone graft, which functions as a template for the deposition of new bone.

Endochondral ossification involves formation of new bone via a cartilaginous intermediate. This process is seen during fetal long bone development and during bony fracture healing via a cartilaginous callus.

Osteoinduction, which is seen in healing of cancellous bone grafts, involves bone morphogenetic protein stimulating mesenchymal cells at the recipient site to differentiate into osteoprogenitor cells.

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2 arteries to anastomose in penile amputation

internal pudendal artery (deep structures)
inferior external pudendal artery (skin)

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What is glut 1 positive ?

infantile hemangioma

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Best views to determine ulnar variance

1) lateral
2) PA

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How to make toe syndactyly dorsal skin scars better

Use plantar flaps for web space surfacing

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The superolateral border of the popliteal fossa is formed by which of the following
muscles?
A ) Biceps femoris
B ) Lateral head of the gastrocnemius
C ) Medial head of the gastrocnemius
D ) Plantaris
E ) Semimembranosus

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What type of agar for mycobacterium marinum

Löwenstein-Jensen medium

Acid fase zeilh neelson stain

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What time does the femur and clavicle ossify ?

8 weeks

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Chances of having an absent EIP

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A 6-year-old boy with right congenital corneal anesthesia and a history of multiple corneal abrasions and ulcerations is scheduled to undergo donor sural nerve grafting. Which of the following graft targets is most likely to provide the greatest improvement in corneal sensation? A ) Left supraorbital nerve to right corneal nerve B ) Left supraorbital nerve to right supraorbital nerve C ) Left supratrochlear nerve to right scleral limbus D ) Right frontal branch of facial (VII) nerve to right supratrochlear nerve E ) Right infraorbital nerve to right corneal nerve

The correct response is Option C. The ipsilateral, supraorbital, and supratrochlear nerves provide sensation to the cornea. There are many causes for insensate cornea, including congenital and acquired conditions. Herpes infection is one of the leading causes. Chronic ulceration and injury can lead to corneal scarring that can lead to blindness. Corneal sensation is critical for protection of the cornea and sight. Reinnervation of the cornea may be possible with donor nerve grafts from the contralateral side to the sclera at the limbus. The fascicles can be divided and the individual fascicles distributed in a subconjunctival fashion to be sutures to the sclera at the edge of the cornea. Use of the ipsilateral, trochlear, or supraorbital nerve is not expected to regain innervation since these nerves themselves are involved

A 2-year-old girl presents to the clinic preoperatively with an unrepaired cleft palate. The patient is meeting developmental milestones. Compared with a similar patient undergoing surgery at 1 year of age, this patient has an increased risk for which of the following? A ) Feeding difficulty B ) Fistula formation C ) Maxillary growth restriction D ) Postoperative airway complications E ) Velopharyngeal insufficiency

E Sooner = maxillary growth restriction Later = speech issues

A 44-year-old woman is evaluated because of pain and clicking anterior to the tragus with mouth opening. In the more common form of internal derangement of the temporomandibular joint, the disc is most often located in which of the following positions? A ) Anterior and medial B ) Inferior and lateral C ) Posterior and lateral D ) Posterior and medial E ) Superior and medial

Highest risk of dermal cyst intracranial extension?/

anterior fontanelle

Syndrome associated with lower lid coloboma

141. A 40-year-old man presents with acute left facial nerve paralysis that began 24 hours ago. In addition to a loss of facial expression on the left side of the face, the patient is most likely to report which of the following symptoms? A ) Crocodile tears B ) Excessive salivation C ) Gustatory sweating D ) Hyperacusis E ) Tongue numbness

The pathology report describes the lesion as having Kamino bodies present with no nuclear atypia or increased mitoses. Results of fluorescence in situ hybridization studies are negative for melanoma markers. What is this and what it the management

spitz nevus expectantMos

Most common complication of lefort 1 + BSSO

permanent nerve damage (10%)

Safe for black people tattoo laser type and wavelength

q switched Nd-Yag 1064

Gland most likely to cause dry eye?

Mebomian

Most commonly associated complication to circumareolar mastopexy?

flattened projection

Last step in rhinoplasty?

Alar flair reduction

Jessner solution depth and response 35% TCA d+r 50% TCA d+r

superficial- no frosting papillary dermis- frosting with erythema reticular dermis - frosting with no erythema

MOA cryolipolysisq

apoptosis

MOA minoxidyl and finasteride

Minoxidil is believed to work primarily by increasing blood flow by opening potassium channels leading to vasodilation at the follicular level, Finasteride inhibits 5-alpha reductase type II, leading to decreased circulating levels of dihydrotestosterone,

Amastia Amazia Athelia

No breast or NAC No breast, present NAC No NAC

MOA TXA

The binding of this receptor prevents plasmin (the activated form of plasminogen) from binding to and ultimately stabilizing the fibrin matrix.A 46-year-old woman who has moderate acne scars on her face is interested in improving the appearance of the scars. She has Fitzpatrick Type IV skin. The patient is very concerned about possible postprocedure dyspigmentation. Which of the following is the most appropriate technique that would address the patient's concerns?

A 46-year-old woman who has moderate acne scars on her face is interested in improving the appearance of the scars. She has Fitzpatrick Type IV skin. The patient is very concerned about possible postprocedure dyspigmentation. Which of the following is the most appropriate technique that would address the patient's concerns?

microneedling

Parotid duct travels through which part of the buccal fat pad ?

Anterior lobe (posterior part)

Mustarde and furnas

Mustarde = chonco-scaphal furnas = scapho-mastoid

frailty index score 5`

* Functional status before surgery * Diabetes mellitus * Chronic obstructive pulmonary disease * Congestive heart failure * Hypertension requiring medication

206. Which of the following healthcare reform laws guarantees the transferability of a patient’s health insurance coverage from one employer to another? A ) 21st Century Cures Act B ) Health Information Technology for Economic and Clinical Health Act C ) Health Insurance Portability and Accountability Act D ) Patient Safety and Quality Improvement Act E ) Women's Health and Cancer Rights Act

relative stability vs absolute

relative = external splinting, intramed nail, external fixation absolute - compression, tension band, lag screw

Complication of phentermine (weight loss drug) pre-op

Non-responsive hypotension

Risk of getting breast cancer BRCA 1 and 2

60 and 50%

MOA 5-fu

The mechanism of action is inhibition of fibroblast proliferation with a decrease in collagen synthesis

Which of the following ventilatory maneuvers is most appropriate immediately prior to cinching the stitch for pleural closure after a pneumothorax

modified valsalva, maximum inspiration

Treatment of benign phylloides tumor

excision with margins

Lab complications of oxandrolone and does it affect mortality ?

AST ALT elevation Non

what can you mix with liposomal bupi?

normal bupi not lido

A ) Expired B ) Probation C ) Retired D ) Revoked E ) Suspended

* Expired – Certification has lapsed; the diplomate has not met the requirements to renew certification. * Retired – No longer in active practice of plastic surgery. * Revoked – Certification is no longer valid due to a failure to maintain required ethical or professionalism standards. * Suspended – Certification is suspended due to action on a medical license by a state medical board. * Probation – Certification is placed on probation due to action on a medical license by a state medical board.

MOA papaverine

phosphodiesterase inhibitors

How long to hold tamoxifen and anastrazole

tamoxifen is debatable, 2-4 weeks anastrazole not at all

CPT codes for benign malignant soft tissue sarcomas

14xxx 16xxx these only include simple closure 21-25xxx this includes all closure types

Best treatment for microcystic lymphatic malformation

sirolimus

subcutaneous abdominal tumor with familial adenomatous polyposis (FAP) syndrome

desmoid

Primary mechanism for bone healing free fib

osteogenesis conduction = cortical induction = cancellous endochondral ossification = fracutre

MOA TPA

converts plasminogen to plasmin

CPT code for cure pectus excavatum

A ) 21740 (reconstructive repair of pectus excavatum or carinatum, open)

Where is the plantaris tendon at the ankle?

medial to the achilles tendond

Reduction for bennet fracture

abduction pronation traction volar pressure

What is the significance of a myoarterial unit under the nail?

glomus tumor

Minimum of bone distal to a joint for elective amputation

5 cm

Cast treatment for minimally displaced radius fracture. 2 weeks later cannot retropulse thumb. What do you do ?

EPL rupture, tendon transfer

Initial cause of thumb boutonniere in RA

E ) Metacarpophalangeal joint synovitis

P-16 protein expression test is significant for ?

HPV

Worse strabisme with fronto-orbital advancement or endoscopic ?

FOA

Lower voice post tracheal shave injured thing

anterior commissure ligament recurrent laryneal - horeseness

Replacement of an avulsed tooth quickly lessens the damage to what structure ?

Periodontal ligamenet

Do you need imaging for a child <2 years old for a lateral brow dermoid cyst?

no, older than this MRI and anything central MRI

Most common complication for discectomy for TMJ

Condylar remodeling

Normal MRD 1

4-5mm

HOw long do you wait after injectivng lidocaine before injecting liposomal buip?

20 mins

Mucosal vs bony hypertrophy of the inferior turbniate treatment

Bony = submuosal resection mucosal = outfracture

How to decrease risk of hypopigmentation for fitz v and c02 laser ?

decrease dwell time

Inferior oblique, what movements

medial and superior

Chemotherapy contra-indication for HBOC

Doxyrubicin

Timing of excision post paradoxical adipose hyperplasia cryolipolysis

6-9 months

Dry wet Superwet TUmescent

Dry= nothing Wet = 200-300 per anatomic area superwet 1:1 Tumescent 2-3:1

Chance of having contralateral BIA-ALCL

4.6%

APBS Flashcards

(86 cards)