Plastic Surgery Flashcards by Mark Hany

Domestic radiator is an example of …………..

Contact burns

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Account for 70% of children burns

Scalds

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………. Accounts for 3-4% of all admissions to burn units

Electrical injury (burns)

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Hydrofluoric acid causes burn by…………

leeching calcium from the body

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In the zone of stasis there is diminished tissue perfusion due to………….

Platelet microthrombus formation
Neutrophils adherence
Fibrin deposition

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………….. can convert the zone of stasis to complete tissue loss

Prolonged hypotension
Infection
Edema

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Increase tissue perfusion in the zone of hyperemia results from ……..

Heat injury
Release of histamine
Prostaglandins
Interleukins
Free O2 radicals

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Degradation products of bunrt tissue as myoglobin and hematochromagen may lead to………..

Acute tubular necrosis (ATN)

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What are the effects of hypothermia?

-may lead to acidosis and coagulopathy
-causes peripheral vasoconstriction and impairs O2 delivery to tissues
-metabolism changes from aerobic to anaerobic

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Tropical anitmicrobial agent of choice is …………….

Silver sulfadiazine

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Acute phase of burn management begins with mobilization of………………..

ECF and subsequent diuresis

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Fluid replacement continues from the ……….. phase to the ……… phase

Emergent
Acute

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For eye care use …….

Saline rinses
Artificial tears

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Neck burns don’t use………… to reduce wound contraction

Pillows

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rehabilitation phase can occur……………..

2 weeks or up to 2-3 months after burn injury

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The major factors contributing to systemic complications of burns are……….

Breakdown of skin integrity
Fluid loss

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Direct injury doesn’t normally occur below the level of bronchus because……

Of the cooling effect of rapid vaporization in the pulmonary tract

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Rhabdomyolysis and hemolysis can occur in burnt patients due to ……………..

-Deep thermal or electrical burns of muscles
-muscle ischemia due to constricting eschars

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Hydrogen cyanide gas is a metabolic poison, which acts by inhibiting the final stages of…………..

Oxidative phosphorylation(cytochrome oxidase) at the mitochondria level and hence causes cellular death

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Hydrogen cyanide poisoning is treated by……………

IV sodium thiosulphate
Hydroxocobalamin
100% O2

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Full thickness graft is also called…..

Wolfe graft

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Split skin graft is also called ……….

Tiersch’s graft

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Flaps is used to cover an area with poor vascularity such as …………..

Post-mastectomy irradiation ulcers
Bedsores
Ulcers over the lower 1/3 of the tibia

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Flaps are used in Full thickness loss of tissue in ………….

Lid
Nose
Cheek
(To cover bony prominence)

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Sensation of the flap returns within………

6weeks - 3years (The sweating returns with sensation)

Any island is considered as ……….

An axial flap

The classical donor sites of double pedicle flap(tube pedicle flap) are …………

Neck Antero-medial aspect of the thigh Anterior abdominal wall (AAW) Acromial-pectoral region

The drawback of advancement flaps is …………..

May cause devascularization of the skin and creation of a dead space with a possibility of hematoma formation

Rhomboid flap is used in ………

BCC in the face

The Z plasty is used for……..

-lengthen a scar contracture line -change the scar direction -to rotate the axis of tissues -to overcome a depressed scar

The most useful free flaps are the …………

TRAM flaps Groin flap Dorsalis pedis flap Latissimus dorsi flap Tensor fascia lata myocutaneous flap

A myocutaneous flap is used to cover a surface, which is unsuitable for skin graft as…………

Cortical bone Opened joint

Latissimus dorsi myocutaneous flap is supplied by………

Thoracodorsal artery A branch of the sub scapular artery

Pectoralis major myocutaneous flap is supplied by ………. , and used to cover………..

-Thoraco-acromial artery -head and neck defects Chest wall Sternum Esophagus (after thinning it out)

Gastrocnemius flap is supplied by ……………… , is used to cover………….

- sural branches of popliteal artery and vena comitantes - defects of the shin of tibia(upper 2/3) Knee In cross leg flap

Transverse rectus abdominis myocutaneous (TRAM) flap is supplied by ………….. , is used to reconstruct…………

-Deep superior epigastric vessels -breast and chest wall defects, can also be used as a free flaps to cover remote defects

Tensor fascia lam is used for reconstruction of ………………..

Bedsores of the greater trochanter Vulva Abdomen Used in the past for hernioplasty of recurrent inguinal hernias

The sequestration type of dermoid cyst is typically found in……….

Pre auricular (temporal) region Post auricular region Inner and outer canthus Midline of the scalp Chin Supra-sternal Pre-sternal Pilonidal Sub-lingual

Epidermal cyst (sebaceous cyst) is common in the…………

Scalp Ears Retro auricular region Face Scrotum Thorax

Most lipomas are painless but may be multiple and painful as……..

neurolipomatosis

The melanocytes are derived from……………

The neural crest

There are several formulas for IV replacement like……….

ABA consensus formula Parkland formula Brooke formula Evan’s formula

……… is another crystalloid solution which is even more closely physiological to human body more than Ringer lactate

Plasmylate

………. It’s the main killer of burnt patients

Septicemia

Suppurative thrombophlebitis is the source of ……………….

Septicemia Hematogenous pneumonia

…….. is the leading cause of death in fire victims

Inhalational injury

The graft can be fixed with…………

Sutures Staples Free bandage

Embryologically blood vessels are …………….

Segmental ( like lumber ) Anastomotic ( like internal mammary ) Axial ( limb vessels )

What’s the methods of reliable monitoring of skin flab blood flow?

-Laser doppler (one of the best) -Injection of fluorocin at the time of operation (early stages) -Temperature probes -trans cutaneous O2 estimation -radioisotope clearance (not easily used) -prick the skin with sterile needle (bright red blood is good)

Papilloma is mostly on …………

Face Neck Trunk Intertriginous zones

Treatment of keloid

-low voltage x ray therapy -in long standing cases: excision and resuturing preceded and followed by radiation -intradermal injection of steroids -shaving the keloid with resurfacing of the area by a thin split graft

Keloid is common in ………

Face Neck Ears Over the sternum Infront of the abdomen

Keratocanthoma usually affects……….

Face Nose

Keratocanthoma is also called…………..

Adenoma sebaceum Molluscum sebaceum Molluscum pseduo carcinomatosum

40% of marjolin’s ulcer occur on ……

Lower limb

Acitinc (UV) rays cause……..

DNA damage T-helper cell suppression

Risk factors of infantile hemangioma (IH)

-White race -Premature infants (low birth weight) ———> up to 30% -maternal factors: Advanced maternal age Multiple gestation pregnancy Placenta brevia Preeclampsia -in utero diagnostic procedures (chorionic villus sampling and amniocentesis) -use of fertility drugs -erythropoietin -breech presentation -being first born

Common side effects of oral propranolol are…………..

Sleep disturbances Night terrors

Adverse effects of intra-lesional steroids in IH

-central retinal artery occlusion (periorbital lesions) -eyelid necrosis (periorbital lesions) -Atrophy -Hematoma -skin depigmentation -possible significant systemic delivery

The thenar eminence is innervated by ……………..

The recurrent branch of the median nerve

The adductor pollicis is innervated by ……………..

Ulnar nerve

Lumbricals originate from ……………..

The FDP distal to the carpal tunnel

The epitenon (epithelial) suture of the tendon add additional support and ……………

Prevent locking of tendon during flexion

Sub-ungual hematoma should be evacuated if it is more than 25% of the size of the nail by ……………….

Terphination Or Removal of the nail plate

SCC is also called………..

Epithelioma Epidermoid carcinoma

Multiple melanomas are very rare (……….% of all melanomas) , in familial cases it can reach……..

1-4 % 20%

Lentigo maligna melanoma is also called……………

Hutchinson’s melatonic freckle

If paronychia or eponychia is chronic so the causative organism is ………….

Candida

……….. is the most common infection in the hand

Paronychia or eponychia

Distal pulp is subdivided into ……. Compartments

Infection of the web space of the thumb occurs secondary to………….

Infection of palmar blisters

Human saliva has demonstrated 42+ species such as ………

Strept Staph E.corrodens (30%) Bacteroides (the most common anaerobe

Plastic Surgery Flashcards

(74 cards)