Plastics

Question 1

Most appropriate ABx for dog bites

Answer 1

PO amoxicillin-caluvanic acid

Question 2

Mng of dog bites

Answer 2

ABx- amoxicillin & clauvanic acid
Thorough wound cleaning and debridement
Aus is rabies free therefore rabies PPX not required
Tetanus consideration

Question 3

Causes of cleft lip/ palate

Answer 3

Genetic predisposition: FH, Pierre Robin sequence
Patau syndrome (trisomy 13)
Edwards syndrome (trisomy 18)
DiGeorge syndrome (22q11.2 deletion syndrome)
Loeys-Dietz syndrome: bifid uvula

Environmental: exposure to teratogenic substances in utero
- Nicotine and/or alcohol
Drugs: antiepileptics, folate antagonists like methotrexate, XS vit A intake during pregnancy

Question 4

Mng of cleft lip/ palate

Answer 4

MDT- oral maxillofacial surgeons, plastics, otolaryngologists, peads, speech therapists
Surgical repair
Speech assessment at 12–14 months and therapy of velopharyngeal insufficiency
Conservative measures before surgery [13]
Proper feeding techniques: feeding in upright position to prevent nasal regurgitation; use of specialized feeding bottles ; frequent burping
Nasoalveolar molding: Use of a custom made orthodontic prosthesis to bridge and reduce the palatal gap and passively mold the maxillary, palatal, and nasal structures into a normal shape
Nasal stent: to lift the drooping nostril and shape the nose
Lip taping: use of adhesive tape to reduce the defect; makes definitive surgery easier
Lip adhesion: suturing the edges of the cleft lip, in conjunction with NAM can be done in infants with complete CL/CP who are not responding well to lip taping

Question 5

Pathognomonic sign consistent with electrical burn

Answer 5

Presence of entry and exit wounds - passes through the body and seeks the path pf least resistance to the ground

Question 6

Management of electrical burns

Answer 6

Cardiac monitoring- risk of arrhythmias
Assessment for compartment syndrome
Measurement of creatinine kinase to assess for rhabdo

Question 7

Classification of congenital hemangiomas

Answer 7

Rapidly involuting- RICH - Resolves within 2 years
Non involuting - NICH

Question 8

Mnf for rapidly involuting congenital haemangioma

Answer 8

observation

Question 9

mng for a non involuting congenital hemangioma

Answer 9

surgical excesion

Question 10

tx for infantile hemangioma

Answer 10

PO propanolol and topical timolol