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382 Cards in this Set
- Front
- Back
|
collagen
normal ratio hypertrophic scar ratio |
I:III
normal = 4:1 hypertrophic = 2:1 |
|
|
wound healing
inflammatory phase |
PMN's and macrophages
|
|
|
% hemangiomas noted in
first year of life |
80%
|
|
|
% lidocaine removed by
liposuction |
10-30%
|
|
|
drugs associated with gynecomastia
|
amphetamine,aldactone, antidepressants (tricyclic), digitalis, methyldopa, opiates, tagamet,
NOT ambien |
|
|
serrtus flap
which ribs |
ribs 6-8
|
|
|
lateral thigh flap
size artey sensorynerve |
large
3rd branch of perf femoris sensate medial and lateral femoral cutaneous nerves |
|
|
osteo-radionecrosis
Rx ? |
hyperbaric O2
surgery for pain, fracture, exposure, fistula |
|
|
Pet scan
|
resolution = 4-5 mm
specificity = 80-90% |
|
|
Delay of flap results in
|
inc capillaries 2-7 days
vasosonstriction early hypertrophy and reorganization of vessels along the axis of the flap |
|
|
hydorxyapetite
%of skeleton onlay vs inlay cement vs ceramic |
70% of calcific skeleton
inlay = osteoconductive onlay = non " cement = resorbable ceramic = non " |
|
|
giant hairy nevus
|
>20 cm diameter
Malig rate = 8 - 10% |
|
|
scleroderma
crest syndrome |
calcium soft tissue
calcinosis reynaud's esophageal involvement sclerodactyly telangiectasia |
|
|
Surgical delay of flap
|
choke vessels dilate day 7-8
dil begins day 3 prior to day 3 = vasoconstriction |
|
|
physical exam false pos or neg for regional lymph nodes
|
30%
|
|
|
trapezius flap
artery |
transverse cervical
|
|
|
integra
when to remove silicon layer |
2-3 weeks
|
|
|
Becker nevus
|
hamartoma (not a nevus)
|
|
|
bipivicaine
duration of action related to |
protein binding
|
|
|
calciphylaxsis
|
skin necrosis
hyperparathyroid |
|
|
dextran
actions |
decrease factor VIII
decrease platlets modify fibrin antigen risk |
|
|
Mongolian spot
Nevus of Ito Nevus of Oto |
Mong. = sacrum
Ito = blue nevus, post supraclavicular shoulder Oto = trigeminal distribution |
|
|
hemophelia A
Rx |
factor VIII decreased
operative hemostasis need 80-100% concentration must maintain 30% for 2 weeks 1/2 life = 12 hrs. --50%gone in 12 hours |
|
|
burn immunology
|
dec func leukocytes
dec t lymphocyte and immunoglobulins inc supresion lymphocyte and complement |
|
|
gene mutation
SCC AK |
P53
|
|
|
pectoralis major
nerves |
medial pectoral nerve = infior and lateral muscle
lateral pectoral nerve = medial muscle |
|
|
Scorpion bite Rx
adult child |
adult = observe
child = admit + antivenum (neurotoxin) |
|
|
rabies bite Rx
|
wound edge = 1 dose RIG (rabies immune globullin)
vaccine = 5 doses HDCV (human diploid cell vaccine) |
|
|
bacteria
leech human bite cat bite |
lee = aeromana hydrophylia Rx = aminoglycocide,trisulfa, 3rd gen. ceph
human = eikonella corrodens Rx= pen/ampicillin cat = pasturella multicida Rx - pen/amoxicillin |
|
|
fanconi
klippel trinau parks weber maffucci |
fan = radial club hand, progressive pancysopenia,life threatening, auto dom
klipp trau = port wine (one extrem) venous and lymphatic park web = same as klippel trauney + a-v fistula |
|
|
polands
sturge weber |
poland = fanconi + syndactyly
sturge weber = port wine stain + siezure |
|
|
rendu osler weber
von hipple landau |
rend = hemorraghic telangiectasia in mucous membrane, hematuria etc
von = retina and meningeal hemangiomas |
|
|
xeroderma pigmentosa
malignancy develops when |
<10 yrs
|
|
|
indications for radio rx tumor
|
large
close margin multiple ln's extracapsular or perineural involvement |
|
|
hemangioma (characteristics)
|
plump endothelial cells
inc mast cells inc 17-beta estradiol multilaminate basement memb. |
|
|
madilung's disease
|
benign symmetric lipomatosis
|
|
|
bone graft
osteocyte life advantage vascualr bone effect of radiation |
ostercytes die 2 hours
vasc.=less resorp of cort bone fewer fracture rapid union rapid hypertrophy raadiation = dec bone regeneration by 70% |
|
|
gracilis flap
nerve |
obturator
|
|
|
fibular free flap
|
peroneal artery
posterior medial knee flexor hallicus longus |
|
|
classification
tibial fractures |
I = open 1 cm
II = open >1cm w/o drainage III = extreme soft tiss. damag a = able to close b = loss tissue, periosteum stripped bone exposed c = above + art. injury |
|
|
BCC
second primary |
50% in 5 years
|
|
|
sternocleidomastoid
artery |
occipital artery
note - spinal acc nerve (XI) runs in the muscle |
|
|
pectoralis major
artery rib complication rate |
thoracoacromial artery
5th rib (or sternum) 60% complication rate |
|
|
melanoma
prognosis factor stains risk of 2nd primary |
ulcer decreases prognosis
s100 and hmb45 2nd prim = 2-3% |
|
|
atypical mole syndrome
risk melanoma |
10%
|
|
|
lymphatic laser
|
ErbYag
|
|
|
saphenous aretery
branch of |
genicular
|
|
|
hydradenitis
organism(s) |
staph
strep viredens |
|
|
brown recluse spider
Rx |
dapsone
(not with G-6-Phos deficiency) |
|
|
gracilis
located |
immediatley posterior to adductor magnus
|
|
|
heterotopic calcificatio
Rx |
etidronate
pamidronate (does not effect bone healing) |
|
|
purpura fulminans
|
toxic shock syndrome
staph aureus (include pneumonia) nissseria meningitis hemophilus influenza remove implant |
|
|
amputation lower ext.
absolute indication |
complete division post. tib n.
crush with warm ischemia > 6 hrs. |
|
|
acute burn
neutrophil function |
inc chemotaxsis
inc degranulation therefore tissue necrosis |
|
|
cultured allgenic keratocytes
survival |
30 months
|
|
|
av malformation
effect on bone |
destruction
|
|
|
pressure ulcer
stages |
I skin intact
II blister skin III into muscle no infection IV involves bone or joint |
|
|
lidocaine
peaks a ______ hours |
12
|
|
|
ISLE
immediate physical change |
reallign collagen
|
|
|
local anesthetic
mech of action |
Na+ transport
|
|
|
defect lower extremity
primary choice of closure |
fasciocutaneous flap
|
|
|
cidex
|
gluturaldehyde
|
|
|
xylocaine (lidocaine)
|
dose4.5 mg/kg
|
|
|
Maffucci syndrome
|
multiple enchondromas and hemangiomas
|
|
|
1st Rx of expanding hemangioma
|
oral conticosteriods
|
|
|
Carcinoma caused by chronis exposure to nickel
|
SCC nasal sinuses
|
|
|
scapula free flap
bone |
augment using angular artery (branch of thoracodorsal)
|
|
|
Actinic Keratosis to SCC
|
10% in 5 years
|
|
|
presure ulcer recurrence post repair (in paraplegia)
|
80%
|
|
|
gracilis flap
|
type II
prim, art = medial circumfles second art = superficial fem. |
|
|
saphenous flap
artey |
saphenous art.
branch of genicular artery |
|
|
fibular flap
bone |
25 cm
maintain 6 cm prox and dist. |
|
|
lower ext. flap choice
prox 1/3 middile 1/3 |
grastocnemius
soleus |
|
|
Flap types
|
I one dom
II one dom several minor III two dom IV mult segmental V one dom several segmental |
|
|
eg. flap
type I |
TFL
gastrocnemius vastis lateralis |
|
|
flap type II
|
gracilis
soleus |
|
|
flap type III
|
gluteus
rectus serratus |
|
|
flap type IV
|
ext hall longus
serratus tib ant |
|
|
flap type V
|
lat dorsi
pect major |
|
|
reverse sural flap
|
5 cm above lat malleous
center over saph vein width = 2 cm contains lesser saph vein deep fascia sural n. superfic sural art. |
|
|
gastrocnemius flap
art |
sural
|
|
|
dx osteomylitis in pressure ulcer
|
MRI
|
|
|
contraindication to hyperbaric O2
|
optic neuritis
existing neoplasm active virus |
|
|
deep peroneal nerve
|
sensory to 1st web space
travels with ant tib/dor ped artery |
|
|
arterial supply
rectus femoris TFL vastus lateralis |
lateral femoral circumflex
|
|
|
gracilis
artery |
medial femoral circumflex
|
|
|
sartorius flap
artery |
superficial circumflex iliac
superficial femoral |
|
|
cover
heel lateral ankle medial ankle |
flex. dig brevis
abductor dig minimi abductor hallicus |
|
|
collagen production/degredation
equlibrium |
21 days
|
|
|
which skin flap provides maximun latitude in positioning the skin paddle?
|
scapula
|
|
|
muscle radiation
transfer risk = |
necrosis
|
|
|
tissue expansion in children
highest rate of complication occurs where |
lower extremity
|
|
|
burn patients
most common cause of death |
pneumonia
|
|
|
dog bite
|
capnocytophaga carnivorsus
Rx = amoxicillin, clavulanic |
|
|
lateral thigh flap
artery |
3rd branch of profundus femoris
originates immediately caudad to adductor brevis |
|
|
salmon eggs
& caviar spots |
lymphangioma (assoc. with bine overgrowth)
|
|
|
dural space ends
|
S 2-3
|
|
|
carbonaceous tatoo
(residual of burn) Rx |
Nd:YAG
(also asphalt, ink from amateur tatoo) multiple treatments |
|
|
dermabrasion end point for reticular dermis
|
confluent bleeding with coarse tissue background
|
|
|
z plasty theoretical gain
|
dergees percent
30 25 45 50 60 75 75 100 90 120 |
|
|
botox
mech of action |
inhibition of acetycholine release at neuromuscular junction
|
|
|
which contain only human dirived material
alloderm apligraf biorane integra transcyte |
alloderm
|
|
|
apligraf
biorane integra transcyte |
apligraf cultured neonatal epidermocytes and bovine collagen
biorane synthetic nylon/silicone integra bovine collagen and silicone transcyte neonatal dermal fibroblasts and silicone/nylon mesh with bovine collagen |
|
|
which is more likely with erb:yag as opposed to co2
erythema scar skin tightening transudate |
transudate
erb:yag absorb in water |
|
|
burn
cardiac output |
decreased 40-60%
(hypovolemia) |
|
|
male pattern baldness
anogen telogen |
anogen (active)decreased
telogen (resting) increased |
|
|
parkland formula
|
4cc/kg/%burn
give 50% in first 8 hours calculated from time of burn |
|
|
bipivercaine longer acting because
|
protein binding
|
|
|
Agdiazine
adverse effect |
neutropenia
|
|
|
extremity mass decomrpesses when elevated
|
venous malformation
|
|
|
wave lengths
erb:yag pulse dye nd:yag co2 |
erb:yag 2940
pulse dye 585 nd:yag 1064 co2 10,600 |
|
|
hemorrhagic necorsis of skin
dissem intravasc coagulation fever shock |
purpura fulminans
60% mortality |
|
|
vascular lesion with central arteiole
|
spider hemangioma
|
|
|
hair donor dominence
|
hairs have individual specific genetically definedlife spans
therefore occipital hair is preferred donor site |
|
|
toxic eipdermal necrosis
scar residua |
none = epidermis only
|
|
|
mechanism of action
silicone scar/scar |
increasing the static electronegative field
|
|
|
preferred reconstruction of 1cm alar defect
|
composite graft from ear
|
|
|
primary benefit of using integra for cover full thickness burn
|
thinner donor site harvest
|
|
|
results from sun exposure
|
lentigines
in addition to scc,bcc,ak, |
|
|
painful lesion on margin of ear
|
chondrodermatitis nodularis helicic
|
|
|
histologic examination of a proliferating hemangioma
|
decreased 17-beta estradiol binding sites
|
|
|
scar evaluation
|
RSTL (relaxed skin tension
lines) vs. ATL (anti- tension lines) width color copntour landmark allignment (i.e. mucocutaneous roll) contracture |
|
|
dextran
|
increased complications
no inc. flap survival |
|
|
pressure ulcer
grades |
I = skin not broken
II = full thickness skin III = to underlying muscle IV = bone or joint involved |
|
|
augmentation pocket irrigation
|
not betadine
(providone-iodine) ans = bacitracin, cefazolin, gentamycin |
|
|
spastic paraplegia
wound closure protection |
intrathecal baclofen pump
|
|
|
burn admission
|
2nd 3rd > 20% any age
" " > 10% under 10 over 50 yrs sig burn face perineum, 3rd deg > 5% any age inhalation component |
|
|
burn reconstruction
|
look carefully at the % tba burn, may preclude flap
|
|
|
avm leg
initial step |
mri/mra
rx = surgery for symptomatic lesions or those fairly easily resectable |
|
|
melasma in fitzpatrick V skin type
rx |
1% tretinoin
|
|
|
6 mo. old with vascular lesion rt. temple and calcification of outer tempmoral cortex
|
capillary hemanioma
(V1 dermatome) sturge-weber syndrome inc.risk siezure, devel delay, hemiplegia, glaucoma, retina detach, blindness |
|
|
silversulfadiazine
causes ? |
decrease in granulocytes
|
|
|
hyaluronic acid dermal fillers
|
said to prolong effect by
molecular cross linking |
|
|
adding albumin at 24hrs post parkland burn resuscitation =
|
maintenance intravasc volume
|
|
|
interga
when to remove silicone layer |
21 days
|
|
|
anhydrous amonia burn to cornea
|
results in liquifaction necrosis - can progress for 2 days even with irrigation
|
|
|
ALA 5-aminolevulinic acid
|
used topically
activated by pulse dye laser rx for aging and acne |
|
|
keratoacanthoma
|
scc
|
|
|
stsg donor site
best for multiple harvest |
thick skin
(dermis never recovers) |
|
|
maximal tensile strength in repaired skin wound\
results from |
molecular cross linking
|
|
|
melena - vasc malformation
mucous membrane, lung, abdomenal visera |
rendu-osler-weber
|
|
|
cell - wound contraction
|
myofibroblast
|
|
|
active hair growth phase
|
anogen
(telogen = resting phase) |
|
|
best bone graft inductive quality
|
autologous cancellous
|
|
|
pectoralis major
artery |
thoracoacormial
|
|
|
most abundant collagen in healed scar
|
type I
|
|
|
black and red tatoo
|
Q-switched Nd:YAG
(switchable) (532 = red, 1064 = black) |
|
|
burn - inhalation injury
30% co2 or higher |
intubate
40-50% = coma, resp depression and deathe |
|
|
predom cell respons for wound healing day 2 - 21
|
fibroblast
|
|
|
integra
|
said to improve cosmesis
when compared to stsg |
|
|
meibobian gland malignancy
|
sebaceous carcinoma
|
|
|
merkel cell carcinoma
origin |
neuroendocrine cells in epidermis
|
|
|
2 month old with circumferential subglottic hemangioma
mild stridor = rx |
corticosteriod
|
|
|
35% tbsa burn
cause of shock via what mechanism |
hypovolemia
|
|
|
large a-v malformation h&n with multiple episodes of bleeding
rx |
excison and immediate flap reconstruction
|
|
|
port wine stain
best laser wave length |
585 nm
(532 = superficial vasc lesion) |
|
|
most effective rx for ischemic flap
|
insure adequate fluid resuscitation
|
|
|
post op alopecia with repeated breakdown
best rx |
tissue expansion
|
|
|
local anesthetic allergy
|
esters (ester cross linked)
benzocaine cloroprocaine procaine tetracaine |
|
|
amide local anesthetics
|
licocaine
bipivacaine mepivacaine prilocaine |
|
|
amide local anesthetics
|
not assoc. with true allergies
when present related to preservatives PABA |
|
|
"doughy" mass grown comsenurate with child
enlarges with viral infections |
lymphangioma
|
|
|
most comm. cause of male pattern baldness
|
inheritance
only cause (X-linked autosomal dominent gene) |
|
|
cap hemangioma in 6 mo. old
rx |
observation
(yellow pulse-dye laser only effective early in prolif phase) |
|
|
grade IV pressure ulcer with communication with hip joint
rx |
resection femoral head and flap reconstr
(vastus lateralis into acetabular fossa) |
|
|
artecol
permanent? |
said to be permanent
(methylmethacrylate beads in a collagen matrix) not avail in u.s. |
|
|
bone, cartilage, fat, muscle
least graft resorption |
cartilage
|
|
|
noncoherant light
|
intense pulse
(not a laser) |
|
|
nevus most difficult to distinguish form melanoma
(clinically and histoloigically) |
spitz nevus
|
|
|
least sensative to inc lidocaine levels
bp, hr, cns, muscle tone |
blood pressure
|
|
|
vitamin E
|
no proof of improving hypertrophic scars
|
|
|
creeping substitution in bone grafting
|
in all except ftt
|
|
|
thigh/buttock lift
prevent scar widening/recur etc. |
suspension superficial fascial
anchor skin to colle's fascia |
|
|
deep devision of supraorbial nerve
supplies |
central scalp
|
|
|
vertical scar reduction mammoplasty
|
central vertical gland resection
|
|
|
shortening or ectropion lower lid post op/trauma
|
shortening posterion lamella (capsulopapebral fascia)
|
|
|
1.5 cm defect on nose
location for best 2nd healing |
medial canthal area
(test answer, be careful with this one) |
|
|
galactorrhea
evaluation |
prolactin level and thyroid function
(also tricyclic antideprss) |
|
|
dr.'s company
most common procedure resulting in malpractice suit |
periqreolar mastopexy
(widening of the areola) |
|
|
suction lipectomy
most common cause of death |
thromboembolism
|
|
|
botox
time of onset of action |
2 weeks
|
|
|
brachioplasty
most common complication |
widening scar
|
|
|
blepharochalasis
|
painless edema of lower lids leading to permanent bags
|
|
|
hair transplant
growth pattern |
growth 1 month
hair loss normal growth after 3 months |
|
|
microtia
rx |
autologous reconstruction age 7 - 8 years.
|
|
|
retinoids
mech of action on skin |
dec. activation
metalloproteases |
|
|
2 week old with prominent ears
rx |
molding ears with splint and tape.
|
|
|
ear, third crus
|
stahl's ear
|
|
|
miosis, anhidrosis, blepharoptosis
|
horner's syndrome
|
|
|
dermabrasion
good for |
graumatid tatoo and perioral rhytids
|
|
|
most common branching pattern for 4th intrcostal n. to nac
|
lateral
|
|
|
blepharoplasty
pain, vomiting, visual disturbances |
retrobulbar hematoma
|
|
|
retrobulbar hematoma
rx |
exploration and latreal canthotomy
|
|
|
smoking and mastectomy
|
risk for native skin flap loss
|
|
|
smoking and tram flap
|
not assoc. with inc risk of
thrombosis fat necrosis flap loss infection |
|
|
gynecomastia
least appropriate rx |
wise pattern
(looks like a female) |
|
|
gracilis
immediate posterior to ? |
adductor longus
|
|
|
groin flap artery
|
superficial circumflex iliac
artery 45-50% common origin with superficial inferior epigastric |
|
|
z-plasty
theoretical gain |
30 deg = 25%
45 deg = 50% 60 deg = 75% 75 deg = 100% 90 deg = 120% |
|
|
3rd degree burn
mech assoc with progession to tissue destruction |
increased chemotaxis
|
|
|
chondrodermatitus helicus
rx |
excision
|
|
|
tram flap
delay = |
increaded diameter of superion epigrastic artery
|
|
|
stsg immediate graft survival
|
plasmatic imbibition
|
|
|
HFl burn
rx |
10% calcium gluconate
inject or topical |
|
|
most common unfavorable result from augmentation with acellular dermal homograft
|
resorption
|
|
|
holo nevus
reason to treat |
only when the nevus resembles a melanoma
|
|
|
Dapsone
complication |
hemolysis
(used to rx brown spider bite) |
|
|
silicone implant rupture
when |
mean = 13 years
|
|
|
multiple keratoacanthomas (or scc/bcc) assoc with viseral malignancy
|
Muir-torre syndrome
colon,kidney,bladder, ovary, pancreas, breast |
|
|
lidocaine,
max safe dose in child |
4.5 mg/kg
|
|
|
best test to see avm assoc with surrounding tissue
|
mri
|
|
|
sclerosing bcc
best rx |
moh's
(test answer) |
|
|
autologous fat injection and blindness +/- cns cmplx
|
glabellar injection
|
|
|
vit c deficiency
results in decreased |
hydroxylation of amino acids (lysine and proline)
|
|
|
% hemangiomas noted in 1st month of life
|
80%
|
|
|
accelular dermal sheet lip augmentation
anatomic placement |
subcutaneous
along wet/dry vermillion border |
|
|
spitz nevus
most common location |
head and neck
|
|
|
Hutchin's melanotic freckle
|
lentigo maligna melanoma
(melanoma in situ) |
|
|
topical reversing potential of developing premilagnant skin lesions
|
retinoids
|
|
|
fracture not visable on initial x-ray
Dx |
wait 2 weeks and repeat x-ray
|
|
|
dysplastic nevus and melanoma
|
very few dysplastic nevi go on to become melanoma
cancer65:12321,1990 |
|
|
most effective method of clearing bone adherent bacteria in an open wound
|
surgical soap
|
|
|
melanoma biopsy
lesion size |
lesions less than 1.5 cm should be completely excised
|
|
|
melonma biopsy
thickness of biopsy |
always full thickness skin
|
|
|
melanoma
sentinel lymph node indications |
breslow 1.0 - 3.99mm
male trunk lesion breslow >.76mm thin melanoma with the following regression, lymphocytic infiltrate, ulceration, clark level III |
|
|
doughy mass growing comensurate with the child
|
lymphangioma
|
|
|
saphenous artery is a branch of ?
|
genicular
|
|
|
dermabrasion end point bleeding
papillary dermis reticualar dermis |
pap = sparse pin point
retic = confluent |
|
|
mech of action of botox
|
inhibits acetylcholine release at neuromusc. junction
|
|
|
organisms in hydradenitis
|
staph aureus
strep viridans |
|
|
becker nevus
Misnomer? |
yes
is smooth muscle therefore a hamartoma |
|
|
vascular lesion with central arteriol
|
spider hemangioma
|
|
|
epidermolysis bullosum
need for splinting to prevent contracture |
none
|
|
|
advantage of using "Integra" in full thickness skin loss
|
able to use thinner autograft
|
|
|
test dose of Zyderm (bovine collagen)
delay time to second injection |
4 weeks
|
|
|
gracilis blood supply
|
medial femoral circumflex
secondary for superficial fem. |
|
|
lentigo - etiology
|
caused by sun exposure
|
|
|
mathes/nehai classification
|
I one dom. ped
II one dom and mult minor III dual dom ped IV segmental' V one dom and mult segmental |
|
|
oral splinting for electrical burn to commisure
length of time ? |
6 months
|
|
|
SENSATE flap with bone for oral reconstruction
|
lateral arm flap
(bone = 10-15x1-2cm) |
|
|
black widdow spider venum
|
name = latrodectus mactans
neurotoxin |
|
|
black widdow spider
Rx |
methocarbamol or valium
antivenum in immunocompromised patient only |
|
|
brown recluse spider
vinus |
sphyngomyelinate (dermonecrotic factor, hemolysis, platelet aggrigation, coagulation)
|
|
|
wolf's law and bone graft survival
|
stress is necessary
|
|
|
periosteum and bone graft survival
|
preservation of periosteum increases bone survival at all stages
|
|
|
membraneous vs enchondral bone
|
membranous bone inc survival
|
|
|
stsg grows proportional with the child
true or false |
false only ftsg
|
|
|
bovine collagen most effective when injected into which site
|
dermis
|
|
|
hydroxyapatite
osteo inductive or conductive |
osteoconductive
|
|
|
hydroxyapatite
effect on ct scan |
none
|
|
|
radial forearm flap
venous outflow |
radial venous comitantes
|
|
|
EMLA cream
delay needed for most effective |
60 min.
|
|
|
progressive edema in upper or lower extremity of child with edema since birth
Dx |
Milroy's disease
|
|
|
lymphedema praecox
|
noncongenital
first presents after puberty |
|
|
will an implanted silicone shell lose biomechanical strength over time
|
yes
|
|
|
nevus of Oto
|
trigeminal distribution
Ito = arm and supraclavicular |
|
|
Rx of hemangioma obstructing vision in an infant
|
excision
(not sure but believe there is an answer on another card that says steriods, poss. infant is the key word) |
|
|
amblyopia
duration of onset |
some studies say as early as one week
(permanent functional blindness following obstruction of vision) |
|
|
free osteocutaneous flap with maximum freedom of positioning skin paddle
|
scapula
|
|
|
burn scar excision and best wound cover
|
one question = ftsg
|
|
|
sebaceous carcinoma
most frequent site |
eyelid
|
|
|
primary closure of sclap defect
|
answer is < 5cm
(i doubt 4 cm is closable) |
|
|
paraplegic
most common cause of death |
renal falilure (chronic amyloidosis)
|
|
|
isotrentoin inhibits
|
epitheliazation
(accutane) |
|
|
erythroplasia of queyrat
|
scc - penis
|
|
|
which graft tissue shows the least graft resorption
|
cartilage
|
|
|
skin defect upper eyelid
cannot close primarily |
ftsg from other upper lid
|
|
|
percent of patients that have infection with aeromonas hydrophilia after 10 days of leach therapy
|
20%
|
|
|
port wine stain is ?
|
cappilary malformation
|
|
|
retin-a (trentinoin) causes
|
decrease in stratum corneum thickness (or "compacting of statum corneum)
|
|
|
allergic rxn to Zyderm
collagen type? % allergic? antibody response |
bovine
3% IgG |
|
|
what characteristic of ftsg inhibits wound contraction
|
% of transferred dermis
|
|
|
vascular abnormality leading to bone destruction
|
avm
|
|
|
collagen equilibrium in wound
production=degredation |
21 days
|
|
|
burn allopecia
Rx |
tissue expansion
|
|
|
columellar defect
best flap |
nasolabial (nlf)
prob better with composite graft |
|
|
fluroscein and flap monitoring
|
not useful for continuous monitoring
|
|
|
best method to monitor jejunal free flap for esophygeal reconstruction
|
exteriorize a portion
|
|
|
periosteal branches of the peroneal artery are found on which aspect of the fibula
|
posteromedial
|
|
|
septal perforation
Rx |
uni or bipedicle septal mucosal flaps
|
|
|
"clean" laceration
rec. for abiotic |
none
rate of infection 5% with abiotic 3% without abiotic |
|
|
most common complx post excision keloid ear with radiation and cortisone
|
recurrence
|
|
|
local anesthetic with sympathomimetic actions
|
cocaine
|
|
|
highest anatomic site for complications with tissue expanders
|
lower extremity
|
|
|
physiologic effect of vit e
|
papular and follicular DERMATITIS
(no effect on scars) |
|
|
clean laceration of face in child with incomplete tet toxoid immunization
recommedation |
tet tox at time of Rx then completion of immun schedule
|
|
|
dog bite wound
abiotic |
amoxicillin-clavulanic acid
(org = capnocytophaga canimorsus) |
|
|
Wartenberg sign
|
inability to adduct small finger
|
|
|
medial plantar flap
artery location |
medial plantar artery
between abd hallucis and flex dig longus tendons |
|
|
true hand dominence occurs at what age
|
18 - 24 months
|
|
|
traumatic exposure of extensor mechanism of finger
Rx |
"reverse" cross finger flap
|
|
|
weight bearing heal defect
flap? |
medial plantar fasciocutaneous flap
|
|
|
pain stiffness and disability relating to a single digit injury
Rx |
ray amputation
|
|
|
finger tip amputation in child
|
heal by secondary intent when part not available
|
|
|
central digit amputations
functional problem = Rx |
fingers cross when making a fist
Rx = transposition of adjacent digit or "metacarpal jog" |
|
|
canal of guyon
|
no sensory deficiet
|
|
|
post traumatic scaphoid - radius arthritis
Rx |
four corner arthrodesis and excison of scaphoid
(capitohamatotriquetrolunate arthrodesis) |
|
|
phenol peel vs dermabrasion
which causes less bleaching |
dermabrasion
|
|
|
corticosteroids mechanism of action in slowing hemangioma growth
|
block estradiol receptors
|
|
|
effect of corticosteroids on stable or involuting hemangioma
|
none
|
|
|
dic in meningococcal sepsis
rx |
administration of activated protein c
|
|
|
6 month resorption of injected fat
|
30% (new answer)
supramuscular site = best survival (81%) |
|
|
hair grows from where in follicle
|
base
|
|
|
"best" stsg donor site dressing
|
op site, tegaderm ("semi-occlusive)
duoderm is considered occlusive |
|
|
microscopic changes in stsg at 2 days
|
edema
not ischemic changes |
|
|
scalp expansion
beneath which layer |
galea
|
|
|
advantage of marcaine (bupivacaine)
|
less motor blockade
|
|
|
Juri flap
|
anterior hairline reconstruction
(temporoparietaooccipital) |
|
|
VAC Rx
wound characteristic with greatest negative effect on outcome |
fibrosis
(chronic wound) |
|
|
giant nevus
(congenital melanocytic nevus) risk of malignancy Rx |
less than 10%
excision if diameter > 20cm (when feasible) |
|
|
medial grastrocnemius
artery |
medial sural
|
|
|
`pressure ulcers
|
excision of the ulcer
not debriedement |
|
|
keloid vs. hypertrophic scar
fibroblast/myofibroblast |
mysofibroblasts not found in keloidd
|
|
|
cutaneous herpes post face resurfacing
|
IV acyclovyr or valacyclovyr
|
|
|
risk of Medpor (high density polyethylene)
|
increased risk of exposure
|
|
|
most appropriate abiotic for necrotzing fasciitis
|
clindamycin
|
|
|
restylene
wrinkle correction at 1 year |
33%
|
|
|
rib cartilage grafting
most effective at long term warping control |
wait 30 minutes before insertion
let initial warping occur and acount for it (???????) |
|
|
neurobfibroma with rapid growth or pain
|
excise
risk malig. (3 - 15%) |
|
|
neurofibromatosis
von recklinghausen |
mild to major
all sex, races central or peripheral varients |
|
|
chronic wound
metalloproteinase level |
increased
|
|
|
sudden swellin and pain in lymphangioma
Rx |
abiotic
|
|
|
telogen phase of hair growth
|
10% of follicles
lasts 2 - 4 months |
|
|
cancellous bone vs cortical
inductive, conductive |
more osteoinductive and osteoconductive
more easily vascularized and remodelled |
|
|
Branham sign
|
slowing of the heart rate with compression proximal to an av malformation
|
|
|
escar present on a composite graft
Rx |
observation
may be superficial |
|
|
mechanism of action in compression garment in scar
|
hypoxia of local tissue
|
|
|
alloplastic cheek implant
under what layer |
subperiostal
|
|
|
SGAP flap disadvantage
|
fat is more difficult to mold
|
|
|
least volume graft loss
dermis fat muscle cartilage bone |
cartilage
|
|
|
with no inhalation injury, early respiratory distress post burn
cause |
inflammatory interstitial edema
|
|
|
following primary wound closure - how long for epithelization (epidermis to be restored)
|
24 hours
|
|
|
how long after acute burn injury is optimal for free tissue transfer
|
4 - 6 weeks
?hypercoaguable state post burn |
|
|
best timing for free tissue transfer for lower ext. reconstr.
|
early, within one week
|
|
|
post intrgra stsg application
when |
2 - 4 weeks
can do at 2 weeks some suggestion that "take" is better at 4 weeks |
|
|
frontonasal flap
artery supply |
angular
|
|
|
swellin in cheek increasing over weeks post injury
dx initial dx test |
injury to parotid duct (stenson)
canalize the duct |
|
|
wave length for laser tatoo removal of red dye
|
532 nm
|
|
|
pain over lateral thigh post iliac bone harvest, which nerve injured
|
lateral femoral cutaneous
|
|
|
transforming growth factor and fibroblast growth factor come from which cell
|
platelet
|
|
|
collegenase and cytokines from which cell
|
macrophages
|
|
|
maximum safe dose of topical cocaine
|
1.5 mg/kg
vasoconstrictive effect |
|
|
painful nodule on ear
|
chondrodermatitis nodularis helicus
|
|
|
apligraf
|
neonatal foreskin
|
|
|
alloderm
|
acellular cadaveric dermal matrix
|
|
|
integra
|
bovine tendo collagen covered with silicone
|
|
|
delay in ischial pressure wound closure awaiting nutritional improvement
|
vac
|
|
|
advantage of alloderm to alloplatic mesh
|
resists infetion better
|
|
|
best measure of adequate fluid ressus in acute burn
|
urine output, 0.5 ml/kg/hr
|
|
|
function of latissimus dorsi muscle
|
shoulder adduction and extension
|
|
|
port wine stains (cap malformations) respond best in what anatomic area to pulse dys laser
|
neck
central face area least favorable |
|
|
alopecia areata
cause Rx |
autoimmune
corticosteroids (25% recover in 3 years) |
|
|
acute burn wound excision and grafting - most important factor in stsg survival
|
timing of excision (best early 24 hrs)
|
|
|
peak tensile strength of skin incision
|
60 days = 80% of normal
|
|
|
Oral abiotic Rx for MRSA
|
trimethoprim-sulfamethoxazole
|
|
|
Rx of painful vssicles post peal or laser
|
anti viral (valacyclovir)
herpes simplex type 1 |
|
|
Mafucci syndrome
|
venous malformation
enchondroma exostoses |
|
|
advantage of vasc bone to free bone graft
|
viable osteocytes
use in defects >6cm |
|
|
"waxy" friable skin lesion
|
seborrheic keratosis
|
|
|
Rx of decreasing O2 sat post closed space burn
|
intubation\ bronchoscope
|
|
|
recurrence rate for Moh's Rx of BCC
|
3-8%
(and they make that sound good?????) |
|
|
contraindication to use of endtine fixation brow lift
|
thin crakial bone or thin scalp
|
|
|
atologous rib cart graft
best method to inhibit post op warping |
balanced crossectional carving, use straigt rib segments and wait 30 min after harvest to allow for natual deformities to occur.
|
|
|
most common site for burn contacture above the waist
|
neck
|
|
|
predom artery supply to lower portion of trapezius
|
dorsal scapular
|
|
|
predom artery supply to superior trapezius
|
occipital artery
|
|
|
middle trapezius
artery ? |
superficial cervical artery
|
|
|
red mottled color to skin over tissue expander
|
normal
|
|
|
only filler approved for lipodystrophy Rx in HIV
|
sculptra (poly-l-lactic acid)
|
|
|
radiesse = ?
|
hydroxyapatite
|
|
|
hyperbaric O2 effective for rx of what wounds
|
diabetic lower extermity
???????? |
|
|
complication of Dextran (low molecular weight dextran)
|
adult resp distess syndrome
|
|
|
application of vac immediately post grafting
|
improves survival
|
|
|
hair color and laser removal
|
darker = better
|
|
|
vit C in wound healing
|
cofactor in hydroxylation of proline and lysine for procollagen formation
|
|
|
most likely local anesthetic for allergic rxn
|
procaine (ester)
|
|
|
subscapular system supplies
|
scapula and parascapular
serratus rib |
|
|
recurrent infections in subcutaneous increasing mass in infant
Dx Rx |
lymphangioma
resection |
|
|
secondary procedure timing after forehead flap
|
3-4 weeks
|
|
|
mechanism of action of silicone sheeting on scar
|
hydration
(?????) |
|
|
medial gastroc. flap
artery ? |
sural
|
|
|
congentital melanocytic nevus = greatest other system at risk
|
CNS (neruoleptomeninges)
|
