OMSITE TEST PAPER QUESTIONS AND ANSWERS
SET A+
✔✔Platelets: day 3-5 PDGF, EGF, TGF-B, macrophages take over days 5-7 - ✔✔TGF
beta is produced by what cells during bone healing?
✔✔Hemimandibular elongation: condylar overgrowth only, will progress to:
Hemimandibular hypertrophy: diffuse enlargement of the condyle and mandibular body -
✔✔Hemimandibular elongation vs. hypertrophy
✔✔Donor site morbidity (tendon exposure + need for skin graft) - ✔✔What is the main
disadvantage of a radial forearm free flap
✔✔Medial (ulnar side) forearm- radial artery supplies the flap, skin on ulnar surface is
supplied by the ulnar artery, if you get too far from the radial artery the tissue will not
survive. If you dissect medial/ulnar you can compromise blood supply to the hand -
✔✔What limits the size of radial forearm free flap
✔✔Full thickness posterior auricular skin graft (best color match, perichondrium must be
intact otherwise need to do a rotational flap) - ✔✔Lesion off tip of nose- full thickness
defect with cartilage exposure but perichondrium is intact what is the best graft to use in
this area
✔✔Resection with 1cm margin (no radiation), superficial parotidectomy if in parotid -
✔✔Treatment of small low grade mucuepidermoid carcinoma
✔✔PLGA (65% in palate)- (also adenoid cystic carcinoma) - ✔✔Which has a propensity
for neural involvement?
✔✔Eyelid or nose and sclerosing (morpheaform) BCC due to the finger like projections -
✔✔What situation is MOHS surgery best used?
, ✔✔Nodular, sclerosing (morpheaform), basosquamous, multicentric - ✔✔4 types of
BCC
✔✔High to low: dexamethasone > prednisone > hydrocortisone > fludrocortisone -
✔✔Highest glucocorticoid: mineralocorticoid ratio
✔✔8 hours - ✔✔Cocaine positive urinalysis, how long to wait before operating?
✔✔Ephedrine (and Demerol)
Epinephrine, NE, and levonordephrine area OK. - ✔✔Absolute CI in MAO-I use:
✔✔Hyperkalemia - ✔✔What must you check for preop in ESRD patients?
✔✔Liver issues (amides metabolized in the liver)- lidocaine = liver, any anesthetic with
two "I"s = amide, articaine is both an amide and an ester - ✔✔Metabolism of amide
anesthetics like lidocaine may be decreased by what?
✔✔For ST elevation in 2 contiguous leads. Except for inferior MI (leads II, III, avF)
because this is volume dependent - ✔✔Patient has chest pain- you give ASA,
morphine, and O2. What do you give nitro?
✔✔Negative inotropic action (decreased contractility)- a2B agonist (tachy, flushing,
hypotension/syncope). Also terminates shivering - ✔✔What are the CV effects of
Demerol (meperidine)
✔✔Narrowest point is subglottic (below cords)- it's at the cords in adults, if ETT is tight
at the level of the cricoid can cause edema and post extubation croup.
Vocal cords are more caudal anteriorly
Larynx at level C3-4 (C4-6 in adults) - ✔✔Pediatric airway differences- especially
position of larynx and vocal cords
✔✔Large lesions: resect with 1cm bony margins and 1 uninvolved anatomic barrier, 15-
30% recur with E&C, be more aggressive with maxillary lesions
Amelo, myxoma, and CEOT always require resection - ✔✔Treatment for CEOT
✔✔20-25% (most common complication is vertical relapse) - ✔✔How much should you
over-compensate on a DO?
✔✔1.5mm - ✔✔When doing a semilunar advancement flap to cover an implant
restoration, how much should you over-advance (overcorrect) the flap?
SET A+
✔✔Platelets: day 3-5 PDGF, EGF, TGF-B, macrophages take over days 5-7 - ✔✔TGF
beta is produced by what cells during bone healing?
✔✔Hemimandibular elongation: condylar overgrowth only, will progress to:
Hemimandibular hypertrophy: diffuse enlargement of the condyle and mandibular body -
✔✔Hemimandibular elongation vs. hypertrophy
✔✔Donor site morbidity (tendon exposure + need for skin graft) - ✔✔What is the main
disadvantage of a radial forearm free flap
✔✔Medial (ulnar side) forearm- radial artery supplies the flap, skin on ulnar surface is
supplied by the ulnar artery, if you get too far from the radial artery the tissue will not
survive. If you dissect medial/ulnar you can compromise blood supply to the hand -
✔✔What limits the size of radial forearm free flap
✔✔Full thickness posterior auricular skin graft (best color match, perichondrium must be
intact otherwise need to do a rotational flap) - ✔✔Lesion off tip of nose- full thickness
defect with cartilage exposure but perichondrium is intact what is the best graft to use in
this area
✔✔Resection with 1cm margin (no radiation), superficial parotidectomy if in parotid -
✔✔Treatment of small low grade mucuepidermoid carcinoma
✔✔PLGA (65% in palate)- (also adenoid cystic carcinoma) - ✔✔Which has a propensity
for neural involvement?
✔✔Eyelid or nose and sclerosing (morpheaform) BCC due to the finger like projections -
✔✔What situation is MOHS surgery best used?
, ✔✔Nodular, sclerosing (morpheaform), basosquamous, multicentric - ✔✔4 types of
BCC
✔✔High to low: dexamethasone > prednisone > hydrocortisone > fludrocortisone -
✔✔Highest glucocorticoid: mineralocorticoid ratio
✔✔8 hours - ✔✔Cocaine positive urinalysis, how long to wait before operating?
✔✔Ephedrine (and Demerol)
Epinephrine, NE, and levonordephrine area OK. - ✔✔Absolute CI in MAO-I use:
✔✔Hyperkalemia - ✔✔What must you check for preop in ESRD patients?
✔✔Liver issues (amides metabolized in the liver)- lidocaine = liver, any anesthetic with
two "I"s = amide, articaine is both an amide and an ester - ✔✔Metabolism of amide
anesthetics like lidocaine may be decreased by what?
✔✔For ST elevation in 2 contiguous leads. Except for inferior MI (leads II, III, avF)
because this is volume dependent - ✔✔Patient has chest pain- you give ASA,
morphine, and O2. What do you give nitro?
✔✔Negative inotropic action (decreased contractility)- a2B agonist (tachy, flushing,
hypotension/syncope). Also terminates shivering - ✔✔What are the CV effects of
Demerol (meperidine)
✔✔Narrowest point is subglottic (below cords)- it's at the cords in adults, if ETT is tight
at the level of the cricoid can cause edema and post extubation croup.
Vocal cords are more caudal anteriorly
Larynx at level C3-4 (C4-6 in adults) - ✔✔Pediatric airway differences- especially
position of larynx and vocal cords
✔✔Large lesions: resect with 1cm bony margins and 1 uninvolved anatomic barrier, 15-
30% recur with E&C, be more aggressive with maxillary lesions
Amelo, myxoma, and CEOT always require resection - ✔✔Treatment for CEOT
✔✔20-25% (most common complication is vertical relapse) - ✔✔How much should you
over-compensate on a DO?
✔✔1.5mm - ✔✔When doing a semilunar advancement flap to cover an implant
restoration, how much should you over-advance (overcorrect) the flap?
