Plastic and Reconstructive Surgery Quiz

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Quiz on Plastic and Reconstructive Surgery

1. Which of the following arteries does not provide blood supply to the nipple areola complex ?
(1) Internal mammary artery
(2) Intercostal perforators
(3) Superior thoracic artery
(4) Lateral thoracic artery

2. The most constant nerve that innervates the Nipple Areola complex is
(1) 2nd Lateral Intercostal Nerve
(2) 3rd Lateral Intercostal Nerve
(3) 4th Lateral Intercostal Nerve
(4) 5th Lateral Intercostal Nerve

3. Which one of the following free flaps is the flap of choice for reconstruction of breast ?
(1) TRAM flap
(2) Anterolateral thigh flap
(3) Tensor fascia lata flap
(4) Gluteal flap

4. An undesirable complication observed by the patient following reduction mammoplasty
(1) unequal reduction and nipple asymmetry
(2) Fat necrosis
(3) Dog ear
(4) Hypertrophic scarring

5. In delayed breast reconstruction, the biggest disadvantage of using internal mammary vessels as recipient vessels for free TRAM flap is
(1) small size of artery
(2) inconsistent size of vein
(3) abnormal course of artery
(4) difficulty in access of these vessels

6. Which one of the following is an absolute contraindication for the use of latissimus dorsi muscle flap for breast reconstruction ?
(1) previous posterolateral thoracotomy
(2) Smoker
(3) Diabetes mellitus
(4) Prior division of the thoracodorsal artery

7. A case of woody hard breast where the implant cannot be felt would fall into which grade as per Baker’s classification
(1) Grade 1
(2) Grade 2
(3) Grade 3
(4) Grade 4

8. Which of the following vessel is preferred as a recipient vessel for a free TRAM flap in immediate breast reconstruction ?
(1) Thoraco-dorsal vessels
(2) Intercostal vessels
(3) Thoraco — acromial vessels
(4) Internal mammary vessels

9. The skate flap has been described for the reconstruction of which one of the following :
(1) Oral commissure
(2) Nipple
(3) Lower lip
(4) Soft tissue contour deformity

10. The rough texture of areola is due to the presence of which one of the following :
(1) Cooper’s ligament
(2) Sweat glands
(3) Montgomery glands
(4) Acne

11. The following is true regarding vaginal agenesis
(1) urinary abnormalities are rare
(2) caused by a defect in the mesonephric duct
(3) can be treated with a split skin oraft
(4) vascularised bowel is the worst reconstruction option

12. With regards to management of pressure sores which is true ?
(1) Serum albumin measurements are helpful as a prelude to surgery
(2) Surgical management is preferred
(3) MRI is a poor modality in the assessment of osteomyelitis
(4) Herbal remedies with or without acupuncture are often curative

13. In relation to penile reconstruction, which one of the following is true ?
(1) An ulnar forearm free flap reconstruction has significant advantages over a radial forearm free flap
(2) Reconstruction to fulfil sexual function and achieve orgasm is not feasible
(3) Vascularised bone reconstruction using a free fibular flap is a fallacy
(4) Penile nerve supply is exclusively from the genitofemoral nerve

14. Which method used to repair hypospadias is the odd one out ?
(1) Byars
(2) Cecil Culp
(3) Horton Devine
(4) Duplay

15. Which is true regarding osteomyelitis in the lower limb ?
(1) The commonest causative organism overall is streptococcus 3 pyogenes
(2) is classified by pairolero
(3) the incidence in severe open tibial fractures is reduced from almost 50% to less than 1% with prophylactic antibiotics
(4) A common causative organism in relation to joint replacements is a common skin commensal

16. For reconstructing a defect of the abdominal wall that is less than 7 cm which of the following is a technique of choice :
(1) Primary direct and layered closure
(2) Local fasciocutaneous flap
(3) Rectus abdominis musculocutaneous flap
(4) Free anterolateral thigh flap

17. Chordee is present circumferentially in which of the following location ?
(1) 6 O’ clock position
(2) all around the organ
(3) ventrally from 3 O’ clock to 9 O’ clock position
(4) dorsally from 9 O’ clock to 3 O’ clock position

18. In Filarial lymphoedema of lower extremity and genitalia, which part escapes involvement in penis ?
(1) Penile base
(2) Penile shaft
(3) Glans and prepuce
(4) None of the above

19. An associated condition with hypospadias is
(1) ventral curvature
(2) misplaced urethral opening on ventral surface of penile shaft
(3) dorsal hood of skin
(4) cryptorchidism

20. Which one of the following is the method of choice for vaginal reconstruction following pelvic exenteration ?
(1) Flap of colon
(2) Gracilis flap
(3) Full thickness skin graft
(4) Split thickness skin graft

21. A decubitus ulcer with exposed bone would be placed in which grade
(1) Grade 1
(2) Grade 2
(3) Grade 3
(4) Grade 4

22. Peyronie’s disease is characterised by the formation of fibrous nodules within which of the following layer ?
(1) Skin
(2) Tunica albuginea
(3) Buck’s fascia
(4) Dartos fascia

23. Virchow’s triad related to deep venous thrombosis in lower limb consists of venous stasis, intimal injury and
(1) Thromboembolism
(2) Hypercoagulability
(3) Low platelet count
(4) Protein C deficiency

24. Which one of the following is an ingredient of tumescent fluid for liposuction that requires bicarbonate need ?
(1) Ringer lactate
(2) Normal saline
(3) Epinephrine
(4) Lidocaine

25. The increased blood viscosity in diabetic microangiopathy is attributed to
(1) White blood cell
(2) Red blood cell
(3) Platelet
(4) Macrophages

26. The various compartments of leg have blood supply from two angiosomes except
(1) Anterior compartment
(2) Lateral compartment
(3) Posterior compartment
(4) Deep Posterior compartment

27. The MAGPI (Meatal advancement and glanuloplasty incorporation) procedure is indicated for which one of the following :
(1) Coronal hypospadias without chordee
(2) Midpenile hypospadias with chordee
(3) Penoscrotal hypospadias
(4) Perineal hypospadias

28. Which one of the following pressure sore typically presents with minimal skin involvement and extensive bursa formation ?
(1) Sacral
(2) Trochanteric
(3) Ischial
(4) Heel

29. The primary advantage of a musculocutaneous perforator flap is to
(1) Spare the muscle
(2) Increase the vascularity of the flap
(3) Increase the versatility of the flap
(4) Increase the skin island of the flap

30. Which of the following is true in the reconstruction of traumatic lower limb injuries ?
(1) Use of the medial head of gastrocnemius leads to a significant functional deficit
(2) Scoring of the fascia of gastrocnemius can allow the flap to cover a larger area
(3) Soleus and gastrocnemius have the same pattern of vascular supply
(4) The lateral head of gastrocnemius is larger than the medial head

31. The mechanism of tissue injury in electrical burns is due to
(1) Thermal trauma
(2) Passage of current through the skin, subcutaneous tissue, nerves, vessels and muscles which offer least resistance
(3) High levels of chemicals that develop inside the tissues namely thromboxane
(4) All of the above

32. In a case with burn contractures of the axilla, elbow and wrist which one should be released first
(1) Axilla
(2) Elbow
(3) Wrist
(4) All of them simultaneously

33. The specific antidote for hydrofluoric acid burns of an upper extremity is
(1) Milk
(2) Calcium gluconate gel
(3) Kerosene
(4) Dilute sodium hyposulfite

34. Contracture is defined as
(1) Limitation of active and passive range of motion across a joint
(2) Fibrosis of skin or underlying musculoskeletal structures across a joint
(3) Approximation of the two opposing surfaces across a joint due to fibrosis with loss of full range of active and passive motion
(4) Contracture of joint with loss of passive movements

35. A burnt hand should be kept elevated and dressed in
(1) Coin picking position
(2) Cricket ball holding position
(3) Hammer throw position
(4) Any of the above

36. Cubital tunnel syndrome is compression of which one of the following nerves ?
(1) Median nerve
(2) Radial nerve
(3) Ulnar nerve
(4) Posterior interosscous nerve

37. How many nerve compression syndromes have been described in the upper extremity ?
(1) Six
(2) Seven
(3) Eight
(4) Nine

38. Buried dermal flap procedure for treatment of lymphoedema was popularised by
(1) Kondolean
(2) Thompson
(3) Miller
(4) Charles

39. Hypoplastic thumbs type II of the Blauth classification can be treated successfully by
(1) Releasing the contracted 1st web space, reconstruction, of ulnar collateral ligament, transposition flap in 1st web space, a full thickness skin graft and opponensplasty.
(2) Releasing the contracted 1st web space, reconstruction of radial collateral ligament, transposition flap in 1% web space, a full thickness skin graft and opponensplasty.
(3) Amputation of the hypoplastic thumb and a toe to hand transfer
(4) Amputation of hypoplastic thumb, index finger pollicisation and FTG

40. Regarding tumours in the hand which is true ?
(1) Giant cell tumours of tendon sheath are always related to synovium
(2) Melorheostosis is a lymphoma
(3) Hildreth’s test differentiates glomus tumours from other vascular tumours
(4) Giant cell tumours of tendon sheath recur commonly and are usually benign.

41. A contraindication to centralisation or radialisation of radial club hand is
(1) Stiff elbow
(2) Stiff finger
(3) Stiff shoulder
(4) Absent thumb

42. In carpal tunnel syndrome all are true except
(1) there is a 25% incidence in males
(2) carpal tunnel decompression was first performed in 1896
(3) it is commonly bilateral
(4) the age of presentation rises towards a peak in the late fifties

43. Excision of a ganglion on the dorsum of the wrist may lead to development of a neuroma in relation to which one of the following nerve
(1) Radial
(2) Median
(3) Ulnar
(4) Posterior interosseous

44. Crossed polydactyly refers to
(1) Radial polydactyly
(2) Ulnar polydactyly
(3) Radial and Ulnar polydactyly
(4) Both hand and feet polydactyly

45. While managing electrical burns of the hand and upper extremity during initial exploration and debridement of necrotic tissue one should refrain from
(1) Extensive debridement of tendons
(2) Ulnar and median nerve debridement
(3) Both (1) and (2)
(4) None of the above