KEAN
Comprehensive Abdominal Wall Reconstruction Quiz
Test your knowledge on abdominal wall reconstruction with this extensive quiz featuring 232 carefully curated questions. Designed for healthcare professionals and students alike, this quiz covers various topics related to surgical techniques, complications, and classifications.
- In-depth questions on hernia repairs
- Focus on nerve injuries and repair techniques
- Assess your understanding of reconstruction methods
1. Border of abdominal wall :
A. Superiorly: Xiphoid process and costal cartilage of ribs 7 and 12
B. Inferiorly: Pubic tubercle and inguinal ligament
Laterally: Midaxillary line
D. All above
D. Laterally: Midaxillary line
2. Which of these component are not concern to abdominal wall
A. Skin and subcutaneous fat
B. Supercial fascia
C. Pericardium
D. Myofascialanatomy, Transversalis fascia
E. Intraperitoneal fat , Parietal peritoneum
3. Risk factor of hernia recurrence
A. Surgical technique
B. Patient factor
C. Wound factor
D. Comorbidities associated
E. All correct
4. Grading of hernia defect by the Ventral Hernia Working Group(VHWG).
A. 2 grade
B. 3 grade
B. 4 grade
B. 5 grade
B. 6 grade
5. Principle repair of abdominal defect
A. Patient optimization
B. Preparation of wound
C. Reapproximation and centralization of rectus muscles to the midline (to the extent possible) using component separation when appropriate
D. Appropriate use of reinforcement material
E. All correct
6. Goal of reconstruction of abdominal wall defect :
A. Prevent visceral eventration
B. Prevent tension-free skin reapproximation and provision of stable soft tissue coverage
C. Restoration of physiologic tension of musculofascia
D. Provide dynamic muscle support
E. All correct
7. Surgical technique by Mesh replacement in hernia defect may be secured as
A. Under layer
B. Overlay
C. Interposition
D. Double lay
E. All correct
8. Complication of reconstruction abdominal defect
A. Infection: Most commonn Seroma
B. Cardiac, pulmonary, or other end-organ dysfunction
C. Enterocutaneous fistula
D. Abdominal compartment syndrome and Recurrence
E. All correct
9. Here are the method of repairing hernia defect, except :
A. Skin graft
B. Retromuscular hernia of the Rives-Stoppa repair uses the space between the rectus muscle fascia and the posterior rectus fascia.
C. Transversus abdominis release (TAR), an extension of the Rives-Stoppa method, uses a posterior component separation
D. Tissue expansion
E. Free tissue transfer
10. Which of the following state that is not concern to treatment algorithm of hernia
A. Grade 4 hernia defects should be repaired by open procedures
B. Synthetic repair materials are most suitable for grade 1, some grade 2, and few grade 3 defects
C. Conversely, biologic materials should be used in all grade 4 hernias
E. Grade 4 hernia defects should be repaired by Endoscopic-assisted component separation
D. Mesh material should be used mostly in grade 3 hernias, and some grade 2 defects
11. Comorbidities associated with increased rates of wound infection include
A. Smoking
B. Diabetes
C. Chronic obstructive pulmonary disease
D. Coronary artery disease (CAD)
E. All correct
12. Physical examination in abdominal wall defect, except
A. Acute versus chronic defect
B. Anatomic tissues involved (i.e., partial versus full thickness)
C. Size and location of defect
D. Wound contamination
E. Under weight
13. Indication of abdominal wall reconstruction, except
A. Hernia repair
B. Congenital defect
C. Tumor defect
D. Traumatic defect
E. Peritonitis
14. Local flap in abdominal reconstruction, except
A. External oblique flap
B. DIEP flap
C. Rectus abdominis flap
D. Groin flap
E. Soleus flap
15. Secondary procedure of abdominal wall reconstruction, except
A. Scar revision
B. Contour improvement/ panniculectomy
C. Correction of diastases
D. Umbilical reconstruction
E. Laparoscopy
16. Local flap for abdominal upper third defect
A. Thoraco epigastric flap and EO flap(rotational flap)
B. DIEP Flap
C. SIEP Flap
D. Groin Flap
None
17. Local flap for abdominal lower third defect
A. Thoracto epigastric flap
B. EO flap (rotation flap)
C. Rectus abdominis flap
D. DIEP flap, SIEP flap and Groin flap
E. Non
18. Local flap for abdominal midd third defect
A. ilio-lumbar bipedicled flap (based on superficial circumflex iliac & lumbar perforators)
B. DIEP flap
C. Groin flap
D. EO flap(advancement flap)
E. All correct
19. Free flap for abdominal wall reconstruction, except
A. ALT free flap
B. LD free flap
C. Gracilis muscle free flap
D. Rectus femoris free flap
E. Forearm flap
20. Vascularisation of groin flap
A. Circumflex iliac superficiel artery and venous
B. Thoracodorsal artery
C. Radial artery
D. Femoral artery
E. Non
21. Groups of axones are call
A. Fascicle
B. Myelin
C. Endoneurium
D. Perineurium
E. All above
22. Surrounding the nerves
A. Epineurium
B. Perineurium
C. Endoneurium
D. Fascicle
E. Axone
23. Complete loss of neural continuity
A. Neuropraxie
B. Axonotmexie
C. Neurotmexie
D. Fascicle rupture
E. All above
24. Sunderland classification, injuries will have variable spontaneous recovery
A. Class I
A. Class II
A. Class III
A. Class IV
A. Class V
25. Classification Sunderland, injuries require surgical intervention
A. Class I
A. Class II
A. Class III
D. Class IV
D. Class IV and V
26. Variables affecting outcome after nerve injury , except
A. Age
B. The mecanism of injuries
C. Co-morbidities
D. Sex
E. a,b and c are corrects
27. Types of Nerve Repair, except
A. Epineural repair
B. Group fascicular repair
C. Individual fascicular repair
D. Axonoplasty
E. a,b and c are corrects
28. Factors Affecting Nerve Repair, except
A. Patient age
B. Proximity of the injury to the end organ
C. Sharp injuries
D. a,b and c are corrects
E. a,b,c and d are incorrect
29. Techniques to decrease tension in peripheral nerve repair , except
A. Nerve mobilization
B. Nerve transposition
C. Bone shortening
D. Local joint positioning
E. Nerf graft
30. Epineural Repair , except
A. Inspect external longitudinal blood vessels to aid in orientation
B. Inspect the intraneural topography for orientation.
C. Serial section to healthy fascicular tissue. Determine this by direct inspection of the nerve with magnification.
D. Minimal sutures in the external epineurium to approximate the nerve ends.
E. Individual fascicular repair
31. Which one of these is the lowest rung of Reconstructive ladder?
A. Free flaps
B. Distant flap
C. Regional flaps
D. Skin grafting
E. Primary closure
32. Which one of these is the last rung of reconstructive ladder?
A. Free flaps
B. Distant flaps
C. Regional flaps
D. Skin grafting
E. Primary closure
33. Which one of these is the best answer for requirements of microsurgery ?
A. Magnification , Micro-instrumentation, Micro-suture and Acquired skills
B. Magnification, Micro-instrumentation, Big-suture and Acquired skills
C. Magnification , Micro-instrumentation, Micro-suture
D. Magnification, Micro- instrumentation and Acquired skills
E. Magnification, none specified instrumentation and Acquired skills
34. Micro-sutures for microsurgery
A. Monofilament nylon and Prolene sutures and the suture size from 8-0 to 11-0
B. Vicryl and prolene sutures and the suture size from 8-0 to 11-0
C. Monofilament nylon and prolene suture and the suture size from 2-0 to 4-0
D. Vicryl and prolene sutures and the suture size from 2-0 to 4-0
E. None specified suture
35. Vessel preparation for microsurgery
A. Arteries need to have strong pulsatile flow
B. Avoid atherosclerotic vessel
C. Intimal inspection and dilation
D. Removal the adventitia
E. All correct
36. Here are the free tissue transfer that is the most used ,except :
A. Radial forearm flap
B. ALT flap
C. Latissimus dorsi free flap
D. Sural flap
E. Gracilis flap
37. Indication of free tissue transfer
A. Large soft tissue or bony defect
B. Tumor resection
C. High-energy trauma
D. Failed local/regional flap
E. All corrects
38. What are advantages of free flap ? except
A. Superior blood supply
B. Easy procedure
C. One-stage reconstruction
D. Immediate mobility
E. Specialized tissues
39. Management of flap failure, except :
Exploration of wound
B. Revision of anastomoses
C. Streptokinase, urokinase
D. Leech therapy
E. Antibiotic treatment is very important
40. Type of Free Toe-to-Thumb Transfer
A. Composite specialized tissue,Trimmed great toe (preferred), 2nd toe
B. Muscle flap
C. Fascio cutaneous flap
D. Skin flap
E. Musclulo-cutaneous flap
41. Advantage of free Toe-to-Thumb Transfer
A. One stage reconstruction
B. Early mobilization
C. Good aesthetics
D. Good function
E. All corrects
42. Pedicle of fibular free flap :
A. Peroneal vessel
B. Fermoral vessel
C. Tibia vessel
D. Radial vessel
E. All corrects
1. Indication for replantation
A. Thumb
B. Single finger injuries
C. Ring avulsion injuries
D. Amputations in children
E. All correct
2. Which is the following answer is not correct for replantation?
A. Limb before Life.
B. Assessment of injury (Level, mechanism, dominant hand ,age ,smoking,full medical history And previous injury to same limb ).
C. Obtaining x-rays for both severd and stumb parts.
D. Obtain Length of ischemia of the severed part, digits can tolerate about 12 hours of warm ischemia and more than 24 hours cold ishemia ,muscles can tolerate about 6 hours warm ishemia, so the more proximal the amputation the faster surgery it needs.
E. Sharp amputations do better than crushed,avulsion or blunt cuts .
3. Which is the following answer is not the conindication for replantation?
A. Severe crush injury
B. Prolonged warm ischemia, especially of muscle
C. Ring avulsion injuries
D. Severe contamination
E. Life threatening injuries
4. Which is the following answer is not the indication for replantation?
A. Thumb
B. Single finger injuries
C. Ring avulsion injuries
D. Amputations in children
E. Severe crush injury
5. How to conserve the amputated part?
A. Amputated part should be warned in saline moistens gaues then in sealed bag then to bag of ice to prevent cold injury to tissue.
B. Amputated part should be keep directly in the ice bin.
C. Amputated part should be kept in the plastic bag.
D. Keeping warm
E. Non
6. Which is the following answer is not the right postoperative care of replantation?
A. Bulky dressing
B. Hand should be elevated , If arterial inflow is diminished, the hand may be lowered. If venous outflow is slow, the hand needs additional elevation.
C. The room is kept cold.
D. Leave simple dressing
E. All correct
7. Suture in microsurgery
A. 4-0
B. 5-0
C. 6-0
D. 7-0
E. 8-0
8. The first fixation repair in replantation
A. Bone fixation
B. Artery
C. Veinous
D. Nerf
E. Tendon
8. The first fixation repair in replantation
A. Bone fixation
B. Artery
C. Veinous
D. Nerf
E. Tendon
9. Which materiel is common used for bone fixation in replantation
A. IM nail
B. Plate screw
C. Ex Fix
D. Back slap
E. All correct
10. What is the best time for replantion in warm ischemia
A. Digits can tolerate about 12 hours
B. Digits can tolerate more than 3 hours
C. Digits can tolerate more than 6 hours
D. Digits can tolerate more than 24 hours
E. Non
11. What is the best time for replantion in cold ischemia
A. Digits can tolerate about 12 hours
B. Digits can tolerate more than 24 hours
C. Digits can tolerate about 2 days
D. Digits can tolerate about 3 days
E. Non
12. Normal capillary refill time after replantation
A. 1-2 second
B. 2-3 second
C. 3 seconds
D. 4 seconds
E. 5 seconds
13. Normal dermal bleeding after replantation
A. Bright red blood
B. Dark red
C. Bleeds briskly
D. Minimal bleeding only serum
E. All correct
14. Venous occlusion sign after replantation
A. Pink
B. Blue, purple hue, cyanotic
C. Pale
D. Mottled
E. Non
15. Artery occlusion after replantation
A. Pink
B. Blue
C. Purple
D. Cyanotic
E. Pale and mottled
16. What is time of postoperative secondary surgey
A. 1 weeks
B. 2 weeks
C. 3 weeks
D. 4 weeks
E. 3 moths
17. Structure should be done for secondary surgery, except
A. Artery
B. Tenolysis
C. Nerve grafting
D. Tendon transfer
E. Bone graft
18. Timing for hand physiotherapy after tranplantation
A. 1 days
B. 2 days
C. 3 days
D. 5 days
E. 1 weeks
19. Flexor Tenolysis usually
A. 3 weeks after repair
B. 6 weeks after repair
C. 4-6 months after repair
D. 12 months after repair
E. Whenever
20. Tendon grafting
A. Supple soft tissues
B. Passive mobilization of joints
C. Motivated, compliant patient
D. One stage grafting must have adequate soft tissue envelope to glide through
E. All are corrects
21. Flexor tendon timig repair
A. Must be urgent
B. The most optimal time is with 14days of the injury
C. 3 months after the injury
D. 6 months after the injury
E. None
1. Zone flexor sheath tendon :
A. 2 zones
B. 3 zones
C. 4 zones
D. 5 zones
E. 6 zones
2. Zone I of flexor sheath tendon
A. Distal to FDS insertion
B. Proximal aspect of flexor sheath to FDS insertion
C. Lumbrical origin to proximal aspect of flexor sheath
Carpal tunnel
E. Proximal to carpal tunnel
3. Which zone of flexor sheath tendon is the most complicated to repair
A. Zone 1
B. Zone 2
C. Zone 3
D. Zone 4
E. Zone 5
4. Time of repairing flexor tendon
A. Must be urgent
B. The most optimal time is with 14days of the injury
C. 3 months after the injury
D. 6 months after the injury
E. None of thoses
5. These management of flexor tendon are correct ,except
A. Update Tetanus immunization
B. Begin antibiotics
C. Obtain radiographs
D. Assess digits for vascular compromise
E. Electromyography to evaluate the nerve injury
6. Goals in flexor tendon repair
A. Prevent gap formation and adhesions
B. Allow differential gliding between FDS and FDP tendons and gliding under pulleys
C. Perform a repair of adequate strength to allow early rehabilitation
D. Allow for full functional recovery
E. All correct
7. Nerve that go through to carpal tunnel
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Musculocutanous nerve
E. All are correct
8. The successful time of flexor tendon repair
A. Up to 3 weeks
B. 3 months
C. 6 months
D. 12 months
Never heal
9. Zone IV of flexor tendon is required
A. Distal to FDS insertion
B. Proximal aspect of flexor sheath to FDS insertion
Lumbrical origin to proximal aspect of flexor sheath
D. Carpal tunnel
E. Proximal to carpal tunnel
10. The common sign of flexor tendon injury ,except :
A. Loss of flexor tone and normal digital cascade
B. Inability to flex DIP or PIP joints
C. Pain on flexion
D. Significantly weak flexion may indicate partial tendon laceration
E. Inability to extend DIP or PIP joint
11. Flexor Tenolysis usually considered
A. 3 weeks after repair
B. 6 weeks after repair
C. 4-6 months after repair
D. 12 months after repair
E. Whenever
12. How many compartment of extensor tendon of the wrist?
A. 2 compartments
B. 3 compartments
C. 4 compartments
D. 5 compartments
E. 6 compartments
13. How many zone injury of extensor tendon of the wrist ?
A. 2 zones
B. 4 zones
C. 6 zones
D. 9 zones
E. 12 zones
14. Zone II of extensor tendon is required
Terminal tendon
B. Triangular ligament
C. Central slip
D. Over proximal phalanx
E. over MCP joint
15. EDC ( Extensor digirum common) is in
A. 1st compartment
B. 2nd compartment
C. 3rd compartment
D. 4th compartment
E. 5th compartment
16. What is Mallet finger?
A. Disinsertion of extensor tendon at PIPJ
B. Disinsertion of extensor tendon at DIPJ
C. Disinsertion of flexor tendon at PIPJ
D. Disinsertion flexor tendon at DIPJ
E. All are corrects
17. Indication of operative treatment of Mallet finger
A. Close injury without subluxation of DIPJ
B. Open injury with subluxation of DIPJ
C. Open injury without subluxation of DIPJ
D. Need to operate every injury
E. All are corrects
18. Carpal tunnel syndrome is compression of
A. Radial nerve
B. Median nerve
C. Ulnar nerve
D. Axillary nerve
E. Musculocutanous nerve
19. Guyon’s cannal syndrome is compression of :
A. Radial nerve
B. Median nerve
C. Ulnar nerve
D. Axillary nerve
E. Musculocutanous nerve
20. Tendon grafting requirement
A. Supple soft tissues
B. Passive mobilization of joints
C. Motivated, compliant patient
D. One stage grafting must have adequate soft tissue envelope to glide through
E. All are corrects
21. De Quervain’s tenosynovitis always happen in
A. Compartment 1
B. Compartment 2
C. Compartment 3
D. Compartment 4
E. Compartment 5
22. Which compartment of extensor tendon is the most traumatic rupture?
A. Compartment 1
B. Compartment 2
C. Compartment 3
D. Compartment 4
E. Compartment 5
23. How many system pulleys in hand flexor tendon?
A. 2 systems
B. 3 systems
C. 4 systems
D. 5 systems
E. 6 systems
How many cruciate pulleys in hand flexor tendon?
2
3
4
5
6
25. How many annular pulleys in hand flexor tendon?
2
3
4
5
6
26. Le plexus brachial est constitué par l’union des branches antérieures « racines » du plexus
A. Des 3 derniers nerfs cervicaux C6, C7, C8 et du 1er nerf dorsal ou thoracique T1
B. Des 4 derniers nerfs cervicaux C5, C6, C7, C8 et du 1er nerf dorsal ou thoracique T1
C. Des 5 derniers nerfs cervicaux C4, C5, C6, C7, C8 et du 1er nerf dorsal ou thoracique T1
D. Des 6 derniers nerfs cervicaux C3, C4, C5, C6, C7, C8 et du 1er nerf dorsal ou thoracique T1
E. Non
27. Combien de type de paralysie du plexus brachial :
A. 2 types : Paralysie supraclaviculaire et Paralysie infraclaviculaire
B. 2 types : Paralysie supraclaviculaire et Paralysie rétro et Infraclaviculaire
C. 3 types : Paralysie supraclaviculaire, Paralysie rétroclaviculaire et Paralysie infraclaviculaire
D. 3 types : Paralysie supraclaviculaire, Paralysie anteroclaviculaire et Paralysie infraclaviculaire
E. Non
28. Les signes de gravité de paralysie du plexus brachial : Réponse faute
A. L’étendue de l’atteinte
B. L’atteinte des racines supérieures
C. L’atteinte du serratus anterior, du latissimus dorsii, des rhomboïdes, du phrénique
D. Initialement un signe de Claude Bernard- Horner, une hémorragie méningée, un Brown-Séquard
E. Non
29. Quel est le temps approprié pour le traitement chirurgical en cas de paralysie du plexus brachial
A. Chirurgie en urgent
B. Chirurgie vers le 3ème mois (avant la dégénérescence définitive des plaques motrices)
C. Chirurgie vers le 6ème mois
D. Chirurgie vers 1 ans
E. Chirurgie vers 2 ans
30. Combien de branches du plexus bracial
1
2
3
4
5
31. Quels sont les branches du plexus brachial
A. Nerf Musculocutané
B. Nerf axillaire
C. Nerf radial
D. Nerf median, nerf ulna
E. All correct
32. Function of hand
A. Flexion
B. Extension
C. Abduction
D. Adduction
E. All correct
33. Which of the following physical findings would be seen with de Quervain tenosynovitis?
A- Trousseau sign
B- Finkelstein test
C- Phalen test
D- Tinel sign
E- Non
34. A bowler presents with wrist pain and grip weakness. On exam, he is found to have pain over the radial aspect of the wrist that is aggravated by flexing the thumb and by applying ulnar flexion. What is the most likely diagnosis?
A- Carpal tunel syndrome
B- Scaphoid fracture
C- De Quervain tenosynovitis
D- Boxer’s fracture
E- All corrects
35. Which ONE of the following is NOT a sign of carpal tunnel syndrome? Please select one of the following:
A- Paresthesia in median nerve distribution
B- Numbness over thenar eminence
C- Wasting of thenar eminence muscles
D- Reduced grip strength
E- Positive Tinel’s test
36. The nerve affected in carpal tunnel syndrome is:
A- Median nerve
B- Ulnar nerve
C- Radial nerve
D- Brachial nerve
E- All correct
37. Which finger can has Dupuytrend’s disease the most?
A- Thumb
B- Index
C- Middle finger
D- Ring finger
E- Little finger
38. Colls’s fracture deformity
A. Posterior
B. Anterior
C. Lateral
D. Medial
E. Non
39. Smit’s fracture deformity
A. Posterior
B. Anterior
C. Lateral
D. Medial
E. Non
40. Sings of compartment syndrome
A. Pain
B. Paresthesia
C. Pulseless
D. Paralysis
E. All correct
41. The management for hand wound
A. Must be done in OR for exploration
B. Can do in dressing room
C. Suture immediately
D. Do everywhere
E. Non
1- Dans le principe de la chirurgie cutanée qu’il ne faut pas préparer,
Calot
Bavette
Se laver
Gants
Pas de champs
2- L’exérèse chirurgicale de la tumeur cutanée ne doit pas tenir compte
- pas de la réparation
Que la tumeur bénigne, incomplète et jouxtante
Que la tumeur maligne, pas de marge de sécurité
- la réparation
La tumeur maligne ou bénigne
3- Ne jamais réparer la perte de substance après l’exérèse,
Par une cicatrisation dirigée
Par une suture
- par des greffes cutanées
- par un lambeau si pas d’examen histologique
Par une suture ou une cicatrisation dirigée
4- L’ analyse histologique des tumeurs cutanées doit être
Systématique
Facultatif
Temporaire
Rare
Souvent
5- Les épithéliomas cutanés sont,
Rare
Fréquents
Unique
Plusieurs
Au nombre de trois
6- Les épithéliomas cutanés sont
Baso-cellulaires
Spino-cellulaires
Mélanomes
Basocellulaire et spino-cellulaire
Sarcomes
7- Les affections pré-épithéliomateuses, il y a,
Transformation en épithélioma
Tranformation maligne
Tranformation bénigne
Transformation bénigne et maligne
Transformation en épithélioma et maligne
Un caractère n’est pas ceux de dermatose actinique ou sénile
A- fréquent
B- rare
C- sujets à peau claire
D- macule pigmentée
E- parties découvertes
9- La radiodermite chronique est
Pas de risque de dégénérescence
Risque de dégénérescene
Risque majeur de dégéneérescence
Aucun risque de dégénérescence
Rarement risque de dégénérescence
Le naevus verruco-sébacé de Jadassohn est
Dégénère dans 1/2 des cas chez l’adulte ( en baso surtout)
Dégénère dans 1/3 des cas chez l’adulte ( en baso surtout)
Dégénère dans1/4 des cas chez l’adulte ( en baso surtout)
Dégénère dans 1/5des cas chez l’adulte ( en baso surtout)
Dégénère dans 1/6 des cas chez l’adulte ( en baso surtout)
1- les interventions de chirurgie esthétique
- pas sollicitées par le patient lui-même
- but fonctionnel et vital,
Amélioration de son état de santé
Subjectif et supposé être pas d’ amélioration physique et pschychologique
Sollicitées par le patient lui-même
2- Rôle du chirurgien
- analyser ou non la demande de patient
- juger de son caractère raisonable ou non
Respecter les contres indications opératoires
évaluer les possibiliés réelles d’amélioration éventuelle
Informer complètement la famille du patient
3- Le chirurgien doit évidement
Ne posséder pas toutes les qualifications légales requises pour la pratique de la chirurgie esthétique
Posséder les qualifications légales requises pour la pratique de la chirurgie esthétique
Ne posséder pas un contrat d’assurance en responsabilité civile professionnelle
Posséder un bon contrat d’assurance en responsabilité civile professionnelle
Posséder un bon assurance en responsabilité civile professionnelle
4- Le chirurgien doit
écouter la demande du patiente
Se concentrer sur la demande
Analyser le demande du patiente
Discuter le demande du patiente
Proposer le demande du patiente
5- Le chirurgien ou la patiente faut
Céder aux demandes abusives
Pas céder aux demandes abusives
Céder aux demandes normales
Céder aux demandes peu abusives
Céder aux demandes un peu abusives
6- Le chirurgien éprouve lui-même besoin de demander l’avis du psychiatre devant un patien, il s’agit très vraisemblablement
D’une indication opératoire
Des indications opératoires
D’une contre- indication opératoire
D- d’une possible contre- indication opératoire
E- d’une bonne contre- indication opératoire
7- L’examen clinique doit
Très rigoureux et complet
Détaillé par écrit
C- pas évaluer les possibilités chirurgicales
D- pas dépister les contre indications opératoires
E- des consultations complémentaires d’autre spécialistes
8- L’observation écrite
Comprenant les demandes du patient
La donnée de l’examen clinique
- la discussion,et la conclusion
De photographie pré-opératoire
F- des courriers détaillés doivent être envoyé au médecin correspondant
9- L’indication opératoire éventuelle elle-même doit être
Prudente, surtout dans les situations de reprise chirurgicale
Correcte, surtout dans les situations de reprise chirurgicale
Acceptable par le patient
Acceptable par le chirurgien
Il faut chercher à “en faire trop
10- L’information du patient concernant l’ indication opératoire doit être,
A- très complète,
B- très détaillée
En indiquant seulement les avantages
Pas d’ indiquer les inconvénients et les risques possibles de l’intervention
Ces risques doivent certes être présentés avec bon sens, mais il est préférable de n’omettre aucune ( en particulier le risque de cécité décrit après blépharoplastie).
. Lyphadenopathy Lower jugular chaine(Fig 1) metastasis from
A/Scal ear / temporal
B/Cancer of the lip
C/Mucosa of the check
D/Thyroid upper oesophagus, pyriform sinuses
E/Floor of mouth
2. Lyphadenopathy Posterior triangle lymph nodes (Fig 1)metastasis from
A/ Scal ear / temporal, bone of skull base
B/Cancer of the lip
C/ Mucosa of the check
D/ Floor of mouth
3. Lyphadenopathy Supmendibular group (Fig 1)metastasis from
A/Naso pharynx
Any portion of oral cavity ( pharynx or larynx)
Primary tumor below clavicle
Two thirds of tongue, floor of mouth , mucosa of check
Scal ear / temporal
4.Lyphadenopathy Submental triangle( submental nodes ) (Fig 1) metastasis from
A/Cancer of the lip
B/Scal ear / temporal
C/Naso pharynx
D/Any portion of oral cavity ( pharynx or larynx)
E/Primary tumor below clavicle
5.Lyphadenopathy Deep lateral cervical nodes(Fig 1) metastasis from
Scal ear / temporal
Cancer of the lip
Floor of mouth, Gum
Any portion of oral cavity ( pharynx or larynx) tonsil, base of tongue
6. These structures are all located in the superficial fascia of the neck EXCEPT
External jugular vein
Platysma muscle
Cervical branch of the facial nerve
Omohyoid muscle
Transverse cervical nerve
Patient with carcinoma tongue is found to have lymph nodes in the lower neck. The treatment of choice for the lymph nodes is ?
A/lower cervical neck dissection
B/ suprahyoid neck dissection
C/ teleradiotherapy
D/ radical neck dissection
E/ Supra sective neck dissection
A man has metastatic carcinoma and enlarged deep cervical lymph nodes. One of his symptoms is a hoarse voice, barely heard above a whisper. Subsequently he succumbs to the disease and at autopsy it is found that one of the enlarged nodes has put pressure on a nerve in the tracheoesophageal groove. Presumably this was the reason for the hoarse voice. What nerve was involved?
a/ External branch of the superior laryngeal nerve
B/ Internal branch of the superior laryngeal nerve
C/Nerve to the cricothyroid muscle
D/Pharyngeal branch of the glossopharyngeal nerve
E/ Recurrent laryngeal branch of vagus
Match of the following description to the current type of neck dissection (levels I through V) Anterior neck dissection preservation of the spinal accessory nerve,the sternomastoid muscle
Radical Neck dissection
/ Modified radical Neck dissection
Lateral neck dissection
Suprahomoyoid neck dissection
Lower cervical neck dissection
Lateral neck dissection
Injury in to Internal branch of the superior laryngeal nerve
Teleradiotherapy
Removal of the soft tissues containing the level II, III, and IV lymph nodes
Preserve the sternomastoid muscle.
. Match of the following description to the current type of neck dissection : Remove of Lymph nodes in the level 1-5, The Spinal accessary nerves , the Sternocleido mastoid muscle, The Jugular vein
Suprahomoyoid neck dissection
Anterior neck dissection
Radical Neck dissection
Modified radical Neck dissection
Lateral neck dissection
. Lymph Node Groups of the Neck all are correct except
A/G I Submental an submandibular
B/G II Upper jugular nodes
C/G III Middle jugular nodes
D/G IV Lower jugular nodes
E/ G. V Anterior compartment lymph nodes
F/ G. VI Anterior compartment lymph nodes
All of the following tumor of the skin are radiosensitive, Except
A/ Squammous cell carcinoma
B/ Basal cell carcinoma
C/ cutaneous lymphoma
D/Malignant Melanoma
E/ All of above
2. What is the diagnosis?
A)Acquired melanocytic nevus
B)Nodular melanoma
C)Seborrheic keratosis
D)Verruca vulgaris
3. The following are true about squamous cell carcinoma:
A. It is a commoner malignant skin tumour than basal cell carcinoma
B. It only occurs in the skin
C. It is the most common skin tumour seen in transplant patient
D. Metastasis is usually to the regional lymph nodes
E. The tumour typically have everted edges
4. Which one of the following features is more characteristic of a benign than a malignant neoplasm
A. Grows by expansion and implantation occurs frequently
B. Metastasizes if the brain is the site of origin
C. Usually non-encapsulated and necrosis seldom occurs
D. Tend to recur after surgical removal
E. Usually occur singly and do not recur after surgical removal
5.What is the most common type of skin cancer?
A) Melanoma
B) Basal cell carcinoma
C) squamous cell carcinoma
D) Merkel cell carcinoma
E) All of above
6.The following are true about malignant melanoma:
A. It is commoner in females than males
B. Amelanotic type is more aggressive than pigmented type
C. Malignant transformation in common moles is about 1:10,000
Staging is according to the size of the tumour
E. It is found exclusively in the skin.
7- Which of the following is NOT a concern of a melanoma skin lesion?
A. Asymmetric shape
Borders which are clearly defined@
Colour change
D. Diameter > 6mm
8. UVB induced mutations on the PTCH gene is associated with the development of:
BCC
B. Merkel cell carcinoma
Angiosarcoma
D. BCC and Merkel cell carcinoma
9. A skin lesion which is ulcerated with rolled, smooth, pearly borders is most likely:
A.Melanoma
B.Basal cell carcinoma
C.Seborrheic keratosis
D.Squamous cell carcinoma
10.All are the epidermal tumors Except
Seborrhoric keratosis / wart
Verrucous epidermal naevus
Syringoma
Becker’s nevus
Kerato acanthoma
11.All are the sweat gland tumor except
Excrin poroma
Cylindroma
Syringoma
Dermatofibroma
12. All are the connective tumors except
A. Acrochordon molluscum pendulum ( skin tag)
B. Dermatofibroma
C. Kerato acanthoma
D. Xanthelasma
E. Angioma
13.Which of the following skin lesions is NOT associated with sun exposure?
A.Actinic keratosis
B.Basal cell carcinoma
C.Seborrheic keratosis
D.Melanoma
E. None of above
14. Which of the following is TRUE about melanoma?
A.The most common skin cancer
B.The most common benign skin cancer
C.The most common cause of death from skin cancer
D.The most common skin cancer among Asians
E. None of above
15. A 65-year-old male presents to clinic with a small skin lesion (0.5 cm) on his chest which is very suspicious for melanoma. Which of the following is the most appropriate option for this patient?
A.Conservative treatment
Excisional biopsy with wide margins
C.Immediate chemotherapy and radiotherapy
D.Immediate CT scan
E.None of the above
16. What is the most common basal cell carcinoma?
A.Sclerosing
B.Morpheform
C.Nodular
D.Pigmented
E.Superficial
17. The following are true of the skin lesions EXCEPT:
A.Actinic keratosis is completely benign with no malignant potential
C.Nodular ulcerative variant is a type of basal cell carcinoma
D.Squamous cell carcinoma occurs in primarily sun exposed area of skin
E.Basal cell carcinoma has a 95% cure rate if lesion is less than 2 cm in diameter
18. Actinic keratoses are skin lesions that may degenerate into the following skin malignancy:
A.Lentigo maligna
B.Basal cell carcinoma
C.Malignant melanoma
C.Squamous cell carcinoma
1-Un malade est pour le moins suspect d'être porteur d'un carcinome situé sur le 1/3 du bord droit de la langue. Les adénopathies sont à rechercher dans les aires lymphatiques :
A - Sous-maxillaire droite
B - Jugulo-carotidienne droite
C - Cervicales droites
D - Cervicales des deux côtés
E - Sous-maxillaire et sus-claviculaire droites
2-La surveillance d'un malade.traité pour un carcinome buccal et curage cervical supérieur bilatéral pour N1, montre la parfaite stabilité durant 6 ans, à tel point qu'on pourrait parler de guérison. Lors d'une consultation ultérieure, on découvre une adénopathie cervicale. La cicatrice en bouche est parfaite. Que doit-on envisager en tout premier comme étiologie de cette adénopathie ?
A - Adénite inflammatoire chronique
B - Maladie de Hodgkin
C - Evolution naturelle du carcinome traité 6 ans plus tôt
D - Tuberculose ganglionnaire
E - Deuxième cancer à localization préférentielle sur les voies aérodigestives supérieures
3-Devant une mobilité post-traumatique des incisives supérieures, quelle est la meilleure incidence radiologique à demander ?
A - Un orthopantomogramme
B - Un film en incidence mordu
C - Un cliche rétro-alvéolaire
D - Une incidence dite "maxillaire défilé
E - Aucune des propositions précédentes
4-A quel âge les accidents infectieux de la dent de sagesse sont-ils les plus fréquents ?
A - A l'âge de 10 ans
B - A l'âge de 16 ans
C - A l'âge de 22 ans
D - A l'âge de 40 ans
E - A l'âge de 60 ans
5-Un enfant de 5 ans 1/2 vous est amené en consultation par ses parents pour une luxation complète des deux incisives centrales supérieures à la suite d'une chute. L'examen clinique de la bouche confirme la perte dentaire, ne montre pas de plaie gingivale importante et ne révèle pas de mobilité anormale contiguës. L'hémostase des alvéoles s'est faite spontanément. Que dites-vous aux parents ?
A - Il faut réaliser un blocage intermaxillaire en urgence
B - Il faut placer un mainteneur d'espace d'urgence
C - De ne pas s'inquiéter car les dents définitives doivent de toute façon évoluer dans les mois à venir, il n'y a lieu que d'exercer une surveillance
D - Il faut absolument retrouver les dents perdues pour tenter une réimplantation le plus rapidement possible
E - Il faudra extraire les germes des dents définitives car ils seront certainement détruits.
1-Parmi ces types de traumatisme facial, un seul ne fait pas évoquer d'emblée le risque de brèche dure-mérienne :
A - Dislocation orbitonasale
B - Fracture de Guérin (Lefort I)
C - Fracture de Lefort II
D - Fracture de Lefort III
E - Fracture du sinus frontal
2-Une jeune femme a présenté au cours d'un repas une tuméfaction douloureuse de la région sous-maxillaire gauche qui a régressé en quelques heures.Cet épisode s'est répété plusieurs fois. Sur ce seul tableau fonctionnel le diagnostic le plus vraisemblable est :
A - Grenouillette sub-linguale
B - Adénite d'origine dentaire
C - Lithiase de la sous-maxillaire
D - Kyste congénital latéral du cou
E - Lithiase parotidienne
3-Une ankylose temporo-mandibulaire unilatérale, observée à l'âge adulte, est caractérisée par les signes suivants dont un est essentiel pour affirmer que l'ankylose s'est installée dans l'enfance. Lequel ?
A - Impossibilité permanente de l'ouverture de la bouche
B - Etat déplorable de la denture (polycaries...)
C - Rétromandibulie asymétrique
D - Découverte d'un gros bloc d'ankylose sur les tomographies
E - Cicatrice cutanée sur le menton
4-Les facteurs pathogènes suivants favorisent le développement d'un cancer de la cavité buccale sauf un. Lequel ?
A - L'alcoolisme
B - Le tabagisme
C - Le lichen plan
D - Le pemphigus
E - L'absence d'hygiène
5-Quel est le risque de la taille endobuccale du canal de Wharton pour ablation d'un calcul postérieur ?
A - Blessure du nerf grand hypoglosse
B - Blessure du rameau buccal inférieur du facial
C - Blessure de l'artère linguale
D - Blessure du nerf lingual
E - Blessure du nerf dentaire inférieur
6- L’antisepsie est une opération momentanée permettant d’éliminer ou tuer des micro-organismes présents sur:
A-Sur les milieu inertes contaminés.
B-Sur les tissus vivants.
C-Sur les tissus vivants, le résultat est limité aux micro-organismes presents au moment de l’opération
D- Sur les milieu inertes contaminés, le résultat de cette opération étant la sterilization.
7-Il y a 4 classes de septicité de l’intervention chirurgicale: Chirurgie propre, Chirurgie propre-contaminée, Chirurgie contaminée et chirurgie infectée. En cas de chirurgie contaminée:
A-L’ínquisition n’est pas traumatique, il n’y a ni inflammation ni drainage.
B-La plaie traumatique est récente et l’inflammation est sans pus, l’ouverture des tractus digestif ou urinaire est avec infection, il y a une contamination importante par le contenue du tube digestif et le manque d’asepsie est important
C- L’ouverture de viscère creux est en conditions contrôlées:soit les urines soit le bile ne sont pas infectées, ainsi que le tube digestif est preparé, le manque d’asepsie est minimale et applicationdu drainage mécanique
D- La contamination est fécale, l’inflammation est avec pus et le viscère est perforé.
8-L’infection du site opératoire(ISO). Le site opératoire(SO) peut être contaminé à cause de facteurs différents. Parmi les quatre réponses repérez un facteur qui amène à l’infection exogène du SO:
A-Les cheveux et cuir chevelu:facteur
B-Staphylococcus
C- Champignons filamenteux
D-Gouttelettes
9-Un malade de 18 ans présente dans les suites d'un traumatisme une lésion de la lèvre, une mobilité des deux incisives centrales supérieures visiblement déplacées, une plaie gingivale en regard de ces dents. La radiographie montre que les racines sont intactes. Quelle est la conduite à tenir ?
A - Extraire les dents et suturer la muqueuse
B - Ne rien faire en dehors d'une antibiothérapie
C - Immobiliser ces dents
D - Blocage intermaxillaire
E - Intervention chirurgicale avec ostéosynthèse
10-La première dent définitive qui apparait sur l'arcade est :
A - Une incisive centrale inférieure
B - Une incisive centrale supérieure
C - Une première prémolaire
D - Une première molaire
E - Une canine
1- The projection of a normal ear (rim-mastoid distance) is:
A. 9mm.
B. 19mm
C. 29mm.
D. 39mm.
E. None of the above.
2- Botulinum toxin:
A. Is derived from Bacillus anthracis.
B. Is derived from Bacillus botulinum
C. May cause hirsutism.
D. Is derived from spore-forming anaerobic bacteria
E. Can cause tetanus
3-Subplatysmal procedures for rejuvenation of the ageing neck include the following except
A. Open fat excision.
B. Tangential excision of the anterior bellies of digastric.
. Intracapsular excision of the superficial portion of the submandibular gland.
D.Release of the suprahyoid fascia for a high hyoid.
E. Corset platysmaplasty
4- Which of the following is not a useful nerve block for peri-orbital surgery?
A. Infra-orbital nerve block.
B. Zygomaticofacial nerve block
C. Frontal nerve block
D. Nasociliary nerve block.
. Anterior ethmoidal nerve block
5- Of the following filler substances, which is correctly matched with its trade name?
A. Hyaluronic acid and Sculptra®
B. Hydroxyapatite and Radiesse
C. Acellular cadaveric dermis and Zyderm®.
D. Large particle hyaluronic acid and Bioalcamid®.
. None of the above
6- The following statement is true with regards to the facial nerve:
A. The buccal branch is crucial for lower eyelid function
. The function of the stapedius muscle is lost if the facial nerve nucleus itself is ablated or infarcted, leading to hyperacusis
It is the most commonly damaged nerve during facelift surgery.
. Branches include the postauricular branch to occipitalis and a branch to the anterior belly of digastric.
Damage to the mandibular branch is less likely to cause sequelae than damage to the buccal branch.
7- Concerning the facial nerves and facelift, which of the following is false?
A-The frontal branch is found on Pitanguy’s line, from 0.5cm below the tragus to 1.5cm above the lateral eyebrow and is accompanied by the anterior branch of the facial artery.
B. Above the zygoma the nerve runs on the undersurface of the temporoparietal fascia.
C. McKinney’s point refers to the position of the greater auricular nerve, 6.5cm caudal to the external acoustic meatus with the head turned to 45°, at which point it crosses the anterior belly of sternocleidomastoid.
D. The buccal branch is the most commonly injured branch of the facial nerve during facelift.
E. If the buccal branch is injured, it is not typically symptomatic as it demonstrates collateral innervation in up to 70% of individuals.
8- The blood vessels immediately supplying the eyelids include all except:
A. Medial superior palpebral artery.
Superior arcade
C. Angular artery.
D. Facial artery
E. Marginal arcade.
9- Which answer is true regarding structural fat grafting?
A. It should never be used in the nose.
B. It can be used to augment midface hypoplasia
C. It cannot be used for breast augmentation without the Brava® device
D. There is no risk of blindness when used around the eye, so long as the orbital septum is not breached
E. HIV is an absolute contraindication.
10- Anaesthesia of the nasal side wall is best accomplished through infiltration of which one of the following nerves?
A. Buccal.
B. Dorsal nasal.
C. Infra-orbital
D. Infratrochlear.
E. Zygomaticofacial.
1-Which is the most appropriate statement concerning in most practical Classification of Cleft lip/cleft palate?
A- Y-Kernahan Classification describes all degree of severity of cleft lip and palate
B- Cleft lip and cleft palate can classify as: Cleft of primary palate and cleft of secondary palate.
C- According to degree of deformity, Cleft lip and palate can category : incomplete or complete and unilateral or bilateral of cleft lip/palate
D- Classification of cleft lip and palate is simply to 3 categories: Cleft of the lip/ Cleft of alveola/ and cleft of palate.
E- Double Y-Noordoof Classification is more detail to describe all degree of severity of cleft lip / palate and other relevant deformity.
2-Which is the most appropriate statement concerning in Management of a newborn cleft patient?
A- Surgical planning anytime of cleft lip after 6 months of age and proper fellow-up for other further treatments.
B- Orthodontic and NAM are prioritized all new cleft patient before other treatment
C- Parent psychological education, orthodontic management to get ready for surgical treatment
D- Multidisciplinary screening, relevant medical check up ready for surgical treatment before other managements
E- Multidisciplinary screening, prioritizing all relevant medical conditions and other deformities for proper management plan.
3-Which is the most appropriate statement concerning in Etiology of Clefts?
A- Etiology of Cleft and other congenital deformity is unknown but genetic background is very high in realistic.
A- Etiology of Cleft and other congenital deformity is unknown but genetic background is very high in realistic.
C- To prevent Cleft lip/palate and other congenital deformity, every pregnancy women need to take Vitamin, Folic Acid and other relevant nutrition.
D- To prevent Cleft lip/palate and other congenital deformity, every pregnancy women whom has family background of congenital anomalies , need to take Vitamin, Folic Acid and other relevant nutrition
E- Etiology of Cleft and other congenital deformity is unknown. The genetic background, vitamin deficiency, environment are risk factors.
4-The Diagnosis of Cleft Lip and other craniofacial anomalies usually makes at prenatal period by ultrasound examination. The prenatal diagnosis is very useful because
A- Parent and medical professional are planning in advance for proper management
B- Prenatal diagnosis helps to identify other congenital anomalies.
C- It is useful to perform intrauterus cleft lip repair
D- It is a good period of time for parent psychological education
E- It is useful for family planning.
5-Presurgical Orthopedic and Nasoalveolar Molding Techniques will be able to modify cleft deformity to improve the overall outcome of cleft lip repair:
A- Narrowing the cleft gaps , and approximating the alveolar gap
B- Alignment the alveolar arch
C- Dropping down premaxilla in bilateral cleft lip
D- Lengthening the nasal columella
E- Repostioning of nasal cartilage, and alveolar process
6- What is the most appropriate statement concerning the benefits of Nasoalveolar Molding (NAM) technique?
A- Presurgical closure of the alveolar gap enables the surgeon to perform a gingivoperiosteoplasty at the time of primary lip repair
B- The presurgical alignment and correction of deformity in nasal cartilage to avoid extensive primary nasal surgery repair.
C- Presurgical alignment alveolar arch technique enables to prepare dentition and to eliminate secondary ABG.
D- Presurgical orthodontic alignment alveolar process benefits to eliminate the postoperative fistula in cleft palate repair.
E- In the bilateral cleft lip deformity nonsurgical columella lengthening eliminates the need secondary surgical columellar elongation.
7- The evaluations of a unilateral Cleft Lip in newborn period for the purpose of treatment planning. The categories of the evaluation are:
A- Unilateral cleft, alveolar cleft, cleft palate
B- Deficiency of soft tissue, cartilage, and bone in unilateral cleft lip
C- Microform cleft, Incomplete cleft, Complete Cleft
D- Unilateral cleft lip associated with other congenital deformity
E- Clinical evaluation of the deformity and imagine study of Unilateral cleft lip
8-Which is the most appropriate statement concerning in Surgical Evaluation of an unilateral cleft lip?
A- Surgeon can make overall impression of cleft width, cartilage distortion, deficiency of soft tissue (orbicularis muscle) and bony framework.
B- Points of Cupid’s Bow at White Skin Roll(WSR), Base of Philtral Column of cleft side
C- The vital concern of a surgeon is amount of tissue medial to the base of ala to assess the vertical height and the horizontal length of lateral lip.
D- Evaluation of discrepancy from the central point of the base of columella to two peaks of Cupid’s Bow is critical for leveling the Cupid’s Bow.
E- The types of cleft lip, unilateral, bilateral, incomplete or complete are the criteria for surgical planning evaluation.
9-Which is the most appropriate statement concerning in microform unilateral cleft lip repair?
A- Straight line repair technique is always performed for microform unilateral cleft as produces a acceptable scaring on the lateral philtral column
B- Try to repair the musculature fiber and alignment WSR and Vermillion mucosa , avoiding skin incision to prevent post operative lip scar.
C- Microform unilateral cleft lip needs to repair : skin, nasal deformity and muscle for improve the outcome functionally and aesthetically
D- Proper presurgical orthodontic is able to correct the deformities: such nasal contouring to eliminate the surgical intervention in microform unilateral cleft lip.
E- Surgical is generally indicated but must be approach cautiously to avoid a surgical deformity wore than the congenital defect.
10-Which is the most appropriate statement concerning in the deformity diagnosis evaluation of a unilateral complete cleft lip ?
A- The critical factors for evaluating unilateral complete clefts are the position of alveolar segment and the vertical height of the lateral lip element
B- The critical factors for evaluating unilateral complete clefts are the associated cleft of secondary palate and the degree of nasal deformity.
C- The degree of alveolar cleft (maxillary segment: narrow, wide, collapse or no collapse) and severity of nasal alar deformity.
D- The degree of unilateral complete clefts deformity and other medical conditions (Malnutrition, or other disease).
E- The degree of cleft deformity with other congenital anomalies ( Syndromic association)
11-Which is the most appropriate statement concerning in treatment planning evaluation of the unilateral complete clefts?
A- The unilateral complete cleft lips with “narrow-no-collapse” of alveolar maxillary segment : Prime candidate for Rotation Advancement lip repair with simultaneous correction of nasal deformity.
B- Presurgical orthopedic and NAM apply all cases of unilateral complete clefts until the time for definitive cheiloplasty.
C- Presurgical orthopedic and NAM are benefit for all unilateral complete clefts with “ Collapse” of alveolar segment to improve the outcome of the definitive cheiloplasty
D- The proper surgical technique, simultaneously of nasal deformity correction fellow by post surgical orthodontic are always benefit for all unilateral complete clefts.
E- Lip adhesion is benefit for all unilateral complete clefts until the time for definitive cheiloplasty.
12-Which is the most appropriate statement concerning in operative technique of the unilateral clefts?
A- Rotation advancement technique is applicable for all unilateral cleft repair.
B- Sub anatomical approximation of Fisher’s Technique is applicable for all unilateral cleft repair
C- Unilateral cleft lip repair technique is always preserved the base triangle flap(Randall-Tennison) to archive the level of the peak of Cupid’s bow.
D- Any surgical techniques can be applied as the critical factors of the VL and HL of the lateral lip segment are taking care.
E- The surgical lip adhesion is the primary surgical technique and re-evaluation of the deformity for the time of definitive cheiloplasty.
13-Which is the most appropriate statement concerning in operative technique to reconstruction of nostril sill and floor of the nose of the unilateral clefts?
A- Advancement flap of the lateral lip segment.
B- Lateral rotation of C-flap.
C- The musculature- alar skin flap of lateral lip /membranous septal area and footplate of columella of medial lip.
D- Inferior nasal turbinate flap.
E- Lateral mucosal L-flap.
14-Which is the most appropriate statement concerning in orbicularis muscle repair of unilateral clefts?
A- Extensive muscle undermining from skin and mucosa to be mobilized and repositioned anatomically and functionally of orbicularis.
B- Release the aberrant attachment of the superficial orbicularis from ala musculature of lateral lip and from anterior nasal spine of medial lip
C- Overlaping muscle repair technique is always carried out to improve natural philtral column aspect.
D- Muscle back-cut to elongate the muscle is benefit VL of unilateral complete cleft lip repair.
E- Proper dissection of musculature fiber is benefit to gain up to 4mm discrepancy of vertical length.
15-Which is the most appropriate statement concerning in operative technique to correction nasal deformity of the primary unilateral cleft lip repair?
A- Open approach technique to repositioning all nasal cartilage deformities.
B- Proper dissection and proper suture Lower Lateral Cartilage
C- Tajima incision approach with suspense suture of lower lateral cartilage
D- Defer for the time for definitive secondary rhinoplasty
E- Primary Septo-rhinoplasty and nasal silicone retainer post operatively
16-The operative technique to reconstruction the sulcus of the primary unilateral cleft lip repair is:
A- Relaxing incision of the lateral aspect of lateral lip mucosa
B- Lateral vermilion L-flap
C- Medial vermilion M-flap
D- Relaxing incision of medial aspect of lip mucosa.
E- Gingivo-periosteal flap.
17-The operative technique to reconstruction the central vermilion mucosa hypoplasia of the primary unilateral cleft lip repair is:
A- Relaxing incision of the lateral aspect of lateral lip mucosa.
B- Lateral mucosal L-flap
C- Medial mucosal M-flap
D- Relaxing incision of medial aspect of lip mucosa
E- Lateral vermilion V-flap.
18- Which is the most appropriate statement concerning in operative technique of the primary unilateral cleft lip repair?
A- Upper triangular rotation advancement flap is the first choice of surgical technique as this surgical technique is suitable of all cases.
B- Base triangular Rendall Tenisson is a technique for all cases and produces a idea level of peak of Cupid’s bow.
C- Rose – Thompson Technique is always produced excellent outcome by elongating the VL which is critical for unilateral cleft lip repair
D- Fisher’s technique is a surgical technique for all degree of unilateral cleft lip repair as it is an anatomical subunit approximation technique.
E- Any surgical technique is able to apply as the critical of lip elements: VL and HL are taken care.
19- Which is the most appropriate statement concerning in deformity diagnosis evaluation of a bilateral cleft lip?
A- incomplete and complete bilateral cleft lip
B- Symmetry and asymmetry bilateral cleft lip.
C- Protruding premaxilla deformity of bilateral lip.
D- Bilateral lip with bilateral palate.
E- Bilateral lip with nasal deformity.
20- The deformities of a bilateral lip are severe, at least two stages for a bilateral lip repair usually carried out. The treatment planning must be considered in range as below
A- Protruding premaxilla deformity correction
B- Central lip vermillion correction
C- The skin paradigm of bilateral cleft lip correction
D- Nasal deformity correction
E- Alveolar arch and maxilla pyriform deformity correction
21- Which is the most appropriate statement concerning in protruding premaxilla deformity correction of a complete bilateral cleft lip?
A- Lip adhesion or bilateral lip repair
B- Nasoalveolar Molding
C- Retracting the premaxilla by elastic bonnet
D- Premaxilla set-back by premaxilla surgical excision
E- Pin-retained premaxilla retraction
22- Which is the most appropriate statement concerning in the most practical technique to correction nasal tip cartilage paradigm of a bilateral cleft lip ?
A- McComb’s Rhinoplasty technique
B- Muliken’s Rhinoplasty technique.
C- Two stage secondary Rhinoplasty.
D- Prolabium Unwinding flap
E- Presurgical columella Elongation.
23- Which is the most appropriate statement concerning in most common post operative complications of a complete bilateral cleft lip repair?
A- Prolabium flap necrosis
B- No vestibular labial sulcus
C- Muscle discontinuity
D- Columella shortening.
E- Nasolabial fistula.
24- Which is the most appropriate statement concerning in the most practical of post operative care of a bilateral cleft lip repair to improve the surgical outcome ?
A- Regular wound dressing, and early wound assessment to prevent any complications
B- Enough post surgical antibiotic to free from infection provides quality of wound healing process.
C- Taping lip together for several weeks to decrease tension, on the vertical lip and philtral column.
D- Logan’s bow appliance and taping over to hole the the prolabial and lateral lip segment
E- Arm restraints for 3 weeks, to prevent the child bringing the hand to the mounth
1- Le chirurgien plasticien est
Non repecter les dispositions du code de Déontologie Médicale
- repecter les dispositions du code de Déontologie Médicale
Non repecter le sermant d’Hypocrate
Non respecter le droit professionel médical
Non inscrire à l’Orde de Médecin
2- Toute personne de choisir librement son médecin et lui en faciliter l’excercice
Respecter
Peut respecter
Non respecter
Peu respecter
Jamais respecter
3- Le médecin est libre de ses prescriptions qui seront celles qu’il estime les plus appropriées en la circonstance
Peut respecter
- peu respecter
Non respecter
Respecter
Jamais respecter
4- Le médecin ne peut aliéner son indépendance professionnelles sous quelque forme que ce soit.
- peu respecter
Peut respecter
- respecter
Non respecter
- jamais respecter
5- Le secret professionnel, institué dans l’intérêt des malades, s’impose à tout médecin dans les conditions établies par la loi.
Jamais respecter
Peut respecter
Non respecter
- respecter
Peu respecter
6- Le médecin doit veiller à la protection contre toute indiscrétion de ses fiches cliniques et des documents qu’il peut détenir concernant ses malades
Jamais respecter
Respecter
Peut respecter
Non respecter
- peu respecter
7- Tout médecin est responsable de chacun de ses actes professionnels.
Jamais respecter
Peu respecter
Peut respecter
Non respecter
Respecter
8- Le médecin doit disposer, au lieu de son exercice professionnel, d’une installation convenable et de son moyens techniques suffisants.
A- non respecter
B- peu respecter
C- respecter
D- jamais respecter
E- peut respecter
9- Les médecins ont le devoir d’entretenir et de perfectionner leurs connaissances
A- respecter
B- peu respecter
C- non respecter
D- jamais respecter
E- peut respecter
10- Tout médecin est habilité à pratiquer tous les actes de diagnostic, de prévention et de traitement. Mais un médecin ne doit pas, sauf circonstances exceptionnelles, entreprendre ou poursvivre des soins, ni formuler des prescriptions, dans les domaines qui dépassent sa compétence ou ses possibilités.
A- peu respecter
B- respecter
C- non respecter
D- jamais respecter
E- peut respecter
1-Devant l'apparition d'une paralysie faciale chez un patient porteur d'un tumefaction parotidienne, quel diagnostic évoquez-vous ?
A - Surinfection
B –Hémorragie intratumorale
C –Tumeur maligne
D – Enclavement d'un calcul du Sténon
E - Calcification intratumorales
2-Parmi les signes suivants, quell est celui qui est caractéristique d'une ulceration néoplasique de la langue ?
A - Bourgeonnement des berges
B - La coloration violacée
C - Le fond sanieux
D - Le saignement au contact
E - L'induration sous jacente plus étendue que la lésion visible
3-Au cours de l'examen d'une sous-maxillite aiguë suppurée, on peut en objectiver la présence de pus :
A - Au niveau d'une fistule cutanée
B - A l'ostium de Sténon
C - A l'ostium de Wharton
D - En regard de la dent de 6 ans inférieure du côté gingival interne
E - En regard de l'amygdale pharyngée
4-Une femme de 50 ans présente depuis plusieurs années une tumefaction sous maxillaire évoluant par poussées. L'interrogatoire révèle la notion d'épisodes aigus avec tumefaction douloureuse et inflammatoire. Parfois, une tumefaction apparait au cours du repas. Qu'évoquez-vous ?
A - Lithiase de la glande sous-maxillaire
B –Parotidite chronique
C –Adénite inflammatoire
D –Infections récidivantes d'un kyste apical dentaire
E –Adénome pléimorphe
5-Devant un tableau de phlegmon périmandibulaire d'origine dentaire, quell signe parmi les suivants est un facteur de particulière gravité ?
A - Douleur continue
B - Trismus
C - Dysphagie
D –Crépitation neigeuse sous cutanée
E –Température supérieure à 38°
6-Quel est le plus grand risqué d'une fracture complexe du massif facial intéressant le massif ethmoïdo-nasal ?
A - Contusion du nerf optique
B - Diplopie
C – Méningite
D –Dystopie canthale
E - Enophtalmie
7-Parmi les complications suivantes de la radiothérapie externe des cancers de la cavité buccale, laquelle est la plus redoutable ?
A - Radiodermite
B - Radiomucite
C - Ostéoradionécrose
D - Jabot sous-mental
E - Dépilation
8-Quel est le seul élément permettant de différencier avec certitude une tumeur maligne d'une tumeur bénigne ?
A - Nécrose
B - Infiltration
C - Récidive
D - Anomalies cytonucléaires
E – Métastase
1- Une lèvre se compose
A- lèvre rouge (vermillon)
B- lèvre blanche
C- lèvre rouge et blanche
D- lèvre noire
E- lèvre jaune
2- Chéloplastie esthétique concerne
A- lèvre blanche
B- lèvre rouge ou vermillon
C- lèvre blanche ou vermillon
D- lèvre rouge et blanche
E- lèvre rouge et vermillon
3- La formes diverse de lèvre concerne,
A- pas de mensuration
B- pas d’épaisseur
C- pas de coloration
D- pilosité
E- pas de race
4- Parmi les fonctions de lèvres il y a,
A- parler
B- fermature buccale
C- ouverture buccale
D- parler et fermature buccale
E- parler, fermature et ouverture buccale
5- Il faut distigué la strurcture de lèvres,
A- lèvre supérieure
B- lèvre inférieure
C- commissures labiales
D- lèvre supérieure, lèvre inférieure et commissures labiales
E- lèvre supérieure et inférieure
6- Limites de lèvre supérieure, un des éléments n’est pas compté,
A- sillon naso-génien
B- sillons nasogéniens
C- seuils narinaires
D- vestibule
E- muqueuse buccale
7- Lèvre supérieure est vascularisée par,
A- artères coronaires orbiculaires
B- veines coronaires orbiculaires
C- branches de vaisseaux faciaux
D- artères et veines coronaires orbiculaires
E- artères et veines coronaires occulaires
8- La sensibilité de la lèvre suérieure est,
A- nerfs sus orbitaires
B- nerfs supra-trochléaires
C- nerfs sous orbitaires
D- nerfs faciaux
E- nerts labiales
9- la motricité de la lèvre supérieure est,
A- nerfs sus orbitaires
- nerfs supra-trochléaires
C- nerfs sous orbitaires
D- rameaux des nerfs faciaux
E- nerts labiales
10- Drainage lymphatique de la lèvre inférieure est
A- chaîne lymphatique sus mendibulaire
B- chaîne lymphatique para mendibulaire
C- chaîne lymphatique sous mendibulaire
D- chaîne lymphatique rétro mendibulaire
E- chaîne lymphatique sous maxillaire
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