Mixed Deck — All ABPS Topics Flashcards

Which finding on a preoperative EKG would most likely require cardiology clearance before elective flap reconstruction?

Answer: New left bundle branch block (LBBB)

A new LBBB may indicate acute cardiac pathology such as ischemia or cardiomyopathy and requires cardiology evaluation before elective surgery.

When performing a risk-benefit discussion for an obese patient requesting panniculectomy, which complication should receive the most emphasis?

Answer: Wound healing complications and infection

Obese patients undergoing panniculectomy have significantly elevated rates of wound dehiscence, infection, and poor healing due to tissue tension and ischemia.

The deep inferior epigastric artery (DIEA) originates from which vessel?

Answer: External iliac artery

The deep inferior epigastric artery arises from the external iliac artery just above the inguinal ligament.

What distinguishes a American Board of Physician Specialties Certification certified professional from a non-certified practitioner?

Answer: Certification validates competency through standardized assessment against benchmarks

Certification provides objective validation of competency through standardized assessment.

Which foundational principle is MOST important for success in American Board of Physician Specialties Certification?

Answer: Commitment to continuous learning, ethical practice, and quality outcomes

Success requires continuous learning, ethical practice, and focus on quality outcomes.

Treacher Collins syndrome (mandibulofacial dysostosis) results from mutations affecting which gene?

Answer: TCOF1 (Treacle)

Treacher Collins syndrome is caused by mutations in TCOF1, encoding the nucleolar phosphoprotein Treacle, which disrupts neural crest cell development.

What is the gold standard technique for peripheral nerve repair when primary tension-free repair is not achievable?

Answer: Autologous nerve graft (sural nerve)

Autologous nerve grafting using the sural nerve remains the gold standard for bridging nerve gaps, providing a scaffold with intact Schwann cells and endoneurial tubes to guide axon regeneration.

Why is continuing education essential for ethical practice?

Answer: To maintain competence and align with best practices and ethical care

Continuing education is essential for ethical practice in plastic surgery as it ensures surgeons remain current with the latest medical advancements, techniques, and safety protocols. This ongoing learning maintains their competence, allows them to provide the highest standard of care, and reinforces their commitment to ethical, evidence-based practice.

What is the most important landmark when planning a TRAM flap?

Answer: Rectus abdominis muscle

When planning a Transverse Rectus Abdominis Myocutaneous (TRAM) flap for breast reconstruction, the rectus abdominis muscle is the most important landmark because the flap is based on perforator vessels that run through this muscle. The integrity and vascular supply of the rectus abdominis are critical for the viability of the transferred tissue. Careful dissection around this muscle ensures adequate blood flow to the flap while minimizing abdominal wall morbidity.

Which factor is crucial in postoperative wound care?

Answer: Consistent monitoring and sterile dressing application

Postoperative wound care is crucial for preventing infection and promoting optimal healing. Consistent monitoring allows for early detection of complications, while sterile dressing application protects the wound from contaminants and supports a clean healing environment, leading to better aesthetic and functional outcomes.

What is the primary purpose of a preoperative marking session in rhinoplasty?

Answer: Identifying anatomical landmarks and planning the surgical approach

Preoperative markings define anatomical landmarks, plan osteotomy sites, and guide the surgical technique specific to each patient's nasal anatomy.

The 'golden period' for primary nerve repair following sharp laceration is generally considered to be within:

Answer: 24 hours of injury

Primary nerve repair is ideally performed within 24 hours of a sharp, clean laceration when tissue planes are well-defined and ends are not yet retracted or fibrotic.

Which practice best exemplifies the ethical principle of justice in a plastic surgery practice?

Answer: Providing pro bono care or reduced fees to underserved populations

Justice in medicine requires fair distribution of care, including participation in pro bono or reduced-fee services for underserved populations.

What is the MOST effective way for new ABPS professionals to build competency?

Answer: Combining formal education, mentored practice, and ongoing professional development

Building competency requires formal education, mentored practice, and ongoing development.

In tissue expander-based breast reconstruction, what is the primary purpose of the acellular dermal matrix (ADM)?

Answer: To provide inferolateral coverage and define the pocket

ADM is used to extend inferolateral coverage of the tissue expander, creating a defined lower pole pocket and reducing implant visibility.

The thoracodorsal nerve innervates which muscle used in reconstructive surgery?

Answer: Latissimus dorsi

The thoracodorsal nerve, a branch of the posterior cord of the brachial plexus, innervates the latissimus dorsi muscle.

Which of the following best describes the anatomical basis of the 'safe zone' for deep plane facelift dissection?

Answer: Dissection deep to the SMAS but above the parotid-masseteric fascia protects facial nerve branches

In the deep plane, dissection deep to SMAS but superficial to the parotid-masseteric fascia keeps the facial nerve protected beneath the fascia while mobilizing the SMAS-platysma unit.

In lower extremity reconstruction using the anterolateral thigh (ALT) flap, the perforators most commonly arise from which source vessel?

Answer: Lateral circumflex femoral artery descending branch

ALT flap perforators most commonly arise from the descending branch of the lateral circumflex femoral artery, located in the septum between the rectus femoris and vastus lateralis.

A patient on chronic SSRI therapy undergoes elective rhinoplasty. The most important perioperative concern related to SSRIs is:

Answer: Impaired platelet aggregation and increased bleeding risk

SSRIs inhibit serotonin reuptake in platelets, reducing platelet aggregation and increasing intraoperative and postoperative bleeding risk.

What is the primary role of preoperative nutritional assessment in free flap surgery candidates?

Answer: Identifying hypoalbuminemia and malnutrition that impairs wound healing

Hypoalbuminemia (<3.5 g/dL) and malnutrition are associated with impaired immunity, poor wound healing, and increased flap complication rates in reconstructive surgery.