ABD Dermatologic Surgery 2 — Questions and Answers
Question 1: During Mohs micrographic surgery, tissue margins are examined using which sectioning technique?
- Vertical bread-loaf sections
- Horizontal en face frozen sections (Correct answer)
- Random punch sampling
- Permanent paraffin cross-sections only
Correct answer: Horizontal en face frozen sections
Mohs uses horizontal en face frozen sections allowing evaluation of 100% of the surgical margin.
Question 2: What is the primary advantage of Mohs surgery over standard excision for high-risk facial tumors?
- Faster operative time
- Complete margin control with maximal tissue conservation (Correct answer)
- No need for reconstruction
- Lower cost in all cases
Correct answer: Complete margin control with maximal tissue conservation
Mohs offers the highest cure rate while sparing the maximum amount of healthy tissue.
Question 3: Which local anesthetic additive prolongs anesthesia duration and reduces bleeding?
- Sodium bicarbonate
- Epinephrine (Correct answer)
- Hyaluronidase
- Normal saline
Correct answer: Epinephrine
Epinephrine causes vasoconstriction, prolonging anesthesia and reducing intraoperative bleeding.
Question 4: What is the maximum safe dose of lidocaine with epinephrine per kilogram?
- 1 mg/kg
- 3 mg/kg
- 7 mg/kg (Correct answer)
- 15 mg/kg
Correct answer: 7 mg/kg
Lidocaine with epinephrine has a maximum safe dose of approximately 7 mg/kg.
Question 5: A patient reports metallic taste, perioral numbness, and tinnitus after injection. This suggests?
- Allergic reaction
- Local anesthetic systemic toxicity (Correct answer)
- Vasovagal syncope
- Normal anesthetic effect
Correct answer: Local anesthetic systemic toxicity
Early CNS signs like perioral numbness and tinnitus indicate local anesthetic systemic toxicity.
Question 6: Which suture material is absorbable and commonly used for deep dermal closure?
- Nylon
- Polypropylene
- Polyglactin 910 (Vicryl) (Correct answer)
- Silk
Correct answer: Polyglactin 910 (Vicryl)
Polyglactin 910 is a braided absorbable suture ideal for buried dermal sutures.
Question 7: The tumescent technique in liposuction primarily reduces which risk?
- Infection
- Blood loss (Correct answer)
- Scarring
- Nerve damage
Correct answer: Blood loss
Tumescent anesthesia with dilute epinephrine markedly reduces intraoperative blood loss.
ABD Dermatologic Surgery 2
During Mohs micrographic surgery, tissue margins are examined using which sectioning technique?