Plastic and Cosmetic Surgery Mcqs

Questions 1-5 (free)          Questions 6-1    Questions 11-14          Burns (6 questions)


Q15)Type of cartilage in basement membrane
a)Type 1
b) Type 2
C)Type 3
D)Type 4

 Ans 15)  D
Type I: Skin, tendon, and mature scar have a 4:1 ratio of type I : type III
Type II: Cartilage and cornea
Type III: Blood vessels and immature scar
Type IV: Basement membrane


Q16 )Melanocytes present in which layer of skin
A)Startum basale
B)Staratum lucidum
C)Stratum granulosum
D)stratum spinosum

 Ans 16A
Stratum basale: This layer contains melanocytes (of neural crest origin) that produce melanin, which is taken
up by the  keratinocytes.
Stratum spinosum: Desmosomes connect cells and create a shiny appearance.
Stratum granulosum: Cytoplasmic granules contribute to keratin formation.
Stratum lucidum: Dead cells without nuclei
Stratum corneum: Acellular layer of keratin

Q17)Epithelization in primary healing occurs in

Ans 17) a

 Primary intention:
a.Immediate primary closure of a surgical incision *
(epithelialization occurs in ~24 hours).
b. Delayed closure of a surgical incision (usually to either allow clearance of infection
or resolution of edema) is known as “delayed primary closure”.
Secondary intention:
Full-thickness wound healing by a combination of wound contraction and migration of
fibroblasts and keratinocytes from the wound periphery

Q18)Predominant cells involved in  inflammatory phase

 Ans 18) c

Proliferative phase (days 3 to 14)
Fibroblasts are the predominant cell population at 3 to 5 days and transform into myofibroblasts to promote wound contraction
(REf Michigan Manual page no 23)

19)TGF b1 released by
D)Platelets platelet-derived growth factor (PDGF) and TGF-β1 released by macrophages.

 Ans 19) A
Fibroblasts are the predominant cell population at 3 to 5 days and transform into
myofibroblasts to promote wound contraction under the influence of platelet-derived
growth factor (PDGF) and TGF-β1 released by macrophages

20 )Max tensile strengthens of wound reaches upto

The wound achieves 3% of its original strength at 1 week, 30% original strength at 3
weeks, and 80% original strength at 2 months and beyond. (Michigan manual page no 24)

21 )Final ratio of collagen in wound
A)Type 1:Type 3 = 1:3.5
B)Type 1: Type 3 = 3.5:1
C)Type 4: Type 1 = 4:1
D)Type 4: Type 1 = 6:1

Ans b 

Final ratio of type I:type
III collagen is 3.5:1 (Michigan manual page no 24)

22 )Phases of Bone healing
A) 1,3;2

Ans A
Osteoconduction: donor bone placed adjacent to the recipient bone will allow
ingrowth of capillaries and osteoprogenitor cells, ultimately resulting in complete
Osteoinduction—active induction of differentiation of osteoblast precursors
into bone-forming cells. Bone morphogenetic proteins: 2, 4, and 7 isotypes have the
most significant osteoinductive effects.
Osteogenesis—formation of new bone by virtue of osteogenic precursors

23 )Intrasynovial tendon graft example

A)Palamaris longus
C)Flexor digitorum longus
D)Extensor digitorum longus

 Ans C
Extrasynovial tendon grafts : (most commonly include palmaris longus or plantaris)
Early cell death and eventual repopulation by fibroblasts and neovascularization.
Acts as a conduit for vessel and cell ingrowth
Intrasynovial tendon grafts (rare; e.g., Flexor digitorum longus)
Cellular viability is thought to be maintained, and healing occurs by the normal
Less adhesion formation

24)According to sutherland classification of nerve injury.
Loss of perineurium comes under
A)1st degree
B)2nd degree
C)3rd degree
4)4th degree

 Ans D
Sunderland/Mackinnon nerve injury classification:
1. First-degree injury
a. Nerve is demyelinated, resulting in a local conduction block.
b. Treatment is nonoperative and recovery is complete within approximately 12 weeks.

2. Second-degree injury
a. Some nerve fibers are disrupted, but the Schwann cell basal lamina remains intact.
b. Wallerian degeneration occurs with second-degree and higher injuries.
c. Tinel’s sign indicates an advancing growth cone.
d. Treatment is nonoperative. Complete recovery is expected in months.

3. Third-degree injury
a. Some areas of Schwann cell basal lamina are disrupted with scarring, while the
perineurium remains intact.
b. Incomplete recovery; some nerve fibers do not reinnervate their target.
c. Treatment is usually nonoperative.

4. Fourth-degree injury
a. Loss of continuity of the perineurium.
b. Scar blocks all fiber growth; little or no nerve recovery.
c. Treatment is operative.

5. Fifth-degree injury
a. The nerve is completely transected.
b. The epineurium is disrupted.
c. No recovery is expected without operative management.

6. Sixth-degree injury
Combination of any of the previous five levels of injury