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ABPS Plastic Surgery study materials
ABPS Plastic Surgery study resources

ABPS Plastic Surgery practice questions

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Question 1Plastic Surgery (general content; not enumerated in source)

Which type of skin graft is most appropriate for resurfacing a large, clean granulating wound on the trunk when donor site availability is limited?

  1. Split-thickness skin graft Correct answer.
  2. Free flap
  3. Full-thickness skin graft
  4. Composite graft

Explanation

Split-thickness grafts can be harvested repeatedly from the same donor site and cover large areas, making them suited to extensive wounds with limited donor availability. Full-thickness grafts are limited in size by donor-site closure requirements.

Question 2Plastic Surgery (general content; not enumerated in source)

The blood supply to a random-pattern skin flap is best described as:

  1. Derived from the dermal and subdermal plexus Correct answer.
  2. Dependent entirely on the underlying muscle
  3. Supplied by a single perforating vessel
  4. Based on a named axial artery

Explanation

Random-pattern flaps lack a named axial vessel and rely on the subdermal and dermal plexus for perfusion. This limits their length-to-width ratio compared with axial flaps.

Question 3Plastic Surgery (general content; not enumerated in source)

Which cleft of the lip is most commonly associated with a complete cleft of the primary palate?

  1. Submucous cleft
  2. Bilateral cleft of the secondary palate only
  3. Unilateral cleft Correct answer.
  4. Midline cleft

Explanation

Unilateral cleft lip is the most common form of cleft lip and frequently extends through the alveolus into the primary palate. Midline and submucous clefts are far less common.

Question 4Plastic Surgery (general content; not enumerated in source)

In the emergency management of a deep partial-thickness burn covering 30% total body surface area in an adult, which initial fluid strategy is standard?

  1. Restriction of fluids until urine output falls
  2. Immediate colloid-only resuscitation
  3. Fluid resuscitation guided by the Parkland formula with crystalloid Correct answer.
  4. Oral rehydration alone

Explanation

The Parkland formula (4 mL/kg/%TBSA of crystalloid over 24 hours, half in the first 8 hours) guides initial resuscitation in major burns. Colloid-only or oral strategies are inadequate for large burns.

Question 5Plastic Surgery (general content; not enumerated in source)

A patient presents with a firm, painless nodule on the volar forearm that has slowly enlarged over years. Excisional biopsy shows a well-circumscribed spindle cell lesion with no atypia. Which diagnosis is most likely?

  1. Nodular fasciitis
  2. Benign fibrous histiocytoma Correct answer.
  3. Dermatofibrosarcoma protuberans
  4. Squamous cell carcinoma

Explanation

Benign fibrous histiocytoma (dermatofibroma) is a common, slow-growing, well-circumscribed spindle cell lesion without atypia. Its indolent course and benign histology differentiate it from malignant spindle cell tumors.

Question 6Plastic Surgery (general content; not enumerated in source)

The primary goal of early excision and grafting in major burns is to:

  1. Minimize the need for blood transfusion
  2. Remove devitalized tissue and promote timely wound closure Correct answer.
  3. Preserve eschar to act as a biologic dressing
  4. Reduce hypertrophic scarring by delaying wound closure

Explanation

Early excision removes necrotic tissue that promotes infection and inflammation, allowing earlier closure and improved survival. Delaying closure or retaining eschar increases sepsis risk.

Question 7Plastic Surgery (general content; not enumerated in source)

Which maneuver best tests the integrity of the flexor digitorum profundus tendon of the index finger?

  1. Passive extension of the wrist
  2. Active extension of the distal interphalangeal joint
  3. Active flexion of the distal interphalangeal joint with the proximal interphalangeal joint stabilized Correct answer.
  4. Resisted abduction of the index finger

Explanation

The flexor digitorum profundus inserts on the distal phalanx and is the sole flexor of the distal interphalangeal joint. Stabilizing the proximal interphalangeal joint isolates DIP flexion as a test of FDP function.

Question 8Plastic Surgery (general content; not enumerated in source)

Which nerve is most at risk during a carpal tunnel release performed through a standard palmar incision?

  1. Recurrent motor branch of the median nerve Correct answer.
  2. Dorsal sensory branch of the ulnar nerve
  3. Anterior interosseous nerve
  4. Ulnar nerve

Explanation

The recurrent motor branch of the median nerve arises near the distal end of the transverse carpal ligament and can be injured if the distal ligament is divided blindly. Careful visualization protects it.

Question 9Plastic Surgery (general content; not enumerated in source)

The most reliable clinical sign of compartment syndrome in the forearm is:

  1. Absent radial pulse
  2. Pallor of the hand
  3. Pain out of proportion with passive stretch Correct answer.
  4. Cool skin temperature

Explanation

Pain with passive stretch is the earliest and most reliable sign of compartment syndrome; pulses are typically preserved because the condition is a microvascular perfusion problem. Waiting for pulselessness risks irreversible damage.

Question 10Plastic Surgery (general content; not enumerated in source)

Which factor most strongly predicts poor outcome after replantation of an amputated digit?

  1. Clean guillotine amputation
  2. Patient age over 50 years
  3. Replantation performed within 6 hours
  4. Avulsion mechanism of injury Correct answer.

Explanation

Avulsion injuries damage vessels over a long segment, making microvascular repair unreliable and increasing failure rates. Sharp, clean amputations with short ischemia times have the best prognosis.

Question 11Plastic Surgery (general content; not enumerated in source)

In a patient with a suspected malignant melanoma, the single most important prognostic factor for survival is:

  1. Patient age
  2. Lesion diameter
  3. Breslow thickness Correct answer.
  4. Clark level

Explanation

Breslow thickness, the depth of invasion in millimeters, is the strongest predictor of survival in cutaneous melanoma and guides staging and margins. Clark level has largely been supplanted.

Question 12Plastic Surgery (general content; not enumerated in source)

A 45-year-old woman requests breast reconstruction after mastectomy. Which statement about autologous versus implant-based reconstruction is most accurate?

  1. Implant reconstruction eliminates the need for staged procedures
  2. Autologous reconstruction is contraindicated after radiation therapy
  3. Implant reconstruction generally provides a more natural ptotic shape
  4. Autologous reconstruction typically offers more durable long-term results Correct answer.

Explanation

Autologous tissue reconstruction generally provides more durable, natural results and tolerates radiation better than implants, which may require exchange over time. Implant-based reconstruction often needs multiple stages.

Question 13Plastic Surgery (general content; not enumerated in source)

Which incision is classically used for reduction mammoplasty to minimize visible scarring?

  1. Vertical or Wise-pattern incision Correct answer.
  2. Transverse abdominal incision
  3. Inframammary fold incision only
  4. Periareolar incision alone for all reductions

Explanation

Reduction mammoplasty typically uses a Wise-pattern (anchor) or vertical (lollipop) incision to allow access and shaping while limiting scar visibility. Periareolar-only approaches are limited to small reductions.

Question 14Plastic Surgery (general content; not enumerated in source)

The most common cause of capsular contracture after breast augmentation is:

  1. Radiation exposure
  2. Hematoma
  3. Subclinical bacterial biofilm Correct answer.
  4. Implant rupture

Explanation

Subclinical bacterial biofilm on the implant surface is the leading proposed cause of capsular contracture. Strategies such as antibiotic irrigation and the no-touch technique aim to reduce this risk.

Question 15Plastic Surgery (general content; not enumerated in source)

Which finding is most characteristic of a benign nevus on dermoscopy?

  1. Atypical vascular pattern
  2. Irregular pigment network with multiple colors
  3. Symmetric pigment pattern with uniform network Correct answer.
  4. Blue-white veil

Explanation

Benign nevi typically show symmetric, uniform pigment patterns with a regular network. Irregular networks, blue-white veils, and atypical vessels raise concern for malignancy.

Question 16Plastic Surgery (general content; not enumerated in source)

A patient has a deep burn to the dorsum of the hand. Which principle guides acute management?

  1. Delay excision until eschar separates
  2. Elevate the hand and plan early excision and grafting Correct answer.
  3. Apply tight circumferential dressings
  4. Immobilize the hand in flexion

Explanation

Hand burns benefit from elevation to reduce edema and early excision and grafting to preserve function and limit contracture. Tight dressings risk ischemia, and immobilization in flexion promotes stiffness.

Question 17Plastic Surgery (general content; not enumerated in source)

Which structure is divided during a standard open fasciotomy of the forearm?

  1. Flexor retinaculum only
  2. Transverse carpal ligament Correct answer.
  3. Pronator teres
  4. Brachioradialis

Explanation

Forearm fasciotomy requires release of the fascia and, when the carpal tunnel is involved, division of the transverse carpal ligament to decompress the median nerve. Limiting release to the retinaculum alone is insufficient.

Question 18Plastic Surgery (general content; not enumerated in source)

Which type of flap is best suited for coverage of a small, full-thickness nasal alar defect with an exposed cartilage framework?

  1. Free radial forearm flap
  2. Split-thickness skin graft
  3. Nasolabial interpolation flap Correct answer.
  4. Full-thickness skin graft over bare cartilage

Explanation

A nasolabial flap provides vascularized skin and subcutaneous tissue that can cover exposed cartilage and restore contour. Grafts placed directly over bare cartilage risk failure due to poor vascularity.

Question 19Plastic Surgery (general content; not enumerated in source)

The primary advantage of a perforator flap over a traditional myocutaneous flap is:

  1. Simpler pedicle dissection
  2. Lower need for microvascular anastomosis
  3. Greater bulk for dead-space filling
  4. Preservation of underlying muscle function Correct answer.

Explanation

Perforator flaps harvest skin and fat supplied by perforating vessels while sparing the underlying muscle, reducing donor-site morbidity. They often require more meticulous dissection than myocutaneous flaps.

Question 20Plastic Surgery (general content; not enumerated in source)

Which congenital anomaly is characterized by a unilateral underdeveloped mandible with ear deformities?

  1. Crouzon syndrome
  2. Hemifacial microsomia Correct answer.
  3. Pierre Robin sequence
  4. Treacher Collins syndrome

Explanation

Hemifacial microsomia presents with asymmetric mandibular hypoplasia and ear anomalies on the affected side. Treacher Collins and Crouzon syndromes are typically bilateral and syndromic.

Question 21Plastic Surgery (general content; not enumerated in source)

Which suture technique is most appropriate for a laceration under tension on the back?

  1. Vertical mattress sutures Correct answer.
  2. Running subcuticular suture
  3. Adhesive strips alone
  4. Simple interrupted sutures

Explanation

Vertical mattress sutures provide layered eversion and distribute tension, making them suitable for high-tension wounds. Simple interrupted sutures may be adequate but offer less tension distribution.

Question 22Plastic Surgery (general content; not enumerated in source)

Which factor most increases the risk of hypertrophic scarring after a surgical incision?

  1. Use of fine monofilament suture
  2. Early suture removal
  3. Application of silicone gel
  4. Wound closure under tension Correct answer.

Explanation

Tension across a healing wound promotes excess collagen deposition and hypertrophic scarring. Techniques that reduce tension and support the wound improve scar outcomes.

Question 23Plastic Surgery (general content; not enumerated in source)

Which imaging modality is most useful for preoperative planning of a large abdominal wall reconstruction with suspected loss of domain?

  1. Plain radiography
  2. Magnetic resonance angiography
  3. Ultrasound
  4. Computed tomography with volumetric assessment Correct answer.

Explanation

CT with volumetric assessment quantifies hernia defect size and loss of domain, guiding mesh selection and operative planning. Plain films and ultrasound lack the necessary detail.

Question 24Plastic Surgery (general content; not enumerated in source)

Which principle underlies the use of tissue expansion before reconstruction?

  1. Expansion eliminates the need for donor tissue
  2. Mechanical stretch induces new tissue growth and increased vascularity Correct answer.
  3. Expansion causes permanent thinning of the dermis
  4. Expansion reduces the need for anesthesia

Explanation

Sustained mechanical stretch stimulates cellular proliferation and angiogenesis, generating additional skin with a robust blood supply. This allows reconstruction with adjacent tissue that matches color and texture.

Question 25Plastic Surgery (general content; not enumerated in source)

A patient with a deep partial-thickness facial burn presents within hours of injury. Which approach best preserves facial aesthetics?

  1. Delayed grafting after eschar separation
  2. Application of topical antibiotics alone
  3. Early tangential excision and grafting with sheet grafts Correct answer.
  4. Immediate full-thickness skin grafting of the entire face

Explanation

Early excision and grafting with sheet grafts preserves facial contour and reduces contracture compared with delayed healing or mesh grafting. Topical therapy alone risks hypertrophic scarring.

Question 26Plastic Surgery (general content; not enumerated in source)

Which type of graft is composed of epidermis and a portion of dermis and is typically harvested with a dermatome?

  1. Composite graft
  2. Cultured epithelial autograft
  3. Split-thickness skin graft Correct answer.
  4. Full-thickness skin graft

Explanation

A split-thickness skin graft includes the epidermis and a variable portion of the dermis, leaving the deep dermal elements and appendages behind for donor-site re-epithelialization. Full-thickness grafts include the entire dermis, composite grafts contain multiple tissue types, and cultured epithelial autografts are laboratory-grown epidermal sheets.

Question 27Plastic Surgery (general content; not enumerated in source)

Which congenital anomaly is characterized by a cleft of the upper lip that extends through the nostril sill and is associated with a unilateral nasal deformity?

  1. Submucous cleft palate
  2. Cleft palate only
  3. Bilateral cleft lip
  4. Unilateral cleft lip Correct answer.

Explanation

A unilateral cleft lip involves a defect in the upper lip that typically extends through the nostril sill and is accompanied by ipsilateral nasal deformity, including malposition of the alar dome. Cleft palate alone does not involve the lip, bilateral cleft lip affects both sides, and submucous cleft palate is an occult palatal defect.

Question 28Plastic Surgery (general content; not enumerated in source)

Which suture material is most appropriate for closure of the skin in a patient who requires prolonged wound support and has a history of poor scar formation?

  1. Nylon Correct answer.
  2. Polyglactin 910 (Vicryl)
  3. Plain catgut
  4. Poliglecaprone 25 (Monocryl)

Explanation

Nylon is a nonabsorbable monofilament suture that provides prolonged tensile strength and is commonly used for skin closure when extended support is desired. Polyglactin 910 and poliglecaprone 25 are absorbable and lose strength over weeks, and plain catgut is rapidly absorbed and rarely used for skin.

Question 29Plastic Surgery (general content; not enumerated in source)

Which agent is most commonly used for chemical peels to treat superficial skin conditions such as mild photoaging and acne?

  1. Phenol
  2. Jessner's solution
  3. Glycolic acid 70% Correct answer.
  4. Trichloroacetic acid 15%

Explanation

Glycolic acid at 70% is a superficial chemical peel commonly used for mild photoaging, acne, and dyschromia. Phenol is a deep peel with systemic toxicity risk, trichloroacetic acid 15% is a superficial peel but less commonly used alone for these indications, and Jessner's solution is a medium-depth combination peel.

Question 30Plastic Surgery (general content; not enumerated in source)

Which type of local anesthetic is an amide and has a longer duration of action than lidocaine?

  1. Procaine
  2. Tetracaine
  3. Bupivacaine Correct answer.
  4. Chloroprocaine

Explanation

Bupivacaine is an amide local anesthetic with a long duration of action, often providing 4–8 hours of anesthesia. Procaine, chloroprocaine, and tetracaine are ester anesthetics, and tetracaine, while long-acting, is an ester.

Question 31Plastic Surgery (general content; not enumerated in source)

Which flap is supplied by the deep inferior epigastric perforating vessels and is commonly used for breast reconstruction?

  1. SGAP flap
  2. TRAM flap
  3. DIEP flap Correct answer.
  4. Latissimus dorsi flap

Explanation

The DIEP (deep inferior epigastric perforator) flap is based on perforating branches of the deep inferior epigastric vessels and spares the rectus abdominis muscle. The TRAM flap uses the rectus muscle, the latissimus dorsi flap is pedicled on thoracodorsal vessels, and the SGAP flap is based on superior gluteal vessels.

Question 32Plastic Surgery (general content; not enumerated in source)

Which vein is most commonly used as a recipient vein in free flap reconstruction of the head and neck?

  1. External jugular vein
  2. Superficial temporal vein
  3. Internal jugular vein
  4. Facial vein Correct answer.

Explanation

The facial vein is a common recipient vein in head and neck free flap surgery because of its accessible location and suitable caliber. The internal jugular vein is too large and deep for routine use, the external jugular vein is superficial but less commonly used for microvascular anastomosis, and the superficial temporal vein is used for scalp defects.

Question 33Plastic Surgery (general content; not enumerated in source)

Which laser is most appropriate for treatment of a port-wine stain in a child?

  1. Pulsed dye laser Correct answer.
  2. CO2 laser
  3. Q-switched ruby laser
  4. Nd:YAG laser

Explanation

The pulsed dye laser targets oxyhemoglobin in vascular lesions such as port-wine stains and is the treatment of choice in children because of its safety and efficacy. CO2 laser is ablative and risks scarring, Q-switched ruby laser targets pigment rather than vessels, and Nd:YAG laser penetrates too deeply and has a higher risk of scarring.

Question 34Plastic Surgery (general content; not enumerated in source)

Which imaging study is most appropriate for evaluating a suspected scaphoid fracture when initial radiographs are negative?

  1. MRI of the wrist Correct answer.
  2. Repeat radiographs in 2 weeks
  3. Bone scan
  4. CT scan of the wrist

Explanation

MRI is highly sensitive for occult scaphoid fractures and can detect marrow edema indicative of fracture soon after injury. Repeat radiographs may delay diagnosis, CT is less sensitive for early fractures, and bone scan is less specific and involves radiation.

Question 35Plastic Surgery (general content; not enumerated in source)

Which tendon is most commonly injured in a zone II flexor tendon laceration of the finger?

  1. Flexor digitorum superficialis
  2. Flexor digitorum profundus Correct answer.
  3. Extensor digitorum communis
  4. Flexor pollicis longus

Explanation

Zone II, or 'no man's land,' spans from the A1 pulley to the insertion of the flexor digitorum superficialis, and lacerations here frequently involve both tendons, but the profundus is most commonly injured because of its deep location. The superficialis may also be injured, but the profundus is more frequently involved. Flexor pollicis longus is in the thumb, and extensor tendons are on the dorsum.

Question 36Plastic Surgery (general content; not enumerated in source)

Which nerve is most commonly injured during a carotid endarterectomy, leading to deviation of the tongue to the side of injury?

  1. Facial nerve
  2. Vagus nerve
  3. Hypoglossal nerve Correct answer.
  4. Glossopharyngeal nerve

Explanation

The hypoglossal nerve (CN XII) runs near the carotid bifurcation and can be injured during carotid endarterectomy, causing ipsilateral tongue deviation. The vagus nerve injury causes hoarseness, the glossopharyngeal nerve is higher, and the facial nerve is not in the surgical field.

Question 37Plastic Surgery (general content; not enumerated in source)

Which type of burn is characterized by a waxy white appearance, insensate skin, and a leathery eschar?

  1. Deep partial-thickness
  2. Superficial partial-thickness
  3. Superficial epidermal
  4. Full-thickness Correct answer.

Explanation

Full-thickness burns destroy all epidermal and dermal layers, resulting in a waxy white or charred appearance, insensibility to pain, and a leathery eschar. Partial-thickness burns are painful and blanch, and superficial burns are erythematous and painful.

Question 38Plastic Surgery (general content; not enumerated in source)

Which flap is most suitable for reconstruction of a large full-thickness cheek defect involving the oral commissure?

  1. Full-thickness skin graft
  2. Radial forearm free flap Correct answer.
  3. Nasolabial flap
  4. Bilobed flap

Explanation

A radial forearm free flap provides thin, pliable skin with a reliable vascular pedicle and is well suited for large intraoral and cheek defects, including those involving the commissure. Nasolabial and bilobed flaps are local flaps for smaller defects, and skin grafts cannot replace full-thickness tissue loss.

Question 39Plastic Surgery (general content; not enumerated in source)

Which condition is characterized by premature fusion of the sagittal suture, resulting in a long, narrow skull?

  1. Trigonocephaly
  2. Scaphocephaly Correct answer.
  3. Brachycephaly
  4. Plagiocephaly

Explanation

Scaphocephaly results from premature sagittal suture fusion, producing a long, narrow head. Plagiocephaly is asymmetric, trigonocephaly involves the metopic suture with a triangular forehead, and brachycephaly is a short, broad skull from coronal suture fusion.

Question 40Plastic Surgery (general content; not enumerated in source)

Which technique is most appropriate for breast reconstruction in a patient with insufficient abdominal tissue and a history of radiation therapy to the chest wall?

  1. Tissue expander with implant
  2. TRAM flap
  3. DIEP flap
  4. Latissimus dorsi flap with implant Correct answer.

Explanation

A latissimus dorsi flap with implant provides healthy, non-irradiated muscle and skin to the chest wall and is a reliable option when abdominal tissue is insufficient and the chest wall has been irradiated. Tissue expanders alone have high complication rates in irradiated fields, and abdominal flaps may not be feasible due to insufficient tissue.

Question 41Plastic Surgery (general content; not enumerated in source)

Which factor is most important in determining the success of a skin graft?

  1. Donor site location
  2. Suture technique
  3. Graft thickness
  4. Recipient bed vascularity Correct answer.

Explanation

The vascularity of the recipient bed is critical for graft survival because the graft initially relies on plasmatic imbibition and then revascularization. Graft thickness, donor site, and suture technique affect outcome but are secondary to bed vascularity.

Question 42Plastic Surgery (general content; not enumerated in source)

Which nerve is most at risk during a facelift procedure in the area of the malar eminence?

  1. Marginal mandibular nerve
  2. Zygomatic branch of the facial nerve Correct answer.
  3. Temporal branch of the facial nerve
  4. Great auricular nerve

Explanation

The zygomatic branch of the facial nerve crosses the malar region and is at risk during dissection over the malar eminence. The marginal mandibular nerve is at risk along the mandible, the great auricular nerve is a sensory nerve in the neck, and the temporal branch is at risk in the temporal region.

Question 43Plastic Surgery (general content; not enumerated in source)

Which type of implant is most commonly used for breast augmentation and has a silicone gel filling?

  1. Silicone gel-filled implant Correct answer.
  2. Saline-filled implant
  3. Double-lumen implant
  4. Cohesive gel implant

Explanation

Silicone gel-filled implants are the most commonly used for breast augmentation because they feel more natural than saline. Cohesive gel implants are a type of silicone gel implant but are more form-stable, and double-lumen implants are less common.

Question 44Plastic Surgery (general content; not enumerated in source)

Which maneuver is used to assess the integrity of the flexor pollicis longus tendon?

  1. Finkelstein test
  2. Watson test
  3. Active flexion of the thumb interphalangeal joint Correct answer.
  4. Tenodesis test

Explanation

Active flexion of the thumb interphalangeal joint specifically tests the flexor pollicis longus tendon. The tenodesis test assesses flexor tendons collectively, the Watson test assesses scapholunate instability, and the Finkelstein test assesses de Quervain tenosynovitis.

Question 45Plastic Surgery (general content; not enumerated in source)

Which type of flap is based on the superficial inferior epigastric artery and is used for breast reconstruction?

  1. ALT flap
  2. TRAM flap
  3. DIEP flap
  4. SIEA flap Correct answer.

Explanation

The SIEA flap is based on the superficial inferior epigastric artery and spares the rectus muscle and deep fascia. The DIEP flap uses deep inferior epigastric perforators, the TRAM flap includes muscle, and the ALT flap is from the thigh.

Question 46Plastic Surgery (general content; not enumerated in source)

Which factor most increases the risk of venous congestion in a free flap?

  1. Excessive flap size
  2. Arterial thrombosis
  3. Prolonged ischemia time
  4. Inadequate venous outflow Correct answer.

Explanation

Venous congestion occurs when venous outflow is inadequate, leading to flap swelling and eventual failure. Arterial thrombosis causes ischemia, excessive flap size may increase demand but not directly cause congestion, and prolonged ischemia time affects reperfusion injury but not specifically venous congestion.

Question 47Plastic Surgery (general content; not enumerated in source)

Which suture technique is most appropriate for closing a wound under high tension on the back?

  1. Staples
  2. Simple interrupted sutures
  3. Vertical mattress sutures Correct answer.
  4. Running subcuticular sutures

Explanation

Vertical mattress sutures provide strong wound edge eversion and distribute tension over a larger area, making them suitable for high-tension wounds. Simple interrupted sutures may cut through under tension, running subcuticular sutures are weak for high tension, and staples are fast but not ideal for high-tension areas.

Question 48Plastic Surgery (general content; not enumerated in source)

Which condition is characterized by a benign, slow-growing tumor of the parotid gland that is the most common salivary gland neoplasm?

  1. Warthin tumor
  2. Adenoid cystic carcinoma
  3. Mucoepidermoid carcinoma
  4. Pleomorphic adenoma Correct answer.

Explanation

Pleomorphic adenoma is the most common benign salivary gland tumor, typically occurring in the parotid gland. Warthin tumor is second most common and often bilateral, while mucoepidermoid and adenoid cystic carcinomas are malignant.

Question 49Plastic Surgery (general content; not enumerated in source)

Which microsurgical technique is most important for successful free flap transfer in a vessel-depleted neck?

  1. Vein grafting Correct answer.
  2. Arteriovenous loop
  3. End-to-side anastomosis to a large vein
  4. Interpositional synthetic graft

Explanation

In a vessel-depleted neck, vein grafting is often necessary to reach distant recipient vessels and provide adequate length for tension-free anastomosis. Synthetic grafts have higher thrombosis rates, arteriovenous loops are complex and used in specific situations, and end-to-side anastomosis to a large vein does not address arterial inflow.

Question 50Plastic Surgery (general content; not enumerated in source)

Which factor is most predictive of a poor outcome after nerve repair?

  1. Delay in repair
  2. Patient age
  3. Mechanism of injury Correct answer.
  4. Suture material

Explanation

The mechanism of injury, particularly crush or avulsion injuries, is a strong predictor of poor nerve regeneration because of associated tissue damage and scarring. Age and delay affect outcomes but are less predictive than the mechanism, and suture material has minimal impact.