In long surgical procedure intubation method is:

 # In long surgical procedure intubation method is: 

A. Nasotracheal tube with cuff 

B. LMA 

C. Nasotracheal tube without cuff 

D. Endotracheal tube 

The correct answer is A. Nasotracheal tube with cuff.

LMA (laryngeal mask airway) is used mostly in situations of emergency and by non-anaesthesiologists. Endotracheal tube is commonly used method during general anaesthesia. For prolonged surgeries especially facio-maxillary surgeries nasaltracheal or Orotracheal intubation especially with cuff is used.

Best way to monitor perfusion of free flap:

 # Best way to monitor perfusion of free flap: 

A. Pulse oximeter 

B. Laser Doppler velocimetry 

C. Prick test 

D. Flourescin & dermoflourometer 

The correct answer is: C. Prick Test.

 During the postoperative phase, the flap is closely monitored for signs of compromised perfusion. Flaps are best assessed by inspection. Clinical monitoring is the current gold standard for assessing free flaps. Dermal bleeding or prick test is used to assess the colour of the blood within the flap circulation. Also scalpel mark on the flap can also be used to assess the colour of the blood.

Many high-end techniques are described in literature to monitor free flaps such as: 

• Serial fluorometry

• Plethysmography

• Laser doppler flow-metry

Reference: [Steel and Marran's head and neck surgery 4th ed 137]

Pulsating varicose vein is due to:

 # Pulsating varicose vein is due to 

A. Arterio venous fistula 

B. Sapheno femoral incompetence 

C. Deep vein thrombosis 

D. Abdominal tumour 

The correct answer is A. Arteriovenous fistula.

Communication between an artery and adjacent vein leads to arteriovenous aneurysm or arteriovenous fistula. When an arteriovenous fistula is created surgically, this is called iatrogenic arteriovenous fistula. For Renal dialysis,iatrogenic fistula is mostly used in the wrist or in the ankle and such temporary arteriovenous fistula is known as Cimino fistula. Presence of a pulsating thrill over the site of the lesion is quite characteristic, particularly if the lesion is located near the surface. If a finger is pressed on the artery proximal to the fistula,there will be slowing of pulse rate and rise in the diastolic pressure. This is known as Branham's sign.

Ref: S. Das Manual of Surgery, 3rd ed 194

Auspitz’s sign is characteristic of

 # Auspitz’s sign is characteristic of 

A. Lichen planus 

B. White sponge nevus 

C. Erythema multiforme 

D. Psoriasis 

The correct answer is D. Psoriasis.

Psoriasis of the skin is characterized by the occurrence of small, sharply delineated, dry papules, each

covered by a delicate silvery scale which has been described as resembling a thin layer of mica. If the deep scales are removed, one or more tiny bleeding points are disclosed, a characteristic feature termed Auspitz’s sign. After removal of the scale the surface of the skin is red and dusky in appearance.

Reference: Shafer's Textbook of Oral Pathology