Multiple Choice Questions MCQ

Question 51# Print Question

Concerning leech therapy used to salvage venously congested tissues, which of the following is false?

A. Complications include postoperative infection with Aeromonas spp.

B. Augmentin® is the most effective prophylactic antibiotic

C. The gastro-intestinal microbiota differs between Hirudo spp.

D. Hirudo medicinalis was FDA approved as a medical device in 2004

E. Recent microbiological studies have shown that Aeromonas is sensitive to fluoroquinolones

Question 52# When vein grafts are used to bridge intra-arterial defects:
A. The vein wall thins due to the increased luminal pressure
B. Graft length decreases by 25-30% long term
C. The graft stretches by 20-30%
D. The vein wall thickens significantly
E. There is no ingrowth of smooth muscle cells

Question 53# The rupture rate of silicone breast implants is approximately:
A. 5% at 5 years
B. 5% at 10 years
C. 50% at 5 years
D. 50% at 12 years
E. 15% at 15 years
50% at 12 years. This is the ‘traditional’ rate quoted ¹. However, many of these were older generation implants. More recent papers/data suggest a number closer to 10% at 10 years. Readers are recommended to reappraise the future literature, and hence the validity of this answer. References: 1. Robinson OG Jr, Bradley EL, Wilson DS. Analysis of explanted silicone implants: a report of 300 patients. Ann Plast Surg 1995; 34(1): 1-6.

Question 54# The following statements concerning hyaluronic acid are true except:
A. It is found in the vitreous humour of the eye
B. It is a major constituent of Perlane®
C. It is a major constituent of Radiesse®
D. It is a glycosaminoglycan
E. It is not available as an oral preparation
It is a major constituent of Radiesse®. C is false. Hyaluronan, also called hyaluronic acid or hyaluronate, is a non-sulfated glycosaminoglycan found in many tissues of the body, such as skin, cartilage, and the vitreous humour. Perlane® contains a much higher concentratation of hyaluronic acid than Restylane®. Radiesse comprises calcium hydroxyapatite particles. Hyaluronic acid can be found as oral preparations in health food shops and marketed commonly for arthritic ailments.

Question 55# The four zones within the capsule surrounding an expander were described by:
A. Radovan
B. Neumann
C. Paysk
D. Brand
E. Nalebuff
Tissue expansion was popularised by Neumann (1957) and Radovan (1975), and Austed undertook important work on histological changes in 1982.

Question 51# Concerning leech therapy used to salvage venously congested tissues, which of the following is false?
A. Complications include postoperative infection with Aeromonas spp.
B. Augmentin® is the most effective prophylactic antibiotic
C. The gastro-intestinal microbiota differs between Hirudo spp.
D. Hirudo medicinalis was FDA approved as a medical device in 2004
E. Recent microbiological studies have shown that Aeromonas is sensitive to fluoroquinolones
Augmentin® is the most effective prophylactic antibiotic. B is false. Aeromonas is a gram negative bacillus which is a well reported cause of infection following leech therapy. Aeromonas spp. strains resistant to Augmentin have been reported in several papers in the literature whereas fluoroquinolones seem to be consistently active. Recent microbiological studies have shown that the gastro-intestinal microbiota differs amongst the European medicinal leeches (Hirudo verbana, orientalis and medicinalis). Bacteria isolated from the leech include Aeromonas veronii, rikenella and Morganella morganii. References: 1. Whitaker IS, Kamya C, Azzopardi EA, Graf J, Kon M, Lineaweaver WC. Preventing infective complications following leech therapy: is practice keeping pace with current research? Microsurgery 2009; Apr 27. [Epub ahead of print].