Free DHA Plastic Surgery mock test

Plastic Surgery sample questions with answers

4 more original exam-style Plastic Surgery questions, worked in full. They are not real or recalled exam questions, and none of them is in the diagnostic above, so sit that first if you have not.

1. Question 1 · Aesthetic Surgery and Non-surgical Procedures

   Two hours after lower lid blepharoplasty, a patient develops severe eye pain, a tense proptosed eye and falling vision. What is the most appropriate immediate step?

   1. ALateral canthotomy and inferior cantholysis
   2. BCold compresses and head elevation only
   3. COral acetazolamide and review in 6 hours
   4. DUrgent CT scan before any intervention
   Show answer and explanation

   Correct answer: A. Lateral canthotomy and inferior cantholysis

   Retrobulbar haemorrhage causes an orbital compartment syndrome that can lead to permanent blindness within a short time. Immediate lateral canthotomy and cantholysis at the bedside decompress the orbit, with the wound opened and the bleeding controlled. Imaging should not delay decompression when the diagnosis is clinical.

   Reference: Neligan, Plastic Surgery, 4th ed.

2. Question 2 · Breast Surgery

   Eight years after reconstruction with textured implants, a woman develops a large unilateral peri-implant fluid collection with no trauma or infection. What is the most appropriate initial investigation?

   1. AMammography alone and review in a year
   2. BAspiration of the fluid for cytology and CD30
   3. CImmediate implant removal without sampling
   4. DEmpirical antibiotics and repeat ultrasound
   Show answer and explanation

   Correct answer: B. Aspiration of the fluid for cytology and CD30

   A late seroma more than a year after textured implants raises suspicion of breast implant-associated anaplastic large cell lymphoma. Ultrasound-guided aspiration of the fluid for cytology, CD30 immunohistochemistry and flow cytometry is the key diagnostic step. Removing the implant without sampling loses diagnostic material.

   Reference: NCCN Guidelines: Breast Implant-Associated ALCL (T-Cell Lymphomas)

3. Question 3 · Burns

   A 70 kg man with 30% total body surface area deep burns arrives 2 hours after injury having received no fluid. Using the Parkland formula (4 mL/kg/%TBSA), what infusion rate of Hartmann solution is needed for the next 6 hours?

   1. A525 mL per hour
   2. B350 mL per hour
   3. C1050 mL per hour
   4. D700 mL per hour
   Show answer and explanation

   Correct answer: D. 700 mL per hour

   Total 24-hour volume is 4 x 70 x 30 = 8400 mL, and half (4200 mL) is given in the first 8 hours from the time of burn, not from arrival. With 2 hours lost, 4200 mL must be given over 6 hours, which is 700 mL per hour. The rate is then adjusted to urine output of about 0.5 mL/kg/h in adults.

   Reference: ABA Advanced Burn Life Support Provider Manual

4. Question 4 · Burns

   A man rescued from a house fire has facial burns, singed nasal hairs, soot in the mouth and a hoarse voice that is worsening. What is the most appropriate airway action?

   1. AObserve with nebulised salbutamol
   2. BGive high flow oxygen and review in 4 hours
   3. CStart nebulised adrenaline and steroids
   4. DArrange early endotracheal intubation
   Show answer and explanation

   Correct answer: D. Arrange early endotracheal intubation

   Progressive hoarseness with signs of inhalation injury warns of evolving upper airway oedema, which can make later intubation impossible. Early intubation by an experienced operator is indicated. Waiting and observing risks complete airway obstruction.

   Reference: ATLS Advanced Trauma Life Support, 10th ed.