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OMSITE MIDTERM ACTUAL EXAM 202 6 (ACTUAL EXAM)
QUESTIONS WITH VERIFIED ANSWERS (LATEST UPDATE
2026 ) UPDATE!!
What type of shock in child shows hypotension but no tachycardia? - CORRECT ANSWER >>> Distributive What agent is responsible for excessive hypotension with induction dose of propofol? - CORRECT ANSWER >>> ACE inhibitor What is the most important determinant of stability of BSSO - CORRECT ANSWER >>> Pattern and orientation of screws What are the endoscopic brow lift incisions - CORRECT ANSWER >>> 1 midline, 2 paramedian, 2 temporal What does Clarks level measure? - CORRECT ANSWER >>> Layer of skin What does Braslows levels measure? - CORRECT ANSWER >>> Depth of invasion in mm What is the significance of the Dedo classification? - CORRECT ANSWER >>> Describes cervical neck changes with aging for facelift Intramembranous bone formation occurs in what bone(s)? - CORRECT ANSWER >>> Ascending ramus
What is a micro gap? - CORRECT ANSWER >>> Space between implant and abutment Excessive torque on implant placement leads to what? - CORRECT ANSWER >>> Necrotic bone What is the most important determinant of failure at one year for immediate implant placement? - CORRECT ANSWER >>> Loading What would be responsible for exposure of 6 threads on implant, but patient is asymptomatic? - CORRECT ANSWER >>> Occlusal trauma What is the difference between peri implantitis and peri mucositis? - CORRECT ANSWER >>> Bone loss What is an absolute contraindication to using bmp2? - CORRECT ANSWER >>> 76 yo male with lung cancer (due to the cancer) What causes rise in paCO2? - CORRECT ANSWER >>> Opioid hypoventilation Most common pediatric airway emergency? - CORRECT ANSWER >>> Airway obstruction What represents the 3 neuron pain system? - CORRECT ANSWER >>> Pain from tooth root goes to cell bodies in gasserian (trigeminal) ganglion then to nucleus caudalis What is an indication for plavix? - CORRECT ANSWER >>> PVD (also myocardial infarction [and other forms of acute coronary syndrome] and stroke) What is the difference between hemangioma and a vascular malformation? - CORRECT
How does one treat IAN after injury? - CORRECT ANSWER >>> Segmental resection of proximal and distal ends Approach to mediastinum to I&D neck fast? - CORRECT ANSWER >>> Transcervical Soap bubble radiolucency in the mandible of a 20's male with painless expansion? - CORRECT ANSWER >>> Odontogenic myxoma Why would any individual experience gait disturbance after AICBG? - CORRECT ANSWER >>> Stripping of tensor fascia lata What is the primary resistance to transverse widening in the SARPE? - CORRECT ANSWER >>> Zygomaticomaxillary buttresses What is the most important place to put plate for stability of ZMC fracture? - CORRECT ANSWER >>> Zygomaticomaxillary A patient with 2 condylar fractures and symphysis fracture will likely experience what physical changes? - CORRECT ANSWER >>> Widening of the lower face What feature is seen in high mandibular plane angle? - CORRECT ANSWER >>> Short condyles Most important anatomical consideration for a long BSSO? - CORRECT ANSWER >>> Curve of Spee What is the most accurate way to measure transverse maxillary discrepancy for orthographic surgery? - CORRECT ANSWER >>> Place casts into class I canine occlusion
What is the best way to assess maxillary occlusal cant? - CORRECT ANSWER >>> Medial canthal line to canines Patient presents to ED with FOM swelling following tori removal, what is the most likely etiology? - CORRECT ANSWER >>> Hematoma from sublingual branch of lingual artery Which of the following poses the greatest airway risk? - CORRECT ANSWER >>> Plunging ranula What is the most dangerous complication of arthrocentesis? - CORRECT ANSWER >>> Fluid accumulation in the lateral pharyngeal space TMJ disc is composed of which types of collagen? - CORRECT ANSWER >>> Type I and II How much residual gingival tissue should remain when planning esthetic crown lengthening? - CORRECT ANSWER >>> At least 2mm residual keratinized tissue What is the advantage of a SARPE? - CORRECT ANSWER >>> Allows for larger transverse movements Which direction should the osteotomies of pterygoid plates be positioned? - CORRECT ANSWER >>> Anterior, inferior and medial (AIM) What is the most common LeFort 1 malocclusion? - CORRECT ANSWER >>> Anterior open bite What kind of TMJ splint can lead to an anterior open bite? - CORRECT ANSWER >>> Anterior bite splint Idiopathic juvenile arthritis in the TMJ has what feature? - CORRECT ANSWER >>> It is unilateral
Folate deficiency leading to megaloblastic anemia, agranulocytosis, aplastic anemia, decreased white blood cell count, and a low platelet count (thrombocytopenia). What blood test should one get when taking Carbemazepine (Tegretol)? Why? - CORRECT ANSWER >>> CBC Agranulocytosis and aplastic anemia What would be seen with respiratory acidosis with following lab values: pH: 7.26, paCO2: 50, HCO3: 26 - CORRECT ANSWER >>> Hypercalcemia What is an indicator of nutritional status? - CORRECT ANSWER >>> Prealbumin Kimmelstiel wilson nodules in a diabetic are visualized on pathology. What are the nodules? - CORRECT ANSWER >>> Nodular sclerosis What is the most widely accepted/ reliable classification system for hair loss? - CORRECT ANSWER >>> Norwood Nevoid basal cell carcinoma presents in what fashion? Listed are 11; try to get as many as possible - CORRECT ANSWER >>> 1) autosomal dominant
- multiple basal cell carcinomas of the skin
- OKCs
- intracranial calcifications
- rib and vertebral anomalies (bifid ribs)
- hypertelorism
- palmar and plantar pits
- Milia/epidermoid cysts
- bridging of sella turcica
- large calvaria
- large paranasal sinuses What is the principle presentation of orofacial granulomatosis? - CORRECT ANSWER >>> Labial swelling What is the treatment for calcifying odontogenic cyst? - CORRECT ANSWER >>> Enucleation and curettage What are the possible etiologies of hemifacial microsomia? - CORRECT ANSWER >>> 1) intrauterine injury to stapedial artery
- Failure of neural crest cells to migrate/ develop What is the most appropriate treatment for microstomia following avulsive tissue injury following? - CORRECT ANSWER >>> Commisurotomy What are the facial features found in Treacher collins? (3 listed) - CORRECT ANSWER >>> 1) Anti- mongolian slant 2)Underdevelopment of zygomatic are malaria region
- Micrognathia
Also...anti-emetic, anticonvulsant, decreases arterial pressure with profound vasodilation and decreases pre and after load How does one keep the maximum number of fat cells alive during graft harvest? - CORRECT ANSWER >>> Using a large bore cannula What is the minimal pedicle width for nasolabial flap? - CORRECT ANSWER >>> 1 - 1.5cm What does the Holdaway ratio demonstrate? - CORRECT ANSWER >>> Relationship of the central incisor to the chin How does one avoid undesirable changes of nose in LeFort 1? - CORRECT ANSWER >>> Alar cinch What suture is associated with Crouzon? - CORRECT ANSWER >>> Coronal What does one suspect when trauma patient cannot see lying down, but can see when standing? - CORRECT ANSWER >>> Hyphema What is the most common type of hair loss? - CORRECT ANSWER >>> Androgenic alopecia What is the biggest negative impact on post operative quality of life when a large tumor resection with grafted with nonvascularized bone graft? - CORRECT ANSWER >>> Occurs in the body of the mandible, because implants cannot be placed into avascular bone What is the most common PICBG nerve injury? - CORRECT ANSWER >>> Superior cluneal nerve (L1, L2, L3) which supplies sensation to skin over superior 1/2 posterior buttocks What is the
blood supply of temporalis muscle flap being used for TMJ disc? - CORRECT ANSWER >>> Anterior and posterior deep temporal arteries Make sure to distinguish from tempoeroparietal fascia flap which is supplied by superficial temporal artery What cosmetic defect should one warn patients about when receiving temporals flap? - CORRECT ANSWER >>> Temporal hollowing What is an adverse outcome of flumazenil? - CORRECT ANSWER >>> Seizure Which inhalatory medication should not be given to patient with end stage renal disease? - CORRECT ANSWER >>> Sevoflurane When a 70kg patient didn't drink from 10pm until 8am for surgery what is fluid imbalance? - CORRECT ANSWER >>> 70 + 40 = 110 cc/hr 110x10 = 1100 What is the minimal strut of septal cartilage that should be maintained for tip support? - CORRECT ANSWER >>> 1cm caudal and dorsal Bilateral maxillary cleft patients experience growth restriction in what direction? - CORRECT ANSWER >>> A/P What is the first line therapy of DVT? - CORRECT ANSWER >>> Heparin (LMWH better than UFH) Which has the best outcome with cardiac ablation? - CORRECT ANSWER >>> AVNRT
CORRECT ANSWER >>> Schwannoma What neoplasm shows histology with leisegang ring calcification? - CORRECT ANSWER >>> CEOT also known as Pindborg tumor Follicular vs. Plexiform Amebloblastoma - CORRECT ANSWER >>> Islands vs. opened up islands 12 yo radiolucency in posterior mandible with photomicrograph? - CORRECT ANSWER >>> Ameloblastic fibroma which looks kind of like ameloblastoma with more fibrous background cells How is a pediatric patient's airway different from an adult? (6 listed) - CORRECT ANSWER >>> 1) Larynx is higher or more cephalic and more anterior Also
- tongue is larger and higher
- pharynx is smaller
- epiglottis is larger and floppier
- attachment of vocal cords is more caudal anteriorly (upward slant)
- narrowest area is cricoid cartilage
- airway is funnel shaped What is etiology on CT. Shown is a patient with restricted opening of 5mm and there is a benign condylar growth on imaging. - CORRECT ANSWER >>> Bony ankylosis Patient with AVNRT/ SVT during sedation. Vagal maneuvers/ carotid massage don't work. What medication is first line? - CORRECT ANSWER >>> Adenosine EKG shows SVT, patient is stable. What medication should be given? - CORRECT ANSWER >>> Adenosine
Patient is given atropine for bradycardia and gets agitated. What should be given for treatment?
- CORRECT ANSWER >>> Physostigmine What should one give a patient for extra pyramidal effects? - CORRECT ANSWER >>> Benadryl Which local anesthetic has the fastest onset? - CORRECT ANSWER >>> Articaine, if not an option then lidocaine Meralgia Paresthetica (also known as Bernhardt-Roth syndrome) is caused by injury to what nerve? - CORRECT ANSWER >>> Lateral femoral cutaneous nerve of the thigh Bone graft taken from what region of the mandible is most likely to have neurosensory damage? - CORRECT ANSWER >>> Symphysis graft Patient given D2 antagonist (metoclopramide, prochlorperazine, chlorpromazine) for PONV and gets EPS (agitation and personal spasms). Treatment is what agent? - CORRECT ANSWER >>> Benadryl What is a complication of prolonged intubation? - CORRECT ANSWER >>> Tracheal stenosis What opioid is metabolized by plasma esterase's? - CORRECT ANSWER >>> Remifentanyl What opioid receptor causes the most respiratory depression? - CORRECT ANSWER >>> Mu Which nerve is most commonly damaged in face lift modified rhytidectomy incision? - CORRECT ANSWER >>> Great auricular nerve
What is the MOA of Sulfonylureas? - CORRECT ANSWER >>> Increase insulin release by directly stimulating release from pancreatic B-Cells? What artery and vein are reanastomosed in free fibula flap? - CORRECT ANSWER >>> Peroneal artery and vena comitans (provide blood supply to flap) with facial artery and vein What areas of the hand can be affected from RFFF without prior Allen's test? - CORRECT ANSWER >>> Thumb and forefinger Dopamine is given to a patient with what condition? - CORRECT ANSWER >>> Euvolemic hypotension At what tooth position is the IAN closest buccally? - CORRECT ANSWER >>> 3rd molar Who is most likely to get Angioedema from ACE inhibitor? - CORRECT ANSWER >>> Black people What class of drugs has a negative impact on lipid and glucose metabolism? - CORRECT ANSWER >>> Beta blockers How do you avoid bat wing deformity following facelift? - CORRECT ANSWER >>> Platysmal plication ATLS is designed to manage patients in: - CORRECT ANSWER >>> Second peak of death
What is the mechanism of botox? - CORRECT ANSWER >>> Impedes Ach release from presynaptic neuron at neuromuscular plate/junction REM sleep compromises what percentage of total sleep? - CORRECT ANSWER >>> 25% What reason would you perform early secondary alveolar cleft grafting? - CORRECT ANSWER >>> If ectopic eruption is occurring What is the treatment for avulsion of tooth with open apex? - CORRECT ANSWER >>> Reimplantation and observe What is the ideal Zygomatic implant position from lateral canthus? - CORRECT ANSWER >>> 2cm inferior, 1.5-2cm lateral (listed twice on OMSITE) 1.5-2cm inferior, 1cm lateral (listed once on OMSITE) Just know more inferior than lateral. All values between 1 and 2 Describe synovial A and B cells - CORRECT ANSWER >>> A are like mAcrophages and B are like fiBroBlasts What type of cartilage for TMJ disc? - CORRECT ANSWER >>> Fibrocartilage (which consists of 85% type I and 115% II collagen) What structure arises from Meckel's cartilage? - CORRECT ANSWER >>> Sphenomandibular ligament
minor exudate) with exposed threads. Xray looked with bone loss. What to do? - CORRECT ANSWER >>> Remove implant then wait to regraft bone and soft tissue When placing Alloderm what is the orientation? (Smooth surface BM likes the blood, rough surface BM likes blood, smooth surface dermal likes blood, rough surface dermal likes blood) - CORRECT ANSWER >>> Smooth surface is the dermal side, becomes red, likes blood, faces tissue (vascular) Rough surface is basement membrane, repels blood, remains white, placed toward root surface (avascular) What is the point of putting soft tissue graft at time of implant sx? - CORRECT ANSWER >>> Add buccal gingival thickness What is a risk of flapless implant placement? - CORRECT ANSWER >>> Increased apical fenestration What is the difference between TADs and implants? - CORRECT ANSWER >>> For TADs time of loading (healing time) is faster and amount of loading is less Which BMP is bad? Why? - CORRECT ANSWER >>> BMP 3. Decreases bone production and osteoblast activity? When using BMP with collagen carrier, what is the most important step? - CORRECT ANSWER >>> Soak for 15 minutes
With immediate loading of implants in edentulous mandible what do you need to be successful?
- CORRECT ANSWER >>> Use acrylic prothesis to splint implants What is the definitive way to differentiate ossifying fibroma from fibrous density? - CORRECT ANSWER >>> Some shit about fibroblasts/ osteoblast lineage Impacted tooth with radiolucent/radiopaque lesion, 13F? - CORRECT ANSWER >>> AOT vs COC Its going to come down to where exactly, and how much calcification. 1/3 COC associated with impacted tooth and usually anterior jaw. 2/3 for AOT. Numbers game. What is the difference of full thickness from split thickness skin graft? - CORRECT ANSWER >>> Overall less contracture. Full thickness has more primary contracture, less secondary contracture and easier post operative wound care. Percentage of patients over 40 years that have radiographic evidence of OA. - CORRECT ANSWER >>> 40% CT recon with L subcondylar fracture - CORRECT ANSWER >>> Only option that appears correct is L V3 paresthesia Other options are L open bite, reduced L: excursion, deviation to the R on opening
