Free Plastic Surgery Section 1 Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Plastic Surgery Section 1 practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1After a brow lift, a patient cannot elevate the right eyebrow, while lower facial movements remain normal. Injury to which facial nerve branch best explains this finding?

   1. A.Temporal branchCorrect answer: A
   2. B.Buccal branch
   3. C.Cervical branch
   4. D.Marginal mandibular branch

   Explanation: The anatomy reference states, "The temporal branch enters the frontalis muscle into its deeper part." Frontalis elevates the eyebrow, so this isolated postoperative weakness localises to the temporal branch. The other named facial nerve branches supply different facial muscle groups.

   Reference: StatPearls: Anatomy, Head and Neck; Frontalis Muscle — Nerves

2. 2A partial-thickness burn develops small islands of new epithelium within the wound, in addition to growth from its edge. Which surviving structures provide this epithelial source?

   1. A.Dermal capillaries and lymphatic vessels
   2. B.Hair follicles and sweat glandsCorrect answer: B
   3. C.Collagen bundles and elastic fibres
   4. D.Sensory nerves and arrector pili muscles

   Explanation: The chapter describes epithelialisation "from basal cells in underlying dermal appendages such as hair follicles and sebaceous/sweat glands." Surviving appendageal epithelium provides the new epidermal cells. Vessels, connective-tissue fibres, nerves and muscles do not supply keratinocytes.

   Reference: StatPearls: Acute and Chronic Thermal Burn Evaluation and Management — Pathophysiology — epithelialisation

3. 3An infant has an isolated cleft of the secondary palate. Which embryological structures failed to fuse in the midline?

   1. A.The paired mandibular processes
   2. B.The paired medial nasal processes
   3. C.The paired palatal shelvesCorrect answer: C
   4. D.The paired lateral nasal processes

   Explanation: The chapter states, "The secondary palate forms from initial outgrowths of the maxillary processes, the palatal shelves." These shelves normally meet and fuse at the midline. Failure of their fusion produces the secondary palatal cleft; the other processes contribute to different facial regions.

   Reference: StatPearls: Cleft Palate — Etiology — secondary palate development

4. 4An older adult has a slowly enlarging nasal papule with surface telangiectasia, a pearly rolled edge and central ulceration. Which tumour is most likely?

   1. A.Basal cell carcinomaCorrect answer: A
   2. B.Squamous cell carcinoma
   3. C.Merkel cell carcinoma
   4. D.Amelanotic melanoma

   Explanation: The BAD handbook describes "Nodular basal cell carcinoma is a small, skin-coloured papule or nodule with surface telangiectasia, and a pearly rolled edge". This characteristic morphology and slow growth favour basal cell carcinoma. The other choices are real malignant skin tumours but do not best fit this combination.

   Reference: British Association of Dermatologists: Dermatology Handbook — Skin Cancer — Basal cell carcinoma, Presentation

5. 5A newborn boy has an exposed urethral plate and a urethral opening on the dorsal surface of the penis. Which congenital anomaly is present?

   1. A.Hypospadias
   2. B.Phimosis
   3. C.Buried penis
   4. D.EpispadiasCorrect answer: D

   Explanation: The source states "epispadias features an open and exposed urethral plate on the penile dorsum.". The dorsal open urethral plate is characteristic of epispadias. Hypospadias has a ventral ectopic meatus; phimosis and buried penis do not describe a dorsal urethral defect.

   Reference: StatPearls: Epispadias — Introduction

6. 6A patient develops peripheral nerve dysfunction after compression during surgery. The lesion is classified as neurapraxia. Which tissue change best characterises this diagnosis?

   1. A.Axonal interruption with preserved endoneurial tubes
   2. B.Focal demyelination with preserved axonal continuityCorrect answer: B
   3. C.Axonal and endoneurial disruption with intact perineurium
   4. D.Complete interruption of the nerve and its supporting sheaths

   Explanation: The source states "Neurapraxia is the mildest form of peripheral nerve injury, characterized by a transient conduction block due to focal demyelination or ischemia, while preserving the structural integrity of the nerve.". Neurapraxia blocks conduction without axonal interruption. The other structural descriptions represent progressively more severe nerve injuries rather than this reversible myelin-level lesion.

   Reference: StatPearls: Neurapraxia — Continuing Education Activity

7. 7A patient with unilateral facial paralysis and viable facial muscles is selected for a cross-facial nerve graft. Which motor source is used to restore spontaneous coordinated facial movement?

   1. A.The ipsilateral hypoglossal nerve
   2. B.The contralateral intact facial nerveCorrect answer: B
   3. C.The ipsilateral nerve to masseter
   4. D.The ipsilateral spinal accessory nerve

   Explanation: The source states "relies on peripheral branches of the contralateral, intact facial nerve to innervate corresponding areas of the paralyzed hemiface to produce spontaneous and purposeful facial movement.". A cross-facial graft uses the healthy opposite facial nerve. Hypoglossal, masseteric and accessory nerve sources are distinct transfer strategies rather than the motor source of a cross-facial graft.

   Reference: Facial Nerve Trauma: Evaluation and Considerations in Management — Cross-Facial Nerve Graft

8. 8A patient with oestrogen-receptor-positive breast cancer asks how tamoxifen acts on the tumour. Which mechanism best explains its breast anti-oestrogen effect?

   1. A.Blocking oestrogen receptors in the tumour cellsCorrect answer: A
   2. B.Inhibiting aromatase-mediated oestrogen synthesis
   3. C.Suppressing pituitary gonadotrophin secretion
   4. D.Blocking human epidermal growth factor receptor 2

   Explanation: The source states "Tamoxifen works by blocking the oestrogen receptors. It stops oestrogen from telling the cancer cells to grow.". Tamoxifen acts at the oestrogen receptor. Aromatase inhibition, pituitary suppression and HER2 blockade are mechanisms of other breast-cancer therapies.

   Reference: Cancer Research UK: Hormone therapy for breast cancer — Tamoxifen

9. 9In the pathology report for a non-ulcerated primary cutaneous melanoma, which measurement represents Breslow thickness?

   1. A.The vertical distance from the top of the granular layer to the deepest invasive tumour cellCorrect answer: A
   2. B.The maximum horizontal diameter of the tumour measured parallel to the epidermal surface
   3. C.The number of mitotic figures counted per square millimetre of viable invasive dermal tumour
   4. D.The deepest anatomical skin compartment reached by invasive tumour in the excision specimen

   Explanation: ICCR states "Breslow thickness is measured from the top of the granular layer of the epidermis (or, if the surface is ulcerated, from the base of the ulcer) to the deepest invasive cell across the broad base of the tumour". For the non-ulcerated lesion, the starting point is the granular layer and the endpoint is the deepest invasive cell. Horizontal diameter, mitotic rate and anatomical invasion level are real alternative pathological measurements, but are not Breslow thickness.

   Reference: International Collaboration on Cancer Reporting: Breslow thickness — Breslow thickness (Core), opening definition

10. 10An adult requesting nasal surgery spends hours checking a barely noticeable contour in mirrors, repeatedly seeks reassurance and avoids work because of the perceived defect. Which condition warrants specific assessment?

    1. A.Generalised anxiety disorder
    2. B.Body dysmorphic disorderCorrect answer: B
    3. C.Panic disorder
    4. D.Post-traumatic stress disorder

    Explanation: The source states "Body dysmorphic disorder (BDD), or body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are often unnoticeable to others.". Disproportionate preoccupation with a minimal appearance defect and repetitive mirror checking suggest BDD. The alternatives involve different primary symptom patterns; this presentation warrants assessment rather than assuming surgery will resolve the distress.

    Reference: NHS: Body dysmorphic disorder — Opening definition