Botox
Fillers
Lasers
Peels/Misc
Random
100
Name the Mechanism of Action of Botox?
Toxins cause temporary chemodenervation by preventing binding and release of acetylcholine
100
Sculptra is FDA approved for which conditions?
HIV associated facial lipoatrophy, aesthetic approval for shallow to deep nasolabial folds and facial wrinkles
Shallow to deep NL folds in facial wrinkles
100
LASER
Lasers (Light Amplification by the Stimulated Emission of Radiation)
100
Name Three Different Types of Peel Depths and solutions used?
Superficial (A or b hyrax acid peels, Salicylic acid), Medium (TCA, Jessners), Deep (Phenol)
100
You have already given antivirals to your peel/laser patient. What other drugs should you inquire about?
Isotretinoin/Accutane min 6-12 months
200
Botox Toxic Dose
2500-2700 units (70 kg Human)
200
Tyndall Effect?
tyndall effect- bluish discoloration when filler is placed too superficially in the skin, caused by light scattering in the particles, blue light is scattered more than red light
200
Laser lights is (list three characteristics)
Coherent - same wavelength
Monochromatic - same color
Collimated - straight line
200
What is the Toxic Dose of Phenol?
Toxic dose 8-15 g fatal in 24 hrs
Processed in Liver, and eliminated via Urinary
200
You are at shrine performing Laser. The surgeon, who is performing laser, witnesses an unexpected flash in the operative field. The surgeon immediately stops the procedureand alerts the anesthesiologist. Smoke and a burning odor coming out of the patient’s airway are noted. Which of the following is the most appropriate next step in management?
In cases of airway fire, the ASA practice advisory recommends immediate (without waiting) removal of the tracheal tube, interruption of flow of all airway gases, removal of all sponges or any other flammable materials from airway, and pouring of saline into the airway.
300
What Key History Components should be collected for someone interested in Botox?
Contraindications are infection, allergy to botox or human albumin, pregnant (category C) or neurologic conditions
ALS, Myasthenia Gravis, Lambert-Eaton Syndrome
300
Name some Pain relieving strategies to avoid Filler Injection Pain? (list three)
Ice, Nerve Blocks (infraorbital, mental), Vibration devices, EMLA or Topical Anesthetic,
300
- Name:
- A. The chromophore in hair removal
- B. The chromophore in ablative resurfacing
- C. The chromophore in vascular lesions
- The chromophore in hair removal:Melanin
- The chromophore in ablative resurfacing: Water
- The chromophore in vascular lesions: Oxyhemoglobin
300
What is of clinical importantance about Phenol Peels?
Targets: middle reticular dermis
Cardiac Monitoring is a must
300
You have a 50 unit vial of Botox and Tila tells you she added 1.25 ml of NS. How many units are in 0.1 ml ?
4.00 Units
400
Name the condition and treatment
Ptosis of eyelid
Tx: obs or alpha-adrenergic agonist ophthalmic eye drops to stimulate mueller’s muscles
400
Rank in order of Longevity:
polymethyl-methacrylate, Human Collagen, Ca Hydroxyapatite
400
Herpes Infection
Pre Operative treatment
400
When Performing dermabrasion what is the endpoint?
Paprika bleeding indicates penetration into the superficial papillary dermis and is a safe endpoint for treatment.
Yellow globules of sebaceous glands should be avoided when treating deeply.
400
What are the stages of hair growth? Bonus which is th elongest .
Anagen, Catogen, Telogen
500
You are preparing some Botox for a 30-year-old woman who has requested treatment for her frown line (glabellar region). It is her first experience with Botox injections. How much should you inject?
A typical starting dose for this woman would be 20 units
500
Which Fillers Require Skin Testing?
Zyderm, Zyplast (bovine derived), Artefill
500
A 65-year-old retired woman wishes to have a face-lift procedure. She has Fitzpatrick type III skin with deep rhytids affecting her forehead and periorbital and perioral areas. She stopped smoking 5 years ago.
CO2 laser
This woman has deep rhytids and will have significant downtime after her face-lift procedure. She is less likely to require a short downtime because she has retired. Combining this resurfacing procedure at the time of surgery is generally safe and time efficient, since she is already having a general anesthetic and an overnight hospital stay. Alternatively, she could have Er:YAG treatment.
500
How do you minimize cardiac or adverse toxicity/damage in Phenol Peels
Approaching systematically through facial subunits and with a time approach of -20-30 min between subunits.
50% as effective as stronger solutions but less toxic
Apply in systematic fashion to facial subunits:
Forehead
Left Cheeck
Right Cheek
Perioral
Nose
Periorbital
500
Accidental injection of hyaluronic acid filler into which of the following areas is most likely to cause blindness by retrograde occlusion of the central retinal artery?
dorsal nasal artery is a distal continuation of the ophthalmic artery from the internal carotid artery. During nasal dorsum augmentation, accidental injection of filler into this artery under pressure can push the filler retrograde into the ophthalmic artery.
600
Name Various High Yield "No Go" Zones for Botox Injections
Stay well above the superior orbital rim with the lateral injections.
Avoid low, lateral brow injections. A high, lateral brow injection results in a significant alteration of the lateral brow (Lateral Limbus)
2 cm above the brow to reduce the risk of brow ptosis.
Do not inject below the zygomatic archor in the region of the zygomaticus muscle
To prevent drooping of the upper lip, take care not to inject the levator labii superioris alaeque nasi and levator labii superiori
600
What is the recommended dose of hyaluronidase for filler complications?
The recommended initial dose is 150 to 300 units. These doses can be repeated as needed. Smaller doses can be used if non-intravascular occlusion is suspected.
(inservice 2018)
600
A prisoner wishes to come out to the real world and remove his Green tattoo. He is paying cash what would you do to remove his I love TDC tattoo?
Q-switched alexandrite
Green tattoo inks are best treated with a laser of wavelength 650 nm. Suitable choices include alexandrite (755 nm) and ruby (694 nm). Q-switched lasers are preferable over pulsed for tattoo removal. They use high bursts of energy in short time intervals and create acoustic waves that result in mechanical pigment disruption. The pigments that are fragmented can then be phagocytized by macrophages.
600
Your patient is interested in a chemical peel what pretreatment strategies should you employ?
2 weeks: Avoid sun and cigarettes smoke Daily skin care, Tretinoins, Sunscreen, Hydroquinone (Fitzpatrick III-IV skins)
600
You just purchased Botox for your practice and reconstituted a 100 unit vial. How long can you store it how fast should you use it?
Manufacturer guidelines promote one-time use within 4 hours of reconstitution.
These products do not contain an antimicrobial agent; prolonged storage is outside FDA guidelines.
Consensus reports support safe and effective use of botulinum toxin A up to 6 weeks after reconstituting and storage at 4° C