1.
What ethnic group has the highest incidence of cleft lip/palate?
Correct Answer
D. Native Americans
Explanation
The incidence of CL(P) varies by ethnic group, with the highest frequency occurring in Native Americans, about 3.6 of 1,000 births (1), followed by Asians with 2.1 of 1,000 births, whites with 1 of 1,000, and blacks with 0.41 of 1,000 births
2.
In what phase of development of the normal lip and palate is the palate formed?
Correct Answer
B. Second
Explanation
Normal embryologic development of the lip and palate can be considered to occur in two related phases: the first phase (beginning at 4 to 5 weeks' gestation), involving the development of the upper lip, nose, and primary palate or premaxilla (the portion of the bony palate anterior to the incisive foramen containing the four upper incisors), and the second phase (beginning at 8 to 9 weeks' gestation), involving the development of the secondary palate (the hard and soft palate posterior to the incisive foramen).
3.
When does the fusion and development of the primary palate occur?
Correct Answer
C. 30 days
Explanation
Differences in the gestational time of development and fusion of the primary palate (about 30 days) and secondary palate (about 50 days) are reflected in the separate genetic inheritance patterns.
4.
When does the fusion and development of the secondary palate occur?
Correct Answer
D. 50 days
Explanation
The fusion and development of the secondary palate occur at around 50 days. This is the stage when the two halves of the palate come together and fuse, forming the roof of the mouth. It is an important developmental milestone in the formation of the oral cavity and is crucial for proper feeding and speech development.
5.
At what age would you do a lip adhesion on a patient with cleft lip?
Correct Answer
B. 3 weeks
Explanation
Lip adhesion, if indicated, is the initial procedure and it is performed at 2 to 4 weeks of age
6.
At what age would you perform definitive lip repair following lip adhesion?
Correct Answer
A. 4-6 months
Explanation
Definitive lip repair follows the adhesion at 4 to 6 months of age, which allows the scar to mature.
7.
What does the ‘rule of tens’ not include:
Correct Answer
C. 10 Hct
Explanation
In the United States, most surgeons follow the “rule of tens”: lip repair is performed when the infant is at least 10 weeks old, weighs 10 pounds, and has a hemoglobin of 10 g.
8.
When does cleft palate repair typically occur?
Correct Answer
B. 8-12 months
Explanation
Typically, cleft palate repair occurs between the ages of 8 and 12 months.
9.
What is the most common technique used for unilateral cleft lip repair?
Correct Answer
D. Millard
Explanation
For unilateral lip repair, the rotation-advancement method (as described by Millard) and various modifications, is probably the most commonly used technique in the United States and abroad.
10.
In cleft palate repair, what muscle sling repair is important for improved velopharyngeal function?
Correct Answer
A. Levator veli palatini
Explanation
Regardless of the procedure used, attention should be directed to approximation and repair of the levator veli palatini muscle sling (known as intravelar veloplasty) for improved velopharyngeal function.