ASDS Exam – Questions With Complete Solutions
Another name for mohs surgery Correct Ans - Microscopically
controlled surgery
5 year cure rate of primary BCC or SCC with Mohs Correct Ans -
99%
5 year cure rate of recurrent BCC or SCC with Mohs Correct Ans -
94-96%
Indications for Mohs Correct Ans - Recurrent tumor, Incompletely
excised tumor, high risk areas, "H" of face, poor clinical margins, perineural
spreads, >2cm, Skin tx with ionizing radiation, aggressive tumor
For Mohs scalpel held at what angle Correct Ans - 45 degrees
Mohs slides typically stained with? Correct Ans - H&E or toluidine
blue
Which margins examided in Mohs Correct Ans - Deep and
peripheral margins
Tumors that may be treated with Mohs? Note some are controversial
Correct Ans - BCC, SCC, Basosquam, Bowenoid papulosis, melanoma*,
merkel cell, DFSP, AFX, MFH, MAC, Sebaceous ca, Verrucous ca,
Extramammary paget's'*, angiosarc*
Fingernail development begins at? Correct Ans - week 10
Toenail development begins at? Correct Ans - Week 14
Nail plate derived from ? Correct Ans - Nail matrix
Growth rate finger nail and toenail Correct Ans - Finger nail
3mm/month toenail 1mm/month
How long does it take fingernail to grow from matrix to distal free edge?
Correct Ans - 4-6 months
,What determines the thickness gradient of nail plate Correct Ans -
Length of matrix
What is the onychodermal band Correct Ans - Narrow delineation
at the distal end of the nail plate marking the separation of the nail bed
from the nail plate
Function of onychodermal band Correct Ans - Prevents onycholysis
after trauma
What is the hyponichium Correct Ans - Begins at onychodermal
band and terminates at the distal groove
which component of the nail is recognized first druing the embryogenic
period Correct Ans - Hyponichium
What divides hyponichium from volar epidermis of the digit Correct
Ans - Distal groove
What structure is a continuation of the dorsal skin of the digit and covers
the nail matrix Correct Ans - Proximal nail fold
What is the end product of the proximal nail fold Correct Ans -
Cuticle
Function of nail cuticle Correct Ans - Protects against
environmental trauma. If trimmed excessively can lead to paronychia
What does the nail matrix lack Correct Ans - Granular layer
Nail thickness is detemined by Correct Ans - Length of matrix
Surgery that affects the proximal nail matrix can cause what defect
Correct Ans - Split nail
Surgery that affects the distal nail matrix can cause what defect
Correct Ans - Defect on the undersurface of the nail plate
,What does the lunula represent Correct Ans - Visible distal
component of the nail matrix
In theory why should distal margin of the lunula be preserved Correct
Ans - To maintain the normal nail shape
Primary role of nail bed Correct Ans - To attach and move the nail
plate
Does surgery of the nail bed lead to dystrophy Correct Ans -
Usually not
The nail bed dermis sits ontop of what structure Correct Ans -
Periosteum
What is the perionychium comprised off Correct Ans - Proximal &
lateral nail folds, hyponychium and nail bed
Describe the freer septum elevator Correct Ans - looks like a small
spatula and used for nail avulsion
Describe the english anvil action nail splitter Correct Ans - Cutting
blade opposite a flat blade, used for splitting nails
Double action nail clipper Correct Ans - Two sharp blades opposed
to each other cuts thickened nail plates
Typically in what direction are nail bed biopsies obtained Correct Ans
- Longitudinal
Best location for nail bed biopsy Correct Ans - Lateral margin
where scarring is decreased
When is trephinations and x-ray of subungual hematoma indicated
Correct Ans - Per ASDS manual when hematoma occupies >50% of nail
Within what time frame can punch biopsy or piercing be considered for
subungual hematoma Correct Ans - Per ASDS manual if there is
pain and the hematoma is less than 48 hours old
, What is the recommeded punch size for the nail bed Correct Ans - 3
mm
Punch biopsy of nail bed should extend to which structure Correct Ans
- periosteum
High or low risk for dystrophy of nail following punch biopsy of nail bed
Correct Ans - low
In which nail structure are the melanocytes located Correct Ans -
Nail matrix
What is a possible complcation of nail matrix biopsy when the proximal
nail fold is reflected back Correct Ans - Ptyergium formation if the
dermis of proximal nail fold and open matrix adhere to each other and form
a scar
3 complications of lateral longitudinal nail biopsy Correct Ans -
Cyst, spicule, malalignment
What happens to nail width after lateral longitudinal nail biopsy
Correct Ans - Nail width is narrowed permanently
What is chemical matricectomy used for Correct Ans - To tx
ingrown nails
Which compounds are used to perform chemical matricectomy Correct
Ans - Phenol (89-92%) or 10% NaOH
How does phenol used for chemical matricectomy prevent further nail
growth Correct Ans - Denatures proteins
What is coldest cryogenic agent? Correct Ans - Liquid nitrogen
Boiling point of liquid nitrogen Correct Ans - minus 196 C
Boiling point of solid carbon dioxide Correct Ans - minus 79 C
Another name for mohs surgery Correct Ans - Microscopically
controlled surgery
5 year cure rate of primary BCC or SCC with Mohs Correct Ans -
99%
5 year cure rate of recurrent BCC or SCC with Mohs Correct Ans -
94-96%
Indications for Mohs Correct Ans - Recurrent tumor, Incompletely
excised tumor, high risk areas, "H" of face, poor clinical margins, perineural
spreads, >2cm, Skin tx with ionizing radiation, aggressive tumor
For Mohs scalpel held at what angle Correct Ans - 45 degrees
Mohs slides typically stained with? Correct Ans - H&E or toluidine
blue
Which margins examided in Mohs Correct Ans - Deep and
peripheral margins
Tumors that may be treated with Mohs? Note some are controversial
Correct Ans - BCC, SCC, Basosquam, Bowenoid papulosis, melanoma*,
merkel cell, DFSP, AFX, MFH, MAC, Sebaceous ca, Verrucous ca,
Extramammary paget's'*, angiosarc*
Fingernail development begins at? Correct Ans - week 10
Toenail development begins at? Correct Ans - Week 14
Nail plate derived from ? Correct Ans - Nail matrix
Growth rate finger nail and toenail Correct Ans - Finger nail
3mm/month toenail 1mm/month
How long does it take fingernail to grow from matrix to distal free edge?
Correct Ans - 4-6 months
,What determines the thickness gradient of nail plate Correct Ans -
Length of matrix
What is the onychodermal band Correct Ans - Narrow delineation
at the distal end of the nail plate marking the separation of the nail bed
from the nail plate
Function of onychodermal band Correct Ans - Prevents onycholysis
after trauma
What is the hyponichium Correct Ans - Begins at onychodermal
band and terminates at the distal groove
which component of the nail is recognized first druing the embryogenic
period Correct Ans - Hyponichium
What divides hyponichium from volar epidermis of the digit Correct
Ans - Distal groove
What structure is a continuation of the dorsal skin of the digit and covers
the nail matrix Correct Ans - Proximal nail fold
What is the end product of the proximal nail fold Correct Ans -
Cuticle
Function of nail cuticle Correct Ans - Protects against
environmental trauma. If trimmed excessively can lead to paronychia
What does the nail matrix lack Correct Ans - Granular layer
Nail thickness is detemined by Correct Ans - Length of matrix
Surgery that affects the proximal nail matrix can cause what defect
Correct Ans - Split nail
Surgery that affects the distal nail matrix can cause what defect
Correct Ans - Defect on the undersurface of the nail plate
,What does the lunula represent Correct Ans - Visible distal
component of the nail matrix
In theory why should distal margin of the lunula be preserved Correct
Ans - To maintain the normal nail shape
Primary role of nail bed Correct Ans - To attach and move the nail
plate
Does surgery of the nail bed lead to dystrophy Correct Ans -
Usually not
The nail bed dermis sits ontop of what structure Correct Ans -
Periosteum
What is the perionychium comprised off Correct Ans - Proximal &
lateral nail folds, hyponychium and nail bed
Describe the freer septum elevator Correct Ans - looks like a small
spatula and used for nail avulsion
Describe the english anvil action nail splitter Correct Ans - Cutting
blade opposite a flat blade, used for splitting nails
Double action nail clipper Correct Ans - Two sharp blades opposed
to each other cuts thickened nail plates
Typically in what direction are nail bed biopsies obtained Correct Ans
- Longitudinal
Best location for nail bed biopsy Correct Ans - Lateral margin
where scarring is decreased
When is trephinations and x-ray of subungual hematoma indicated
Correct Ans - Per ASDS manual when hematoma occupies >50% of nail
Within what time frame can punch biopsy or piercing be considered for
subungual hematoma Correct Ans - Per ASDS manual if there is
pain and the hematoma is less than 48 hours old
, What is the recommeded punch size for the nail bed Correct Ans - 3
mm
Punch biopsy of nail bed should extend to which structure Correct Ans
- periosteum
High or low risk for dystrophy of nail following punch biopsy of nail bed
Correct Ans - low
In which nail structure are the melanocytes located Correct Ans -
Nail matrix
What is a possible complcation of nail matrix biopsy when the proximal
nail fold is reflected back Correct Ans - Ptyergium formation if the
dermis of proximal nail fold and open matrix adhere to each other and form
a scar
3 complications of lateral longitudinal nail biopsy Correct Ans -
Cyst, spicule, malalignment
What happens to nail width after lateral longitudinal nail biopsy
Correct Ans - Nail width is narrowed permanently
What is chemical matricectomy used for Correct Ans - To tx
ingrown nails
Which compounds are used to perform chemical matricectomy Correct
Ans - Phenol (89-92%) or 10% NaOH
How does phenol used for chemical matricectomy prevent further nail
growth Correct Ans - Denatures proteins
What is coldest cryogenic agent? Correct Ans - Liquid nitrogen
Boiling point of liquid nitrogen Correct Ans - minus 196 C
Boiling point of solid carbon dioxide Correct Ans - minus 79 C
