ENT Promotion 2010
1.
The most common facial nerve paralysis in otological procedures is
associated with
A - tympanoplasty
B - mastoidectomy
C – translabrynthine excision of acoustic neuroma
Answer : The most common otologic procedure resulting in facial nerve
injury is the mastoidectomy
SOURCE :Facial Nerve Trauma: Grand Rounds Presentation, UTMB, Dept. of
Otolaryngology DATE: June 29, 20009
2.
Mobius syndrome is associated with
A - hemifacial microsomia
B - club finger
C - congenital facial nerve palsy
Answer : congenital facial nerve palsy
SOURCE : Pasha page 365
3.
The most common segment of facial nerve affected by cholesteatoma is
A – geniculate ganglion
B – horizontal part
C – 2nd genu
D- vertical segment
E- stylomastoid foramen
Answer :Most common site is the geniculate ganglion (from disease in the
anterior epitympanum)
Source : gift to my residents/Gift to My Dear Residents/exam notes/RCPSC
Toronto Notes 1/Otology / Cholesteatoma & Mastoidectomy
4.
Level III of evidence is
A – descriptive study
B – RCT
C – expert opinion
D – meta-analysis
5.
Positive predictive value is a
A – true positive in diseased patient
B – true negative
C – false positive
D – false negative
6.
Brun’s nystagmus is
A - a railway nystagmus
B – a form of congenital nystagmus
C – seen in vestibular neuronitis
Answer: small amplitude rapid primary position jerk nystagmus that beats
away from the side of the lesion and a slow gaze-evoked or gaze-paretic type
of nystagmus toward the side of the lesion
-signifies compression of brain stem with peripheral vestibular nerve
involvement
source : gift to my residents/Gift to My Dear Residents/exam notes/RCPSC
Toronto Notes 2/Notes/otology
Coarsebeating nystagmus on ipsilateral gaze, fine–beating nystagmus on
contralateral gaze (Brun's nystagmus)
Source :
Myers_Operative_Otolaryngology_Head_and_Neck_Surgery__2nd_Edition__20
08(3)/ 124-Acoustic Neuroma
Brun's nystagmus
� Combination of
� Gaze-evoked central nystagmus
(from compression of the pons)
� Horizontal-rotatory peripheral nystagmus
(from damage to the vestibular verve)
� Secondary to CPA lesions
7.
CHL of 30 – 45 dB will have rinne test
A – negative at 256, negative at 512, positive at 1024
B - negative at 256, positive at 512, positive at 1024
Answer : negative at 256, negative at 512, positive at 1024
Source : dhingra page 23
8.
Lesion that will be hyperintense on T1 and T2 MRI is
A - cholesterol granuloma
B – meningioma
Answer : cholesterol granuloma
Source : Pasha page 330
9. Invasion of bone in cholesteatoma is caused by
A – action of osteoblast
B – pressure necrosis
C – action of osteoclast
D – toxic metabolite
10. Most common area of fixation of the malleous is in the
A – head in epitympanum
B – long process to the medial wall
C – umbo at the tympanic membrane
11. All are candidate for cochlear implant except patient with
A - michle deformity
B - mondini
C - Alexander
12. True about mast cells in nasal mucosa
A - inhibited to degranulate by disodium cromolyte
B - attach to IgE by Fc portion
C - is not like mast cells in other tissues
13. Appear as white patches in oral cavity
A - leukoplakia
B - pigmented nevi
C - erythroplakia
D - papilloma
14. The best monitoring for a patient started on ototoxic medication is
A - PTA (8000 Hz to 16000 Hz )
B - PTA ( 1000 to 4000)
15. Draf type II is
A - resection of uncinate, frontal recess anterior ethmoid air cells
16. Carry poor prognosis for patient with aural atresia
A - poor definition of ossicles on CT
B - decrease of middle ear space by 30 %
C - palsy of lower lip
D - poor definition of facial nerve on CT
17. Used for monitoring of free flap
A - capillary refill
B - B.P
C - fever
18. Airway stenting in laryngeal trauma
A - selectively used in laryngeal trauma and can cause further injury
B - axial CT will not show displaced fracture
19. Nasal dermoids
A - usually isolated cyst
B - associated with tract going to a cyst at the septum
C - associated with tract going superficially
20. Best option of treatment for T2N0M0 NPC is
A - radiotherapy only
B - chemoradiotherapy
21. common site of lymphoepithelial cyst is
A - floor of mouth
B - tongue
C - lip
22. cauliflower ear is caused by
A - subcutaneous collection affecting the perichondrium
B - recurrent secondary infection causing cartilage loss
23. Patient with uvula going to the right side, the lesion is affecting
A - right vagus nerve
B - right cranial accessory nerve
C - left glossopharyngeal nerve
D - hypoglossal nerve
E - trigeminal nerve
Left vagus or left cranial accessory
24. Patient with relapsing symptoms of blurred vision, sensory and motor deficit.
Dx is
A - multiple sclerosis
B - amyotrophic lateral sclerosis
25. Symptoms of vertigo, blurred vision, drop attack. Dx is
A - vertebrobasillar insufficiency
26. Vertigo in BPPV is typically characterized by except
A - geotropia
B - fatigubility
C - latency
D - ageotropia
27. A 5 years child that cochlear implant was done by age of 3 years had OME for the
last 4 months, management will be
A - myringotomy
B - myringotomy and tubes
C - start antibiotics
D - observation
28. Double swallow is seen in
A - achalasia
B - plummer-vinson
C - pharyngeal pouch
D - esophageal pouch
29. The best tool to assess degree and etiology of aspiration is
A - fluoroscopic swallow study
B - videolaryngoscopy
30. Site of origin of juvenile angiofibroma is
A - nasopharynx
B - superior/posteriolateral
Sphenopalatine foramen, superioposterior lateral nose
31. The most common complication of inhalational burn is
A - respiratory tract infection
B - tracheal stenosis
C -laryngeal stenosis
32. Lung disease that is associated with more morbidity postop is seen in
A - obstructive lung disease in 48 years old patient
B - restrictive lung disease in 52 years old patient
33. Common cause of SNHL
A - CMV
B - rubella
34. Mumps is
A - retrovirus
B - paramyxovirus
35. Type of cell affected by radiotherapy in salivary gland is
A - acinar cells
B - intercalated cells
C - myoepithelial cells
36. Female patient with acne at the lateral nose, she was instructed not to squeeze it
because of
A - infection in area between ear, angle of mouth and eye is hazardous
B - this area is drained by superior and inferior ophthalmic veins to cavernous sinus
37. True about rhinoplasty
A - rim incision is made at caudal end of LLC
B - intracartilagenous incision is associated with more nasal valve stenosis than
intercartilagenous incision
38. Choice for pleomorphic adenoma of parotid
A - eneculation
B - excision
C - superficial parotidectomy
39. Parotid tumor associated with more facial nerve involvment
A - adenoid cystic carcinoma
40. Test of malingering
A - stenger
41. Not associated with transverse temporal bone fracture
A - vertigo
B - foramen spinosum involvment
C - stylomastoid foramen involvment
42. Case of recurrenet dacryocystitis and nasal obstruction you should think of
A - nasolacrimal duct cyst
43. Obese patient, drunk, obtunded with noisy breathing that improve after pulling
the mandible. The option for securing airway is
A - oropharyngeal airway
B - nasopharyngeal airway
C - ETT
44. Von-willbrand disease postop you expect to find
A - prolonged bleeding time and PTT with normal PT
B - prolonged bleeding time and normal PT and PTT
45. Most common cause of revision in stapes surgry
A - incus necrosis
B - granuloma
46. Most common cause of death in wegner is
A - renal failure
B - respiratory failure
47. Bowing of glottis is caused by
A - cricothyroid weakness
B - thyroarytenoid
C - posterior cricoarytenoid
48. Spasmodic dysphonia is considered
A - dystonia
49. The best option for inverted papilloma of lateral nasal wall is
A - total maxillectomy
B - medial maxillectomy
50. Most common area of fracture mandible
A - body
B - angle
C - parasymphisis
D - condyle
E - coronoid
51. CSF rhinorrhea etiology/site ( most commonly )
A - traumatic in cribriform, spontaneous in sphenois sinus
B - cribriform plate and ethmoid for both traumatic and spontaneous
52. Nasolacrimal duct is formed by
A - ectoderm between lateral nasal swelling and maxillary swelling
Ectoderm between frontonasal and maxillary
53. Imaging in laryngeal trauma
A - CT is the best option as an initial imaging
54. While doing endarterectomy of carotid artery . You clipped the ECA near its
origin , this might affect which branch
A - superior thyroid artery
55. Palpable delphian node is considered …….. until proven otherwise
A - laryngeal ca
B - thyroid ca
56. Invisible laser
A - argon
B - KTP532
C - ND:Yag
D - Co2
57. Laser used in papillomatosis to prevent massive bleeding
A - Co2
B - pulse dye laser
58. Seen in late phase of otosclerosis
A - dense of sclerosis seen histologically
B - blue mantle of manasse
59. Semicircular canal 1st to develop
A - superior
B - posterior
C - lateral
D - all develop at almost the same time
60. Progressive hoarseness in a post intubation patient is
A - granuloma
B - persistent odema
61. For mapping before frontal osteoblastic flap, Xray that will help is
A - water view
B - lateral soft tissue
C - 6 feet water
D - 6 feet culdwell
62. Syphilis is infectious in
A - primary stage
B - secondary stage
C - tertiary stage
D - not infectious in all stages
63. Nerve involved in corneal reflex
A – V1 : VII
64. Extension of deep neck fascia
A - prevertebral fascia to coccyx
B - superficial of the deep layer to mediastinum
65. Hyperparathyroidism cause
A - osteitis cystica fibrosa
B - osteitis deformans
66. Most common site of ectopic superior parathyroid
A - retropharyngeal retroesophageal
67. Patient post neck dissection develop horner syndrome . this is because of
dissection deep to
A - jugular vein
B - common carotid artery
68. Hematological disease ( chronic anemia, extramedllary hematopoeisis ) that can
present as a mass in the oral cavity is
A - chidiak disease
B - B thalasemia
C - plummer-vinson disease
69. A child with inspiratory stridor , scope shows bilateral vocal cord paralysis.
Consultant shold ask for
A - US renal
B - echo
C - imaging of CNS
70. Blunt trauma to the larynx without airway compromise, scope shows only mild
edema, Managmenet is
A - rest, humidified air and voice rest
71. A child with fatigue at the end of day, test you will ask for is
A - tensilon test
72. Contraindication for obliteration of frontal sinus
A - allergic fungal sinusitis
B - benign tumors
C - severe frontal fracture
D - mucopyocele
73. Detection of facial nerve recovery 6 to 12 weeks before clinical evidence is by
A - EMG
74. Most common combination of paraganglioma of neck
A - bilateral carotid body tumor
B - vagus shwannoma
75. Ongrhen line
A - medial canthus and angle of mandible
76. Inner ear structure involved in otosclerosis
A - spiral ligament
B - stria vascularis
77. Wicham’s stria is carachteristic of
A - leukoplakia
B - erythroplakia
C - lichen planus
D - candidiasis
78. Symptom least likely to benifet from FESS is
A – headache??
B - nasal discharge
C - nasal congestion
D - facial pain
E - fatigue
79. A child is intubated in ICU, NG tube is inserted .Patient is running fever. The
most likely source of fever is
A - sinusitis
80. Patient post pituatry adenoma resection with high urine output. Manaagment is
IVF and
A - DDVAP
81. The best test to check mobility of arytenoid cartilage is
A - endoscopy and palpation
82. Immobility of vocal cord in patient with laryngeal ca is caused by
A - invasion of thyroaretynoid muscle
B - invasion of cricothyroid
83. Apnea is defined as cessation of breath more than
A - 5 seconds
B - 10 seconds
84. Laryngeal inlet
A - pyriform sinus is located on either side of the laryngeal inlet
B - pyriform sinus is sensitive to sensation
C - A-E fold is superior to pyriform sinus
85. Patient with lateral neck mass, came to the clinic . Your management is
A - FNA
B - observation
C - do nothing
86. Grade of facial nerve in a patient with inability to close eye, no movment of
forehead and normal facial symmetry at rest is
A - III
B - IV
C-V
87. Sign of dislocated oval window
A - pneumolabrynth
88. Difinition of nasocomial pneumonia
A - patient is in the hospital for at least 72 hours
B - patient is in the hospital for at least one week
C - patient is in the hospital for at least tow weeks
89. A stucture causing compression anterior to the trachea. This anomaly is
derivative of which pouch
A - III
B - IV
C-V
90. Most common complication of stapes surgery is
A - perilymph fistula
B - granuloma
Displaced prosthesis
91. Common site of hemangioma
A - lip
Followed by tongue
92. OSA is associated with
A - hypertension
93. Most dangerous site of foreign body in aerodigestive tract causing death is
A - larynx
94. Adverse effect of radioactive iodine is
A - sialadenitis
B - pulmonary fibrosis
C – headache ??
95. Most common branchial cleft cyst is
A - 2nd branchial cleft cyst
96. Most common nerve injured durng resection of carotid body tumor is
A - superior laryngeal nerve
B - hypoglossal nerve
97. Diagnosis of relapsing chondritis is made by
A - clinical appearance
B - increase in ESR
C - biopsy
D - response to steroid
E - increase in CRP
98. Choanal atresia
A - unilateral more common than bilateral
99. While doing tympanoplasty, you found stapes fixation . you will do
A - 2nd stage stapedectomy