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[OS 212] ORL > 2013 > Flashcards

2013 Flashcards

1
Q

What findings do you expect in using a pneumatoscope?

a. Decreased movement on the right tympanic membrane
b. Increased movement of the right tympanic membrane
c. Decreased movement of the left tympanic membrane
d. Increased movement of the left tympanic membrane

A

A

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2
Q

What is your diagnosis in #1?

a. Hyperemic AOM
b. Suppurative AOM
c. Exudative AOM
d. Barotrauma
e. NOTA

A

C

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3
Q

What is an appropriate test to determine hearing loss in the patient in #1?

a. Behavioral Audiometry
b. Visual Audiometry
c. Play Audiometry
d. Standard audiometry

A

D

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4
Q

In a patient complaining of otalgia, tragal tenderness is most likely associated with which diagnosis?

a. Acute otitis media
b. Acute otitis externa
c. Otomycosis
d. Impacted cerumen

A

B

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5
Q

The Eustachian tube is best described as:

a. 1/3 cartilaginous, 2/3 bony
b. 2/3 cartilaginous, 1/3 bony
c. Lined with pseudostratified squamous epithelium
d. Directed posterior-medially from middle ear to nasopharynx

A

B OR C

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6
Q

Audiometric examination based on the presence of emitted sound from ear which is picked up by a sensitive microphone.

a. Tympanometry
b. ABR
c. Tuning Fork Test
d. Otoacoustic Emission

A

D

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7
Q

Which of the following medications is most likely to cause irreversible hearing loss?

a. Aspirin
b. Furosemide
c. Gentamicin
d. Chloramphenicol

A

C

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8
Q

Which below has the most dangerous prognosis?

a. Central perforation with exudates
b. Central perforation with foul smelling discharge
c. Attic perforation with cholesteatoma
d. Hyperemic tympanic membrane

A

C

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9
Q

The following microorganisms are causes of chronic suppurative otitis media except:

a. Pseudomonas aeruginosa
b. Bacteroides
c. S. aureus
d. M. cattarhalis

A

D

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10
Q

When a person is sitting still with the head facing forward, which of the following vestibular physiologic principles is at work?

a. Afferent vestibular input from both sides is absent
b. Afferent vestibular input from both sides is present and asymmetric
c. Afferent vestibular input from both sides is present and symmetric
d. Afferent vestibular input is present but inhibited

A

C

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11
Q

A girl presenting with atrial fibrillation describes her dizziness as:

a. Near syncope
b. Dysequilibrium
c. Vertigo
d. Light headedness

A

A

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12
Q

Which of the following points to a central lesion using the Dix-Hallpike Test?

a. Nystagmus occurs after 5 seconds
b. Nystagmus disappears after 30 seconds
c. Nystagmus is prolonged even in head hanging position
d. Nystagmus occurs in vertical-tortional direction

A

NO IDEA

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13
Q

A patient with an acute right-sided vestibular loss will have nystagmus described as

a. Horizontal, right-beating nystagmus
b. Horizontal, left-beating nystagmus
c. Horizontal, direction-changing
d. Horizontal, slow phase towards the left

A

D (NOT SURE)

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14
Q

Which of the following examinations is the most important test to perform on a patient suspected of having an inner ear injury from a grenade blast?

a. Pure tone audiometry
b. CT of temporal bone
c. Electronystagmography
d. MRI of the internal auditory canal

A

A

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15
Q

Acute vestibular compensation occurs primarily because of the influence of which structure?

a. Midbrain
b. Pons
c. Cerebellum
d. Vestibular nerve

A

C

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16
Q

Canalolithiasis is the pathologic finding in which disease entity?

a. Vestibular neuritis
b. Meniere’s
c. Perilymphaoid Fistula
d. BPPV

A

D

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17
Q

Which of the following disease entities presents with vertigo attacks of the longest duration?

a. BPPV
b. Meniere’s Disease
c. Viral Labyrinthitis
d. Acoustic Neuroma

A

D

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18
Q

Which of the following medications is used to treat acute attacks of vertigo from Meniere’s Disease?

a. Hydrochlorothiazide
b. Diazepam
c. Low salt diet
d. Gentamycin

A

A

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19
Q

The Epley Maneuver is the appropriate therapy for which of the following diseases?

a. Meniere’s Disease
b. Vestibular Neuritis
c. BPPV
d. Acoustic Neuroma

A

C

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20
Q

A patient who suffers from anosmia should still be able to detect

a. Scented soaps
b. Flowers
c. Vinegar
d. Coffee

A

C

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21
Q

Which medication is least likely to relieve congestion associated with allergic rhinitis?

a. Topical anticholinergics
b. Intranasal corticosteroids
c. Intranasal antihistamines
d. Oral decongestants

A

A

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22
Q

Which of the following symptoms is least likely to be associated with allergic rhinitis?

a. pale edematous turbinates
b. crease across the lower nose
c. nasal polyps
d. infraorbital venous dilation

A

C

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23
Q

If you have a nasal discharge that is bloody, you are most likely to have:

a. Allergic rhinitis
b. Mucositis
c. Foreign body
d. Cerebrospinal fluid leak

A

B

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24
Q

An abnormal Glatzel’s will most likely be due to:

a. Nasal fracture
b. Unilateral nasal polyps
c. Allergic rhinitis
d. Angiofibroma

A

B

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25
Q

A positive halo sign will most likely be found in a patient with:

a. Maxillary sinus carcinoma
b. Intranasal foreign body
c. Frontal sinus fracture
d. Allergic rhinitis

A

C

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26
Q

A neoplastic process should be suspected when the nasal discharge is

a. Mucopurulent
b. Watery
c. Serosanguinous
d. Mucoid

A

C

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27
Q

Which of the following structures is least likely to be visualized via anterior rhinoscopy?

a. Nasal septum
b. Inferior nasal turbinate
c. Middle nasal turbinate
d. Fossa of Rossenmuller

A

D

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28
Q

With regards to the arachidonic acid pathway, what is the chemical mediator in smooth muscles?

a. Leukotrienes
b. Thromboxane
c. Prostacyclin
d. Prostaglandin

A

D

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29
Q

NSAIDS will not inhibit the production of:

a. LTC 4
b. TXA2
c. PGI 2
d. PGF2

A

A

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30
Q

The vocal folds acts as a

a. Generator
b. Vibrator
c. Resonator
d. Articulator

A

B

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31
Q

Acute epiglottitis is usually caused by

a. Streptococcus pneumonia
b. Staphylococcus aureus
c. Hemophilus influenza
d. Influenza virus

A

C

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32
Q

When touched with a tongue depressor, which structure is LEAST likely to cause gagging?

a. Posterior third of tongue
b. Retromolar trigone
c. Soft palate
d. Posterior pharynx

A

B

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33
Q

Which of the following is least likely to be a cause of dysphagia?

a. Caustic ingestion
b. Cerebrovascular accident
c. Head trauma
d. Sjogren’s syndrome

A

C

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34
Q

The most appropriate test to perform for evaluation of a retropharyngeal abscess

a. Plain film of the neck
b. Functional evaluation of swallowing
c. Modified barium swallowing
d. Panoramic x-ray view

A

A

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35
Q

Most probable for immunocompetent person with recurrent ulcerations in the oral cavity?

a. Aphthous ulcer
b. Pemphigus
c. Herpes stomatitis
d. Necrotizing ulcerative gingivitis

A

A

36
Q

Primary consideration for people with chronic oral cancers who smoke cigarettes and drink alcohol?

a. Apthous ulcer
b. Malignancy
c. Oral candidiasis
d. Herpes stomatitis

A

B

37
Q

What is the least indication of tonsillectomy?

a. Apnea
b. Hemorrhagic
c. Malignant
d. Recurrent tonsillitis

A

D

38
Q

Cranial nerve responsible for taste in the anterior 2/3 of the tongue

a. CN 7
b. CN 9
c. CN 10
d. CN 11

A

A

39
Q

Which of the following disease is characterized by a progressive disorder marked by the triad resting tremor, bradykinesia and rigidity?

a. Amylotropic lateral sclerosis
b. Parkinson’s disease
c. Multiple sclerosis
d. Myasthenia gravis

A

B

40
Q

Structural causes of swallowing dysfunction EXCEPT:

a. Cleft palate
b. Mandibular ameloblastoma
c. Tracheoesophageal fistula
d. Cerebrovascular accident

A

D

41
Q

The following are symptoms of vocal fold paralysis except:

a. Hoarseness
b. Odynophagia
c. Aspiration
d. Chronic cough

A

B

42
Q

Which of the following structures functions as articulator in vocal production?

a. Tongue
b. Vocal folds
c. Lungs
d. Supraglottic space

A

A

43
Q

Inability to phonate for extended periods of time without change in voice quality

a. Dysphonia
b. Hoarseness
c. Vocal fatigue
d. Stertor (Ed. Stridor?)

A

C

44
Q

Excessive loss of air during vocalization due to incomplete approximation of the vocal folds defines the term.

a. Hoarseness
b. Breathiness
c. Vocal Fatigue
d. Dysphonia

A

D

45
Q

The newborn baby presenting with respiratory stridor that is worse on the supine position and is relieved when the baby is upright most likely has which condition?

a. Congenital subglottic stenosis
b. Congenital vocal fold paralysis
c. Laryngomalacia
d. Tracheo-esophageal fistula

A

C

46
Q

The following are characteristic of laryngotracheobronchitis except:

a. The location of airway narrowing is infraglottic
b. Presents with a thumb sign on lateral radiography of the neck
c. Viral in etiology
d. Tends to occur in infants and children under the age of 3

A

B

47
Q

In a patient with vocal fold nodules, the following management strategies are appropriate EXCEPT:

a. voice rest
b. anti-inflammatory meds
c. proper hydration
d. whispering when one needs to speak

A

D

48
Q

Which of the following structure is not innervated by the recurrent laryngeal nerve?

a. Interarytenoid muscle
b. Cricothyroid muscle
c. Posterior cricoarytenoid muscle
d. Lateral cricoarytenoid muscle

A

B

49
Q

Which of the following symptoms is least likely to be felt by a patient with unilateral recurrent laryngeal nerve injury after thyroidectomy?

a. Hoarseness
b. Vocal fatigue
c. Breathiness
d. Stridor

A

D

50
Q

Which of the following is least likely to cause Ortner’s syndrome?

a. Tricuspid stenosis
b. Aortic aneurysm
c. Mitral stenosis
d. Atrial septal defect

A

A

51
Q

Abnormal form of a body structure caused by non-disruptive mechanical forces is:

a. malformation
b. deformation
c. disruption
d. degeneration

A

B

52
Q

The triad of mandibular micro-retrognathia, glossoptosis and a cleft of the secondary palate is found in

a. Treacher-collins syndrome
b. Pierre-Robin sequence
c. Mobius syndrome
d. Kallman syndrome

A

B

53
Q

Which of the following steps in wound healing occurs last?

a. WBC clear the wound debris and bacteria
b. Blood vessels constrict to control bleeding
c. Fibroblasts make collagen to fill the wound
d. New blood vessels form.

A

D

54
Q

The start of palatogenesis in the human embryo begins at what week of gestation?

a. 3rd week
b. 4th week
c. 5th week
d. 6th week

A

B

55
Q

With regards to feeding infants with a cleft lip and palate, which of the following is false?

a. An infant with bilateral cleft lip and palate is better breastfed than bottlefed
b. An upright or seated feeding position is better than a supine position
c. When bottle-feeding, a soft nipple is better than a hard nipple
d. An infant with an isolated cleft lip will probably have little difficulty feeding

A

A

56
Q

A fracture where the bone cracks on one side only is referred to as:

a. Comminuted
b. Open
c. Greenstick
d. Single

A

C

57
Q

A fastfood delivery driver collided head-on with a truck on Taft Avenue. At the emergency room, the first thing you should attend to is:

a. ask the patient about the accident
b. secure the airway
c. apply bandages to all facial lacerations
d. insert an intravenous tube

A

B

58
Q

A patient with Bell’s Palsy exhibits the following EXCEPT:

a. most patients have bilateral involvement
b. may be associated with hearing loss
c. most patients have a successful recovery to normal function
d. may be associated with altered taste

A

A

59
Q

A patient with Ramsay-Hunt syndrome is affected by which virus?

a. Herpes simplex
b. Varicella zoster
c. Adenovirus
d. HIV

A

B

60
Q

Which of the following is MOST likely to remain intact in a patient with facial paralysis due to mastoid surgery where injury occurred at the upper mastoid segment of the facial nerve?

a. Taste sensation
b. Eyelid closure
c. Tearing
d. Contraction of stapedius

A

C

61
Q

Retinoblastoma is the most common intraocular malignancy in:

a. Early childhood
b. Late childhood
c. Early teen years
d. Early adulthood

A

A

62
Q

On CT scan, a retinoblastoma has the following clinical features

a. Calcifications within the globe
b. Blood within the globe
c. Irregular borders
d. Microphthalmia

A

A

63
Q

A cholesteatoma develops due to chronic ear infections. Radiographically, they are seen as:

a. Irregular area of sclerosed bone
b. Rounded area of lucency
c. Pyramidal area of lucency
d. Ovoid area of sclerosed bone

A

B

64
Q

The most common mass in the nasopharynx in minors is:

a. Nasopharyngeal cancer
b. Nasal polyp
c. Juvenile Angiofibroma
d. NOTA

A

C

65
Q

On CT scan, normal nasopharynx looks

a. cuboid
b. rounded
c. like two small hills
d. sunken

A

B

66
Q

Most common sinonasal affliction is.

a. polyps
b. sinusitis
c. angiofibroma
d. nasal fracture

A

B

67
Q

Most sinonasal polyps arise from:

a. inferior turbinate
b. middle meatus
c. superior turbinate
d. sphenoethmoid recess

A

B

68
Q

On contrast CT scan, when compared to normal surroundings, a juvenile angiofibroma would look.

a. Hyperdense (more white)
b. Normodense
c. Hypodense (more black)
d. NOTA

A

A

69
Q

While screening CT scan is the best study to rule out sinusitis, the following is an acceptable alternative:

a. Caldwell’s view
b. Schuller’s view
c. Towne’s view
d. Water’s view

A

D

70
Q

Radiographically, one can diagnose acute sinusitis based on this finding

a. thickened sinus walls
b. congested turbinate
c. air-fluid level
d. multiple grape-like masses

A

C

71
Q

Allergic rhinitis is positively correlated with

a. facial deformity
b. nasal polyps
c. acute sinusitis
d. nasal cancer

A

B OR C

72
Q

A 2-year old child presented to your clinic with a cystic lesion on the posterior midline portion of the tongue. Your working diagnosis is:

a. thyroglossal duct cyst
b. dentigerous cyst
c. brachial cleft
d. odontogenic cyst

A

A

73
Q

To confirm the diagnosis in #75, what type of imaging should you use?

a. open mouth x-ray
b. ultrasound
c. CT scan
d. Angiogram

A

B

74
Q

28-year old female went to the clinic experiencing jaw pain for the past year. Imaging test done showed her mandible with honeycomb appearance in the area that was painful. Working diagnosis is:

a. dentigerous cyst
b. odontogenic cyst
c. ameloblastoma
d. osteosarcoma

A

C

75
Q

Most common malignant carcinoma of the MINOR salivary glands

a. adenoid cystic CA
b. mucoepidermoid CA
c. acinic cell CA
d. carcinoma ex pleimorphic adenoma

A

A

76
Q

Sialadenitis may be caused by:

a. calculi
b. bacteria
c. both of the above
d. none of the above

A

C

77
Q

Which can be used as a bone graft when doing mandibular surgery?

a. femur
b. tibia
c. fibula
d. tarsal

A

C

78
Q

When analyzing a CT Scan of the head and neck. One of the first things to notice is

a. Regularity of borders
b. Symmetry
c. Density of Tissues
d. Location of structures

A

C

79
Q

A uniocular lucency that is noted to surround an unerupted tooth and which is lined by squamous epithelium is best diagnosed as

a. Radicular cyst
b. Branchial cleft cyst
c. Dentigerous cyst
d. Thyroglossal duct cyst

A

C

80
Q

Intranasal masses associated with systemic allergic conditions are most likely

a. Schneiderian papillomas
b. Squamous papillomas
c. Inflammatory nasal polyps
d. Tubular adenomatous polyps
e. NOTA

A

C

81
Q

Most commonly found in adolescent males, surgery for this neoplasm, although benign, is quite formidable, being fraught with the risk of haemorrhage. What is this neoplasm?

a. Hemangiopericytoma
b. Angiosarcoma
c. Angiofibroma
d. Capillary hemangioma
e. Any OTA

A

C

82
Q

The most common benign tumor of the salivary gland with the propensity to become bilateral is

a. Lipoma
b. Schwanoma
c. Warthin’s tumor
d. Benign mixed tumor
e. NOTA

A

C

83
Q

A squamous-epithelial-lined cyst containing keratinous debris and occurring within the middle ear is a

a. Cholesterol-granuloma
b. Cholesterolosis
c. Cholesteatoma
d. Steatocystoma
e. NOTA

A

C

84
Q

A 35-year old male consulted for epistaxis. He also reported unilateral ear discomfort for quite some time now. Physical examination of the head and neck revealed palpable nodularities at the right cervical area. Oral cavity examination showed a bulging fullness of the nasopharyngeal mucosa. Which of the following correctly describes the lesion?

a. Histopathologic type does not affect response to therapy
b. Prognosis is uniformly dismal regardless of age upon diagnosis
c. A significant role for viral oncogenesis is associated with the disease
d. Chemotherapy currently provides the most optimal therapeutic response
e. NOTA

A

C

85
Q

A 56-year old female consults for a pre-auricular mass on the right of ten years duration. It had been fairly stable in size for several years but during the last 3 months, there was a subjective impression of a sudden increase in size. Physical examination showed a firm mass measuring 9cm in diameter. Give the most likely diagnosis.

a. Adenoid cystic carcinoma
b. Carcinoma ex pleomorphic adenoma
c. Benign mixed tumor
d. Malignant lymphoma
e. NOTA

A

B

[OS 212] ORL (5 decks)

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