ORL Compiled 2011 DeMyer Flashcards
1
Q
Otoscope visualized: A. outward & downward B. outward and forward C. does not matter D. outward, upward, backward E. outward, upward, forward
A
D
2
Q
For adequate visualization of the pharynx you should not touch the following to avoid gag except
a. posterior 1/3 of tongue
b. tonsils
c. posterior pharyngeal wall
d. middle 1/3 of tongue
e. NOTA
A
D
3
Q
When performing posterior rhinoscopy
a. ask the patient to relax and breathe through mouth
b. ask the patient to relax and breathe through nose
c. pull the tongue out
d. make the patient alternate between breathing and vocalization
e. always decongest the nose
A
B
4
Q
Rinne on patient with otitis media on left ear, BC
a. laterlize to R
b. AC
d. Lateralize to L
A
C
5
Q
An eardrum perforation invades the annulus fibrosus is a
a. tubal perforation
b. near total
c. marginal
d. attic
A
C
6
Q
Which vestibular structure is responsible for detection of linear acceleration
a. cochlea
b. macula in utricle
c. cristae in saccule
d. macula in superior semicircular canal
e. cristae in lateral SCC
A
B
7
Q
Least likely with Meniere’s disease
a. presents with hearing loss, tinnitus, vertigo
b. hearing loss fluctuates and affects high pitch
c. histopath: endolyphatic hydrops
d. familial predisposition
e. immunologic etiology
A
E
8
Q
Medication least likely to have a role in the treatment of acute vertigo associate vestibular neuronitis
a. diazepam
b. meclizine
c. promethazine
d. dimenhydrinate
e. betahistine
A
E
9
Q
In a patient with subjective tinnitus the most important initial diagnostic exam is
a. MRI of brain
b. PTA and ST
c. ABR
d. PET of auditory cortex
e. CT imaging of temporal bone
A
B
10
Q
Sound is produced by the parts of the vocal tract in this order
A
Generator, vibrator, resonator, articulator
11
Q
Inflammatory causes of hoarseness except
a. TB
b. allergies
c. GERD
d. bacterial laryngitis
e. NOTA
A
E
12
Q
In a 50 YO female, a neck mass is usually
a. congenital
b. inflammatory
c. neoplastic
A
C
13
Q
Scrofuloderma is usually caused by
a. clostridium tetanae
b. M. tuberculi
c. S. aureus
d. NOTA
A
B
14
Q
An ultrasound is useful to distinguish
a. a benign from malignant neoplasia
b. vascular vs non vascular lesions
c. solid vs cystic lesion
d. cold vs hot thyroid nodules
A
C
15
Q
Thryoid scan most useful to assess
a. thyroid function
b. size
c. vascularity
d. blood iodine levels
A
A
16
Q
In an aggressive thyroid malignancy, what imaging modality is most useful to assess involvement of the trachea
a. angiogram
b. PET
c. CT
d. MRI
A
D
17
Q
Most common benign salivary tumor in children
a. pleomorphic adenoma
b. warthin’s tumor
c. lipoma
d. abscess
e. hemangioma
A
E
18
Q
To confirm if adenoids are enlarged
a. posterior rhinoscopy
b. anterior rhinoscopy
c. nasal endoscope
d. lateral xray
e. palpate
A
A
19
Q
Sensory innervation of the posterior 1/3 of tongue
a. lingual nerve
b. chorda tympani
c. hypoglossal
d. vagus
e. glossopharyngeal
A
E
20
Q
In facial trauma management
a. soft tissue lesions should be closed by 48 hours
b. thoracic and abdominal injury should be prioritized
c. reduction of fractures should be closed in 2 weeks
d. NOTA
A
B
21
Q
Function of the nose except
a. phonation
b. respiration
c. olfaction
d. humidification
e. NOTA
A
E
22
Q
Opening of the nasolacrimal duct at
a. inferior meatus
b. middle meatus
c. superior meatus
d. sphenoethmoidal recess
e. OMC
A
A
23
Q
Most common nasal mass on the nasal cavity
a. nasal polyp
b. juvenile angiofibroma
c. invasive papilloma
d. SCCA
e. chronic granulomatous disease
A
A
24
Q
Primary palate is developed from the
a. medial process
b. frontal process
c. maxillary process
d. palatal process
A
A or C (medial nasal and maxillary processes)
25
Cleft palate are prone to have ear problems because of involvement of
a. tensor veli palatine
b. tensor tympani
c. levator veli palatine
d. levator tympani
A
26
Procedure done at or before 9 years old when all permanent teeth have erupted EXCEPT
a. orthognatic surgery
b. velopharyngoplasty
c. alveolar bone grafting
d. orthodontic devices
A
27
Which is true
a. deformed ear repair is best done at 1-2 years of age
b. repair is best done in one stage
c. total auricular amputation is satisfactorily reconstructed using graft/prosthesis
d. lop ear is unfurrowed antihelix...
C
28
Mandibular fracture except
a. Mal occlusion
b. bone deformity
c. tooth mobility
d. pain on swallowing
D
29
Maxillary fractures except
a. mobility or displace of palate
b. epistaxis
c. mobility of nose
d. NOTA
D
30
For evaluation of bone fractures, the view/s requested is/are
a. water
b. towne
c. lateral
d. AOTA
D
31
True about nasal bone fracture reduction
a. best done under GA
b. done during 1st 48 hours
c. commonly involves depression of 1 nasal bone
d. open reduction is preferred
C
32
The primary component of scar tissue is
a. proline
b. collagen
c. hyaluronic acid
d. epithelial cells
B
33
Which of the following is responsible for wound contraction?
a. fibroblasts
b. myofibroblasts
c. collagen
d. hypertrophic scar
B
34
Which of the ff impedes epithelialization in wound healing
a. eschar
b. moist wound
c. fibroblasts
d. vitamin C
A
35
Incision scars are less apparent if they are concealed in natural crease lines and into
a. langer's lines
b. subdermal plane
c. perpendicular to crease lines
d. shadows
A
36
In addition to intralesional corticosteroids and pressure for 4-6 months, treatment for keloid includes
a. excision
b. subtotal excision
c. wide excision
d. shave excision
B
37
Which of the ff should be the initial care of a trauma patient
a. radiologic studies
b. suturing of lacerations
c. reduction of fractures
d. rapid evaluation of vital signs
D
38
The first priority of initial care of a maxillofacial trauma patient is
a. control of oozing
b. suturing of facial lacerations
c. radiologic studies
d. maintenance of the airway
D
39
The second priority in the initial care of a maxillofacial trauma patient is
a. head and neck physical exam
b. maintenance of a sufficient cardiac output
c. radiologic studies
d. suturing of lacerations
B
40
Head and neck physical examination should be done as soon as possible since
a. swelling may obscure bony or cartilaginous deformities
b. the patient is in pain
c. radiologic studies will be affected by the swelling
d. the lacerations must be explored and repaired asap
A
41
Nasal bone fractures are usually best demonstrated radiographically in
a. waters projection
b. lateral view
c. caldwell projection
d. schullers projection
A
42
Which of the ff is a priority compared to reduction and fixation of the facial fractures?
a. evaluation and therapy of abdominal and thoracic injury
b. radiologic studies
c. initiation of antibiotic therapy
d. anti-tetanus prophylaxis
A
43
In almost all circumstances, to avoid problems of malunion or nonunion because of delayed reduction and fixation, facial fractures should be reduced
a. within 48-72 hours
b. within the first week
c. within the first 2 weeks
d. within the first 3 weeks
C
44
Because of the rich blood supply of the face, in the treatment of facial injuries, one should follow the rule: "If in doubt, ___"
a. remove tissue
b. preserve tissue
c. debride tissue
d. NOTA
B
45
Hypoesthesia of the cheek in zygomatic fractures is caused by injury to the
a. ophthalmic division of the trigeminal nerve
b. maxillary division of the trigeminal nerve inferior orbital nerve
c. zygomatic branch of the facial nerve
d. buccal branch of the facial nerve
B
46
Which fracture involves the palate only with mobility or displacement of the maxillary dental arch and with malocclusion?
a. le fort I
b. le fort II
c. le fort III
d. panfacial fracture
A
47
Restriction of upward gaze in fractures of the orbital floor is due to
a. entrapment of the inferior oblique muscle
b. entrapment of the inferior rectus muscle
c. injury to the abducens nerve
d. injury to the trochlear nerve
A
48
Depression of the lateral temporal region may be due to
a. temporal bone fracture
b. zygomatic arch fracture
c. condylar fracture
d. coronoid fracture
A
49
Frontal sinus fractures of the posterior table with CSF leak and dural tear must be managed
a. after the fractures are reduced
b. neurosurgically
c. by reduction and fixation of the posterior table
d. none of the above
B
50
Diagnosis of autoimmune thyroiditis can be made by
a. thyroid scan
b. thyroid ultrasound
c. fine needle aspiration biopsy
d. antithyroglobulin antibodies
D
51
Thyroid suppression therapy is the main treatment for
a. thyroid CA after total thyroidectomy
b. hashimoto's thryoiditis
c. -
d. Graves disease
D
52
Which virus is associated with the development of nasopharyngeal CA?
a. HPV
b. Rubella
c. AIDS
d. EBV
D
53
What type CA is associated with hardwood furniture workers?
a. Squamous cell CA
b. mucoepidermoid CA
c. adenoCA
d. Sarcoma
C
54
Where in the head and neck region is the most common extranodal site of malignant lymphoma?
a. thyroid gland
b. parotid gland
c. waldeyer's ring
d. lateral nasal wall
C
55
What is the most common type of sarcoma in children
a. rhabdomyosarcoma
b. fibrosarcoma
c. osteosarcoma
d. malignant fibrous histiocytoma
A
56
Ohngren's line is applied in evaluating
a. nasopharyngeal CA
b. maxillary sinus CA
c. temporal bone CA
d. parotid CA
B
57
Characteristics of salivary gland calculi
a. more common in the submandibular gland
b. most parotid gland stones are radioopaque
c. treatment is by surgical resection of the involved gland
d. usually associated with bacterial infection
A
58
Sialography is useful in which situation?
a. differentiating between benign and malignant tumors
b. acute sialiadenitis and calculus is suspected
c. ductal stricture is suspected
d. sarcoidiosis
C
59
The combination of mandibular hypoplasia, glossoptosis, and posterior soft palate makes up the
a. apert syndrome
b. crouzon syndrome
c. down syndrome
d. pierre robin anomaly
D
60
Embyologic failure of the thyroid gland to descend from the foramen cecum to its normal position in the neck results in
a. thyroglossal duct cyst
b. lingual thyroid
c. hypothyroidism
d. hyperthyroidism
B
61
A true cyst is defined as a cavity
a. situated entirely within soft tissue
b. situated deep within bone
c. lined by epithelium
d. which lies on the bony surface
C
62
This odontogenic cyst surrounds the crown of an unerupted tooth
a. dentigerous cyst
b. eruption cyst
c. gingical cyst of the newborn
d. palatal cyst of the newborn
e. dermoid cyst
A
63
This is a recurrent manifestation of reactivated chickenpox virus
a. primary herpes simplex
b. secondary herpes simplex
c. herpes zoster
d. varicella zoster
C
64
Scrofuloderma is usually attributed to
a. clostridium tetani
b. mycobacterium TB
c. Staph aureus
d. infectious mono
B
65
Which is a lesion most commonly located on the midline of the neck?
a. brachial cleft cyst
b. dermoid cyst
c. reactive lymph node
d. paraganglioma
B
66
An ultrasound is useful to distinguish
a. benign from malignant lesions
b. vascular vs. non vascular
c. solid vs cystic lesions
d. hot vs cold
C
67
In an aggressive thryoid malignancy, what imaging omdality is most useful to assess involvement of the esophagus?
a. angiography
b. PET
c. CT
d. MRI
D
68
In an aggressive thyroid malignancy, what imaging modality is most useful to assess involvement of the trachea?
a. angiography
b. PET
c. CT
d. MRI
C/D ?
69
Patients with oral cavity malignancy may also present with otalgia. This may be attributed to which cranial nerve?
a. hypoglossal nerve
b. glossopharyngeal nerve
c. trigeminal nerve
d. acoustic nerve
e. abducens nerve
C
70
The most important function of the larynx
a. protection
b. respiration
c. phonation
d. swallowing
A
71
Which of the following statements about laryngeal innervations is true?
a. the superior laryngeal nerve is primarily motor, and it supplies the laryngeal tensor and abductor
b. the superior laryngeal nerve provides external sensory innervations to the laryngeal mucosa superior to the free margin of the true vocal folds, and internal motor innervations to one muscle- the cricothyroid
c. the recurrent laryngeal nerve provides motor supply to all extrinsic and intrinsic laryngeal muscles, with the exception of the cricothyroid
d. the internal branch of the superior laryngeal nerve pierces the cricothyroid membrane to provide supraglottic sensory innervations
e. all two superior and inferior laryngeal nerves are branches of the 10th CN
B
72
This most common congenital abnormality in the larynx causing stridor int he newborn is almost always a benign self-limiting condition that resolves with growth and maturation
a. tracheomalacia
b. laryngomalacia
c. hemangioma
d. vocal cord paralysis
e. web
B
73
True of treatment for croup barking cough
a. culture results are almost always awaited before initiating antibiotic therapy
b. steroids are to be absolutely avoided
c. children's larynges are less resilient, thus allowing longer intubation than of adults
d. laryngotracheobronchitis is usually of a viral etiology
D
74
All are cartilages of the laryngeal framework except
a. hyoid
b. epiglottis
c. thyroid
d. arytenoid
e. cuneiform
A
75
Which is subject to the most trauma during prolonged intubation?
a. hyoid
b. epiglottis
c. thryoid
d. cricoids
e. arytenoids
D
76
Herniated soft tissue through the muscular weakness located above the cricopharyngeus and below the inferior constrictor muscle
a. zenker's diverticulum
b. Killian-Jamieson diverticulum
c. Ranula
d. Pharyngeal hernia
A
77
A newborn is referred for cyanosis and inability to pass the suction catheter through both nasal cavities
a. consider adenoid hypertrophy
b. consider bilateral choanal atresia
c. consider severe nasal congestion
d. consider plugging of the nasal cavities due to accumulated lochia and other debris
B
78
Vincent's angina is due to
a. organisms that invade the pharynx when the normal oral flora is eliminated by broad spectrum antibiotic intake
b. diplococci implanted by direct contact
c. fusiform bacilli and spirochetes normally found in the oral cavity
d. a toxigenic strain of organisms. Infection is preventable by adequate immunization
C
79
Severe throat pain with high grade fever, trismus, hot potato voice, and deviation of the uvula are characteris of
a. diphtheria
b. infectious mononucleosis
c. peritonsillar abscess
d. acute bacterial tonsillopharyngitis
C
80
Tonsillectomy is often advised for patients except
a. chronic tonsillitis regardless of tonsil size
b. recurrent sore throat
c. after a bout of peritonsillar abscess
d. sleep anea if the tonsila are hypertrophic
B
81
Deep neck infection with firm swelling of the submandibular area and floor of mouth which pushes the tongue superiorly and posteriorly. This can cause life threatening airway compromise
a. Vincent's angina
b. Ludwig's angina
c. parapharyngeal abscess
d. retropharyngeal abscess
D
82
Mechanisms of pulmonary hypertension in patients with obstructive sleep apnea
a. fragmentation of sleep
b. rise in systemic blood pressure
c. chronic hypoxia and respiratory acidosis
d. increased work of breathing resulting in failure to thrive
C
83
The most common etiologic agent for acute thinosinusitis in adults
a. strep pyogenes
b. strep pneumoniae
c. strep viridans
d. haemophilus influenzae
B
84
Characteristic radiologic appearance of acute maxillary rhinosinusitis
a. expansion of the maxillary sinus
b. air fluid level in the maxillary sinus
c. obstruction of the OMC
d. complete opacification of the anterior ethmoids
B
85
Initial antibiotic of choise for acute maxillary rhinosinusitis
a. cefuroxime
b. clarithromycin
c. amoxicillin
d. levofloxacin
C
86
The antrochoanal polyp is a bilobed structure in the
a. frontal sinus and nasopharynx
b. maxillary sinus and nasopharynx
c. frontal sinus and oral cavity
d. maxillary sinus and oral cavity
B
87
The Caldwell-Luc operation
a. is a minimally invasive procedure
b. is limited to middle meatal antrostomy
c. includes removal of a portion of the anterior maxillary wall
d. includes extraction of the incisor
C
88
The most common etiologic agent for acute rhinosinusitis in children
a. strep pyogenes
b. strep pneumoniae
c. strep viridans
d. h. influenzae
D
89
Pott's puffy tumor is a complication of
a. frontal sinusitis
b. sphenoid sinusitis
c. anterior ethmoid sinusitis
d. posterior ethmoid sinusitis
A
90
The most reliable diagnostic test for cystic fibrosis is
a. 10 to 15-fold elevation of sodium and chloride in the sweat test
b. 3 to 6- fold elevation of sodium and chloride in the sweat test
c. 10 to 15- fold elevation of sodium and chloride in the mucus test
d. 3 to 6-fold elevation of sodium and chloride in the mucus test
B ?
91
If a young boy presents with a long history of epistaxis and nasal obstruction and the examiner discovers a violaceous mass in the nasopharynx, he should suspect a
a. juvenile nasopharyngeal angiofibroma
b. nasopharyngeal CA
c. paraganglioma
d. malignant melanoma
A
92
In a patient who presents with nasal obstruction following facial trauma and in whom the septum appears widened with reddish-blue discoloration, the most important aspect of treatment is
a. topical antibiotic ointment
b. systemic antibiotics
c. incision and drainage
d. nasal packing
C
93
The most common site for epistaxis is
a. anterior end of the inferior turbinate
b. posterior end of the septum
c. anterior end of the middle turbinate
d. anterior end of the septum
D
94
Which antihistamine is the LEAST likely to cause sedation
a. diphenhydramine
b. brompheniramine
c. chlorpheniramine
d. fexofenadine
D
95
The most common problem seen in pediatric office is
a. common cold
b. otitis media
c. allergy
d. colic
A
96
The unsafe ear has a tympanic membrane perforation that is
a. tubal
b. central
c. marginal
d. partial
C
97
In bullour myringitis, the most notable finding is
a. hearing loss by tuning fork testing
b. swelling of the ear canal
c. erosion of the ossicles
d. bleb formation on the tympanic membrane
D
98
The principal muscle that controls the eustachian tube is
a. levator veli palatini
b. tensor veli palatini
c. palatoglossus
d. palatopharyngeus
B
99
For patients with palatal clefts
a. incidence of otitis media is similar to normal infants
b. tonsillectomy and adenoidectomy is advised
c. ventilation tube insertion may be part of otologic management
d. inability of the eustachian tube to close results in failure of ventilation
C
100
The diagnosis of barotraumas of the middle ear is confirmed by
a. history
b. otoscopy
c. tuning fork test
d. audiometry
B
101
The middle ear ossicles derive from which brachial arches?
a. 1st
b. 2nd and 3rd
c. 1st and 2nd
d. 1st and 3rd
C
102
The basic causative factor in acute otitis media
a. congestion of the nose and nasopharynx
b. increase in middle ear pressure
c. presence of pathogens in the upper respiratory tract
d. obstruction of the eustachian tube
D
103
In chronic otitis media
a. hearing loss is usually conductive but may be mixed
b. the most common causative anaerobes are the peptostreptococcus
c. foul-smelling discharge suggests labyrinthine fistula
d. central perforation is commonly associated with cholesteatoma
A
104
Primary aim of surgery for chronic otitis media is
a. eradication of infection
b. recreating an intact tympanic membrane
c. reconstruction of the ossicles
d. restoration of normal hearing
A
105
In the Weber test, lateralization to the right indicates
a. conductive hearing loss if the right ear is diseased
b. sensorineural hearing loss if the right ear is diseased
c. conductive hearing loss if the left ear is diseased
d. mixed hearing loss if the left ear is diseased
A
