More difficult to perform than the usual tracheostomy at a lower level
Often complicated by subglottic stenosis
Useful in the short-necked individual
The key to identification of the recurrent laryngeal nerve during thyroid surgery is:
The superior thyroid artery
The middle thyroid vein
The inferior thyroid artery
The parathyroid glands
With a nerve stimulator
In the previously radiated neck, a precaution taken during radical neck dissection is:
Tracheotomy
Preservation of the spinal accessory nerve
Avoidance of electrocautery
Use of a muscle flap for carotid artery protection
Preservation of the internal jugular vein
The key to surgical removal of a branchial cleft cyst is:
Aspiration of the cyst before surgery
Transaction of the sternocleidomastoid muscle
Removal of the medial portion of the hyoid bone
Dissection of the duct to its pharyngeal origin
Cautery of the base
During the course of mediastinoscopy, a biopsy of a lymph node at the origin of the right main bronchus followed by profuse dark bleeding suggests damage to the:
Superior vena cava
Azygos vein
Right pulmonary artery
Subclavian vein
Innominate vein
Cerebellar signs such as nystagmus, dysarthria, and ataxia may be produced by:
Corticosteroids
Diphenylhydantion (phenytoin-Dilantin)
Vitamin C
Diphenhydramine (Benadryl)
Cephalothin
The greatest single factor in reconstructive skin flap necrosis is:
Hematoma formation
Inadequate arterial inflow
Poor nutritional state of patient
Excessive tension
Excessive length/ width ratio
The most common management of a depressed zygomatic fracture (not associated with maxillary fracture) is by:
Gillies elevation via temporal incision
Open reduction and transosseous wiring
Placement of a Kirshner pin
External traction from a plaster cap
Watchful waiting
In the typical blow-out fracture of the orbit, motion of the eye is affected primarily in:
Upward gaze
Downward gaze
Medial gaze
Lateral gaze
In a child where several attempts at closure of a cleft palate have failed, the best management is:
While doing Functional Endoscopic Sinus Surgery, the surgeon is trying to preserve middle turbinate and work lateral to it. Middle turbinate of nose is part of which bone:
Ethmoid bone
Maxillary bone
Palatine bone
Vomer bone
Not a part of any of these but a separate bone
Which of the following statements is true:
External auditory canal is 2/3rd cartilage and 1/3rd bone
Eustachian tube is 1/3rd cartilage and 2/3rd bone
Internal auditory canals all bone
Canal of tensor tympani muscle is 1/4th cartilage and 3/4th bone
A 38-year old female patient was subjected to subtotal thyroidectomy.The parathyroid glands were identified and preserved. After extubation the patient had difficulty in breathing and had stridor. You suspect paralysis of the main abductor of larynx, the posterior crico-arytenoid muscle. Which of the following nerves was most likely damaged during operation:
Phrenic
External laryngeal
Internal laryngeal
Recurrent laryngeal
Superior laryngeal
Endolymphatic K+ ion concentration is near:
5 meq/L
50 meq/L
100 meq/L
150 meq/L
Not yet known
An 85 year old woman who complains of difficulty in hearing conversational speech also complains about the noise her grandchildren are making. What best explains these complaints?
A 16-year-old boy has a 1-day history of pain in the right ear. He swims every morning. The right ear canal is red and swollen. He has pain when the auricle is pulled or the tragus is pushed. Which of the following is the most likely diagnosis?
Acute otitis media
Bullous myringitis
Chronic otitis media
External otitis
Mastoiditis
The most common cause of cerebro spinal otorrhea is:
Rupture of tympanic membrane
Fracture of petrous ridge
Fracture of mastoid air cells
Fracture of parietal bone
Fracture of nasal bone
The quality of voice in a patient with gross adenoids hypertrophy is described as:
Rhinolalia aperta
Rhinolalia clausa
Hoarse
Hot potato voice
The inner ear is a derivative of:
Ectoderm
Endoderm
Mesoderm
Neural crest cells
In managing epistaxis, posterior nasal packing:
Should be the first line therapy
Should be avoided
Should not be performed with anterior for hypoxia, apnea, and arrhythmias
Requires the patient to be monitored for hypoxia, apnea, and arrhythmias
May predispose to hypocarbia
Management of deviated nasal fractures in children should include all of the following except:
Early closed nasal reduction
General anesthesia during closed nasal reduction
Immediate incision and drainage of septal hematoma
Nasal stenting after closed nasal reduction for infants less than 6 months of age
Open reduction for injuries with deviation greater than one-half the width of the nasal bridge
The most important tool in making the diagnosis of allergy is
A positive skin prick test
A positive intradermal skin test
A positive history for symptoms associated with exposure
A total IgE >100 IU/mL
A n mRAST value of class II or higher
Nonallergic rhinitis usually presents with all of the following symptoms except:
Rhinorrhea
Nasal congestion
Nasal obstruction
Itching
Negative skin test
The patient with a sinus computed tomography showing mucosal thickening the osteomeatal complex:
Requires endoscopic sinus surgery
May have a cold, a bacterial sinus infection, nasal polyps, or an irreversible obstruction of the maxillary infundibulum
Should be treated with a broad-spectrum antibiotic
Requires a culture-directed antibiotic and nasal steroid sprays
All of the following are true about nasal steroid except:
Are contraindicated in infectious sinusitis
More potent nasal steroids like fluticasone may have some pituitary suppression
Should be used cautiously in elderly patients taking inhaled steroids
Septal perforation is a rare side effect
Are effective against acute and late-phase effects
Which of the following statements are true:
Most instances of CSF rhinorrhea caused by closed-head trauma resolve with conservative management
Most instances of nontraumatic CSF rhinorrhea require operative repair
Endoscopic repair of CSF rhinorrhea has emerged method for surgical closure of skull base defects when operative closure is indicated
Only pedicled mucosal flaps can be reliably used to reconstruct the site of a CSF leak
All of the above
Computed tomography scans are the best imaging study for detection of:
Neoplasm
Calculi
Abscesses
Chronic inflammatory disease
Parapharyngeal masses
Which statement about facial nerve injury is true
Repair should be delayed 7 days
Best results are obtained when repair occurs after 14 days
It should be performed on injuries medial to the lateral canthus
Best results are obtained the sooner repair is performed
Branches may be stimulated up to 96 hours after injury
Which of the following statements regarding treatment of oropharyngeal carcinoma is true:
For early tonsil cancer there is no significant different in survival between surgery and primary radiotherapy
Primary closure of the tongue base defect can be performed only if less the tongue an 25% of the tongue base is removed
Tumors of the upper pharyngeal wall are usually accessible through a transoral route
For soft palate cancer radiotherapy should be considered for lesions less than 2cm in diameter
To objectively monitor the progression of NIHL in instances of continued exposure
To determine the frequency /amplifying characteristics of a prescribed digital hearing aid
Which of the following statements about aminoglycoside antibiotics is false:
Aminoglycoside antibiotics may cause permanent sensorineural hearing loss
Permanent vestibular damage may result from aminoglycoside therapy
Serum levels are predictive of aminoglycoside vestibular toxicity
Oscillopsia is a symptom of sever vestibular damage from aminoglycoside antibiotic treatment
Intratympanic therapy with gentamycin carries a risk of permanent sensorineural hearing loss
During mastoidectomy, the sigmoid sinus is injured. The bleeding is ultimately controlled, and the procedure is completed. After awakening the patient reports visual changes and persistent headaches. Which of the following is not indicated:
Magnetic resonance imaging
Magnetic resonance venography
Ophthalmology consultation
Immediate surgical exploration
All of these are indicated
The second branchial arch gives rise to the:
1Xth cranial nerve
Semilunar ganglion V3
Geniculate ganglion V11
Recurrent laryngeal nerve
The hyoid bone is usually calcified by age:
4 year
10 year
20 year
2 year
Wood workers have an increased incidence of this type of tumor:
Adeno carcinoma
Squamous cell carcinoma
Adenoid cystic carcinoma
Malignant mixed tumor
The strap muscle of the neck are enveloped in the:
Deep layer of the deep cervical fascia
Middle layer of the deep cervical fascia
Superficial layer of the deep cervical fascia
Carotid sheath
None of the above
The incidence of rheumatic fever with untreated acute streptococcal tonsillitis is:
1%
3%
5%
8%
10%
The most common site of deep hemangiomas within the head and neck are within the:
Omohyoid space
Masseter muscle
Submandibular space
Lower neck
A nasal smear showing mastocytosis with eosinophilia is typical of:
Allergic rhinitis
Vasomotor rhinitis
Atrophic rhinitis
Rhinitis medicamentosa
Viral rhinitis
A 30 years old female had a previous frontal fracture and was treated with observation. She presents 6 monthly later with severe headache. The most likely diagnosis is:
Mucocele
Temporal arteritis
CSF leak
Migraine
Meningitis
The most common complication of cholesteatoma:
Facial nerve paralysis
Brain abscess
Semicircular canal erosion
Supperative labyrinthitis
Sensorineural hearing loss
Recurrent acute otitis media:
Affects 10% of children in first decade
Hereditary
Allergy is the principal cause
Is associated with nasal polyp
The frontal sinus is fully developed by------year(s) of age:
11
4
8
16
18
What structure is visible in the wall of the sphenoid sinus:
Optic nerve
Internal carotid artery
Maxillary nerve
Ophthalmic artery
Facial nerve
The most common cause of chronic parotitis is:
Structure of the anterior part of Stenen’s duct
Obstruction due to stones
Compression by tumor
Structure of the duct orifice
Congenital dilation of the main duct
During a tonsillectomy, the surgeon accidentally traverses the tonsil bed and muscle directly posterolateral. Which of the following structures is in most danger of being damaged?
Common carotid artery
Hypoglossal nerve
Ascending pharyngeal artery
Mandibular nerve
External carotid artery
Which of the following arteries is not usually seen in neck dissection:
Superior thyroid
Lingual
Ascending pharyngeal
External maxillary
Occipital
Which of the following are not removed in radical neck dissection:
Submental nodes
Jugular nodes
Spinal accessory nodes
The tail of the parotid gland
All of the above are removed in radical neck dissection
Trismus associated with deep neck infection is most indicative of:
Peritonsillar abscess
Parapharyngeal abscess
Parotitis
Submandibular abscess
Infection tracking along the carotid sheath
The tensor veli palatine muscle is innervated by the:
Mandibular division of the trigeminal nerve
Maxillary division of the trigeminal nerve
Glossopharyngeal nerve
Vagus nerve
Hypoglossal nerve.
A common reason that revision stapes surgery is necessary is:
Tympanic membrane perforation
Formation of adhesions in the middle ear
Exostosis of the external auditory canal
Incus erosion
Malignant external otitis
what are the embryologic origins of the laryngeal cartilages