In the supraclavicular nodes of level 5a. In the supraclavicular nods of level In the level 6 noods

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1. When a patient is found to have a Virchow node, it will be located

  1. In the supraclavicular nodes of level 5a.

  2. In the supraclavicular nods of level 4.

  3. In the level 6 noods.

  4. In the level 5b supraclavicular nods.

  5. In the submental sublevel la nodes.

2. Which of the following statements regarding Addison’s disease is false?

  1. It results in both glucocorticoid and mineralocorticoid deficiencies.

  2. Hyperpigmentation is caused by overproduction of adrenocorticotropic hormone and B-lipotropin.

  3. Glucocorticoid replacement is required twice a day.

  4. Mineralocorticoid therapy is given once a day.

  5. Stress-dose steroids are not necessary perioperatively.

3. Which of the following is not risk factor for perioperative cardiovascular complications?

  1. Recent myocardial infarction.

  2. Older than 50 years of age.

  3. Third heart sound.

  4. Nonsinus rhythm.

  5. Valvular aortic stenosis.

4. Which of the following radiographic properties of a lymph node on contrast-enhanced CT does not support identification of cervical adenopathy as inflammatory (reactive)?

  1. Less than 10mm.

  2. Well-defined margins.

  3. Central hilar or mild homogeneous enhancement.

  4. Central low intensity.

  5. Calcification.

5. Which of the following is not a common toxicity associated with cisplatin therapy?

  1. Nausea.

  2. Vomiting.

  3. Renal dysfunction.

  4. Ototoxicity.

  5. Severe Neutropenia.

6. Donor site selection can be influenced by

  1. Prior surgery or trauma.

  2. Handedness or footedness.

  3. Occupation.

  4. Hobbies.

  5. All of the above.

7. Which of the following vocal fold lesions is most appropriate for CO2 laser excision?

  1. Polyp.

  2. Nodule.

  3. Intracordal cyst.

  4. Sulcus vocalis.

  5. Papilloma.

8. All of the following reduce the risk of airway fire except

  1. Avoiding the use of nitrous oxide.

  2. Minimizing the inspired oxygen concentration.

  3. Using bipolar rather than unipolar cautery within the airway.

  4. Using special endotracheal tubes during laser surgery.

9. Which of the following is not part of the treatment of malignant hyperthermia?

  1. Dantrolene.

  2. Discontinuation of the volatile anesthetic.

  3. Succinylcholine.

  4. Symptomatic cooling.

10. Eosinophils produce all of the following except





11. Airway obstruction in newborns may cause rapid ventilator fatigue because

Their diaphragm is low in type I muscle fibers.

Their diaphragm is low in type II muscle fibers.

Of relative low compliance of the chest wall.

Of their relatively low basal metabolic rate.

They have a low rest tone while sleeping.
12. The laryngeal chemoreflex (LCR) causing laryngospasm is most sensitive to:






13. Because newborn cardiac muscle has fewer contractile fibers and more connective tissue, cardiac output is most dependent on which of the following:




Systolic pressure.

Diastolic Pressure.
14. Often the first sign of hypoxia in a neonate is





15. Of the following physical signs, which is the best estimate that a young infant’s blood volume is adequate?

Heart rate.

Mean arterial blood pressure.



Percent hemoglobin saturation.
16. Which portions of the ossicular chain derive from the first branchial arch?


Short processes of the malleus and incus.

Long processes of the malleus and incus.

Short process of the malleus and long process of the incus.
17. What are the embryologic origins of the laryngeal cartilages?

First branchial arch.

Second branchial arch.

Third branchial arch.

Fourth, fifth, and sixth branchial arches.
18. Complete injury of the accessory nerve in the right supraclavicular fossa results in

Inability to turn the head to right.

Inability to turn the head to the left.

Inability to turn the head to the left and shrug the right shoulder.

Inability to shrug the right shoulder.
19. Which of the following masses present as midline masses of the neck?

Branchial cyst and carotid body tumor.

Branchial cyst and thyroglossal duct cyst.

Thyroglossal duct cyst and dermoid cyst.

Pharyngocele and laryngocele.
20. What receptor type has been implicated in postoperative nausea and vomiting?





All of the above.
21. Craniofacial abnormalities associated with Down syndrome include all of the following except

Brachycephaly .

Midface hypoplasia.

Wide and long palate.

Reduced interorbital distance.

small ears.
22. Which of the following statements about open-mouth posture (OMP) in children is correct?

It alters dentofacial growth.

It is an indication for adenoidectomy.

It is associated with a posterior crossbite.

It indicates nasal airway blockage.

It may be a normal part of development
23. Premature fusion of the sagittal suture results in which craniofacial abnormality?





24. The velopharyngeal sphincter is composed of all of the following expect

Levator veli palatine.

Palatopharyngeus .

Superior Pharyngeal constrictor.

Middle pharyngeal constrictor.

Muscularis uvulae.

25. Dermoids are composed of which germinal layers?

Mesoderm and ectoderm.

Endoderm and mesoderm.

Endoderm, mesoderm, and ectoderm.

Mesoderm only.

Ectoderm only.
26. The most common salivary gland neoplasm in young children is

  1. Mucoepidermoid carcinoma.

  2. Lymphangioma.

  3. Lymphoma.

  4. Acinic cell carcinoma.

  5. Hemangioma.

27. Treatment options for excessive salivation/chronic drooling include all of the following except.

  1. Bilateral submandibular duct rerouting.

  2. Bilateral submandibular gland excision with parotid duct ligation.

  3. Sublingual gland excision.

  4. Bilateral parotid duct and submandibular duct ligation.

  5. Use of glycopyrrolate.

28. Certain populations of children are at increased risk for malignancies. These include

  1. Down syndrome.

  2. Patients who have received radiotherapy.

  3. Bloom syndrome.

  4. Hemihypertrophy.

  5. All of the above.

29. Routine elective neck dissection for pediatric patients with salivary gland malignancies is

  1. Always recommended.

  2. Recommended only if there are suspicious nodes on computed tomography (CT).

  3. Not recommended.

  4. Recommended depending on tumor subtype.

30. A post-liver transplant patient is seen with new enlargement of the tonsils and/or adenoids. The otolaryngologist should

  1. Schedule the Patient for T &A.

  2. Observe the patient for 6 weeks.

  3. Start decreasing the immunosuppressive drugs.

  4. Perform an FNA.

31. A patient with advanced but treatable cancer wants to refuse treatment – a choice that seems irrational based on the current literature. Which of the following is a potential reason for the patient’s refusal?

  1. Fear of disfigurement.

  2. Fear of pain.

  3. Fear of death.

  4. Fear of isolation.

  5. All of the above.

32. The following descriptions of the nasolabial angles are correct except

  1. 95 to 110 degrees in women.

  2. 90 to 95 degrees in men.

  3. A measure of the nasal projection in relation to the upper lip.

  4. A measure of nasal tip rotation.

33. Treatment of hemangiomas may by indicated for all circumstances except

  1. Ocular involvement.

  2. Airway involvement.

  3. Rapidly growing.

  4. Ulceration.

  5. Beginning involution.

34. Adjuvant radiation therapy is considered in all of the following settings except

  1. Neurotropism.

  2. Extracapsular spread.

  3. Multiple lymph node involvement.

  4. Tumor ulceration.

  5. Recurrent melanoma.

35. Which of the following statements regarding scarre-excision is true?

  1. Re-excision with primary closure is an irregularization procedure.

  2. Sharp excision of the scar should proceed with the scalpel exactly parallel to the skin surface.

  3. Direct closure of the area should be performed without undermining.

  4. Vertical mattress sutures are an effective way to properly evert the

wound edges.
36. A painful facial burn with significant erythema and blistering is best classified as a

Fill-thickness burn.

Third-degree burn.

First-degree burn.

Second-degree burn.
37. In panfacial fractures, what should be the first and primary focus?

Orbital reconstruction.

Establishing facial height.


Repositioning the zygoma.

Repairing the central face.
38. To prevent postoperative enophthalmus, the surgeon must remember that the medial orbital wall

  1. Should not be repaired.

  2. Is concave.

  3. Is convex.

  4. Cannot be accessed through the approach used to the orbital floor.

  5. Lies in a sagittal plane.

39. In androgenetic alopecia, hair growth of specific hair follicles on the scalp is sensitive to which of the following androgens?

  1. Testosterone.

  2. Estradiol.

  3. Estrone.

  4. Dihydrotestosterone.

  5. Dehydroepiandrosterone.

40. Which is a disadvantage of a subperiosteal mid-face lift?

  1. It requires preauricular incision.

  2. It impairs vascular supply of facial skin.

  3. It weakens orbicularis occuli.

  4. It risks injury to buccal branch of facial nerve.

41. Which mimetic muscle is part of the superficial muscular aponeurotic system (SMAS)?

  1. Zygomatic major.

  2. Zygomatic minor.

  3. Orbicularis occuli.

  4. Platysma.

  5. Orbicularis oris.

42. All of the following are brow depressor muscles except

  1. Corrugator.

  2. Frontalis.

  3. Procerus.

  4. Supraorbital orbicularis oculi.

  5. Depressor supercilii.

43. To achieve brow elevation, all of the following structures are “released” in the endoscopic browlift except

  1. Zygomaticotemporal nerve.

  2. Supratrochlear nerve.

  3. Supraorbital nerve.

  4. Frontal branch of the facial nerve.

  5. Auriculotemporal nerve.

44. If bony osteotomies are made, where should they be in relation to the mental foramen?

  1. Supraperiosteal placement may cause bone erosion.

  2. Subperiosteal placement may cause erosion.

  3. The mentalis should be reapproximated.

  4. Subperiosteal placement increases fixation of the implant.

  5. An intraoral or extraoral approach may be used.

45. Malar and/or submalar augmentation is indicated for all of the following except

  1. Congenital defects.

  2. Traumatic deficiencies.

  3. Accentuating the nasolabial fold.

  4. Cheek soft-tissue ptosis.

  5. Submalar wasting.

46. Which branch of the facial nerve has the highest priority when reinnervation procedures are being considered?





None. They are equally important.
47. After transaction of the facial nerve, the distal branches retain their stimulability with a portable electrical stimulator for how long?

  1. 1 day.

  2. 3 days.

  3. 1 week.

  4. 3 weeks.

  5. 12 months.

48. What is the most appropriate indication for pursuing otoplasty?

  1. Age of patient.

  2. Auriculocephalic angle.

  3. Cartilage proportions.

  4. Distance of helical rim from scalp.

  5. Cartilage stiffness.

49. The primary neuron cell body for cranial nerve I is located in the

  1. Olfactory bulb.

  2. Nasal mucosa.

  3. Entorhinal cortex.

  4. Cribriform plate.

  5. Prefrontal cortex.

50. Of a random population of people, which person would do best on an olfactory identification test?

A 38-year old man.

A40- year old woman.

A 68 - year-old woman.

A 67 -year old man.

A 5- year old girl.
51. Which of the following can be a source of variability in objective airway testing?

The nasal cycle.


Time of day.


All of the above.
52. In patients with large, dry septal perforations without evidence of ulceration and in whom histopathologic findings are nonspecific and c-ANCA testing is negative, the most likely cause of the nasal changes is

Wegener’s granulomatosis.

T-cell lymphoma.



Substance abuse.
53. Which of the following laboratory results is incorrect in the diagnosis of patients suspected of having sarcoidosis?



High number of T lymphocytes in broncho- alveolar lavage fluid.

Elevated angiotensin –converting enzyme.

Increased levels of sIL-2R serum.
54. Epistaxis presenting in a delayed fashion after maxillofacial trauma should raise suspicion for

Undiagnosed nasal fracture.

Arterial aneurysm.

Continued traumatic insult to nasal mucosa.

Altered nasal airflow.

Bacterial infection.

55. The most common familial bleeding disorder to consider in frequent, difficult-to-manage epistaxis is

  1. Hemophilia A.

  2. Hemophilia B.

  3. Von Willebrand’s disease.

  4. Thrombocytopenia.

  5. Osler-Weber-Rendu disease.

56. In managing epistaxis,posterior nasal packing

  1. Should be the first-line therapy.

  2. Should be avoided.

  3. Should not be performed with anterior nasal packing.

  4. Requires the patient to be monitored for hypoxia, apnea, and


  1. May predispose to hypocarbia.

57. Signs of fever, nausea, vomiting, and diarrhea in the presence of nasal packing may indicate

    1. Toxic shock syndrome.

    2. Streptococcal infection.

    3. Viral infection.

    4. Contamination of the packing material.

    5. Anaphylactic reaction of packing material.

58. The most important tool in making the diagnosis of allergy is

  1. A positive skin prick test.

  2. A positive intradermal skin test.

  3. A positive history for symptoms associated with exposure.

  4. A total IgE > 100 IU/mL.

  5. An m RAST value of class II or higher.

59. Nonallergic rhinitis usually presents with all of the following symptoms except

  1. Rhinorrhea.

  2. Nasal congestion.

  3. Nasal osbstruction.

  4. Itching.

  5. Negative skin testing.

60. Gustatory rhinitis appears related to

  1. Food allergy.

  2. Excess sympathetic activity.

  3. Stimulation of afferent sensory nerves.

  4. Positive skin testing.

  5. Altered mucociliary clearance.

61. The complete transfixion incision

  1. Promotes cephalic rotation.

  2. Corrects a caudal septal deflection.

  3. Helps to narrow a wide tip.

  4. Is always combined with an intercartilagionous incision.

  5. Results in tip retroprojection.

62. A patient is seen with supra-alar pinching and alar retraction. A common cause of this deformity is

  1. Inadequate osteotomies.

  2. Over-resected lower lateral crura.

  3. Improper graft placement.

  4. Excessive hump removal.

  5. Avulsion of the upper lateral cartilages.

63. An open roof deformity can occur after

  1. Bony hump removal with inadequate osteotomies.

  2. Excessive resection of lower lateral crura.

  3. Avulsion of the upper lateral cartilages.

  4. Excessive soft tissue in the supratip.

  5. over-resection of septal cartilage.

64. Which of the following is the material of choice in reconstructing the nasal dorsum?

  1. Calvarial bone.

  2. Iliac bone.

  3. Rib.

  4. Irradiated cartilage.

  5. Alloplastic implants.

65. Radiographic signs of chronic sinusitis include all of the following except

  1. Drainage of intermediate attenuation on CT.

  2. Thickening of the bony walls.

  3. Opacification of the middle meatus.

  4. Mucoperiosteal thickening of the maxillary sinus.

  5. Hyperintense drainage on TI-weighted MRI images.

66. Concerning nasal ciliary physiology and anatomy, which of the following statement is LEAST accurate?

  1. The nose is lined by cilitated pseudostratified glandular columnar epithelium

  2. The nasal cilia are arranged as 9 microtubule doublets formed in an outer circle around a central pair.

  3. The outer microtubular doublets are linked by the protein nexin.

  4. Ciliary movement is described as having 2 phases.

  5. Normal ciliary beat frequency is approximately 10-25 beats per minute.

67. Which of the following bones is LEAST likely to be transected as part of an endoscopic transethmoidal sphenoidotomy

  1. Uncinate process.

  2. Bulla ethmoidalis.

  3. Anterior wall of the sphenoid.

  4. Palatine bone.

  5. Ground lamella of the middle turbinate.

68.Which of the following bones do not form part of the osteology of the

lateral nasal wall?

  1. Maxilla.

  2. Palatine.

  3. Ethmoid.

  4. Perpendicular plate of the sphenoid.

  5. Inferior turbinate.

    1. Performing FES surgery you are operating to remove the anterior ethmiodal air cells when you see clear fluid flowing from the region of the lateral lamella of the cribiform plate What is the next most appropriate action?

  1. Stop surgery, wake the patient up and see if the clear fluid continues.

  2. Inject intrathecal fluorscein to confirm the presence of a CSF leak.

  3. Perform a local repair of the probable CSF leak.

  4. Continue the surgery, then pack the nose with a nasal tampon for 48 hours.

  5. Request the neurosurgeons to perform a craniotomy and dural repair.

    1. A carotid body tumour is likely to receive its major blood supply from

which vessel?

  1. Common carotid artery.

  2. Ascending pharyngeal artery.

  3. Superior thyroid artery.

  4. Lingual artery.

  5. Thyrocervical trunk.

    1. Which of the following does part of the bony orbital cavity?

  1. Lacrimal bone.

  2. Zygomatic bone.

  3. Palatine bone.

  4. Greater wing of the sphenoid.

  5. Nasal bone.

    1. Which of the following statements best describes Wegner's granulomatosis?

  1. Untreated, the disease is usually asymptomatic for many years.

  2. Cirrhosis of the liver is a common feature of the disease.

  3. The perinuclear anti- neutrophil cytoplasmic antibody (p- ANCA) is highly, sensitive for the disease.

  4. Is most common in those of Afro- Caribbean origin.

  5. The cytoplasmic anti- neutrophil cytoplasmic antibody (c- ANCA)

is highly sensitive for the disease.

    1. A 44 year male with a 4- month history of ansomia reports that he can still Smell ammonia. Which crania nerve is likely to be responsible for this?

  1. One- olfactory.

  2. Five- trigeminal.

  3. Seven- facial.

  4. Nine- glossopharyngeal.

  5. Ten- vagus.

74.Concerning the embryology of the nose and paranasal sinuses which of the following statements is FALSE?

  1. The frontal sinus originates from pneumatization of the frontal

recess and is usually not visible at birth.

  1. At 2 years of age the floor of the maxillary sinus is usually higher

than the floor of the nasal cavity.

  1. Failure of resorption of the naso-buccal membrane results in

choanal atresia.

  1. An absence of nasal bones on intra uterine screening is associated\

with Down's syndrome.

  1. Branchio- oto- renal syndrome is characterized by abnormal cilia

function and chronic sinusitis.
75. Which of the following is NOT closely related to the frontal recess?

  1. Agger nasi.

  2. Ethmoidal bulla.

  3. Middle turbinate.

  4. Lamina papyracea.

  5. Superior turbinate.

76.A 79- year- old man presents to the clinic with left- sided nasal discharge and obstruction. A mass is found arising from the ethmoid sinuses and histology shows an adenocarcinoma. Which of the following is the most significant risk factor for developing this disease?

  1. Smoking.

  2. Alcohol.

  3. A and B.

  4. Wood dust.

  5. Asbestos.

    1. Which of the following is LEAST likely to improve the symptoms from an anterior nasal septal perforation

  1. Nasal hygiene.

  2. Free tissue transfer cartilage graft repair (cartilage, perichondrium only).

  3. Silastic button placement.

  4. Local flap repair.

  5. Free tissue transfer composite graft repair (epithelium, cartilage, epithelium).

78.Tumors of the lower lip are typically:

  1. Basal cell carcinomas.

  2. Associated with poor oral hygiene.

  3. Associated with neck metastases in 45% of patients at presentation.

  4. Almost universally in males.

  5. Associated with late metastasis in 50%.

79.Which of the following would be the LEAST appropriate recipient site for a full- thickness skin graft?

  1. Pericardium.

  2. Muscle.

  3. Fat.

  4. Cartilage.

  5. Bone.

80. lowing Excision of a 4mm diameter BCC from tip of the nose with a 3 mm margin, which of the following is the LEAST appropriate method of repair?

  1. The use of a full- thickness skin graft "Wolf graft" using post auricular skin.

  2. The use of a nasolabial advancement flap based on the facial artery.

  3. Primary closure.

  4. The use of a paramedian rotational forehead flap based on the suprathrochlear artery

  5. The use of a bilobed rotation flap.

81.A 75- year- old man is undergoing a local anaesthetic excision of a

suspected basal cell carcinoma on his cheek. What clinical margin of

excision is most appropriate?

  1. 0 mm

  2. 2 mm

  3. 5 mm

  4. 1 cm

  5. 2-3 cm

    1. A patient presents with diplopia and nasal obstruction. He is found to have a nasopharyngeal carcinoma that extends though the foramen lacereum into the cavernous sinus. Which of the following is least likely to be affected?

  1. Oculomotor nerve.

  2. Trochlear nerve.

  3. Opthalmic division of the trigeminal nerve.

  4. Mandibular division of the trigeminal nerve.

  5. Sympathetic plexus.

83.umour in the pterygopalatine fossa may have developed there primarily or it may have spread directly into the fossa from any of the following except …?

  1. Orbit through the infra orbital fissure.

  2. The cranial cavity through the foramen ovale.

  3. The cranial cavity through the foramen rotundum.

  4. The nasal cavity.

  5. The oral cavity through the greater palatine canal.

84. A 46- year- old man presents with a 5- day history of an upper respiratory tract infection and 2 day's right cervical lymphadenopathy. He is febrile and with a raised white cell count. Ultrasound of his neck reveals thrombus in his right internal jugular vein and a chest x- ray is reported as having changes consistent with 'septic emboli'. Which is the most likely organism responsible for his symptoms?

  1. Proteus mirabilis.

  2. Clostridium difficile.

  3. Fusobacterium necrophorum.

  4. Strptococcus pyogenes.

  5. Staphylococcus aureus.

85.A 46- years- old Caucasian male presents with a post nasal space mass and a 5 cm ipsilateral lymph node. Biopsy of the post nasal space is reported as non- keratinizing squamous cell carcinoma. The most appropriate treatment is:

  1. Radiotherapy to the post nasal space and ipsilateral modified radical neck dissection.

  2. Chemo- radiotherapy to the post nasal space, ipsilateral modified radical neck dissection and contralateral selective neck dissection

  3. Surgical debulking of the post nasal space, bilateral modified radical neck dissections and post operative radiotherapy

  4. Primary chemo- radiotherapy

  5. Palliative care

86.Following enucleation of a superficial pleomorphic adenoma a patient

develops a parotid fistula which discharges onto the cheek. Which is the least effective treatment?

Repeat aspiration.


Vidian neurectomy.

Completion parotidectomy.

Tympanic neurectomy.
87.Which of the following statement is true with respect to juvenile nasal


It is centered on the shenopalatine foramen.

It rarely recurs after excision.

It occurs predominantly in adolescent females.

It usually presents with a mass in the neck.

It has an association with HLA B17.
88.A diagnosis of “Leukoplakia”effectively rules out all of the following


Lichen planus.

White sponge nevus.


Epithelial dysplasia.
89. Which of the following classifications of medications does not cause salivary hypofunction?

  1. Tricyclic antidepressants.

  2. Antihistamines.

  3. Cox-2 nonsteroidal antiinflammatories.

  4. Diuretics.

90. Which of the following diseases is most likely to have oral mucocutaneous ulcers?

  1. Pemphigus vulgaris.

  2. Parkinson’s disease.

  3. Renal osteodystrophy.

  4. Down syndrome.

91. Squamous cell carcinoma of the tongue may manifest the following oral sequelae except

  1. Nonhealing oral ulcer.

  2. Erythroplakic lesion.

  3. Exophytic erythroleukoplakic pustule.

  4. Mucocele of the lower lip.

92. Which is a radiographic feature often found in benign odontogenic cysts

and tumors?

  1. Radiopaque border.

  2. Blunted tooth roots.

  3. Cortical expansion.

  4. All of the above.

93. Which of the following signs and symptoms is most commonly

associated with odontogenic infections?

  1. Constipation.

  2. Diarrhea.

  3. Productive cough.

  4. Mental confusion.

  5. Facial swelling.

94. Which of the following fascial spaces is not primarily involved in

Ludwig’s angina?

  1. Submandibular space.

  2. Submental space.

  3. Sublingual space.

  4. Lateral pharyngeal space.

95. Optimal treatment of nasoalveolar cysts requires

  1. Marsupialization.

  2. Marsupialization with curettage.

  3. Conservative surgical excision.

  4. Complete surgical excision.

  5. Complete surgical excision followed by radiation therapy.

96. Which of the following lesions grows in response to local trauma?

A. Nasoalveolar cyst.

  1. Mandibular torus.

  2. Fibroma.

  3. Choristoma.

  4. Parulis.

97. Esophageal ulcers are seen in all the following except

    1. Herpes esophagitis.

    2. Acute radiation esophagitis.

    3. Intramural pseudodiverticulosis.

    4. Barrett’s esophagus.

    5. Crohn’s disease.

98. Complications of esophagoscopy include

  1. Esophageal perforation.

  2. Dental trauma.

  3. Bleeding.

  4. Cardiac arrhythmia.

  5. All of the above.

99. Which muscle opens the larynx?

  1. Cricothyrid.

  2. Thyroarytenoid.

  3. Lateral cricoarytenoid.

  4. Posterior cricoarytenoid.

  5. Interarytenoid.

100. The shaping of vocal sound into words is termed

  1. Phonation.

  2. Resonance.

  3. Articulation.

  4. Intonation.

  5. Transduction.

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