Concerning nasal ciliary physiology and anatomy, which of the following statements is LEAST accurate? The nose is lined by ciliated pseudostratified glandular columnar epithelium.
The nasal cilia are arranged as 9 microtubule doublets formed in an outer circle around a central pair.
The outer microtubular doublets are linked by the protein nexin.
Ciliary movement is described as having 2 phases.
Normal ciliary beat frequency is approximately 10—25 beats per minute.
Which of the following bones do not form part of the osteology of the lateral nasal wall? Maxilla
Perpendicular plate of the sphenoid
A 44 year male with a 4-month history of anosmia reports that he can still smell ammc’nia. Which cranial nerve is likely to be responsible for this? One — olfactory
Five — trigeminal
Seven — facial
Nine — glossopharyngeal
Ten — vagus
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? Smoking
A and B
A 14-year-old boy presents to the hospital accompanied by his father with hypovolaemic shock and active bleeding following a secondary tonsillar haemorrhage. He has a haemoglobin of 5.5 g!dl on a blood gas. You advise that the boy requires resuscitation including blood transfusion and return to theatre to arrest the haemorrhage. The boy informs you that he is a Jehovah’s Witness and he forbids you to perform a blood transfusion. What is the next MOST appropriate action? Call a senior colleague and ask him to come in to give a second opinion.
Call the blood bank to find a cell saver device.
Perform the blood transfusion as clinically indicated.
Contact the hospital lawyer for advice.
Perform all measures necessary except the transfusion
Tumours of the lower tip are typically: Basal cell carcinomas
Associated with poor oral hygiene
Associated with neck metastases in 45% of patients at presentation
Almost universally in males
Associated with tate metastasis in 50%
What is the single most common cause of an incorrect blood transfusion being administered? Laboratory error
Which of the following is LEAST Likely to improve the symptoms from an anterior nasal septal perforation? Nasal hygiene
Free tissue transfer cartilage graft repair (cartilage, perichondrium only)
Silastic button placement
Local flap repair
Free tissue transfer composite graft repair (epithelium, cartilage, epithetium)
A 42-year-old male presents with nasaL obstruction. A CT of the paranasal sinuses is reported as showing opacification of the right maxillary sinus with ‘doubLe density’ signals throughout the sinus. Which of the followir.g is the LEAST likely pathology? Allergic fungat sinusitis
Endotracheal intubation of patients with laryngeal injuries is Problematic and should be avoided
Beneficial in all patients and avoids the need for tracheotomy
Permissible and frequently safely performed in the emergency room setting
Permissible when the airway appears intact and skilled personnel are available.
Cricothyrotomy or tracheotomy are the only options
Which of the following statements best describes the role of computed tomography of the larynx after blunt trauma? All patients with suspected laryngeal injuries should undergo computed tomography to document the extent of their injury.
Computed tomography should be used only when the results of the study will influence the course of treatment.
Suspected fractures of the laryngeal ‘skeleton that are difficult to document by physical examination should be viewed by computed tomography.
b and c
All of the above
Which of the following is true regarding vocal fold nodules? They are often seen in men.
They are rarely unilateral.
They result from trauma to capillaries.
They are most often treated surgically.
They are rarely associated with vocal abuse.
Which of the following risk factors are associated with laryngeal cancer? Gastroesophageal reflux
56. Users of the multichannel auditory brainstem implant have experienced all of the following except Variations in pitch sensations across electrodes
Open-set speech discrimination
All have been experienced
57. patient undergoes resection of a skull base mass with a transnasal endoscopically assisted approach and complains of visual changes in the recovery room and is ultimately found to have optic nerve damage. The injury to the optic nerve most likely accompanied injury in which of the following areas The optic foramen
91. The most common cause of unilateral vocal fold paresis is Thyroid surgery
Concerning the pharmacokinetics of local anesthetics, which of the following statements is FALSE? Lidocaine acts to reversibly block sodium channels in the nerve fibre.
Lidocaine acts to cause vasoconstriction when injected subcutaneously.
Alcoholic cirrhosis can reduce the metabolism of bupivocaine. -
Local anaesthetics with a low pKa have a faster onset of action.
8.4% sodium bicarbonate added to 2% cocaine speeds up the onset of Action
Concerning the hyoid bone, which of the following statements is FALSE? The lesser cornu of the hyoid is derived from the second branchia arch.
The hyoid bone is incompletely ossified at birth.
The hyoglossus and middle constricter muscles attach to the greater cornu.
The intermediate tendon of the digastric muscle passes between the bifurcated tendon of the stylohyoid.
The geniohyoid muscle acts to depress the larynx during swallowing.
You are asked by the haematologists to perform a local anesthetic biopsy of a cervical lymph node. The patient, a 45-year-old woman, has had a suspected relapse of her non- Hodgkin’s lymphoma. Following her recent treatment, she is known to be thrombcytopaenic. What is the lowest platelet count (in platelets x 1OIl) that you would consider it acceptable to proceed with the operation? 10
A patient with HIV is placed on the waiting list for a parotidectomy. You are keen to warn the operating department staff of his Infection risk. When the operating List is printed, which of the following is generally acceptable to use to highlight his status? HIV positive
None of the above — it is not ethical to highlight his status on acirculated list.
Which answer BEST describes the content of the cavernous sinus? Internal carotid artery, oculomotor, trochlear, abducent and ophthalmic and maxillary divisions of the trigeminal nerve
Internal carotid artery, oculomotor, trochlear, abducent and ophthalmic and mandibular divisions of the trigeminal nerve
Internal carotid arter)c superior ophthalmic vein, optic. abducent and ophthalmic and maxillary divisions of the trigeminal nerve
Common carotid arter)c oculomotor. trochlear, abducent and ophthalmic and maxillary divisions of the trigeminal nerve
Superior ophthalmic vein, oculomotor, troch(ear. abducent and ophthalmic and maxillary divisions of the trigeminal nerve
If a mother and a father are both carriers of an autosomal recessive gene, which of the following statements is TRUE? All of their children will have the disease.
Half of their children will have the disease.
One quarter of the children will have the disease.
All the males will have the disease.
None of the children will have the disease.
A patient is taking warfarin for paroxysmal atrial fibrillation (PAF). Under what circurristances wouLd it be reasonable to stop the warfarin and administer fresh frozen plasma (FFP) (or factor concentrate) and Vitamin K? Epistaxis controlled with anterior nasal packing
Epistaxis controlled only with posterior and anterior nasal packing
Elective admission for endoscopic sinus surgery
Pharyngoscopy for globus pharyngeus symptoms
Excision of a lipoma
Which of the following is NOT an opening into the temporal bone? internal auditory canal
Parasympathetic innervations to the sumandibular gland is carried by the: Lesser petrosal nerve