D & N OF THE NOSE, PARANASAL SINUSES & FACE 1.1 (AB)

Question 1

What is choanal atresia?

Answer 1

Embryologic failure of the bucconasal membrane to rupture before birth

Question 2

What connects the nasal cavities with the nasopharynx?

Answer 2

Choanae

Question 3

When do the choanae develop?

Answer 3

Between the 3rd and 7th embryonic weeks

Question 4

How often does choanal atresia occur?

Answer 4

1 in 5000 to 8000 live births

Question 5

What is the female to male ratio in choanal atresia?

Answer 5

2 to 1

Question 6

What is the treatment for choanal atresia?

Answer 6

Surgery. Puncture or remove the uncultured bucconasal membrane

Question 7

When do nasal dermoid cysts usually present?

Answer 7

At birth but may remain unrecognized until later childhood or adult life

Question 8

What are nasal dermoid cysts composed of?

Answer 8

Epithelium-lined cavities or sinus tracts filled with keratin debris. hair follicles. sweat glands. and sebaceous glands

Question 9

What causes nasal dermoid cysts?

Answer 9

Failure of ectodermal elements of the fetal trilaminar septum to degenerate

Question 10

What is a nasal glioma?

Answer 10

Rare congenital lesion composed of dysplastic glial cells that have lost intracranial connections

Question 11

What causes nasal glioma?

Answer 11

Abnormal closure of the fonticulus frontalis

Question 12

Where are nasal gliomas most commonly located?

Answer 12

60 percent extranasal. 30 percent paranasal. 10 percent both

Question 13

What is encephalocele?

Answer 13

Congenital extracranial herniation of CNS tissues through a skull base defect

Question 14

What is the cause of encephalocele?

Answer 14

Arrested closure of normal confining tissue and early outgrowth of neural tissue

Question 15

What conditions are associated with encephalocele?

Answer 15

Midline fusion defects and CNS anomalies

Question 16

What is a mucocoele?

Answer 16

Cyst-like. mucus-containing sac within a sinus

Question 17

What is a pyocoele?

Answer 17

Mucocoele containing pus due to superinfection

Question 18

What causes mucocoeles?

Answer 18

Adhesions. mass lesions. and obstruction of drainage pathways

Question 19

What is the most common site for mucocoeles?

Answer 19

Frontal sinus

Question 20

What is the least common site for mucocoeles?

Answer 20

Sphenoid sinus

Question 21

How does a maxillary sinus mucocoele present?

Answer 21

Cheek swelling with proptosis due to orbital floor displacement

Question 22

How does a frontal sinus mucocoele present?

Answer 22

Tense swelling over frontal sinus. inferolateral displacement of orbit

Question 23

How does an ethmoid sinus mucocoele present?

Answer 23

Proptosis or diplopia due to lateral displacement of medial orbital wall

Question 24

How does a sphenoid sinus mucocoele present?

Answer 24

Headache radiating to vertex and occiput

Question 25

How are mucocoeles diagnosed?

Answer 25

History. CT scan. and MRI

Question 26

What is the treatment for mucocoeles?

Answer 26

Surgical removal and re-establishment of drainage or sinus obliteration

Question 27

What is nasal septum deviation?

Answer 27

Congenital or traumatic bending or bowing of the nasal septum

Question 28

What are symptoms of nasal septum deviation?

Answer 28

Nasal obstruction. olfactory impairment. sinusitis. epistaxis

Question 29

How is nasal septum deviation diagnosed?

Answer 29

Anterior rhinoscopy. endoscopy. rhinomanometry

Question 30

What are treatments for nasal septum deviation?

Answer 30

Septoplasty. scoring. or submucous resection

Question 31

What is anterior epistaxis?

Answer 31

Bleeding in front of the maxillary sinus ostium. usually mild

Question 32

What is posterior epistaxis?

Answer 32

Bleeding behind the maxillary sinus ostium. often severe

Question 33

What is the most common cause of anterior epistaxis?

Answer 33

Trauma

Question 34

What is the typical age for posterior epistaxis?

Answer 34

Over 40 years old

Question 35

How is epistaxis diagnosed?

Answer 35

BP. Hgb. platelet count. coagulation profile. anterior rhinoscopy and endoscopy

Question 36

What are general measures for treating epistaxis?

Answer 36

Nasal compression. upright posture. avoid swallowing blood. ice bag

Question 37

What is Trotter’s method for epistaxis?

Answer 37

Patient sits and leans forward while pinching the nostril and breathing through mouth

Question 38

What is silver nitrate cautery used for?

Answer 38

Mild epistaxis from Kiesselbach’s area

Question 39

When is nasal packing used?

Answer 39

For severe epistaxis

Question 40

When is vascular ligation indicated?

Answer 40

Persistent bleeding despite nasal packing

Question 41

What arteries may be ligated in epistaxis?

Answer 41

Sphenopalatine artery. internal maxillary artery. ethmoid artery. external carotid artery

Question 42

When is embolization used in epistaxis?

Answer 42

Posterior epistaxis refractory to standard treatments

Question 43

Q

Answer 43

A

Question 44

What are the signs of inflammation?

Answer 44

Hotness. Redness. Swelling. Pain. Loss of function.

Question 45

What is the cardinal sign of inflammation?

Answer 45

Pain.

Question 46

What is the sequence of inflammation?

Answer 46

Injury. Vascular response. Cellular response. Healing.

Question 47

What is the vascular response in inflammation?

Answer 47

Vasodilation. Increased vascular permeability.

Question 48

What causes vasodilation in inflammation?

Answer 48

Histamine. Prostaglandins. Bradykinin.

Question 49

What causes increased vascular permeability?

Answer 49

Histamine. Bradykinin. Leukotrienes.

Question 50

What are the main cells involved in acute inflammation?

Answer 50

Neutrophils. Macrophages.

Question 51

What are the main cells involved in chronic inflammation?

Answer 51

Lymphocytes. Plasma cells. Macrophages.

Question 52

What are the types of exudate?

Answer 52

Serous. Fibrinous. Purulent. Hemorrhagic.

Question 53

What is serous exudate?

Answer 53

Watery fluid with low protein content.

Question 54

What is fibrinous exudate?

Answer 54

Thick

Question 55

What is purulent exudate?

Answer 55

Thick yellow-green fluid with many neutrophils. Dead cells. Microorganisms.

Question 56

What is hemorrhagic exudate?

Answer 56

Contains RBCs due to severe vessel damage.

Question 57

What is an abscess?

Answer 57

Localized collection of pus.

Question 58

What is cellulitis?

Answer 58

Diffuse

Question 59

What is an ulcer?

Answer 59

Localized area of tissue necrosis on skin or mucous membrane.

Question 60

What are systemic effects of inflammation?

Answer 60

Fever. Leukocytosis. Malaise. Anorexia.

Question 61

What is leukocytosis?

Answer 61

Increased white blood cells in the blood.

Question 62

What causes fever in inflammation?

Answer 62

Pyrogens. Cytokines like IL-1 and TNF.

Question 63

What is granulomatous inflammation?

Answer 63

Chronic inflammation with granuloma formation.

Question 64

What are examples of granulomatous diseases?

Answer 64

Tuberculosis. Sarcoidosis. Leprosy.

Question 65

What is a granuloma?

Answer 65

Collection of macrophages. Giant cells. Lymphocytes.

Question 66

What are the outcomes of acute inflammation?

Answer 66

Resolution. Abscess formation. Chronic inflammation.

Question 67

What are the phases of wound healing?

Answer 67

Inflammation. Proliferation. Maturation.