ENT Final Flashcards by Gerald Libranda

The phayrnx functions chiefly in:

d. Respiration, deglutition, articulation and voice resonance

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Acute suppurative bacterial tonsillitis is most often caused by:

b. Group A beta-hemolytic streptococcus, H. Influenzae, Streptococcus viridans

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A 25y/o male consulted at the OPD due to dysphagia of 2 days duration. PPE: (+) trismus, increased salivation, swelling of the left side of the soft palate extending to the anterior pillar, pushing the uvula across midline. What is your working diagnosis?

d. Peritonsillar abscess

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Most important point in the history of foreign body ingestion:

d. Believe the patient

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The pharyngeal phase of swallowing is completed by:

b. Cricopharyngeal sphincter relaxation

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The antibiotic of choice for Streptoccoccus pharyngitis in a 7-year old boy with Sickle Cell Trait:

b. Penicillin

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A 20-year old sailor has a persistent sorethroat and is found to have a pharyngitis with enlarged tonsils and cervical adenophaty . Gram stain of pharyngeal secretions shows gram- negative diplococci. These findings support a diagnosis of:

b. Gonococcal pharyngitis

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Majority of foreign body coins will be trapped in the:

c. Cricopharyngeal constriction

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A 50 y/o female presents clinically with globus hystericus. This is usually associated with a/an:

a. A normal PE and barium swallow

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The absence of this structure distinguishes the esophagus from the the rest of the gastrointestinal tract:

a. Serosa

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The tone and function of the esophagus is best evaluated by:

b. Cineradiography

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Majority of ‘fish spine” foreign bodies will be lodged in the

a. Tonsils

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Caustic substance ingestion can affect which stages(s) of swallowing:

c. Stage III / d. Stage IV

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What is the most common cause of deep neck infections in adults?

a. Odontogenic sources

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An example of an indirect diagnostic test for neck masses:

c. Ultrasound

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Squamous cell carcinoma is the most common malignant tumor of the paranasal sinuses. The most commonly affected paranasal sinus by this tumor is:

A. Maxillary sinus

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Which of the following statements is true regarding basal cell CA:

C. It is the most common skin malignancy

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A surgical procedure used as a treatment for thyroglossal duct cyst which include the removal of the central portion of the hyoid bone to ensure complete removal of the cyst is known as:

B. Sistrunk procedure

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At what level of the neck can you palpate the superior deep jugular lymph node?

B. Level II

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Whartin’s tumor is a relatively common benign salivary gland tumor that usually occur among:

D. Adult male

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How much of the actual total daily volume of salivary production comes from the parotid and submandibular glands?

a. 90%

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Schirmer’s test is considered positive if the difference between the ipsilateral and contralateral results exceed a difference of:

a. 25%

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A 30 year old female comes in with fever, pains in the right pre-auricular area. On examination, you see a swollen, tender, erythematous right parotid area. The orifice of the stensen’s duct is also swollen with minimal purulent material coming out. What is the diagnosis?

c. Acute bacterial sialadenitis

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Sudden facial paralysis associated with vesicles in the external audiotory canal and pinna:

c. Ramsay hunt syndrome

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Which branch of the facial nerve is responsible for secretomotor function of submandibular gland?

c. Chorda tympani

Primary neoplastic growth that metastasizes to the supraclavicular area may come from neoplasm involving the:

d. Esophagus

A middle lower lip lesion would drain into the:

c. Submental node

A 54 y/o patient presented with a midline mass that moves with deglutition. Your primary diagnostic impression as to its nature would be:

c. Thyroid malignancy

The second most common fracture in the face is:

c. Mandibular fracture

Blow-out fracture from a blunt object hitting the eye occurs at

c. The floor of the orbit

The best replacement fluid to use for hypovolemic shock is:

c. Whole Blood

The best material for use in internal fixation for fracture is:

a. titanium plate

The best x-ray view to request for suspected nasal bone fracture is:

c. Soft tissue lateral view

The best x-ray view to request for a suspected zygomatic arch fracture is:

a. Basal view of the skull

To visualize the condylar neck of the mandible, one would request for an x-ray projection:

c. Modified Towne’s view

A fracture of the body of the mandible is best visualized by:

d. Mandible oblique view

Of the following, which fracture produces epistaxis?

a. Tripod fracture

Hypesthesia of the cheek due to inferior orbital rim fracture is due to involvement of which nerve?

d. Inferior orbital nerve

Hypesthesia of the cheek is associated with:

a. Inferior orbital rim fracture

Which of the following is NOT associated with epistaxis?

c. Depressed zygomatic archfracture

“Tear- drop” sign on Water’s x-ray view is evidence for presence of :

b. Blow-out fracture

The treatment of choice for alveolar ridge fracture is:

b. Interdental wiring

Procedure of choice for sagging double chin in 24 y/o female

c. Submental lipectomy

A scar that usually stays within the boundaries of the wound and occur more frequently in areas of motion or skin tension

b. Hypertrophic scar

The blood supply of a free flap is derived from:

c. The arterial supply in the donor site

Augmentation rhinoplasty maybe achieved by any of the following, EXCEPT:

a. Silicone injection

Undue wound tension is best avoided by ________.

c. Tissue undermining

Injection of fat harvested from the same individual is called ________.

a. Autologous fat transfer

The most inert suture material

d. Nylon

Decreases rate of wound healing

b. Triamcinolone

To reduce local bleeding from the operative site in the face, it is a common practice to mix lidocaine with _________.

d. Adrenaline

A graft derives its blood supply from ___________.

a. Capillaries in the recipient site

The best rate of take is from ________.

b. Partial thickness skin graft

The least contraction is exhibited by _________.

a. Full thickness skin graft

A skin chemical peel aims to _______.

b. Eliminate fine wrinkles

Procedure of choice for a 60y/o female with sagging double chin

b. Submental lipectomy

Ophthalmic artery is a branch of ________.

b. Internal carotid artery

This is considered the most common source of profuse epistaxis especially in adult

c. Sphenopalatine artery

Which of the following drains into the middle meatus?

a. Anterior ethmoid

Headache of sphenoid sinusitis is projected where?

d. Occipital

Nasal obstruction due to pregnancy and hormones are classified under which type of rhinitis?

d. Vasomotor

Rhinitis medicamentosa is due to overuse of

d. Local decongestants

Which condition usually presents as profuse epistaxis?

c. Juvenile angiofibroma

A sequela of untreated septal hematoma

b. Saddle nose

The most commonly involved site in malignancy of the nose and the paranasal sinuses

c. Maxillary sinus

A 40 year-old male presents with nasal obstruction, blood-streaked nasal discharge, impaired hearing on the right and a 2 X 2 cm hard, right infra-auricular mass. The most likely cause of the nasal obstruction is

b. Inflammatory disorder

Cause of the immediate rhinitis symptoms in allergic rhinitis

c. Breakdown of mast cells

Which of the following best describe a patient with allergic rhinitis?

d. Presence of watery nasal discharge with obstruction

A coagulation disorder of the congenital type which may be a cause of epistaxis and characterized by a prolongation of the prothrombin time and/or the PTT.

b. Vit K deficiency

An autosomal dominantly inherited vascular anomally characterized by abnormal subepithelial vessels, multiple cutaneous telangiectasia, frequent epistaxis and gastro intestinal bleeding

b. Osler weber-rendu disease

“Bowing” of the vocal cords on phonation is due to a non-functioning:

c. Thyroarytenoid m.

Laryngomalacia is present due to a defect in which structure:

c. Epiglottic cartilage

Laryngeal carcinoma with the best prognosis:

a. Glottic CA

The best way to examine the larynx in the OPD is by:

c. Indirect laryngoscopy

The sensory arm of the cough reflex is innervated by the:

b. Superior laryngeal nerve

Pitch of the voice is controlled by:

a. Pressure of the tracheal air column / b. Length of the vocal cords / c. Tension and bulk of the vocal cord /d. All of the above

The structure mainly responsible for prevention of aspiration is:

B. Vocal cords

Unilateral recurrent laryngeal nerve paralysis will result in:

A. Breathy voice / B. Stridor in children/ C. Good airway / D. All of the above

Congenital subglottic stenosis is defined as a subglottic diameter less than

A. 4 mm

Bowing of the true vocal cords is caused by the paralysis of:

C. Interarytenoid muscle

A 1 1/2 month-old baby girl was brought to your clinic because of stridor. There was no associated cough. The patient was delivered to a G8P7 40 year old laundrywoman from payatas via NSD. Birthweight was 6.5lbs with APGAR score of 9 and 10. She was sent home after 2 days with no perinatal complications. She had a good suck with normal swallowing, good cry and weight gain. Stridor is slightly relieved by putting her in a supine position. T=37.2 C ; RR= 40/min. Your initial impression is:

d. Laryngomalacia

A 6 year-old boy was brought in to the clinic because of cough associated with moderate-grade fever and sorethroat characterized by painful swallowing few days PTC. The patient was sent home with antibiotics, cough syrup and antipyretics. The following day, patient was brought to the ER because of stridor associated with cyanosis. Patient was relieved by sitting up with mouth open and chin forward. He was restless and cyanotic with flaring of alae nasi, substernal and intercostal retractions. T=40C ; RR=36/min. Your initial impression is:

b. Acute epiglottitis

A 62 year old farmer from Iriga City came in because of dyspnea. His condition started 10 months PTC as hoarseness associated with hemoptysis. One month PTC, he developed persistent dyspnea accompanied by a lump on the right side of the neck. Patient is a chronic alcoholic and smoker. On PE, patient is obese, afebrile, and in respiratory distress. Your initial impression is:

d. Laryngeal CA

A 3 year-old girl was taken to the ER because of stridor and cyanosis. Few hours PTC, patient was playing in the sala while her daddy was eating peanut while watching world meeting of families. The patient was restless with audible slap and palpable thud. Your initial impression is:

b. Tracheal foreign body

While on duty at the ER, a patient was brought in due to hoarseness and coughing out of blood. Patient was the driver of a car involved in a vehicular accident moments ago. From the history, you learned that unfortunately he was not wearing his seatbelt and was thrown forward on the steering wheel upon impact. Examination revealed a patient in moderate respiratory distress with stridor. Your most likely diagnosis is:

b. Laryngeal fracture

Deflection of the kinocillium away from the stereocilia results in

b. Decrease of discharge rate

The single most important test to request in cases of vertigo is

c. Electronystagmography

ENG(electronystagmography) works on the principle of voltage difference between the

b. Cornea and retina

In caloric stimulation a cold fluid is applied to the right ear. The expected resulting nystagmus is

a. A slow phase to the right

The utricle of the inner ear responds to

a. Linear acceleration

A round window fistula is best treated by

a. A flat graft to the round window

Motion sickness is due to

b. Visual and vestibular information mismatch

A transverse fracture produces dizziness because it

c. Cuts across the inner ear

In a normal patient which of the following would be observed after cold water irrigation of the right ear

b. Left nystagmus

Vestibular neuritis is manifested clinically by one or more severe prolonged episodes of vertigo. The most likely etiology is

d. Viral infection

A 18 y/o male consulted in the Out patient department due to pain on the right ear whenever the auricle is touched. The most likely diagnosis is

a. Otitis externa

A 3 y/o boy with a 3 day colds was brought to the out patient department because the mother noted the child to be constantly pulling the left ear. The most likely diagnosis is

c. Acute otitis media

Conditions predisposing to the development of otitis media

a. Upper respiratory tract infection / b. Allergic rhinitis / d. Cleft palate

Which is the most important principle in the management of draining ear

a. Cleaning of the ear canal

Acute otitis media early stage II is most appropriately managed with

c. Systemic antibiotics, decongestants