1.Superfical parotidectomy is contraindicated in patients with sialectasis because

1.  There is high risk of dry mouth2.  There is a high risk of fistula

formation3.  There is high risk of infection4.  There is risk of facial palsy

2.In superficial parotidectomy1.  Only a part of superfical lobe is

removed2.  The whole of superfical lobe and part

of deep lobe of the gland is removed3.  The superfical lobe is removed

completely4.  The deep lobe is removed completely

3.In patients with diabetes mellitus the parotid gland is

1.  Shrunken2.  Enlarged3.  Cystic in nature4.  Fibrosed

4.Carbohydrate-protein substances corresponding to the blood group antigens are not secreted by

1.  Parotid glands2.  Submandibular salivary glands

3.  Accessory salivary glands4.  Sublingual salivary glands

5.Warthin's tumor is known to develop from 1.  Acinar cells2.  Lymphoid tissue within parotid gland3.  Myoepithelial cells4.  Basal cells

6.Anesthesia over parotid gland area is caused by injury to

1.  Marginal mandibular nerve2.  Orbital nerve3.  Buccal nerve4.  Greater auricular nerve

7.The antibiotic that is actively secreted in the saliva is

1.  Clindamycin2.  Streptomycin3.  Cefixime4.  Ampicillin

8.Parotid gland is a 1.  Mucoserous salivary gland2.  Serous salivary gland3.  Protenaceous salivary gland4.  Mucinous salivary gland

9.Technitium pertechnetate scans are useful in the diagnosis of

1.  Pleomorphic adenoma

2.  Monomorphic adenoma3.  Warthin's tumor4.  Sialadinitis

10. Food stimulates secretion of1.  Sublingual salivary gland2.  Accessory salivary glands3.  Parotid gland4.  Submandibular salivary gland

11. In Bulimia parotid glands are1.  Nodular2.  Enlarged3.  Cystic in nature4.  Shrunken in size

12. Perineural invasion is common in1.  Acinous cell carcinoma2.  Adenoid cystic carcinoma3.  Mucoepidermoid carcinoma4.  Pleomorphic adenoma

13. Benign tumors of superfical lobe of parotid gland takes a very long time to project outwards because

1.  Slow rate of tumor growth2.  The styloid process stops the

progression of tumor3.  The external surface of the parotid

gland is covered by tough parotid fascia

4.  Ramus of the mandible stops tumor progression

14. Calcium content of saliva is low in1.  Sublingual salivary gland secretions2.  Submandibular salivary gland

secretions3.  Parotid secretions4.  Accessory salivary gland secretions

15. Warthin's tumor is commonly seen in1.  Parotid gland2.  Accessory salivary gland3.  Sublingual salivary gland4.  Submandibular salivary gland

16. Sublingual salivary gland is situated1.  Above the mylohyoid2.  Posterior to the mylohyoid muscle3.  Below the mylohyoid muscle4.  Under the palatopharyngeous muscle

17. The parotid gland is divided into superficial and deep portions by

1.  Facial nerve branches2.  Mandible3.  Cartilagenous portion of external

auditory canal4.  Internal maxillary artery

18. Parotid gland secretions constitute about

1.  100% of salivary secretion2.  90% of salivary secretion3.  1/5 th of salivary secretion4.  3/4 th of salivary secretion

19. Chemical stimulation maximises the secretion of

1.  Parotid gland2.  Accessory salivary gland3.  Sublingual gland4.  Submandibular gland

20. Submandibular salivary gland swelling is differentiated from submandibular lymphadenitis clinically by

1.  Movement during swallowing2.  Bidigital palpation3.  Palpation from behind the patient4.  Presence of transillumination in

submandibular salivary gland21. Oncocytoma almost exclusively

occurs in1.  Submandibular salivary gland2.  Parotid salivary gland3.  Accessory salivary gland4.  Sublingual salivary gland

22. Acini of parotid glands are formed by1.  Seromucinous cells2.  Serous cells

3.  Cloudy cells4.  Mucinous cells

23. Submandibular salivary gland is separated into superficial and deep portions by

1.  Mylohyoid muscle2.  Digastric muscle3.  Buccinator muscle4.  Sternomastoid muscle

24. In parotid surgeries the most reliable way of identifying the facial nerve is

1.  Searching at the tympanomastoid sulcus

2.  By using the tragal pointer3.  By removing the styloid process4.  By tracing it from the mastoid cavity

25. During sleep salivary secretion is maintained by

1.  Submandibular gland only2.  Sublingual gland only3.  Submandibular and sublingual

salivary glands4.  Parotid gland only

26. Tumors arising from deep lobe of parotid gland extending across the parapharyngeal space is covered on their anterior aspect by

1.  Stretched out fibers of middle constrictor muscle

2.  Stretched out fibers of superior constrictor muscles

3.  Stretched out fibers of medial pterygoid muscle

4.  Stretched out fibers of lateral pterygoid muscle

27. In submandibular salivary gland surgery, the branch of facial nerve at risk is

1.  Buccal nerve2.  Marginal mandibular nerve3.  Lower zygomatic nerve4.  Upper zygomatic nerve

28. The first salivary gland to develop is1.  Parotid gland2.  Sublingual salivary gland3.  Accessory salivary glands4.  Submandibular salivary gland

29. Sialolithiasis is common in1.  Accessory salivary gland2.  Parotid gland3.  Sublingual salivary gland4.  Submandibular salivary gland

30. All major salivary glands arise from1.  Ectoderm

2.  All three embryonal tissue3.  Endoderm4.  Mesoderm

31. Daily average volume of saliva produced in a human being is

1.  3 - 5 litres2.  1 - 1.5 litres3.  8 - 10 litres4.  3 - 4 litres

32. Adenoid cystic carcinoma is known to commonly involve

1.  Sublingual salivary gland2.  Minor salivary glands3.  Submandibular salivary gland4.  Parotid gland

33. During sleep the parotid gland is known to secrete about

1.  50% of basal salivary secretion2.  75% of basal salivary secretion3.  100% of basal salivary secretion4.  Parotid secretion ceases during sleep

34. The parotid has constant relationship with

1.  Lower zygomatic nerve2.  Buccal branch of facial nerve3.  Upper zygomatic nerve4.  Marginal mandibular nerve

35. Multiple cystic lesions inside both the parotid glands in a patient should alert the clinician for a possible diagnosis of

1.  Mumps2.  Measles infection3.  HIV infection4.  Malignancy

36. Parotid calculi are diagnosed by1.  Xray skull lateral view2.  Plain radiograph of parotid gland3.  CT scan4.  Plain radiograph occlusal view

37. Sialadenosis commonly involves1.  Accessory salivary gland2.  Submandibular gland3.  Sublingual gland4.  Parotid gland

38. Parotid gland swellings are very painful because

1.  The outer layer (parotid fascia) is inelastic and firm

2.  The parotid glands suppurate easily3.  The parotid gland is closely related

to the external auditory canal4.  There is no outer layer of fascia

covering the parotid gland39. Parotid duct is known as

1.  Stenson's duct2.  Wharton's duct3.  Stylle's duct4.  Finely's duct

40. Salivary fistula is commonly originates from

1.  Submandibular salivary glands2.  Accessory salivary glands3.  Sublingual salivary glands4.  Parotid glands

Deep part of Submandibular gland is related to

1-facial nerve

2.lingual nerve

3- Accessary nerve

4- mandibular nerve

1] Following tonsillectomy , a patient noticed loss of general sensation & taste from his posterior third of tongue. Most likely nerve to get injured here :

A.FacialB.GlossopharyngealC.LingualD.Vagus

Ans : B

2] Diplacusis is due to lesion in :

A.CochleaB.Auditory nerveC.Pontaine gliomaD.None of the above

Ans : A

3] Gradinigo syndrome has all the following components except :

A.DiplopiaB.HeadacheC.Abducent palsyD.Facial palsy

Ans : C

4] Commonest cause for unilateral muco-purulent discharge in children :

A.RhinitisB.Foreign bodies C.SinusitisD.Polyp

Ans : B

5] Color of tympanic membrane in otosclerosis

A.RedB.Flamingo-pinkC.orangeD.Pearly grey

Ans : D

1.Which of the following is not true for stridor in young children?

 a) Croup (Laryngotracheobronchitis) happens mostly in younger children (<2Years).

 b) Croup always occurs in cluster. c) Acute epiglottis is viral in origin.

 

d) Refer patient to A & E department of nearby acute hospital with ENT support if there is cyanotic or respiratory distress in young children with stridor.

 e) Apyrexial stridor can be due to foreign body, injury, scald or papilloma.

2.The following are the causes of Acute facial nerve paralysis except:

 a) Congenital cholesteatoma b) Herpes zoster c) Temporal bone tumour d) Facial laceration e) Otitis externa

3.Treatment of acute severe epistasis includes the following except:

 a) Monitor vital signs b) Nasal pinching c) Nasal packing d) Refer to acute hospital e) X-ray study

4.Which of the following statement of Ramsay Hunt

Syndrome is not true?  a) It is also known as Herpes zoster oticus. b) It is viral in origin. c) It causes intense pain in ear. d) It causes facial paralysis only. e) Treatment includes steroid.

5.Which of the following is not the intracranial complication of ear infection?

 a) Meningitis

 b) Lateral sinus thrombosis

 c) Facial paralysis

 d) Otitic hydrocephalus

 e) Extradural abscess

Question

Your AnswerCorrect Answer

Q1b

Q2a

Q3e

Q4d

Q5c

Explanations:-

Q1) Acute epiglottis happens in slightly older child (>2years) and occasionally in adult.

There is rapid progression of stridor and drooling of saliva.

Hemophilus influenzae is the most common pathogen.

Lateral neck X-ray will show swollen

epiglottis (Thumb sign).

Q2)

Causes of Acute facial nerve paralysis include:

Intracranial - Meningioma, Congenital cholesteatoma, Acoustic neuroma

Intratemporal - Acute and chronic ear infection, Glomus tumours, Herpes zoster, Fracture, Post surgery, Temporal bone tumour, Bell's palsy

Extratemporal - Parotid malignancy, Facial laceration

Q3)

Treatment of acute severe epistasis includes monitoring of vital signs, control of bleeding by nasal pinching or packing, referring patient to acute hospital if there is massive bleeding, suspected pathology, failed control of bleeding or complication.

Q4)

Herpes zoster oticus (Ramsay Hunt Syndrome) is due to viral infection of spiral /vestibular ganglion in the inner ear or ganglion of facial nerve.

There is intense pain in ear with vestibular eruption on pinna and external ear few days later.

Patient will suffer from sudden sensori-neural hearing loss, vertigo and facial paralysis.

Treatment includes care of eye, steroid, antiviral drug and vasodilator.

Q5)Intracranial complication of ear infection

includes meningitis, lateral sinus thrombosis, otitic hydrocephalus, extradural abscess, subdural abscess, brain abscess and cortical thrombophlebitis

the following are true of pleomorphic adenoma of the parotid gland

a) they are characteristically of high signal on T2 b) contain epithelial cells c) usually presents with paralysis in the distribution of the facial nerve d) compose less than 50% of all benign parotid tumours e) commonly affect young adults

1. Superfical parotidectomy is contraindicated in patients with sialectasis because

1.   There is a high risk of fistula formation2.   There is risk of facial palsy3.   There is high risk of dry mouth4.   There is high risk of infection

2. Calcium content of saliva is low in1.   Sublingual salivary gland secretions2.   Accessory salivary gland secretions3.   Submandibular salivary gland secretions4.   Parotid secretions

3. Salivary fistula is commonly originates from1.   Sublingual salivary glands2.   Accessory salivary glands3.   Parotid glands

4.   Submandibular salivary glands4. In submandibular salivary gland surgery, the branch

of facial nerve at risk is1.   Upper zygomatic nerve2.   Buccal nerve3.   Lower zygomatic nerve4.   Marginal mandibular nerve

5. The first salivary gland to develop is1.   Sublingual salivary gland2.   Accessory salivary glands3.   Submandibular salivary gland4.   Parotid gland

6. Adenoid cystic carcinoma is known to commonly involve

1.   Parotid gland2.   Sublingual salivary gland3.   Submandibular salivary gland4.   Minor salivary glands

7. Oncocytoma almost exclusively occurs in1.   Accessory salivary gland2.   Submandibular salivary gland3.   Parotid salivary gland4.   Sublingual salivary gland

8. Parotid duct is known as1.   Stylle's duct2.   Finely's duct3.   Stenson's duct4.   Wharton's duct

9. In Bulimia parotid glands are1.   Shrunken in size2.   Nodular3.   Enlarged4.   Cystic in nature

10. During sleep salivary secretion is maintained by

1.   Sublingual gland only2.   Submandibular gland only3.   Parotid gland only4.   Submandibular and sublingual salivary glands

11. In superficial parotidectomy1.   The whole of superfical lobe and part of deep

lobe of the gland is removed2.   The deep lobe is removed completely3.   Only a part of superfical lobe is removed4.   The superfical lobe is removed completely

12. Benign tumors of superfical lobe of parotid gland takes a very long time to project outwards because

1.   The external surface of the parotid gland is covered by tough parotid fascia

2.   Slow rate of tumor growth3.   The styloid process stops the progression of

tumor4.   Ramus of the mandible stops tumor

progression13. Technitium pertechnetate scans are useful in

the diagnosis of1.   Monomorphic adenoma2.   Sialadinitis3.   Pleomorphic adenoma4.   Warthin's tumor

14. Submandibular salivary gland swelling is differentiated from submandibular lymphadenitis clinically by

1.   Movement during swallowing2.   Bidigital palpation

3.   Presence of transillumination in submandibular salivary gland

4.   Palpation from behind the patient15. The antibiotic that is actively secreted in the

saliva is1.   Cefixime2.   Ampicillin3.   Clindamycin4.   Streptomycin

16. Sublingual salivary gland is situated1.   Above the mylohyoid2.   Posterior to the mylohyoid muscle3.   Below the mylohyoid muscle4.   Under the palatopharyngeous muscle

17. The parotid has constant relationship with1.   Lower zygomatic nerve2.   Upper zygomatic nerve3.   Marginal mandibular nerve4.   Buccal branch of facial nerve

18. During sleep the parotid gland is known to secrete about

1.   100% of basal salivary secretion2.   Parotid secretion ceases during sleep3.   50% of basal salivary secretion4.   75% of basal salivary secretion

19. Acini of parotid glands are formed by1.   Mucinous cells2.   Seromucinous cells3.   Serous cells4.   Cloudy cells

20. Food stimulates secretion of1.   Submandibular salivary gland2.   Accessory salivary glands

3.   Parotid gland4.   Sublingual salivary gland

21. Submandibular salivary gland is separated into superficial and deep portions by

1.   Buccinator muscle2.   Sternomastoid muscle3.   Mylohyoid muscle4.   Digastric muscle

22. Perineural invasion is common in1.   Pleomorphic adenoma2.   Acinous cell carcinoma3.   Adenoid cystic carcinoma4.   Mucoepidermoid carcinoma

23. Sialadenosis commonly involves1.   Sublingual gland2.   Accessory salivary gland3.   Parotid gland4.   Submandibular gland

24. Parotid calculi are diagnosed by1.   Plain radiograph of parotid gland2.   Xray skull lateral view3.   CT scan4.   Plain radiograph occlusal view

25. In patients with diabetes mellitus the parotid gland is

1.   Fibrosed2.   Enlarged3.   Shrunken4.   Cystic in nature

26. Parotid gland swellings are very painful because

1.   The parotid glands suppurate easily

2.   There is no outer layer of fascia covering the parotid gland

3.   The parotid gland is closely related to the external auditory canal

4.   The outer layer (parotid fascia) is inelastic and firm

27. Parotid gland secretions constitute about1.   100% of salivary secretion2.   3/4 th of salivary secretion3.   1/5 th of salivary secretion4.   90% of salivary secretion

28. Sialolithiasis is common in1.   Parotid gland2.   Submandibular salivary gland3.   Sublingual salivary gland4.   Accessory salivary gland

29. The parotid gland is divided into superficial and deep portions by

1.   Cartilagenous portion of external auditory canal

2.   Facial nerve branches3.   Mandible4.   Internal maxillary artery

30. In parotid surgeries the most reliable way of identifying the facial nerve is

1.   By using the tragal pointer2.   By tracing it from the mastoid cavity3.   Searching at the tympanomastoid sulcus4.   By removing the styloid process

31. Tumors arising from deep lobe of parotid gland extending across the parapharyngeal space is covered on their anterior aspect by

1.   Stretched out fibers of medial pterygoid muscle

2.   Stretched out fibers of superior constrictor muscles

3.   Stretched out fibers of lateral pterygoid muscle

4.   Stretched out fibers of middle constrictor muscle

32. Parotid gland is a 1.   Serous salivary gland2.   Protenaceous salivary gland3.   Mucinous salivary gland4.   Mucoserous salivary gland

33. All major salivary glands arise from1.   Ectoderm2.   All three embryonal tissue3.   Mesoderm4.   Endoderm

34. Multiple cystic lesions inside both the parotid glands in a patient should alert the clinician for a possible diagnosis of

1.   HIV infection2.   Measles infection3.   Mumps4.   Malignancy

35. Anesthesia over parotid gland area is caused by injury to

1.   Buccal nerve2.   Marginal mandibular nerve3.   Orbital nerve4.   Greater auricular nerve

36. Daily average volume of saliva produced in a human being is

1.   1 - 1.5 litres2.   8 - 10 litres3.   3 - 4 litres4.   3 - 5 litres

37. Carbohydrate-protein substances corresponding to the blood group antigens are not secreted by

1.   Submandibular salivary glands2.   Sublingual salivary glands3.   Accessory salivary glands4.   Parotid glands

38. Chemical stimulation maximises the secretion of

1.   Sublingual gland2.   Accessory salivary gland3.   Parotid gland4.   Submandibular gland

39. Warthin's tumor is commonly seen in1.   Sublingual salivary gland2.   Parotid gland3.   Submandibular salivary gland4.   Accessory salivary gland

40. Warthin's tumor is known to develop from 1.   Myoepithelial cells2.   Lymphoid tissue within parotid gland3.   Acinar cells4.   Basal cells

A 54-year-old male smoker notices a slowly enlarging mass over the past 2 years within his right parotid gland. At the time of surgical excision, the mass measures 2.8 cm in diameter and is focally cystic. Microscopic examination reveals a tumor composed of benign

papillary oncocytic epithelial fronds supported by benign lymphoid stroma. Which of the following is the most likely diagnosis?

A) acute suppurative sialoadenitisB) adenoid cystic carcinomaC) mucoepidermoid carcinomaD) pleomorphic adenomaE) Warthin tumor (adenolymphoma)

most common ectopic location for salivary gland? a.palate b.over hyoid c.tongue d.pyriform fossa

Which of the following salivary gland tumors shows perineural spread

A.Warthin's tumor B.adenoid cystic carcinoma C.carcinoma in pleomorphic adenoma D.mucoepidermoid carcinoma