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Baileys General Otolaryngology

Total questions: 51

Worksheet time: 51mins

Name
Class
Date
1.

Which stimuli use ion channels for taste transduction?

a)

Sweet

b)

Sour

c)

Salty

d)

Bitter

e)

sour and salty

2.

Which of the following symptoms of chronic rhinosinusitis would be least improved

by endoscopic sinus surgery?

a)

Postnasal discharge

b)

Facial pain

c)

Hyposmia

d)

Nasal congestion

3.

A 44-year-old woman with diabetes presents with a 2-day history of painful swelling of

the submandibular gland. Her symptoms are exacerbated by eating. Purulence is expressible

from Wharton duct. A Cf scan demonstrates enlargement of the submandibular

gland with surrounding fat stranding, and a 3-mm intraductal sialolith is present. Her

blood glucose is 320 mgfdL. The next appropriate step in management would be:

a)

Sialendoscopy and removal of the obstructing sialolith

b)

Admission to the hospital, intravenous antibiotics, and tight blood glucose control

c)

Oral antistaphylococcal antibiotics, sialagogues, and gland massage

d)

Transoral removal of the sialolith

4.

The Agency for Healthcare Research and Quality (AHRQ) offers a number of health

care effectiveness resources for clinicians. Which of the following is one among them?

a)

Health-related quality-of-life instruments

b)

Technology assessments

c)

Meta-analysis tutorials

d)

Links to patient interest group sites

5.

A 45-year-old woman presents to the emergency room with a 2-day history of progressive

swelling of the floor of mouth, firm induration of the submandibular region,

trismus, and dyspnea. Which of the following is the most appropriate next step in

management?

a)

Awake tracheotomy

b)

Conventional endotracheal intubation

c)

Close observation and monitoring in the intensive care unit

d)

Thoracic surgery consultation

6.

Which of the following is the most common etiology of acute pharyngitis in children

and adults?

a)

Bacterial

b)

Viral

c)

Fungal

d)

Inflammatory

e)

Autoimmune

7.

Which is the most robust taste sensation?

a)

Sweet

b)

Salty

c)

Sour

d)

Bitter

8.

Severe complications of Kawasaki disease include:

a)

Acute renal failure

b)

Coronary artery aneurysm

c)

Pulmonary hemorrhage

d)

Ascending neuropathy

e)

Hepatic dysfunction

9.

A 7-year-old boy presents with a 5-week history of a parotid mass. The boy was

evaluated by his pediatrician and completed a 14-day course of amoxicillin without

improvement. There is a 2-cm fluctuant mass with a violaceous hue to the closely adherent

overlying skin. Fine-needle aspiration (FNA) demonstrated acid-fast bacilli in

the aspirate. Resolution of the patient's disease would be most effectively achieved by:

a)

Incision and drainage of the abscess and culture

b)

Incision and drainage of the abscess and clarithromycin

c)

FNA, culture, and clarithromycin

d)

Superficial parotidectomy

10.

A 3-year-old boy presents with an abscess of the retropharyngeal space. What is the

most likely etiology for this infectious process?

a)

Sialadenitis

b)

Upper respiratory tract infection

c)

Tooth decay

d)

Surgical instrumentation trauma

11.

Which of the following is the most consistent landmark for the localization of the

facial nerve?

a)

1 cm lateral and inferior to the tragal pointer

b)

6 mm to 8 mm deep to the tympanomastoid suture

c)

Anterolateral aspect of the styloid process

d)

Lateral to the posterior belly of the digastric muscle

12.

Which of the following statements is true regarding treatment of disorders of the

temporomandibular j oint (TMJ) ?

a)

Clinical evidence supports the use of open surgical intervention over arthroscopy for

intracapsular disorders of TMJ .

b)

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce discomfort

from myofascial pain, symptomatic intracapsular disorders, and otalgia associated

with temporomandibular disorder (TMD ) .

c)

Restorative dental procedures prevent worsening ofTMD i n the presence o f mild TMD .

d)

Comminuted, laterally displaced segments i n fractures o f the mandibular condyle

should be treated nonoperatively.

13.

A 2 7 -year-old otherwise healthy man is admitted to the hospital for a fever of unknown

origin. The next morning he presents with a right-sided jugular vein thrombosis,

ptosis, anhidrosis, and miosis. The infection is most likely located in which deep neck

space?

a)

Prestyloid parapharyngeal space

b)

Poststyloid parapharyngeal space

c)

Retropharyngeal space

d)

Anterior visceral space

14.

Which of the following organisms are common sources of infection in acute bacterial

sialadenitis?

a)

Gram positive cocci

b)

Aerobic gram-negative rods

c)

Anaerobic gram-negative rods

d)

All of the above

15.

An 81-year-old woman presents on postoperative day 6 following a hemicolectomy

with swelling and severe tenderness over the right preauricular region, purulent fluid

from Stensen duct, and no trismus. In addition to hydration, antimicrobials targeting

which organism should be administered?

a)

Klebsiella pneumoniae

b)

Streptococcus viridians

c)

Streptococcus pyogenes

d)

Staphylococcus aureus

16.

Sensory innervation of the temporomandibular j oint is from:

a)

Facial nerve

b)

Auriculotemporal, deep temporal, and masseteric nerves

c)

Great auricular nerve

d)

Superficial temporal nerve

17.

A 25-year-old woman is diagnosed with Crohn disease. Which characteristic oral manifestation

of Crohn disease might you expect to see in this patient?

a)

Strawberry gingivitis

b)

Ulcers that heal with scarring

c)

Fissuring of the tongue

d)

Buccal mucosal cobblestoning

18.

Odontogenic infections are more prevalent in which demographic?

a)

Children

b)

Elderly men

c)

Middle age men

d)

Elderly women

19.

Which of the following medications has demonstrated efficacy in preventing

chemoradiation-related mucositis?

a)

Topical triamcinolone

b)

Palifermin

c)

Hydroxyurea

d)

Second-generation cephalosporins

20.

Which of the following odontogenic space infections do not commonly have trismus

at presentation?

a)

Buccal space infection

b)

Masseteric space infection

c)

Temporal space infection

d)

Pterygoid space infection

21.

Where are taste buds located?

a)

Fungiform papillae

b)

Filiform papillae

c)

Foliate papillae

d)

Circumvallate papillae

e)

Fungiform papillae, Foliate papillae dan Circumvallate papillae

22.

Which of the following statements is true regarding pemphigus vulgaris ( PV) ?

a)

Direct immunofluorescence shows linear deposition of IgG and C3 along the basement

membrane.

b)

Oral involvement is rare in PV.

c)

The pathogenesis of PV is loss of cell-to-cell adhesion due to damaged desmosomal

proteins.

d)

PV has not been associated with other autoimmune disorders.

23.

Which of the following properties allow saliva to act as a good lubricant and biofilm

barrier?

a)

High solubility

b)

Low viscosity

c)

High elasticity

d)

Weak adhesiveness

24.

Which of the following glands produce the majority of the unstimulated saliva?

a)

Parotid glands

b)

Minor salivary glands

c)

Sublingual glands

d)

Submandibular glands

25.

Which of the following attributes of a health-related quality-of-life instrument would

be particularly important in planning a study to evaluate the effect of an intervention?

a)

Construct validity

b)

Interobserver reliability

c)

Face validity

d)

Responsiveness

26.

Which of the following is important in the evaluation of burning mouth syndrome?

a)

Punch biopsy of the tongue

b)

Patch testing of oral mucosa

c)

Trial of a-lipoic acid

d)

Serum ferritin and B vitamin levels

27.

Based on the multicellular theory of tumorigenesis, mucoepidermoid carcinoma

arises from:

a)

Excretory duct cells

b)

Striated duct cells

c)

Acinar cells

d)

Intercalated duct cells

28.

Appropriate management of an 18-year-old patient with infectious mononucleosis

with a positive monospot test includes:

A.

a)

A single dose of intramuscular ceftriaxone

b)

Oral penicillin

c)

Intravenous penicillin

d)

Oral acyclovir

e)

Rest, hydration, antipyretics, and analgesics

29.

How many cell types are there in a taste bud?

a)

Five

b)

One

c)

Three

d)

More than 1 0

30.

Which of the following antibiotics represents the most appropriate empiric treatment

of an odontogenic infection?

a)

Amikacin

b)

Clindamycin

c)

Erythromycin

d)

Doxycycline

31.

Temporomandibular disorders (TMDs) are associated with:

a)

Depression

b)

Irritable bowel

c)

Fibromyalgia

d)

All o f the above

32.

Tasters and nontasters are identified based on the individual's ability to perceive:

a)

Capsaicin

b)

Alcohol

c)

Sucrose

d)

6-n-Propyl-thiouracil (PROP)

33.

Which of the following statements regarding juvenile recurrent parotitis is false?

a)

The disease typically resolves by the end of adolescence.

b)

Treatment during acute parotitis episodes is similar to acute bacterial sialadenitis.

c)

Ligation of Stenson duct and tympanic neurectomy have been shown to be effective

treatment options.

d)

Sialendoscopy with dilation, saline irrigation, or steroid irrigation has been shown to

improve symptoms.

34.

Which cells are responsible for producing the primary salivary secretion?

a)

Myoepithelial cells

b)

Ductal cells

c)

Acinar cells

d)

Basal cells

35.

Which of the following statements best describes concurring occlusal appliance

(splint) therapy?

a)

The type of appliance is of critical importance.

b)

Use of the device repositions the displaced articular disc over time.

c)

This therapy is effective for temporomandibular j oints (TMJs) -related myofacial pain.

d)

This therapy slows the progression of arthritis in the TMJ.

36.

Which structure directly contributes to the borders of the retropharyngeal space?

a)

Pharyngobasilar fascia

b)

Pharyngeal constrictor musculature

c)

Buccopharyngeal fascia

d)

Prevertebral fascia

37.

Which muscle attachment helps predict the spread of odontogenic infections into the

submandibular space?

a)

Anterior digastric muscle

b)

Genioglossus muscle

c)

Mylohyoid muscle

d)

Stylohyoid muscle

38.

Which of these salivary glands are most sensitive to injury from radiation treatment?

a)

Submandibular glands

b)

Parotid glands

c)

Sublingual glands

d)

Minor salivary glands

39.

According to the World Health Organization's International Classification of Functioning,

Disability, and Health (ICF) definitions, tinnitus would be classified as a(n) :

a)

Disorder

b)

Handicap

c)

Disability

d)

Impairment

40.

Generic health-related quality-of-life instruments are usually divided for measurement

into three core domains. They are:

a)

Physical, social, and psychological

b)

Physical, emotional, and self-help

c)

Physical, role functioning, and mood

d)

Physical, interpersonal interactions, and vocational

41.

Odontogenic infections are most likely to arise from:

a)

Maxillary central incisor

b)

Mandibular lateral incisor

c)

Maxillary first molar

d)

Mandibular second molar

42.

Which of the following disorders can be confused with oral mucosa drug eruptions,

contact allergies, and lupus?

a)

Lichen planus

b)

Behcet disease

c)

Recurrent aphthous stomatitis

d)

Orofacial granulomatosis

43.

Which of the following statements is not true regarding temporomandibular disorder

(TMD) pathology?

a)

Studies have shown abnormal pain processing in patients with chronic myofascial

pain.

b)

Cytokines, metalloproteinases, free radicals, and reperfusion inj ury likely all contribute

to intracapsular pathology and symptoms in TMD .

c)

The disc o f the temporomandibular j oint has a central, abundantly neurovascular

zone which contributes to pain when it is damaged.

d)

Disc displacement in intracapsular disorders moves the disc anteriorly, and may be

followed by reduction and accompanied by j oint noise, or may be nonreducing and

have an absence of j oint noise.

44.

After a positive rapid antibody detection test (RADT) for group A 􀃨-hemolytic streptococcus

(GABHS) in a 4-year-old patient, which of the following is the next appropriate

step in management?

a)

Confirmation with GABHS culture on blood agar

b)

Symptomatic therapy

c)

Treatment with amoxicillin

d)

Treatment with azithromycin

e)

Treatment with acetaminophen

45.

In a patient with suspected acute retroviral syndrome pharyngitis, initial diagnostic

testing for human immunodeficiency virus (HIV) is performed by:

a)

Western blot

b)

Southern blot

c)

Culture on chocolate agar

d)

Enzyme-linked immunosorbent assay (ELISA)

e)

Monospot test

46.

A 34-year-old man with drooling and fever. What is the most likely source for the

abscess seen on this CT?

a)

Hematologic

b)

Palatine tonsils

c)

Odontogenic

d)

Suppurative node

e)

Osteomyelitis

47.

A 19-year-old girl with deep space neck infection. What is the most likely complication

that should be sought through further imaging?

a)

Retropharyngeal abscess

b)

Danger space extension to the mediastinum

c)

Osteomyelitis

d)

Intracranial infection

e)

Lung abscess

48.

A 29-year-old with neck swelling. The key finding on this CT is:

a)

Submandibular sialadenitis

b)

Sublingual sialadenitis

c)

Sialolithiasis

d)

Cellulitis

e)

All of the above

49.

68-year-old woman with headaches and facial pain. What is the most likely cause?

a)

Sinusitis

b)

Paget disease

c)

Cervical spondylopathy

d)

Cerebrospinal fluid leak

e)

Temporomandibular osteoarthropathy

50.

A 38-year-old woman with sinus pain. What is the most likely source of maxillary

sinusitis?

a)

Odontogenic

b)

Isolated nasal polyp

c)

Nasal polyposis

d)

Cystic fibrosis

e)

Nasal cavity malignancy

51.

A healthy, nonsmoking 48-year-old man with painless neck mass. What is the most

likely diagnosis?

a)

Branchial cleft cyst

b)

Thyroglossal duct remnant

c)

Mycobacterial infection

d)

Bacterial abscess

e)

Squamous cell carcinoma (SCC)