SELF-ASSESSMENT

BY DR. MOHAMMED ATIAA KAREEM

ALNASHY
 BY DR. MOHAMMED ATIAA KAREEM ALNASHY
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BY DR. MOHAMMED ATIAA KAREEM

ALNASHY

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1. In the evaluation of patients with maxillary sinus carcinoma, Ohngren's line can
be drawn between
A. The lateral and medial vault of the maxillary sinus
B. The angle of the mandible and the medial canthus
C. The infraorbital foramen and the nasal spine
D. The maxillary tuberosity and the condyle of the mandible
E. The inferior turbinate and the lateral canthus

2. In patients with a cleft palate secondary to the Pierre Robin sequence, the palatal
repair should be performed
A. Immediately following birth
B. At the same time as the tracheotomy
C. When the airway problem has finally resolved due to mandibular growth
D. At age 6
E. At any age

3. Of the following which does not constitute a common finding of transverse

temporal bone fracture?
A. Anacusis
B. Debilitating vertigo
C. Facial paralysis
D. Involvement of foramen spinosum
E. Fracture of the stylomastoid foramen

4. A 48-year-old man presents with a post-traumatic subglottic stenosis. He has

stridor with exertion. CT scan reveals an approximately 4-cm segment of stenotic
trachea beginning in the immediate subcricoid region. The best treatment for this
patient would be
A. CO, laser excision of the stenotic segment
B. Sequential dilation of the segment
C. Transoral placement of a Montgomery T-tube
D. An indwelling expandable intraluminal stent
E. Tracheal resection

5. A 48-year-old woman presents complaining of tired-looking eyes. On examination,

her lid margins appear to be in the proper position relative to the iris, but excess
lid skin hangs down below the lid margin. This condition is referred to as
A. Pseudoptosis
B. Blepharoptosis
C. Dermatochalasis
D. Blepharochalasis
E. Lid retraction

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6. A common finding in patients with obstructive sleep apnea is

A. Clubbing of the fingers
B. Hypertension
C. Psychosis
D. Narcolepsy
E. Nasal obstruction

7. The most effective class of drugs that can be used to improve the symptoms of
reflux laryngitis is
A. Systemic steroids
B. Topical inhaled steroids
C. Seratonin reuptake inhibitor
D. Calcium channel blockers
E. Proton pump inhibitors

8. Which of the following factors is most commonly associated with postoperative

carotid artery rupture?
A. Previous radiation therapy
B. Patient older than age 70
C. The MacFee incision
D. Smoking
E. Diabetes

9. Most cases of obstructive anosmia can be successfully treated with

A. Steroid administration
B. Septoplasty
C. Phenylpropanolamine
D. Topical chromilyn sodium
E. Cryotherapy

10. The primary predisposing factor that results in stomal recurrence following
laryngectomy is
A. Preoperative emergency tracheotomy
B. Poor histopathologic differentiation of the tumor
C. Advanced laryngeal tumor with subglottic extent
D. Poor nutritional status
E. Bilateral cervical nodal metastasis

11. A typical CT scan finding in a patient with surgical necrotizing fasciitis is

A. Free air is almost always seen within the fascial plains
B. Multiple distinct abscesses are usually seen within the soft tissues of the neck
C. The appearance of fluid collections that conform to the fascial plains of the neck is typical
D. Thrombosis of the internal and/or external jugular veins is almost universal
E. Extension to the prevertebral fascia is almost always present

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12. Surgical excision of a first branchial arch cyst in an infant should be postponed until
the child reaches the age of 2. The reason for this is
A. Because the cyst may degenerate and disappear
B. To allow the cyst to increase in size and thereby facilitate the dissection
C. To facilitate dissection of the facial nerve
D. To allow any associated tracts to involute, and resorb
E. To allow infection to occur prior to recommending surgical removal

13. Which of the following surgical therapies have been used successfully for vasomotor
rhinitis?
A. Endoscopic total sphenoethmoidectomy
B. Ablative surgery to the inferior turbinate
C. Tympanic neurectomy
D. Stellate ganglion block
E. Young's procedure

14. A 29-year-old man presents with evidence of a parapharyngeal space abscess. The
most likely microbiologic flora responsible for the infection is
A. Group A and non-Group A streptococci
B. Anaerobic organisms
C. Gram-negative organisms
D. Polymicrobial flora with both aerobic and anaerobic organisms
E. Staphylococcus aureus

15. All of the following tumors would commonly be included in the differential diagnosis
of facial palsy. except
A. Neuroma
B. Meningioma
C. Adenoma
D. Glomus tumor
E. Clival chordoma

16. The most common benign tumor of the submandibular gland is

A. Monomorphic adenoma
B. Lymphoepithelial cyst
C. Warthin's tumor
D. Schwannoma
E. Pleomorphic adenoma

17. The term Carhart's notch refers to which of the following?

A. The maximal airborne gap demonstrated on-audiogram
B. The narrowest air bone gap demonstrated on audiogram
C. A low-frequency sensorineural trough
D. A shallow sensorineural loss noted at 2,000 Hz
E. The high-frequency sensorineural loss noted on audiogram.

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18. Following a total thyroidectomy, you are called to see a patient complaining of
severe anxiety and paresthesias of the face and hands. During your evaluation she
has a seizure following establishment of an airway and stabilization of this patient,
the next therapeutic modality should be
A. Immediate IV administration of sodium chloride
B. Immediate intramuscular injection magnesium
C. To start oral calcium carbonate supplementation
D. Immediate institution of intravenous calcium gluconate
E. To draw ionized calcium level and base further therapy on this lab test

19. Suppurative labyrinthitis may occur when bacteria invade the otic capsule. Which
of the following symptom complexes reflects invasion of the petrous apex?
A. Severe vertigo with profound sensorineural hearing loss
B. Facial paralysis with sensorineural loss
C. Facial paresthesias with retro-orbital pain
D. Suppurative otorrhea and facial paralysis
E. Retro-orbital pain and sixth nerve palsy

20. Patients with advanced laryngeal carcinoma (stage III or stage IV)
A. Always require surgery as part of their therapeutic regimen.
B. Can be treated in an organ preservation program only if they do not respond to
chemotherapy
C. Are only candidates for organ preservation therapy if they respond favorably to
chemotherapy.
D. Can usually be treated with radiation therapy alone
E. Rarely require concomitant therapy of the neck

21. In an elderly patient with poor hearing and ongoing debilitating vertigo the
treatment would be
A. Cochleosacculotomy
B. Labyrinthectomy
C. Vestibular neurectomy
D. Transtympanic gentamicin
E. Ventilation tube placement

22. Foreign bodies of the aerodigestive tract are associated with the highest mortality
when the site of impaction is the
A. Oropharynx
B. Larynx
C. Trachea
D. Main stem bronchus
E. Esophagus

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23. Elective radical neck dissection should be considered in cases of malignant

melanoma with
A. A thickness of less than 0.75 mm
B. A thickness greater than 4 mm
C. Lesions between 0.75 and 4 mm in thickness
D. Any time the parotid gland is in the lymphatic drainage pathway
E. Any time distant metastases can be excluded

24. Radiotherapy in the treatment of juvenile nasopharyngeal angiofibroma is

generally used
A. Following surgical excision to help prevent recurrence
B. Preoperatively to decrease blood supply
C. When there is extension into the nasal cavity.
D. When there is extension into the ethmoid or maxillary sinus
E. When there is intracranial extension with involvement of vital structures.

25. The most common congenital nasal masses are encephaloceles, gliomas, and
dermoids. An encephalocele may be distinguished from a glioma based on a
positive Furstenberg sign. This sign reflects
A. Venous engorgement
B. Arterial supply from both the internal and external carotid arteries
C. A patent intracranial communication with cerebrospinal fluid
D. Absence of a patent intracranial connection with cerebrospinal fluid
E. Connection to the skull base

26. A 61-year-old male undergoes Moh's excision of a large basal cell carcinoma
involving the right nasal alar margin. The final defect includes 65% of the right
ala along with the lower lateral cartilage; however, the nasal lining remains intact.
The most appropriate method of reconstruction is
A. Allow to heal by secondary intention.
B. A midline forehead flap
C. A free conchal cartilage graft with midline forehead flap
D. A free conchal cartilage graft with midline forehead flap after resecting the remaining
alar skin
E. A full thickness skin graft

27. One of the easiest techniques currently available for identifying suspicious mucosa
in patients with field cancerization is
A. Supravital staining with toluidine blue
B. Identification of fluorescence using a Wood's lamp
C. High-resolution MRI scanning
D. Cytologic evaluation of tissue surface scrapings
E. Contact surface microscopy

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28. A 57-year-old male presents with an enlarging ulcerative lesion involving the floor
of the mouth. Clinical findings that would suggest mandibular invasion include
A. Tenderness to palpation
B. Pain with eating
C. Decreased sensation along the tongue
D. Decreased sensation along the lower lip
E. Palpable submandibular lymph nodes

29. A 28-year-old woman presents with a granulomatous nasal condition. A

microscopic vasculitis with fibrinoid vascular necrosis is identified
histopathologically. Further evaluation of this patient should include
A. Serum angiotensin converting enzyme levels
B. Purified protein derivative (PPD)
C. Nasal culture
D. Antinuclear antibody (ANA)
E. Chest x-ray

30. A 30-year-old woman is diagnosed with ameloblastoma of the mandible. The most
appropriate therapy of this lesion is
A. Simple enucleation or curettage
B. Radiation therapy
C. Curettage followed by radiation therapy
D. Complete excision, including marginal or segmental mandibulectomy if indicated, to
obtain clear margins
E. Complete excision, with radical neck dissection

31. In patients with papillary carcinoma the thyroid with tumors greater than 1.5, the
best therapy is
A. Iodine-131 therapy
B. Total thyroidectomy followed by iodine 131 therapy
C. Hemithyroidectomy followed by close postoperative observation
D. Total thyroidectomy and bilateral anterior neck dissections
E. Total thyroidectomy followed by external beam radiation therapy

32. In an adult who presents with signs and symptoms consistent with acute
epiglottitis the best initial clinical assessment tool is
A. Lateral soft tissue x-ray of the neck
B. Fiberoptic laryngoscopy
C. Blood cultures
D. General anesthesia with direct laryngoscopy and possible tracheotomy
E. IV antibiotics and observation

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33. The gradual onset of biphasic stridor in a previously healthy 6-month-old infants
suggests which of the following diagnoses?
A. Epiglottis
B. Congenital bilateral vocal cord paralysis
C. Foreign body aspiration
D. Subglottic stenosis
E. Croup

34. Patients with Down syndrome are prone to recurrent episodes of croup. This is
because of
A. Recurrent tonsillitis with tonsil hypertrophy
B. Depressed immunity
C. Macroglossia
D. The high incidence of sleep apnea
E. Subglottic narrowing

35. The optimal age for surgical excision of a large congenital cervicofacial
lymphangioma
A. At the time of delivery due to the possibility for airway compromise
B. At approximately 1 week of age before the infant is discharged but otherwise has been
stabilized
C. At several months of age, allowing time to determine whether the airway will be
compromised
D. At several years of age, to allow the child time to grow
E. It should not be resected, because these lesions will always regress

36. Sudden sensorineural hearing loss occurs with what frequency in patients with
acoustic neuroma?
A. 1%
B. 5%
C. 15%
D. 30%
E. 50%

37. The most appropriate first-line treatment for early laryngeal papillomatosis in a
child is
A. CO2 laser excision
B. Tracheostomy
C. Interferon
D. Photodynamic therapy
E. Acyclovir

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38. The classic histologic appearance of a minor salivary gland in a patient with
Sjögren's disease is
A. Charco-Leyden crystals throughout
B. Oncocytic proliferation in the acinar region
C. Multiple areas of cystic degeneration
D. Lymphocytic infiltration with ductal hyperplasia
E. Severe vasculitis

39. The most common cause of subglottic stenosis is

A. Esophageal reflux
B. Wegener's granulomatosis
C. Relapsing polychondritis
D. Endotracheal tube trauma to the airway
E. Scleroma

40. A 51-year-old woman presents with stage I tonsillar squamous cell carcinoma.
Treatment of this lesion can best be provided utilizing
A. Radiation therapy alone
B. Surgical therapy alone
C. The efficacy of both surgical and radiation therapy in this situation is approximately
equal to that of chemotherapy.
D. This patient will require surgical therapy followed by postoperative radiation therapy
E. Surgical or radiation therapy to the primary site followed by elective neck dissection

41. When evaluating a patient with hereditary hemorrhagic telangiectasia (HHT) the
workup should include
A. Upper and lower GI endoscopy
B. Intravenous pyelogram
C. Chest CT scan
D. Serum clotting factors
E. Electrocardiogram

42. Confirmation of cerebrospinal fluid leakage is best made by which laboratory

assessment?
A. Total protein
B. Testing blood glucose
C. B2-transferrin
D. Amylase
E. Enolase

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43. The most common audiologic pattern for children with congenital atresia would show
A. 50 to 60 dB conductive hearing loss with normal nerve function
B. 20 to 30 dB conductive hearing loss with normal nerve function
C. 10 to 20 dB conductive hearing loss with normal nerve function
D. 60 dB air bone gap with a mild to moderate nerve loss
E. 20 to 30 dB conductive hearing loss with moderate to severe nerve component

44. Characteristics of benign intracranial hypertension include the following except:

A. Pulsatile tinnitus
B. Papilledema
C. Increased intracranial pressure
D. Visual field defect
E. Hearing loss

45. Allergic mucin is typically characterized by

A. Eosinophils and Charco-Leyden crystals
B. Periodic Acid-Schiff positive intranuclear inclusions
C. Granulomatous inflammation
D. A thin watery consistency
E. Submucosal fungal invasion

46. Surgical resection of the recurrent laryngeal nerve is no longer recommended for
spasmodic dysphonia because
A. Long-term results are poor despite good short-term improvement
B. There is a high incidence of breathiness following this procedure
C. If the opposite vocal cord becomes spasmodic, stridor will result
D. Both vocal cords are usually involved with spasmodic dysphonia
E. Spasmodic dysphonia is usually multisystem disorder unaffected by treating the larynx
alone

47. In a patient presenting with grade 5 laryngeal trauma

A. Conservative management is appropriate
B. Endotracheal intubation is the preferred technique for airway control
C. Chest tubes should be placed prophylactically on both the right and left sides
D. A nasogastric tube should be carefully passed into the stomach
E. Hoarseness may only be intermittent

48. When a patient presents with cervical necrotizing fascitis, the best way to rule out
mediastinal involvement is
A. A CT scan including the neck and mediastinum
B. Direct surgical exploration of the mediastinum
C. Findings of hypoesthesia and necrosis of the skin of the chest wall
D. Careful auscultation of the chest in the region of the superior mediastinum
E. Mediastinoscopy

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49. An HIV-infected man has white pseudomembranous inflammatory patches

throughout his oral cavity. He is also complaining of severe odynophagia and
retrosternal discomfort. The next step in the evaluation of this should be
A. Esophagoscopy
B. Electrocardiogram
C. Esophageal manometry
D. Pulmonary function testing
E. Place a PPD

50. A common presenting symptom in patients with myasthenia gravis is

A. Vertigo
B. Ptosis and diplopia
C. Aphasia
D. Spasmodic dysphonia
E. Visual field defects

51. Malignant transformation of long standing recurrent pleomorphic adenoma more

commonly occurs
A. lf the recurrence is a single nodule of…..
B. If the recurrence is multiple small nodules
C. When the recurrence is in the deep lobe of the parotid
D. When the previous surgery was simple lumpectomy
E. In patients with diabetes

52. A child awakens from a chronic ear procedure (tympanomastoidectomy) with

unilateral facial paralysis. The surgeon should
A. Assure the patients that the nerve will recover
B. Start the patient on antibiotics
C. Institute steroids and release packing the and dressing
D. Immediately take the patient to the operating room
E. Prepare the patient for a VII/XE anastomosis

53. A patient sustains severe frontal trauma during a motor vehicle accident. The
cervical. spine is cleared with a single lateral neck x ray. Some injuries of the
cervical spine will be missed from this single view because
A. Such patients are usually poorly cooperative, making for an inadequate standing
B. It is difficult to position patients properly for these views
C. The upper cervical vertebrae are not well visualized on this film
D. The lower cervical vertebrae are not well visualized on this film
E. Such films are difficult to interpret because of soft tissue injury

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54. Up to 67% of patients with naso-orbito-ethmoid fractures have associated ocular

trauma. The incidence of blindness is
A. 2%
B. 3%
C. 4%
D. 5%
E. More than 5%

55. A 30-year-old male victim of a house fire presents to the Emergency room. He is
alert and communicative, and no external burns of the skin are visible. His lips
are erythematous with carbonatious discoloration around the mouth. No stridor
is audible; however, the patient is slightly tachypneic, and O2 saturation is 96%.
The most appropriate treatment would be
A. Place some antibiotic ointment around the lips and discharge the patient to be followed
up the next day as an outpatient
B. Administer 100% humidified oxygen and observe the patient for 4 to 6 hours
C. Administer 100% humidified oxygen and admit the patient to the intensive care unit
overnight for observation
D. Place a central line for monitoring cardiovascular status and a Foley catheter for
monitoring fluids, and admit the patient to the intensive care unit
E. Perform a tracheotomy

56. The following physical finding is suggestive of a naso-orbito ethmoid fracture:

A. An intracanthal distance equal to half the interpupillary distance
B. Bilateral periorbital ecchymoses
C. Proptosis
D. Pig-nose deformity
E. Epistaxis

57. A blepharoplasty patient presents with postoperative orbital hemorrhage and

secondary hematoma. The goal of therapy is to
A. Stop the bleeding
B. Decrease intraglobe pressure
C. Expand intraorbital volume
D. Maintain intraorbital volume
E. Decrease intraorbital volume

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58. Nine months following a total laryngectomy to remove a squamous cell carcinoma,
a patient presents with a recurrence at the superior aspect of his stoma. CT scan
reveal no evidence of extension to the esophagus or superior mediastinum. The
chances of successful surgical management of this lesion are
A. Less than 5%
B. 20 to 30 %
C. Greater than 80%
D. Dependent on the histopathologic grading of the tumor
E. Dependent on the: patient's pulmonary function tests

59. A 56-year-old man presents with a maxillary sinus carcinoma confined primarily
to the. medial wall of the maxillary sinus. It extends into the bony alveolar ridge
but does not extend up to the orbital floor. The best surgical therapeutic modality
to manage this lesion might be
A. An infrastructure maxillectomy
B. Radical maxillectomy
C. A superstructure maxillectomy
D. A medial maxillectomy
E. A total maxillectomy with orbital exoneration

60. A 37-year-old man presents with a unilateral nasal mass, which on biopsy is
diagnosed as esthesioneuroblastoma. The lesion appears to penetrate the skull
base to the dura but it does not penetrate the dura. The best therapy for this
patient is.
A. Chemotherapy and palliative radiation therapy
B. Radiation therapy followed by surgery for salvage
C. Craniofacial resection followed by radiation therapy
D. Intranasal debulking followed by radiation therapy
E. Radiation using interstitial implants

61. The highest mortality and functional morbidity associated with basal cell
carcinoma occurs in
A. The postauricular region
B. The nasal vestibule
C. The lower lip
D. The nasal tip
E. The medial canthus

62. The treatment for Wegener's granulomatosis includes all of the following except
A. Radiation therapy
B. Cyclophosphamide
C. Corticosteroids
D. Trimethoprim-sulfamethoxazole
E. Frequent debridement of crusts in the nasal cavity

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63. In patients with facial nerve paralysis electroneuronographic degeneration

greater than which percentile portends a potentially poor prognosis?
A. 25%
B. 50%
C. 75%
D. 1280%:
E. 95%

64. Which of the following statements best defines cholesteatoma?

A. Cholesteatoma is the presence of keratinizing squamous epithelium found to be
invading the spaces of the temporal bone
B. Cholesteatoma is a skin cyst that forms at the site of PE tube placement
C. Cholesteatoma is a benign neoplasm commonly found in the temporal bone
D. Cholesteatoma is a cyst containing globules of fat formed in the temporal bone at the
previous site of mastoid inflammation
E. Cholesteatoma is a premalignant skin condition found in chronic otitis media

65. A 60-year-old man has undergone full course radiation therapy for a tonsillar
carcinoma. He is now complaining of dry mouth, burning tongue, and loss of taste.
Examination of his oral cavity reveals generalized erythema of the tongue. It has
a bald smooth appearance secondary to depapillation. The best treatment for this
patient's problem is
A. Chlorhexidine gluconate
B. Pilocarpine
C. Clotrimazole oral lozenges
D. Topical steroid solution
E. Dental fluoride applications

66. The most important diagnostic test that should be performed in patients suspected
to having postradiation chondronecrosis of the larynx is
A. A barium swallow
B. CT or MRI scan of the larynx
C. Chest x-ray
D. Pulmonary function tests
E. A laryngeal biopsy

67. A 55-year-old woman is evaluated for possible blepharoplasty. She is determined to

have senile ptosis of the upper lid. The best therapeutic treatment for this would be
A. Upper lid blepharoplasty
B. Upper and lower lid blepharoplasty
C. Tightening of the apeurosis of the levator of the upper lid
D. A brow lift
E. Brow lift combined with upper lid blepharoplasty

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68. A common physical finding in patients with laryngitis secondary to esophageal

reflux
A. Pooling of secretions in the pyriform sinus
B. Early penetration and aspiration ingested liquids
C. Erythema and edema of the arytenoid mucosa and occasional granulomas in the same
region
D. Leukoplakia of the anterior commissure
E. Laryngomalacia of the epiglottis

69. A pleomorphic adenoma of the parapharyngeal space has been diagnosed using
imaging and fine-needle aspiration biopsy. It is determined that this tumor is
probably of extra parotid origin. Treatment should include
A. Total parotidectomy and facial nerve resection
B. Mandibular osteotomy for complete exposure
C. Preoperative angiography and embolization
D. Simple blunt dissection and removal through an external approach without
parotidectomy
E. Partial pharyngectomy and intraoral tumor removal

70. The best time to perform an otoplasty for protruding ears is

A. Within the first 6 months of life
B. At age5 or 6 prior to entering school
C. During the late, teens following: the growth spurt
D. When the child is old enough to decide if he or she wants to have the surgery
E. There is no ideal time for performing this surgery

71. Diagnosis of the perilymph fistula can be best made with

A. Hennebert's test
B. Tullio's test
C. Brown's test
D. Exploratory tympanotomy
E. Metrizomide CT scan.

72. A 19-year-old woman presents with a temperature of 102°F. She has swelling at
the angle of the jaw, swelling in the left peritonsillar region, and complains of
trismus. In addition, she is noted to have Horner’s syndrome. The most likely site
of infection is
A. A peritonsillar abscess.
B. An anterior compartment, lateral pharyngeal space abscess.
C. A posterior compartment, lateral pharyngeal space abscess
D. A septic thrombosis of the internal jugular vein
E. A retropharyngeal space abscess

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73. Speckled leukoplakia

A. Has the same incidence of malignant transformation as does erythroplakia
B. Has the same incidence of malignant transformation as does leukoplakia
C. Is more likely to become malignant than plain leukoplakia
D. Is caused by a viral infection and has no malignant transformation potential
E. Is another name for carcinoma in situ

74. Which of the following statements is false?

A. Of all children with sensorineural hearing loss, 75% have loss due to non-congenital
causes, while 25% are due to congenital causes
B. Half of all congenital hearing impairment is due to nonhereditary causes
C. Fewer than 50 syndromes have actually been associated with hearing impairment
D. Eighty percent of genetic hearing loss is due to autosomal recessive transmission
E. Five percent of hearing loss is due to X-linked chromosomal disorders

75. A 68-year-old woman complains of nasal obstruction. She has undergone previous
rhinoplasty and has a pinched overly rotated tip and a scooped-out dorsum. In
repairing this defect, which of the following implant materials would not be
suitable?
A. Rib cartilage
B. Auricular cartilage
C. Septal bone and cartilage
D. Polytetrafluorethylene
E. An implant material should never be used in this situation

76. Meniere's syndrome has been associated with all of the following except
A. Otosyphilis
B. Acoustic neuroma
C. Autoimmune disease
D. Viral labyrinthitis
E. Gardner's syndrome

77. When a patient presents with an acute postoperative carotid artery rupture
following head and neck cancer surgery, the most common site of injury is the
A. External carotid artery
B. Internal carotid artery
C. Common carotid artery
D. Carotid bulb
E. All sites are equally likely to rupture

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78. The classic audiometric findings in cupulolithiasis would be

A. A high-frequency sensorineural hearing loss
B. A low-frequency sensorineural hearing loss
C. A flat sensorineural hearing loss at 40 dB
D. Mixed hearing loss
E. Normal hearing

79. The primary limitation of a contrast cysternogram for localizing the site of a
cerebrospinal fluid leak is
A. A high percentage of patients are allergic to the contrast material
B. Most patients develop aseptic meningitis following this study
C. The leak must be very brisk during the procedure for this technique to be useful
D. Surgery must be delayed for up to 2 weeks following this diagnostic test
E. A lumbar drain is often needed to relieve the severe headache that can accompany this
test

80. A radiographic finding indicating possible subluxation of the stapes would include
A. Soft tissue in the mastoid
B. A fracture in the epitympanum
C. Pars flaccida retraction with scutal erosion
D. Pneumolabyrinth
E. Extended IAC

81. Following the excision of a medial canthal. basal cell carcinoma with clear
margins, it is elected to perform a full-thickness skin graft to this area. The best
donor site for full-thickness skin to be placed in this anatomic region is
A. The inner thigh
B. Lower back
C. Supraclavicular region
D. Upper eye lid
E. Dorsum of the foot

82. Chronic sinusitis is a common problem in patients with cystic fibrosis. The
incidence of nasal polyps in this population is i
A. 0%
B. 25%
C. 50%
D. 75%
E. 100%

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83. Hearing should be assessed in patients with Pierre Robin sequence because
A. This syndrome is often associated with middle ear ossicular deformities
B. Recurrent middle ear effusions are common
C. This condition is often associated with a Mondini deformity
D. Speech therapy will almost always be necessary
E. The sensorineural hearing loss associated with this syndrome is often progressive

84. A 25-year-old male is diagnosed with cervical tuberculosis. He has an

approximately 3 cm mass in the right neck from which a fine needle aspiration
biopsy was positive for tuberculosis. The primary treatment of this disease is
A. Medical therapy with multiple antituberculosis drugs.
B. Surgical therapy consisting of the removal of the involved lymph node
C. Surgical therapy combined with antituberculosis antibiotic therapy
D. Curettage of the lymph node followed by antituberculosis chemotherapy
E. Combination of rifampin and alpha interferon

85. For a patient with vocal cord paralysis the procedure that provides the best
rotation of the vocal process of the arytenoid and therefore the glottic closure is
the
A. Teflon injection
B. Thyroplasty type I
C. Arytenoid adduction procedure
D. Collagen or gelfoam injection
E. Vocal cord reinnervation procedure

86. The most definitive test for establishing the identification of a foreign body in the
upper aerodigestive tract is
A. PA and lateral neck x-ray
B. PA and lateral chest x-ray
C. Lateral decubitus x-ray
D. Fluoroscopy
E. Direct endoscopy

87. Which of the following drugs should not be used in a patient with chronic
sinusitis?
A. Systemic steroids
B. Guaifenesin
C. Phenylpropanolamine
D. Loratadine
E. Chlorpheniramine

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88. A 2-cm parotid mass is found during examination of a 29-year-old HIV-infected

man. Fine-needle aspiration reveals straw-colored cystic fluid The best
management of this parotid lesion is
A. Antituberculosis antibiotics
B. Superficial parotidectomy
C. Surgical enucleation of the mass
D. Radiation therapy
E. Repeated needle aspirations as needed

89. When performing a biopsy of a skin lesion, the following method should be
avoided due to its failure to demonstrate tumor thickness
A. Excisional biopsy
B. Punch biopsy
C. Incisional biopsy
D. Shave biopsy
E. Skin lesions should not undergo a preliminary biopsy

90. If a lumpectomy is performed for a parotid pleomorphic adenoma, the incidence

of recurrence is increased. The reason for this high incidence of recurrence is felt
to be
A. Tumor spillage during the initial procedure
B. Inadequate resection by enucleation
C. Multicentric pleomorphic adenoma unrecognized at the time of initial surgery
D. A genetic predisposition to forming multiple humors
E. Tumorigenic factors released during the surgical procedure

91. The Anti-SS-A. and Anti-SS-B tests are often useful in making the diagnosis of
Sjögren's syndrome. These tests measure:
A. Serum levels of Sjögren’s factors
B. Circulating serum antibodies to specific nuclear antigens
C. The functional status of major and minor salivary glands
D. The functional status of circulating C-8 lymphocytes
E. The titre of circulating anti acinar cell antibodies

92. Cervical nodal metastasis in patients with tonsillar carcinoma are often
A. Primarily in the posterior cervical region
B. Cystic in appearance on CT or MRI
C. Difficult to palpate on physical examination
D. Extending into the parotid lymph chain
E. Difficult to remove surgically because of the sclerosis and fibrosis that is often
associated with these lymph nodes

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93. When healing does not occur in a postoperative fistula following major resection
for head and neck squamous cell carcinoma, the first concern should be
A. Nutritional depletion
B. Persistent cancer
C. Electrolyte imbalance
D. Persistent infection
E. Poorly vascularized tissues

94. The Mustarde technique for repairing protruding ears consists of

A. Decreasing the cupping and displacement of the pinna by placing chondral mastoid sutures
B. Recreating the antihelix by incorporating permanent scapha chondral and scapha fossa
triangularis horizontal sutures
C. Recreating the antihelix by incising the cartilage and placing buried mattress sutures
D. Making parallel cartilage incisions to weaken the cartilage
E. Scoring the anterior aspect of the auricular cartilage to create posterior bending

95. The Hertel exophthalmometer measures

A. Enophthalmos
B. Hypophthalmos
C. Entrapment
D. Proptosis
E. Intraocular pressure

96. The most likely diagnosis in a 4-year-old child with persistent hoarseness is
A. Laryngitis
B. Vocal cord nodule
C. Vocal cord papillomas
D. Vocal cord paralysis
E. Gastroesophageal reflux

97. The halo or ring sign seen on CT scan in a patient with otosclerosis is indicative of
A. Congenital otosclerosis
B. Paget's disease
C. Associated meningitis
D. Cochlear otosclerosis
E. Neural otosclerosis

98. Indications for open exploration of a laryngeal fracture include which of

the following?
A. Subcutaneous emphysema
B. Ecchymosis of the anterior neck
C. Hoarseness
D. Displaced laryngeal skeletal fracture
E. Dysphagia

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99. Following a total thyroidectomy, a routine serum albumin level is obtained. A

slight decrease in serum albumin is noted. This factor can probably be explained
by
A. Serum albumin loss interoperatively
B. Urinary proteinuria
C. A dilutional effect due to overzealous intravenous fluid therapy during surgery
D. The effects of the release of ADH in the immediate postoperative period
E. Pending liver dysfunction, probably as a result of hypothyroidism

100. Vasomotor rhinitis can often be effectively treated with ipratropium bromide.
This agent works by
A. Decreasing mucosal inflammation in the nasal cavity
B. Acting as a topical anticholinergic and inhibiting mucosal glandular secretion of the
nasal cavity.
C. Inducing atrophic changes of the nasal cavity
D. Producing a strong vasoconstrictive effect through its sympathomimetic action
E. Causing the release and depletion of substance P in the nasal mucosa

101. WHO type II nasopharyngeal carcinoma is

A. Not associated with elevated Epstein-Barr virus titers
B. A keratinizing squamous cell carcinoma
C. The most common type of nasopharyngeal carcinoma encountered
D. Almost never associated with skull base invasion
E. Easily treated with surgery

102. Of the following studies, which would be most beneficial prior to surgical
intervention in patients with temporal bone fracture?
A. Routine audiometrics
B. ABR
C. ENG
D. High-resolution CT scanning
E. MRI with gadolinium.

103. A 49-year-old man presents with a 1-cm irregular variegated pigmented lesion of
the right cheek. A shave biopsy should not be obtained of this lesion because
A. This will increase the rate of metastasis if it is malignant
B. This does not allow identification of cells at the basal layer that may be malignant
C. It is impossible to make a definitive diagnosis using this technique
D. The thickness of the lesion will be difficult to determine for tumor staging purposes
E. If this is a benign lesion, shaved biopsies often lead to malignant transformation

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104. A 40-year-old woman presents with what appears to be a parapharyngeal space

mass on the right. A CT scan is obtained and there appears to be a 2-cm poststyloid
mass in the parapharyngeal space. At this point you should proceed with
A. A fine-needle aspiration biopsy
B. A transoral biopsy
C. Immediate surgical exploration and removal through an external approach
D. An MRI and possibly MRA
E. Angiography

105. The treatment of spasmodic dysphonia with the injection of botulinum toxin type
A is effective because
A. The recurrent laryngeal nerve is paralyzed by this agent
B. This agent produces an immunologic response to the laryngeal muscles
C. By interfering with transmission at the neuromuscular junction this agent causes
temporary vocal cord paralysis
D. This agent produces a central effect in the region of the basal ganglia
E. This agent causes an immediate improvement in voice, which lasts for up to 1 year

106. Following an extensive rhinoplasty a patient complains of nasal obstruction.

Examination reveals collapse of the upper lateral cartilages, as well as retraction
of the ala secondary to overzealous lower lateral cartilage resection The best
approach to manage this problem would be
A. An open rhinoplasty approach
B. Bilateral rhinotomies
C. Delivery of the lower lateral cartilages through a closed approach
D. To perform a transcartilaginous approach to the nasal tip
E. To perform a facial degloving

107. The easiest and most widely utilized test of olfactory function is the University of
Pennsylvania smell identification test. This test. allows the examiner to
A. Determine a threshold for odorant detection
B. Determine the precise etiology of an olfactory problem
C. Provide a sensitive test of olfactory loss
D. Differentiate between parosmia and phantosmia
E. Specifically identify the site of dysfunction along the olfactory tract

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108. A 50-year-old man presents with a 2×2-cm mass in the left submandibular gland.
Fine-needle aspiration biopsy confirms the diagnosis of adenoid cystic carcinoma.
MRI scan reveals no involvement into the mandible and no pathologically involved
neck nodes. Therapy should consist of
A. Surgical resection of the tumor followed by full-course radiation therapy
B. Concurrent chemotherapy and radiation therapy followed by surgical salvage
C. Surgical resection including a radical neck dissection followed by full-course radiation
therapy
D. Pull-course radiation therapy alone followed by close follow-up
E. Palliation therapy only since this is an incurable lesion

109. Neonatal audiometric screening is important to establish the early detection of

hearing loss. Which of the following entities does not portend a specific risk factor for
hearing impairment?
A. A family history of hearing loss
B. Craniofacial anomalies
C. Asphyxia
D. Birth weight under 2,500 grams
E. Mechanical ventilation for 5 days or longer

110. In Chandler's staging system of orbital complications of sinusitis, stage IV is

characterized by
A. Proptosis ophthalmoplegia and occasionally visual loss
B. Lateral displacement of the globe with possible diplopia and decreased visual acuity
C. Edema and erythema of the periorbital region including the conjunctiva
D. Ophthalmoplegia; visual loss, and extension to the contralateral eye
E. Intracranial extension with meningitis, epidural abscess, subdural empyema or brain
abscess.

111. Angular. cheilitis, which is characterized by redness and cracking at the angles of
the mouth, is most often secondary to
A. Herpes simplex
B. Herpes zoster
C. Aspergillus
D. Cytomegalovirus
E. Candida albicans
112. A 48-year-old woman presents with hoarseness following a hemithyroidectomy. She
undergoes laryngeal EMG, which shows spontaneous activity with no voluntary
motor units
A. Return of function is very likely in this situation
B. There is a 50% chance of return of normal function
C. Return of function is not likely
D. The laryngeal EMG should be repeated because this is probably a spurious result
E. These results are of no prognostic significance

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113. Currently the most sensitive test available to diagnose multiple sclerosis is
A. ENG
B. CSF protein electrophoresis
C. Myelin specific protein (MSP)
D. MRI scanning
E. Auditory brain stem response audiometry

114. Due to its morphology, the type of lymphangioma most often associated with
incomplete excision is
A. Cystic hygroma
B. Lymphangioma simplex
C. Cavernous lymphangioma
D. Capillary lymphangioma
E. Cervical lymphangioma

115. Following an MVA, a patient presents with a severe frontal sinus fracture
involving extensive comminution of the anterior and posterior tables, with some
moderate loss of bone. Radiologic study indicates no intracranial injury The most
appropriate method for repair induces
A. Open reduction with plate fixation through an osteoplastic flap
B. Open reduction with fat obliteration of the frontal sinuses through an osteoplastic
approach
C. Open reduction with obliteration using cancellous bone, through an osteoplastic
approach
D. Open reduction with obliteration of the frontal sinus using an alloplastic material such
as methylmethacrolate, via an osteoplastic approach
E. A Lynch external frontoethmoidectomy

116. Risk factors associated with The development of congenital facial paralysis
include all of the following except
A. Forceps delivery
B. Birth weight of greater than 3,500 grams
C. Primiparity
D. Multiparity
E. Traumatic delivery

117. To optimize surgical results from atresia repair, Jahrsdoerfer suggests all of the
following be present except
A. Stapes suprastructure
B. Round window
C. Oval window
D. Malleus incus complex
E. Normal fallopian canal

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118. In the absence of prior surgery or infection, the rate of recurrence after surgical
resection of branchial anomalies is
A. 5%
B. 10%
C. 15%
D. 20%
E. 25%

119. Secondary post-tonsillectomy hemorrhage generally occurs

A. Within the first 24 hours following surgery
B. 1 to 3 days postop
C. 3 to 5 days postop
D. 5 to 7 days postop
E. More than 10 days postop

120. A woman presents with a thyroid mass that is evaluated with a fine-needle
aspiration biopsy. The cytopathologist returns a diagnosis of follicular cell
carcinoma. At this point the appropriate therapy for this patient is
A. Total thyroidectomy
B. Hemithyroidectomy
C. Total thyroidectomy with neck dissection on the side of the lesion
D. Total thyroidectomy followed by iodine 131 therapy
E. A thorough discussion with the cytopathologist regarding his histopathologic diagnosis

121. A 63-year-old man presents with a unilateral nasal mass. He is also complaining
trismus and hypoesthesia in the distribution of V2 on the side of the mass.
Intranasal biopsy in the office reveals findings consistent with inverting
papilloma. The next step in this patient’s workup should be
A. Imaging studies to assess the extent of the underlying tumor
B. Intranasal polypectomy for palliation
C. Caldwell Luc operation to obtain more biopsy material
D. A complete metastatic workup
E. Referral to radiation oncology for consideration for therapy

122. The roentgenographic sign considered pathognomonic for juvenile

nasopharyngeal angiofibroma is the Holman-Miller sign. This is
A. Anterior bowing of the posterior wall of the maxillary antrum
B. Erosion of the sphenoid bone
C. Erosion of the hard palate
D. Erosion of the medial maxillary sinus
E. Displacement of the nasal septum

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123. The incidence of epiglottitis has decreased in children during the past 15 years.
This decrease can probably be attributed to
A. Inherent decreased virulence of organisms responsible for epiglottitis
B. Improved public health conditions in the public schools
C. The Haemophilus influenzae type B vaccine
D. Widespread use of broad-spectrum antibiotics
E. A greater awareness of this disease on the part of pediatricians

124. When treating patients with chronic sinusitis, which of the following antibiotic
regimens would be most appropriate?
A. Amoxicillin for 3 weeks
B. Cefuroxime axetil for 10 days
C. Ciprofloxacin for 3 weeks
D. Amoxicillin/clavulanate for 3 weeks
E. Clindamycin for 3 weeks

125. The fibula osteocutaneous flap is an ideal flap for reconstructing large mandibular
defects. Its advantages include
A. Reliability of the skin paddle
B. Decreased donor site morbidity
C. Length of available bone for reconstruction
D. Easy plate fixation
E. Decreased operative time

126. A patient with obstructive sleep apnea is determined to have type III obstruction.
The most effective treatment for this patient would be.
A. Nasal continuous positive airway pressure (CPAP)
B. Uvulopalatal pharyngoplasty (UPPP)
C. Genioglossus advancement with hyoid myotomy (GAHM)
D. Maxillomandibular advancement
E. Nasal septoplasty

127. The initial management for cerebrospinal fluid otorhinorrhea associated with
temporal bone fracture includes
A. Head elevation with bed rest
B. Antibiotic treatment
C. Lumbar drainage
D. Exploratory tympanotomy
E. Steroid utilization

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128. Of the following viruses, which is most commonly associated with unilateral
sensorineural hearing loss?
A. Cytomegalovirus
B. Mumps
C. Measles
D. Herpes
E. Rubella

129. Medical therapy for chronic sinusitis in patients with cystic fibrosis is often
disappointing. It is particularly important that medical therapy in this population
cover
A. Aspergillus fumigatus
B. Candida albicans
C. Pseudomonas aeruginosa
D. Klebsiella
E. Mycoplasma pneumoniae

130. The most common site of metastasis for esthesioneuroblastoma is

A. Lung
B. Liver
C. Cervical spine
D. Cervical lymph nodes
E. Bone marrow

131. The anatomic site most commonly associated with a naturally dehiscent facial
nerve is
A. Vertical segment
B. Second genu
C. Tympanic segment
D. First genu
E. Geniculate ganglion

132. An 8-year-old girl presents with bilateral nasal polyps. The initial workup should
include a test for
A. Aspirin sensitivity
B. Inhalant sensitivities
C. Cystic fibrosis (Mucovicidosis)
D. Kartagener's syndrome
E. Asthma

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133. Which of the following is not indicative of an aberrant internal carotid artery?
A. Enlargement of the inferior tympanic canaliculus
B. Enhancing mass in the hypotympanum
C. Absence of the vertical segment of the internal carotid
D. Absence of the bony covering of the internal carotid
E. Transposed fallopian canal

134. The best test currently available to diagnose cerebrospinal fluid rhinorrhea is the
A. Chloride level in the fluid
B. Glucose level of the fluid
C. β-transferrin test
D. Radioimmunoassay for neuronal specific antigen (NSA)
E. Air contrast cysternogram

135. A 61-year-old male underwent a total laryngectomy and lateral pharygectomy for
a large pyriform sinus carcinoma. Reconstruction was performed with a
pectoralis myocutaneous flap. On the fifth postoperative day, a foul-smelling
discharge appeared through the lower end of the wound just lateral to the
laryngostome. Further examination revealed a defect at the upper end of the
closure adjacent to the pectoralis skin paddle and posterior tongue. Initial
treatment should be
A. Open the wound more superiorly to establish direct drainage
B. Increase tube feedings to ensure adequate nutrition
C. Return the patient to the operating room for surgical debridement and closure.
D. Schedule the patient for a gastrostomy placement and removal of the nasogastric tube
E. Place the patient on thyroid hormone supplements

136. Significant fluid shifts occur with total body surface area burn in adults exceeding
A. 10%
B. 20%
C. 30%
D. 40%
E. More than 50%

137. Facial paralysis secondary to developmental defects usually presents at birth. All
the following are commonly associated with exception of
A. Cleft palate defect
B. Hypoplastic maxilla
C. Auricular atresia or microtia
D. Gait instability and unsteadiness
E. Sensorineural hearing loss

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138. One of the primary reasons for the reemergence of tuberculosis in the United
States is
A. Poor public health conditions in inner cities
B. Increased intravenous drug usage
C. Acquired immunodeficiency syndrome (AIDS)
D. The overuse of antituberculosis chemotherapy
E. Genetic mutations occurring in mycobacterium tuberculosis

139. The hallmark of nonsurgical management of cholesteatoma would be represented

by which of the following?
A. Systemic antibiotic treatment
B. Topical drop application
C. Active otomicroscopic debridement
D. Aural antibiotics with aural douche
E. Radiation

140. The reliability of EEMG or ENoG is more dependable at

A. 24 hours
B. 48 hours
C. 1 week
D. 3weeks
E. 6 months

141. Forced duction testing measures

A. Enophthalmos
B. Exophthalmos
C. Entrapment
D. Proptosis
E. Intraocular pressure

142. In penetrating neck trauma, the mortality approaches 66% when the common
carotid artery is lacerated and the injury is in
A. Zone 1
B. Zone 2
C. Zone 3
D. The oral cavity
E. The region of the larynx

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143. A 27-year-old male is involved in a high speed motor vehicle accident. Preliminary
examination reveals a possible LeFort II and mandible fracture. Preliminary
cervical spine films and a chest x-ray are obtained The cervical spine is cleared,
and the chest x-ray is normal except for possible mediastinal widening. The next
test should be
A. CT Scan of the face to better define the facial injury
B. CT Scan of the: neck to more definitively rule out cervical spine injury
C. CT scan of the chest
D. Arteriogram
E. A barium swallow

144. The most specific serologic test for evaluating Epstein-Bari virus titers in patients
with nasopharyngeal carcinoma is the
A. Viral core antigen
B. Viral capsid antigen
C. The mono spot test
D. Antinuclear Epstein-Barr virus antigen
E. Short-chain anti-IgG antibody

145. Of the following diagnoses; which is made by radiographic finding?

A. Acute mastoiditis
B. Coalescent mastoiditis
C. Suppurative labyrinthitis
D. Petrous apicitis
E. Bezold's abscess

146. A 20-year-old male involved in a motor vehicle accident presents to the emergency
room with near complete avulsion of his left ear. It remains attached only by a
very small superior pedicle. The most appropriate method of reconstruction is
A. Simple reapproximation
B. Reapproximation with a microvascular anastomosis
C. Reapproximation and at the same time burying the cartilage under a postauricular skin
flap
D. Reanastomosis with application of medical-grade leeches
E. If the ear does survive, the reconstructive result will be poor, it is best to cut the pedicle
and plan reconstruction using osseointegrated implants

147. A patient has suffered a mandibular fracture. If the mandibular arch is disrupted
at two or more points
A. The airway. may become compromised
B. Restoring proper occlusion becomes very difficult
C. The patient will have great difficulty eating
D. The patient is best kept in a supine position
E. The patient is best kept in a prone position

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148. A39-year-old woman presents following a motor vehicle accident with almost
complete avulsion of the left ear. The ear is reattached primarily The most likely
reason for failure would be
A. Infection
B. Inadequate arterial supply
C. Venous engorgement
D. Technically improper closure
E. Cartilage necrosis

149. In penetrating neck trauma, an arteriogram is not routinely indicated when the
injury occurs in
A. Zone 1
B. Zone 2
C. Zone 3
D. The temporal bone
E. The region of the sphenoid sinus

150. A 4-month-old infant presents with increasing respiratory stridor, but as yet no
respiratory compromise. Endoscopic examination reveals a large subglottic
hemangioma encompassing close to 50% of the subglottic lumen The most
appropriate first step is
A. Administration of high-dose steroids
B. Tracheostomy
C. Surgical excision using the CO2 laser
D. Cryotherapy
E. Embolization

151. Before starting medical therapy for a patient with allergic fungal sinusitis, the
workup should include
A. A creatine clearance
B. A glucose tolerance test
C. A histopathologic review of silver stained biopsy specimens
D. A serum immunoglobulin electrophoresis
E. A chest CT scan

152. Hereditary hemorrhagic telangiectasia (HHT) is

A. An autosomal dominant disorder
B. An autosomal recessive disorder.
C. A sex-linked disorder
D. Always sporadic in its appearance
E. Of unknown genetic etiology

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153. A 37-year-old woman underwent bilateral upper and lower lid blepharoplasty. In the
recovery room, she complains of severe left eye pain, and examination reveals
ecchymosis, proptosis, and decreased range of motion. A gross test of visual acuity
indicated only light perception. The next step should be to
A. Elevate the head of the bed and apply ice packs
B. IV mannitol
C. Place a tarsorrhaphy to prevent corneal injury
D. Incise and drain the orbital hematoma
E. A lateral canthotomy and inferior cantholysis

154. A 9-year-old Down syndrome patient presents with an acute peritonsillar abscess,
high fever, and impending airway obstruction. The patient is taken to the operating
room for emergent tonsillectomy and drainage of the abscess. Because of the history
of Down syndrome:
A. A tracheostomy should be performed
B. A large endotracheal tube should be utilized to secure the airway
C. The surgery should be performed with the patient in the neutral position
D. The abscess only should be drained and the tonsils not removed
E. An uvulopalatopharyngoplasty should be performed at the same time

155. A 65-year-old man has received a full course of radiation for a T3 glottic squamous
cell carcinoma. Approximately 1 year following treatment he presents with increasing
pain upon swallowing and mild stridor. Physical examination reveals an ulcerative
region on the laryngeal surface of the epiglottis, in addition to generalized laryngeal
edema. The most likely cause for this patient's laryngeal problem is
A. Invasive laryngeal candidiasis
B. Postradiation chondrosarcoma of the larynx
C. Recurrent squamous cell the larynx
D. Postradiation chondritis
E. Severe reflux esophagitis

156. The most reliable predictor of post tonsillectomy haemorrhage is

A. Patient history
B. Physical examination
C. CBC
D. PT, PTT
E. Bleeding time

157. All of the following would be considered in the different diagnosis of Bill’s palsy
except
A. Herpes zoster oticus
B. Facial neuroma
C. Acoustic neuroma
D. Jugular foramen tumor
E. Otosclerosis

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158. A patient presents with a T3N2 squamous cell carcinoma of the larynx. He has
positive lymph nodes in the left neck, however no lymphadenopathy on the right.
His primary crosses the midline. In managing the neck disease in this patient.
A. He should undergo a radical neck dissection on both the right and left sides
B. No therapy is indicated for right side since it is clinically negative for disease
C. If a right neck dissection is undertaken the spinal accessory nerve can usually preserved
but the jugular vein should be taken
D. Both necks should be treated
E. The right neck dissection should be performed only if there is extra capsular spread in
the left neck.

159. lf a patient presents with an orbital or periorbital infection secondary to acute

sinusitis, an appropriate initial antibiotic regimen would be
A. Cefuroxime and metronidazole
B. Ampicillin
C. Ciprofloxacin
D. Clindamycin
E. Erythromycin

160. Nystagmus associated with benign paroxysmal positional vertigo is characterized

by all of the following except
A. Fatigability
B. Latency
C. Geotropic nystagmus
D. Ageotropic nystagmus
E. Habituation

161. Of the following clinical findings in a patient with an odontogenic tumor, which
suggests a malignancy?
A. Dysesthesia, pain, and loose dentition
B. A bruit
C. Radiographic evidence of sclerotic bony walls surrounding the lesion
D. Occurrence of the tumor on the maxilla
E. Occurrence of the tumor on the mandible.

162. The incidence of malignant transformation of inverting papilloma to squamous

cell carcinoma is
A. 1%
B. 10 to 15%.
C. 60 to 70%
D. Unknown
E. Highly dependent on the age of the patient
GOOD LUCK

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1. B 31. B 61. E 91. B 121. A 151. C

2. C 32. B 62. A 92. B 122. A 152. A
3. E 33. D 63. E 93. B 123. C 153. E
4. E 34. E 64. A 94. B 124. D 154. C
5. A 35. B 65. C 95. A 125. C 155. C
6. B 36. C 66. E 96. B 126. A 156. A
7. E 37. A 67. C 97. D 127. A 157. E
8. A 38. D 68. C 98. D 128. B 158. D
9. A 39. D 69. D 99.D 129. C 159. A
10. C 40. A 70. B 100. B 130.D 160. D

11. C 41. C 71. D 101. C 131. C 161. A

12. C 42. C 72. C 102. D 132. C 162. B
13. B 43. A 73. C 103. D 133. E
14. D 44. E 74. C 104. D 134. C
15. E 45. A 75. A 105. C 135. A
16. E 46. A 76. E 106. A 136. B
17. D 47. B 77. D 107. C 137. D
18. D 48. A 78. E 108. A 138. C
19. E 49. A 79. C 109. D 139. C
20. C 50. B 80. D 110. A 140. C

21. B 51. C 81. D 111. E 141. C

22. B 52. C 82. C 112. C 142. A
23. C 53. D 83. B 113. D 143. D
24. E 54. B 84. A 114. C 144. B
25. C 55. C 85. C 115. C 145. B
26. D 56. D 86. E 116. D 146. A
27. A 57. C 87. E 117. B 147. A
28. D 58. B 88. E 118. A 148. C
29. E 59. A 89. D 119. D 149. B
30. D 60. C 90. B 120. E 150. B

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‫الحمد هلل رب العالمين‬

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