ENT-MCQ PDF

1. The following statements are true regarding the relations of the ethmoidal labyrinth: 1. Optic nerve runs at distance to posterior ethmoidal cells 2. Maxillary sinus has relation with the inferior wall of the ethmoidal labyrinth 3. Posterior ethmoidal cells open in the anterior meatus 4. Lamina papiraceea separates the orbit from the ethmoidal sinuses 5. Retrobulbar neuritis is determined by trigeminal nerve 6. Rhinogenic intracranial infections are spreaded through the roof of upper ethmoidal cells 7. The cranial fossa lies above the roof of the ethmoidal cells which is very thin 8. The surgical approach way of the sphenoid sinus is performed through ethmoidal cells 9. Lacrimal sac has relations frontal to the anterior cells 10. Orbit complications spreading is by maxillary sinus 2. About frontal sinus we can state the following: 1. The right and the left sinuses are most often asymmetrical 2. It represents an upward extension of an anterior ethmoidal cell 3. The frontal sinus complete formation ends around 2nd decade of life 4. The frontal sinuses can be absent in about 4% of the subjects 5. Nasofrontal duct opens orally 6. Orbit lies above the floor of the sinus 7. Anterior wall is covered only by skin 8. Complete formation never ends 9. Periosteum of forehead covers periodontium 10. In adult, frontal sinus has an average capacity of about 7ml 3. About the sphenoidal sinus are true the following: 1. In adult, sphenoidal sinus has an average capacity of 3ml 2. Above the sinus lies the pituitary gland and the frontal lobe of brain 3. The cavernous sinus lies anteriorly 4. It is present in all individuals. 5. The sphenoid sinus starts to develop after the age of 6 y.o. 6. It lies above the lower part of nasal fossa 7. It has relations with the cavernous sinus which contains 3rd,4th,5th and 6th cranial nerves 8. It occupies the entire body of the sphenoid bone 9. Its posterior wall is thin and dense 10. Begins to develop at birth 4. The mucous membrane of the nose: 1. Below it continues with the olfactory mucosa 2. The respiratory mucous membrane of the nose is pink in color 3. The respiratory mucous membrane of the nose is red in color 4. The respiratory mucous membrane of the nose extends through out the nose into the upper half of the nasopharynx 5. Respiratory mucous membrane of the nose is yellowish in color 6. The respiratory mucous membrane is not in the sinuses 7. Eustachian tube continues the respiratory mucosa 8. The respiratory mucous membrane of the nose lines the lower two-thirds of the nasal septum, the lateral wall of the nose below the superior turbinate and the floor of the nasal fossa 9. Is of two types: respiratory and olfactory 10. The respiratory mucous membrane of the nose it is aslo continuous with the epithelia of the nasolacrimal duct and the Eustachian tube 5. The olfactory mucous membrane of the nose: 1. The olfactory epithelium contains a specific yellowish color 2. The basal cells contain pink pigment 3. Serous gland of Bowman is missing 4. The basal cells contain yellow pigment 5. The olfactory epithelium is pink in color 6. The olfactory epithelium contains the serous glands of Bowman 7. Lines the upper one-third of the nasal septum, the roof of the nose and the lateral wall 8. The cells are olfactory: bipolar and basal 9. Lines the upper two-third of the nasal septum 10. The cells are olfactory and of three types: bipolar, supporting and basal 6. Lymphatic drainage: 1. The anterior one collects only the nasal pyramid 2. Consists of two parts: the anterior part and posterior part 3. The anterior one drains to retropharyngeal lymp nodes 4. The anterior one drains to jugular lymh nodes 5. The posterior one drains to the lymph from the posterior part of nasal fossae and nasopharynx 6. The anterior one drains to the submandibular lymph nodes 7. Consists of three parts: anterior, medial and posterior 8. The posterior one drains to the submandibular nodes 9. The anterior one collects from the nasal pyramid and the anterior part of the nasal fossae 10. The posterior one drains to the jugular and retropharyngeal lymph nodes 7. The local causes of epistaxis are: 1. Leukemia 2. Idiopathic 3. Acute infections 4. Endocrine causes 5. Traumatic 6. Hemophilia 7. Environmental 8. Inflammatory 9. Hypertension 10. Neoplastic 8. The general causes of epistaxis are: 1. Acute infections disease 2. Traumatic 3. Uremia 4. Hemophilia 5. Neoplastic 6. Idiopathic 7. Environmental 8. Inflammatory 9. Endocrine causes 10. Leukemia 9. The treatment of epistaxis is: 1. Curative and preventive: vitamin C and K, Ca may be addes 2. Immediately treatment: anterior nasal packing 3. Immediate: embolization 4. Curative and preventive: cauterization of the bleeding 5. Immediate: blood transfusion 6. Immediately treatment: Ice or cold pack applied to the bridge of the nose and held against the roof of the mouth 7. Curative: sedative 8. Curative: pressure on the nostril 9. Curative: pack of postnasal space 10. Immediately: pressure on the nostril 10. The complications of hematoma of septum are: 1. Cartilage necrosis 2. Neoplasm 3. Perforation of septum 4. Septal abscess 5. Saddle nose 6. Septal thickening 7. Meningitis 8. Septal abscess 9. Cavernous sinus thrombosis 10. Perforation of septum is not a complication of hematoma 11. Which are true about the evolution of ENT organs? 1. the distal extremity (end) of the primitive intestine reaches the cephalic extremity 2. its ectoderm becomes preeminent 3. its ectoderm becomes like a bud - frontal bud 4. starting on the day 33 of intrauterine life 5. the cerebral vesicle grows much ahead 6. the cerebral vesicle does not grows much ahead 7. its ectoderm does not become preeminent 8. its ectoderm does not become, like a bud - frontal bud 9. the proximal extremity (end) of the primitive intestine reaches the cephalic extremity 10. starting on the day 22 of intrauterine life 12. During the evolution of ENT organs forms: 1. The ectoderm of the first branchial pouch gives rise to the internal auditory meatus 2. The mesenchyme tissue of mandibula ossifies indirectly 3. From the lateral side of the second branchial arch grows inferior a prolongation-cervical operculum- 4. It results a cavity named cervical sinus which communicates short time with the outside 5. On the lateral walls of the embryo the branchial system will develop, represented by branchial arches and pouches. 6. In this way the primitive pharynx is delimited superiorly (upper) by the stomodeum and inferiorly by the laryngo-tracheal groove. 7. The ecto- and endoblastic membranes, which separate stomodeum from the digestive tract, come in contact and will dissolve on day 26, 8. Below the bud it appears a bottom, named "stomodeum", which will form the future mouth. 9. The first branchial arch borders upon the primitive mouth. It bends in long way, dividing into two buds: maxillary and mandibular buds. 10. The nerve of the first arch is the olfactory (I) 13. Which muscles will form the mesenchyme tissue of the third branchial arch? 1. omohyoid 2. sternohyoid 3. longus capitis 4. scalenus anterior 5. stylopharyngeus 6. the lower rim of hyoid. 7. digastric 8. greater horns of hyoid 9. superior constrictor of pharynx 10. Styloglossi 14. Richard’s cartilage differentiates into: ( page 5 in the book) 1. internal belly of the digastric. 2. posterior belly of the digastric 3. stapes muscle 4. styloid process without stylohyoid ligament 5. lesser horns and lower rim of hyoid 6. anterior belly of the digastric 7. styloid process with stylohyoid ligament 8. stylohyoid muscle 9. lateral belly of the digastric 10. stapedius muscle 15. The first stage of the embryology of the human face “ the budding stage “: 1. Both external and internal portions grow down and give rise to the external and internal nasal buds. 2. The mesenchyme of the external nasal bud gives rise to the bridge of the medial nasal process 3. The mesenchyme tissue of the mandibulary swelling differentiates into Meckel’s cartilage 4. Gives rise to the lateral faces of the nose 5. The frontal buds on both sides of the medial line differentiate and form the olfactive epithelium (olfactive placode) 6. The nasolacrimal groove will form the future eyesocket. 7. Olfactive placode will divide the frontal bud into an external portion (out of the placode) and into an internal portion. 8. The grove between the lateral nasal bud and the adjacent maxillary bud is called the nasolacrimal grove. 9. Develops the constitutive elements of the face. 10. Maxillary swelling differentiates into central part of cheek 16. The second stage of the embryology of the human face ” the coalescence stage”: 1. Maxillary swelling differentiates into central part of cheek, lateral part of superior lip, mala bones, superior maxilla and mala arch. 2. The mesenchyme of the internal nasal bud gives rise to the bridge of the medial nasal process, nose, the middle of the superior lip (the philtrum) and to the intermediary bone. 3. The mesenchyme of the external nasal bud (lateral nasal process) gives rise to the lateral faces of the nose (nasal bones, lacrimal bones and lateral masses of the ethmoid), 4. The mesenchyme of the internal nasal bud (lateral nasal process) gives rise to the lateral faces of the nose (nasal bones, lacrimal bones and lateral masses of the ethmoid), 5. First and second incisors, cartilaginous nasal septum and part of mucosa result from this intermediary bone. 6. Between these buds spaces are delimited. 7. After growing and joining, these buds form the nasal cavities, the eyesocket and the oral orifice, while from the mesoderm of the swelling, develop the constitutive elements of the face. 8. Gives rise to the external and internal nasal buds. 9. At this stage, all these spaces communicate. 10. Represents future nasal cavities. 17. Which is correct about the lymph node methastases ? 1. The subglottic region comprises the top of epiglottis. 2. The free margin of the vocal cords has minimal lymphatic drainage. 3. The supraglottic space is limited superiorly by the free edge of the vocal cord. 4. The duration of the symptoms, the size and site of the tumor and the histologic differentiation influence also the frequency of regional lymph node metastases. 5. Tumors of subglottis are more diffuse and have superficial ulceration. 6. The duration of the symptoms, the size and site of the tumor and the histologic differentiation does not influence the frequency of regional lymph node metastases. 7. Lymph node metastases are found in about 20% of subglottic carcinomas about 40% of supraglottic carcinomas and in about 40% of transglottic carcinomas (Becker). 8. The lymphatics within the larynx can be divided into a supraglottic and a subglottic network. 9. Lymph node metastases are found in about 40% of subglottic carcinomas about 10% of supraglottic carcinomas and in about 20% of transglottic carcinomas (Becker). 10. Primary supraglottic carcinoma are rare and usually unilateral. 18. Which is correct about the indirect laryngoscopy? 1. Up to 15% of patients with a head and neck malignancy have a second primary tumor, either synchronously or metachronously. 2. tumors of supraglottic region are often ulcerating; 3. Plain radiography of the neck, polytomography, laryngography, laryngeal stroboscopy, CT (computer axial tomography), MRJ (magnetic resonance imaging) are other necessary exams. 4. Glottic lesions tend not to be proliferative. 5. A definitive diagnosis is not made on direct microscopic laryngoscopy. 6. One cubic centimeter of tissue contains l 09 cells. 7. Plain radiography of the neck is not a necessary investigation. 8. Tumors of subglottic do not have a whitish ''cawliflower" appearance. 9. Tumors of supraglottic region are often not ulcerating. 10. Tumors of subglottis are more diffuse and have superficial ulceration. 19. Surgical treatment in lymph node metastases: 1. decortication of the vocal cord is indicated for severe dysplasia and some carcinomas in situ. 2. decortication of the vocal cord is not indicated for severe dysplasia and some carcinomas in situ 3. total laryngectomy is indicated for tumors that have recurred after radiotherapy or partial procedures. 4. cordectomy is not indicated for a vocal cord carcinoma with a mobile vocal cord. 5. After total laryngectomy breathing is not possible via the tracheostomy. 6. total laryngectomy is indicated for tumors that cannot be removed by partial laryngectomy and for tumors that have spread to neighboring structures such as the tongue. 7. vertical and horizontal partial laryngectomies are used for carcinomas when a cordectomy is not suitable because of the extent or site of the tumor. 8. After total laryngectomy voice is not produced by esophageal speech. 9. After total laryngectomy swallowing is not normal once the wound has healed 10. total laryngectomy is indicated for tumors that cannot be removed by partial laryngectomy. 20. Which are correct in radiotherapy and surgery treatment for tumors of the larynx? 1. Radiotherapy does not achieve similar results to surgery for T1NO glottic tumors. 2. Radiotherapy must not be used for patients with inoperable tumors. 3. Induction chemotherapy is not indicated in any of the tumor cases. 4. The combination of surgery and radiotherapy does not offer any advantages. 5. Extension of a laryngeal carcinoma to the hypopharynx may also be an indication for radiotherapy since even the most extensive surgery does not produce a 5 years survival rate better than 20%. 6. Combined use of surgical resection and radiation therapy offers distinct advantages in larger lesions. 7. Radiotherapy achieves similar results to surgery for T1NO glottic tumors and some T2NO tumors. 8. For all other sites and stages of tumor, especially if lymph node metastases are present, surgery is clearly superior to radiotherapy (Becker). 9. Radiotherapy must also be used for patients with inoperable tumors or those unwilling to undergo surgery. 10. Surgery is not superior to radiotherapy when lymph nodes metastases are present. 21. The external nose: 1. Does not have arterial blood supply. 2. Contains the nasal septu , nasal ala, nasal vestibule, Glabella. 3. is triangular in shape 4. Has bony constituents that support the upper part of the external nose. 5. Is pyramidal in shape with a base inferiorly and three faces. 6. Does not have bony constituents. 7. Contains Orbicularis muscle. 8. the skin is thin over the upper part of the nose and thicker over the lower cartilaginous part. 9. Arterial blood supply is both from external carotid artery and internal carotid artery. 10. The skin is mucosa. 22. The nasal cavity: 1. Is triangular in shape 2. Medial wall is formed by the nasal septum. 3. The skin is irregular. 4. Medial wall main constituents are perpendicular plate of ethmoid, vomer, septal cartilage 5. Does not have bony constituents. 6. The nasal fossa includes only that part which is lined with mucous membrane. 7. The floor is formed by palatine process of maxillae in anterior ¾. 8. The right and left fossae (cavities) are separated by the nasal septum. 9. The floor is formed by horizontal parts of palatine bones- posterior ¼. 10. Is formed in 2 months 23. The lateral wall of nasal cavity: 1. is formed by perpendicular part of palatines bones 2. not formed by walls of maxilla 3. Is formed by ascending process of maxilla 4. not formed by sphenoid. 5. not formed by ascending process 6. Is formed by medial Pterygoid processes of sphenoid. 7. Is formed by medial walls of ethmoid 8. Not formed by ethmoid 9. not formed by palatine bones 10. Is formed by the medial walls of maxilla 24. Three meatuses (inferior, middle and superior): 1. The inferior meatus lies between the inferior turbinate and the floor of the nasal cavity. 2. The superios meatus contains the opening for the posterior ethmoid cells. 3. The middle meatus lies between the inferior and middle turbinate. 4. The superior meatus lies between the superior and the middle turbinate 5. Is triangular in shape. 6. The middle meatus is the most complex and by far the most important. 7. The skin is irregular. 8. Does not contain the nasolacrimal duct. 9. There is no space. 10. The inferior is bigger. 25. Paranasal Sinuses: 1. The incisive is part of. 2. Frontal sinus is not present. 3. They are lined with a mucous membrane. 4. Maxillary sinus is not present. 5. There are no paranasal sinuses. 6. There is one paranasal sinus. 7. Contains lamina cribrosa, crista galli, ethmoidal cells, vomer. 8. Lined with a mucous membrane continuos with that of the corresponding nasal fossa. 9. There are four paranasal sinuses on each side. 10. Is maxillary, ethmoidal, frontal and sphenoidal. 26. Maxillary sinus: 1. It has a pyramidal shape with the base that lies medially. 2. It has a triangular shape. 3. It has an average capacity of about 7 ml in adult. 4. The apex of the pyramid lies in the zygomatic portion of the maxilla. 5. The medial wall is separating wall between the sinus and the nasal fossa. 6. It does not contain air. 7. It has an oval shape. 8. The base lies vertically. 9. It is the largest of the sinuses, with and average capacity of 15ml in adult. 10. It is a paranasal sinus. 27. Maxillary sinus: 1. The anterior wall separates the sinus from the skin of the cheek. 2. It is closely related with the incisive. 3. The high position of the opening does not favor spontaneous emptying of the cavity. 4. It has a triangular shape. 5. Develops its final size after the second dentition appears. 6. The base lies vertically. 7. Contains the mandibular artery. 8. It has an oval shape. 9. The posterior wall contains the maxillary division of the 5th cranial nerve. 10. The roof is the thin floor of the orbit, which contains the infraorbital nerve. 28. The ethmoidal labyrinth: 1. consists of a number (6-10) of thin walled, air containing cavities within the lateral masses of ethmoid bones. 2. this paranasal sinus Is fully developed at birth. 3. Has three types of cells: anterior, posterior and lateral. 4. Maxillary sinus is related to the inferior wall of ethmoidal labyrinth. 5. There are two groups of cells: anterior and posterior. 6. Orbit is separated from the ethmoidal sinuses by the lamina papirraceea. 7. consists of a number (6-10) of thin walled, air containing cavities within the lateral masses of ethmoid bones. 8. Is not related to the nasal cavity. 9. Does not contain air. 10. It has a pyramidal shape. 29. Frontal sinus: 1. Has a pyramidal shape. 2. It is always present at birth. 3. The frontal sinuses may be absent in 4% of the subjects. 4. Has an elliptical shape. 5. Its average capacity is about 7ml in the adult. 6. The right and left sinuses are often asymmetrical. 7. Does not contain air. 8. Is bigger in females. 9. is an upward extension of and anterior ethmoidal cell. 10. It is separated by a thin bony septum. 30. Sphenoidal sinus: 1. cavernous sinus containing the third, fourth, fifth, sixth of the cranial nerves, together with the internal carotid artery. 2. It lies behind the upper part of nasal fossa. 3. is fully developed at birth. 4. It occupies the body of the sphenoid bone. 5. The average capacity is about 3ml in the adult. 6. The sphenoid sinus may be absent in 15% of the subjects. 7. The sinus begins to develop after 6 years of ages. 8. The sphenoid sinus begins to develop intrauterine. 9. Is the biggest sinus in the human body. 10. It can not be absent. 31. Local causes of epistaxis are not: 1. Foreign bodies 2. Uremia 3. Hypertension 4. Conditions of the blood as in: leukemia, hemophilia 5. Nasal operations 6. Inflammatory rhinitis 7. Neoplastic tumors either benign or malignant 8. Traumatic bone fractures or cartilage 9. Endocrinal complications 10. High altitudes that involve lower pressure 32. General causes of epistaxis are: 1. Nasal operations 2. Hypertension 3. Patients affected by measles or influenza 4. Environmental factors 5. Uremia 6. Arterial bleeding in the nasal septum 7. conditions of the blood such as purpura, leukemia 8. Traumatic bone fractures or cartilage 9. Inflammatory rhinitis 10. Endocrinal compilations 33. During treatment of epistaxis the immediate measures of action are: 1. Systemic antibiotics are contraindicated 2. Packing of the postnasal space 3. Pressure of the nostril 4. Cauterization of the bleeding 5. Applying pressure on the nostril is contraindicated 6. Systemic antibiotics are indicated 7. Sedation is indicated 8. Anterior nasal packing with cotton wool impregnated with paraffin 9. Embolization 10. Leaving nasal packing for 8-10 days 34. The following statements about curative and preventive measures are true: 1. hemostatic injection is contraindicated 2. cauterization of bleeding point with silver nitrates 3. transfusion during severe blood loss false 4. cauterization of bleeding point with titanium oxide 5. measures are used when immediate treatment fails 6. packing of the postnasal space is rarely necessary 7. vitamins C and K may be given in short doses 8. arterial ligatures when epistaxis is not controlled by packing 9. those measures are used when immediate treatment succeed 10. during embolization there is risk of deficit in 20% of patients 35. True statements about the etiology of nose fractures: 1. type 3 fracture does not require a major blow 2. least common causes are: personal assault, sport injuries, traffic accidents 3. injuries can both be of a closed and open type 4. type 1 is cause by fronto-lateral blow 5. most common causes are: personal assault, sports injuries, traffic accidents 6. the nose is the least frequently fractured bone in the body 7. type 2 fracture is due to lateral trauma 8. the nose is the most frequently fractured bone in the body 9. in type 2 fracture there is gross depression 10. injuries can only be of a closed type 36. Which statements about the treatment of nose fracture are true: 1. malunion requires rhinoplasty 2. late treatment is during 7-14 days 3. septal deformity nearly always requires septal exploration 4. an early treatment occurs if the septum is dislocated and antibiotic cover is given 5. when swelling is marked and landmarks lost reduction is not delayed 6. late treatment is during 5-7 days 7. septal deformity nearly never requires septal exploration 8. an early treatment occurs if the septum is not dislocated and antibiotic cover is not given 9. malunion does not require rhinoplasty 10. when swelling is marked and landmarks lost reduction is delayed 37. Symptoms of foreign bodies penetrating the nose are not: 1. radiography is not indicated for diagnosis 2. anterior rhinoscopy is always useful 3. the pain due to intrusion is temporary and subsides quickly 4. the pain due to intrusion is constant and does not subside 5. radiography is indicated for diagnosis 6. anterior rhinoscopy is not useful 7. nose bleeding 8. nasal obstruction is of only one place 9. nasal obstruction of varying degrees 10. no nose haemorrhage 38. True statements about foreign bodies penetrating the nose are: 1. nasal obstruction of varying degrees 2. the pain due to intrusion is constant and does not subside 3. it can not develop a fetid odor 4. radiography is not indicated for diagnosis 5. it is usually bilateral 6. anterior rhinoscopy is always useful 7. anterior rhinoscopy is not useful 8. radiography is indicated for diagnosis 9. nose bleeding 10. the pain due to intrusion is temporary and subsides quickly 39. Which of the following statements about furunculosis of the nasal vestibule are true? 1. one of the symptoms is the mild pain that disappears fast 2. manipulation of the nose is allowed 3. It is an acute infection of one or more pilosebaceous follicles in the nasal vestibule 4. the furuncle pointing spontaneously in the vestibule for 5-6 days 5. single furuncles are the common type of infection 6. manipulation of the nose is forbidden 7. multiple furuncles are the common type of infection 8. the furuncle pointing spontaneously in the vestibule for 3-4 days 9. It’s a chronic infection of one or more pilosebaceous follicles in the nasal vestibule 10. one of the symptoms is the increasing pain that becomes severe 40. Which of the following statements about erysipelas are correct? 1. chronic inflammation of the skin primary to the invasion of the skin lymphatics 2. during treatment moist dressings are applied 3. there is painful reddening of the skin with regular and undefined margins 4. the prognosis after penicillin is taken for 8 days is bad 5. during treatment dry dressings are applied 6. differential diagnosis can be made with pemphigus vulgaris, behcet syndrome 7. acute inflammation of the skin secondary to the invasion of the skin lymphatics 8. there is painful reddening of the skin with irregular and defined margins 9. the prognosis after penicillin is taken for 8 days is good 10. differential diagnosis can be made with hemangiomas, herpes zoster 41. Rhinophyma: 1. There are no symptoms. 2. It usually occurs in older man 3. It is a disease of the skin of the nose, characterized by chronic inflammation and hypertrophy, producing a large, red, violaceous nasal tip and comedones. 4. Symptoms - the external nose, in its anterior part, has appearance of a markedly protuberant lobular swelling. 5. Treatment - is surgical - removal of the exuberant tissue (dermabrasion). 6. The Etiology of the disease may follow Acneea rosacea 7. There is no treatment. 8. It is tumor in the ear. 9. It usually occurs in newborns. 10. There is no need for treatment. 42. The common cold (coryza): 1. The common cold (coryza) is an acute non specific inflammation of the mucosa of the nasal cavities. 2. The catarrhal phase includes malaise and fever. 3. The resolution phase: in 5 to 10 days the whole process is healed and there are no symptoms anymore. 4. The prodromal stage includes: malaise (chills, headache, fatigue) mild fever, burning sensation, itching and a feeling of dryness in the nasopharynx. 5. The etiological agent is usually viral and the most important group is that of the rhinoviruses; 6. It is always chronic inflammation. 7. It presents 4 stages: the prodromal stage; the catarrhal stage; the mucous stage and the resolution stage. 8. The etiologic agent is always fungal. 9. The etiology is never viral. 10. It requires surgical treatment. 43. In the treatment of common cold (coryza) the following statements are true: 1. The treatment is always surgical. 2. Antibacterial treatment (antibiotics): always needs to be given to patients "at risk", for secondary bacterial infections (culture and sensitivity tests should be taken first); 3. Therapeutic/symptomatic treatment consists in local measures such as steam inhalations. 4. Therapeutic/symptomatic treatment consists in general measures rest and warmth; oral decongestants, analgesics (aspirin); (vitamin C and antihistamines are of doubtful value). 5. Adenoidectomy in children belongs to the prophylactic treatment. 6. Steam inhalations are never recommended. 7. There is no need of treatment in symptomatic patients. 8. The prophylactic treatment includes antiobiotics. 9. The treatment in patients “at risk” does not include antibacterial treatment. 10. The prophylactic treatment focuses on building up patients’ resistance and avoidance of contact with infected patients. 44. Nasal diphtheria: 1. Symptoms of it does not include nasal obstruction. 2. Symptoms of it does not include hemorrhagic and purulent rhinorrhea. 3. Positive Diagnosis of nasal diphtheria is made by culture. 4. Treatment of nasal diphtheria is by administration of diphtheria antitoxin serum. 5. The treatment of nasal diphtheria includes antibiotics only. 6. The etiology is not Streptococcus diphtheriae. 7. Symptoms of nasal diphtheria include nasal obstruction either unilateral or bilateral. 8. The etiology is Corynebacterium diphtheriae. 9. Nasal diphtheria is asymptomatic. 10. Symptoms of diphtheria include hemorrhagic and purulent rhinorrhoea and crusts 45. Which of the following are internal factors of Simple chronic rhinitis: 1. Abnormal humidity 2. Diseases of heart and circulation 3. Deviation of septum 4. Sudden and extreme changes of temperature 5. Endocrine disorders 6. Pregnancy 7. Side effects of drugs 8. Menstruation 9. Chronic irritation of nasal mucosa as from dust 10. Tobacco smoke 46. Which of the following are external factors of Simple chronic rhinitis? 1. Deviation of septum 2. Abnormal humidity 3. Sudden and extreme changes of temperature 4. Diseases of heart and circulation 5. Side effects of drugs 6. Endocrine disorders 7. Pregnancy 8. Menstruation 9. Chronic irritation of nasal mucosa as from dust 10. Tobacco smoke 47. Which of the following treatments are used for hypertrophic rhinitis? 1. Acyclovir 2. Antifungal therapy 3. Argon Laser 4. Broad spectrum Antibiotics 5. Beta-Blockers 6. Sclerosing agents (Hydrocortisone) 7. Cryosurgical probe 8. Radiotherapy 9. CO2 Laser 10. Electrocoagulation by submucosal diathermy or by linear cauterization by galvanocautery 48. Which of the following are clinical features for primary atrophic rhinitis (Ozena): 1. The patient always presents night sweats, dry cough and nose bleedings during night 2. Because of the anosmia the patient can not notice the foul smell that he or she emanates 3. The disease can begin in early life 4. The patient complains of sore throat while eating 5. It is usually bilateral 6. The disease only occurs in early life 7. There are fetid secretions and crusts 8. The patient complains of nasal obstruction despite the wide airway 9. The patient presents over sensitive sense of smell 10. It is always unilateral 49. The following statements about syphilis are true: 1. The disease is due to an infection with Treponema palidum 2. Acquired syphilis presents 5 stages 3. Acquired syphilis presents 3 stages 4. On congenital syphilis, the infection may come from passage through the birth canal or it may be transplacental 5. On congenital syphilis, the infection is passed on by fecal-oral contamination 6. The diagnosis is confirmed by serology test, Nelson’s test and biopsy 7. The diagnosis is confirmed only with anamnesis and clinical examination 8. Treatment is carried out by the venereologist 9. The disease is due to an infection with Koch’s bacillus 10. Treatment is carried out only by the dentist 50. The following statements about Rhinoscleroma are true: 1. Treatment is of long term, consisting in high doses of antibiotics dictated by culture and sensitivity tests 2. Rhinoscleroma begins like chronic rhinitis with purulent rhinorrhea and crusts 3. Rhinoscleroma is not very infectious 4. Biopsy is highly contraindicated in the diagnosis of Rhinoscleroma 5. Rhinoscleroma is very infectious 6. Young adults are rarely affected 7. The treatment is only supportive treatment and usually short term 8. Young adults are usually affected 9. The disease is caused by Klebsiella rhinoscleromatis 10. The disease is caused by Treponema palidum 51. The following statements about Allergic rhinitis is true: 1. Non-seasonal allergens are usually plant pollens (Trees, grasses, weeds) 2. Seasonal allergens are usually plant pollens (Trees, grasses, weeds) 3. There are three clinical types of allergic rhinitis 4. Allergic rhinitis usually occurs in patients older than 50 years of age 5. Allergic rhinitis usually occurs at school age and is less common after 50 years of age 6. Symptoms of allergic rhinitis can include itching in the nose and nasal obstruction due to venous stasis 7. Allergic rhinitis usually occurs at school age and is less common after 50 years of age 8. There are two clinical types of allergic rhinitis 9. Seasonal (Pollinosis) and non-seasonal (Perennial) are types of allergic rhinitis 10. Symptoms of allergic rhinitis can include sharp pain of teguments in the facial region J. Allergic rhinitis only affects males 52. The following statements about Vasomotor rhinitis is true: 1. Vasomotor rhinitis is a sympathetic system’s disorder 2. Symptoms consist in attacks of nasal obstruction which may alternate from side to side 3. Differential diagnosis can be Allergic rhinitis 4. Patient can present blue, pale nasal mucosa, hypertrophic inferior turbinates and polypi 5. Predisposing factors include heredity, stress, endocrine disorders, drugs, alcohol, smoking 6. Predisposing factors include only smoking 7. Vasomotor rhinitis is a parasympathetic system’s disorder with a paroxysmal course of unknown etiology, that affects the blood vessels of the nasal mucosa 8. Differential diagnosis can be labial herpes 9. It is considered a malignant tumor 10. It can not be treated 53. Regarding the treatment of Vasomotor rhinitis, the following are conservative: 1. Vidian neurectomy 2. Avoidance of irritant factor 3. Correction of septal deflections or spurs 4. Sodium chromoglycate 5. Removal of polypi 6. Sedatives and/or tranquilizers 7. Turbinectomy 8. Hot wire cauterization or cryosurgery of the inferior or middle turbinates 9. Antihistamine 10. Steroids for a limited period 54. Which of the following can be the symptoms of maxillary sinusitis? 1. Unilateral nasal secretions 2. Itching of the ears 3. Hyposmia or anosmia 4. Abnormalities of smell 5. Sudden weight gain 6. Severe throbbing pain in the face 7. Pain on left arm 8. Permanent vision loss 9. Swelling of the lower extremities 10. Nasal obstruction 55. Regarding the treatment of maxillary sinusitis, the following statements are true: 1. Antihistamines are highly contraindicated in the treatment of maxillary sinusitis 2. In sinusitis of dental origin, treatment is by irrigation of sinus and general therapy 3. In patients with severe pain and pressure symptoms, antral lavage is indicated 4. Antibiotics are highly contraindicated in the treatment of maxillary sinusitis 5. The antibiotics used to treat maxillary sinusitis can be ampicillin, amoxicillin/clavulanate, cefaclor 6. Dental treatment is never conducted in the treatment of maxillary sinusitis 7. Antihistamines can help prevent the onset of sinusitis secondary to allergy 8. Does not involve surgical treatment 9. In patients with severe pain and pressure symptoms, antral lavage is highly contraindicated 10. In less severe cases treatment consists in administration of broad spectrum antibiotics and nose drops to ensure good drainage 56. Which of the following can be the symptoms of Acute frontal sinusitis? 1. Edema of the cheek 2. Severe pain in the regions neighbouring the affected sinus 3. Presents only one symptom, which is headache 4. Pain in lower extremities 5. Headache 6. Edema of the forehead and upper eyelid 7. Itching in the neck 8. Nasal discharge 9. Always presents night sweats 10. Extreme tenderness to pressure on the orbital roof 57. Acute sphenoiditis: 1. Secretions usually drain into the nasopharynx and may be seen in the posterior rhinoscopy 2. Clinical examination is the main procedure of diagnosis 3. Radiography is the main procedure of diagnosis 4. The patient has pain in the occiput, in the center of the skull or deep in the eyes 5. Treatment consists in catheterization of the ostium in severe cases 6. Treatment always consists in catheterization of the ostium 7. The pain can be only present in the center of the skull 8. In less severe cases, surgical approach is always indicated 9. In less severe cases, conservative treatment is to be done 10. Secretions usually drain into the laryngopharynx 58. Chronic maxillary sinusitis: 1. The diagnosis is based mainly on the radiological appearances 2. Pain is often described as a feeling of pressure or as a dull ache over the sinus 3. Symptoms are similar to those of acute form but they are usually of a smaller degree 4. The treatment is carried out only by administration of broad-spectrum antibiotics J. Is a type of malignant tumor 5. Patients can complain about neuralgias in the distribution of the infraorbital nerve 6. Is asymptomatic 7. Symptoms are similar to those of acute form but they are usually of a smaller degree 8. The treatment begins with repeated punctures followed by lavage of sinuses, supported by antibiotics F. Symptoms of chronic maxillary sinusitis are usually more severe to those of acute form 9. The diagnosis is based mainly on anamnesis 10. Pain is often described as a feeling of pressure or as a dull ache over the sinus 59. Chronic ethmoiditis: 1. Chronic ethmoiditis presents severe symptoms 2. Treatment does not include surgical approach 3. Tomography and endoscopy are required for diagnosis 4. Chronic ethmoiditis is almost symptomless 5. May present the following symptoms: Nasal obstruction, nasal discharge, nasal polyps and disorders of smell 6. The ethmoidal labyrinth can be approached via the nose (Intranasal exenteration of the ethmoidal labyrinth) 7. Only clinical examination and anamnesis is required for positive diagnosis 8. Always presents pain in the neck 9. If chronic ethmoiditis does not react satisfactorily to conservative treatment, surgery should be considered 10. Is a premalignant lesion 60. Chronic frontal sinusitis: 1. Is asymptomatic 2. The treatment of Chronic frontal sinusitis is done only by conservative treatment 3. The treatment of Chronic frontal sinusitis can include conservative treatment or surgical treatment 4. The treatment of Chronic frontal sinusitis is done only by surgical treatment 5. The diagnosis is made radiographically 6. Presence of sensitivity of the supraorbital nerve to pressure and nasal discharge 7. Anterior rhinoscopy may show oedema of the nasal mucosa and chronic rhinitis 8. Symptoms are reduced to a feeling of pressure over the sinus 9. The diagnosis is made only by anamnesis 10. Anterior rhinoscopy may show oedema of the cheeks 61. Maxillary sinusitis characterized by: 1. Cacosmia is very rarely 2. Pain in the cheek is bilateral 3. Its origin may be dental 4. Its origin may be nasal 5. Sinusitis may be result of dental extraction 6. No pain 7. Sinusitis may be result of apical abscess 8. Radiography is not necessary 9. Number of related teeth depends on the size of antrum 10. History of rhinitis 62. Barotraumatic sinusitis characterized by: 1. Analgesics and sedatives are not necessary 2. Treatment can be preventive by avoidance of flying in case of upper respiratory infections 3. Congestion and inflammation of the lining membrane 4. Severe headache 5. Fracture traiect 6. Etiology is flying while suffering from upper respiratory infection predisposes 7. Treatment can be symptomatic by analgesics and sedatives 8. Treatment is only symptomatic 9. Mucosal or the submucosal hemorrhages 10. Treatment can not be preventive 63. Complications of the sinus infections characterized by: 1. Spread may be venous in case of septic venous thrombosis 2. Spread may be direct through bony wall by osteoporosis 3. Spread may be lymphatic leading to subperiosteal abscesses 4. Spread may be direct through bony wall by osteomyelitis 5. Spread is not lymphatic 6. Spread is not venous 7. Spread is not direct 8. Periodontal recession 9. Intense swelling 10. Spread may be direct through bony wall by osteitis 64. Orbital complications arising from the ethmoids characterized by: 1. Differential diagnosis is not with osteoma 2. No subperiosteal abscess 3. X-Rays is not necessary for differential diagnosis 4. There is no surgical treatment 5. Treatment is usually surgical in the orbital area 6. Orbital periostitis 7. Differential diagnosis is not with cavernous sinus thrombosis 8. Orbital abscess 9. It is due to the rupture of pus through the bony orbital wall 10. Infection orbital spread is a serious emergency 65. Osteomyelitis of frontal bone characterized by: 1. Swelling over the sinus 2. Pain and tenderness over the sinus 3. Acute disease 4. There is no surgical treatment 5. Is very common and life-threatening disease 6. Fever, chills and headache 7. Asymptomatic 8. Patient has clouding of consciousness 9. Without exhaustion 10. Radiography is not necessary 66. Osteomyelitis of frontal bone is NOT characterized by: 1. Are not indicated high-dose of antibiotics 2. Chills 3. Exhaustion 4. Headache 5. Poor status 6. Treatment is not surgically with radical resection of infected bone 7. Is not very common and life-threatening disease 8. Fever 9. The spread cannot be hematogenous 10. There is no pain and tenderness over the sinus 67. Osteomyelitis of the maxilla characterized by: 1. Diagnosis is by clinical examination 2. Corticosteroids use 3. Appears mostly in the mandibular ramus 4. Swelling, redness and tenderness over the cheek 5. Less common than osteomyelitis of the frontal bone 6. High-dose of antibiotics are indicated urgently 7. Antiuretics use 8. Abscess points into the mouth or externally 9. Antral-oral fistulas and orbital cellulitis 10. Surgical treatment is not necessary 68. Benign Tumors of the nose and paranasal sinuses characterized by: 1. Osteoma 2. Basal cell carcinoma 3. Malignant Melanoma 4. Xeroderma pigmentosum 5. Hemangiomas 6. Squamous cell carcinoma 7. Senile Keratoma 8. Papilloma 9. Adenoma 10. Gliomas 69. Malignant Tumors of the external nose characterized by: 1. Squamous cell carcinoma 2. Adenoma 3. Basal cell carcinoma 4. Xeroderma pigmentosum 5. Gliomas 6. Senile Keratoma 7. Hemangiomas 8. Papilloma 9. Malignant Melanoma 10. Osteoma 70. On Malignant Melanoma the Clark staging is characterized by: 1. Level 3 is into reticular dermis 2. Level 2 is extending into papillary dermis 3. Level 1 is epidermis 4. Level 5 is epidermis 5. Level 1 is into subcutaneous fat 6. Level 5 is into subcutaneous fat 7. Level 3 is filling papillary dermis 8. Level 4 is extending into papillary dermis 9. Level 2 is filling papillary dermis 10. Level 4 is into reticular dermis 71. What is the differential diagnosis of malignant melanoma? 1. Adenocarcinoma 2. Blue nevus 3. Osteosarcoma and lipoma 4. Papilloma 5. Acute rhinitis 6. Fibrosarcoma and osteoma 7. Sinusitis 8. Pigmented basal carcinoma 9. Juvenile melanoma 10. Hemangioma 72. Which of the following can be the symptoms of tumor in the maxillary sinus? 1. Diplopia 2. Loosing of teeth 3. Unilateral nasal obstruction 4. Bleeding 5. Polypi 6. Palate swelling 7. Unilateral chronic nasal discharge 8. Palate deformity 9. Large red polypoid mass 10. Proptosis 73. Which of the following can be the symptoms of tumor in the ethmoid? 1. Large red tumoral or polypoid mass 2. Palate swelling 3. Facial paraesthesia 4. Lymphadenopath 5. Facial swelling 6. Loosing of teeth 7. Diplopia 8. Nasal obstruction 9. Blood-stained nasal discharge 10. Epiphora 74. What is the correct about the diagnosis of malignant tumors of the nose and nasal sinuses? 1. Bone marrow biopsy 2. CT scan 3. Urine analysis 4. Radiographies of sinuses and base of the skull 5. MRI 6. Blood test 7. Complete physical examination 8. Chest Xray 9. Endoscopic evaluation of the nose and sinuses 10. ECG 75. What is the differential diagnosis of the malignant tumors of the nose and nasal sinuses? 1. Polypi of the nose 2. Complication of sinusitis 3. Benign tumors 4. Fibrosarcoma 5. Polypi of the nasal cavities 6. Sinusitis 7. Lipoma 8. Osteoma 9. Hemangioma 10. Osteosarcoma 76. What are the methods of treatment for malignant tumors of the nose and nasal sinuses? 1. Only surgery 2. Flexible combination of surgery, radiotherapy and chemotherapy 3. Use of antibiotics 4. Chemotherapy 5. Use of herbal remedies 6. Surgery 7. Radiotherapy 8. Radical neck dissection 9. Regular monitoring without any treatment 10. Removal of eyeball 77. What are the structures found in the oral cavity? 1. Lower alveolar process 2. Liver 3. Upper teeth 4. Large intestine 5. Upper alveolar process 6. Soft palate and uvula 7. Kidneys 8. Lower teeth 9. Nose 10. Stomach 78. Which of the following statements are correct about nasopharynx? 1. It is bounded above the base of the skull, below the soft palate 2. Fossa of Rosenmuller is not lie behind the tubal elevation 3. Nasopharyngeal isthmus leads from the nasopharynx into the oropharynx 4. Nasopharyngeal tonsil sits at the junction of the roof and posterior wall of the nasopharynx 5. Nasopharyngeal tonsil does not sit at the junction of the roof and posterior wall of the nasopharynx 6. Fossa of Rosenmuller lies behind the tubal elevation 7. Does not open anteriorly into the nasal fossa 8. Nasopharyngeal isthmus does not lead from the nasopharynx into the oropharynx 9. It is not bounded above the base of the skull, below the soft palate 10. Opens anteriorly into the nasal fossae 79. What structures are contained within the oropharynx? 1. Esophagus 2. Salivary glands 3. Trachea 4. Epiglottis 5. Larynx 6. Soft palate and uvula 7. Palatine arch and tonsillar fossae 8. Base of the tongue 9. Oropharyngeal walls (lateral and posterior) 10. Vallecula 80. What structures are found in laryngopharynx? 1. Kidneys 2. Sloping laryngeal inlet 3. Postcricoid region 4. Pyriform sinuses 5. Pharyngeal wall 6. Upper border of epiglottis or plane of hyoid bone F- Bronchi 7. Liver 8. Pyriform sinuses x2 9. Small intestine 10. Stomach 81. Acute non specific pharygitis: 1. ulcer bleeds 2. cervical adenitits 3. unilateral pain 4. foetor oris 5. complications such as respiratory obstruction due to laryngeal edema, otitis media or rhinosinusites may occur 6. treatment include conservative thearpy isolation, rest, fluids, asprin, systimic antibiotics, pencilin in fulll dosage 7. sore throat especially on swallowing, earache, mucopurulent exudate and sometimes low pyrexia 8. inflammation is usually caused by both viruses (adenoviruses and rhinoviruses) and bacteria 9. onset is sudden 10. marked infection of the mucosa sometimes with oedema of the soft palate and mouth 82. Acute membranous pharyngitis: 1. Pain is unilateral, foetor oris, fever, ipsilateral cervical adenitis 2. Symptoms usually subside 12-17 days 3. The pain is bilateral 4. Characterized by a gram negative fusiform bacillus and a spirillum 5. Characterized by gram positive bacteria 6. A severe infection due to Corynebacterium 7. No loss of tissue in upper pole 8. The acute symptoms usually subside 4-7 days 9. Acute ulcerative lesion, usually involving one or both tonsils 10. The treatment consists of penicillin and metronidazole, antiseptic mouthwash 83. Acute diphteric pharyngitis: 1. the generalized form is not progressive and toxic 2. incubation period 10-14 days 3. in most cases, children are particularly affected especially those between 2 and 5 years 4. temperature is more than 39c 5. localized forms, the disease is restricted to the tonsils, the nose, the larynx 6. Albuminuria is not common 7. the disease is transmitted from person to person by contact droplets, or contamination by oral or nasal secretions. 8. the membrane can only be wiped off with difficulty and it than leaves a bleeding surface behind. 9. A severe infection due to the Corynebacterium diphtheriae. 10. the membrane cannot be wiped 84. Candidiasis: 1. Treatment includes intensive oral hygiene painting with borax-glycerine nystatin and local nizoral 2. Symptoms are dysphagia, sore throat and mouth with white superficial exudate 3. it only affects tonsils 4. treatment includes pencillin 5. surrounding mucosa is normal 6. The candidiasis affects the tonsils, the palate, the posterior pharyngeal wall 7. white superficial exudate cannot be whipped 8. The causative organism is fungi, usually a candida albicans 9. There is usually only slight redness of the surrounding mucosa 10. Aspergillosis is very common 85. Herpangina: 1. Incubation period 10-15 days 2. The treatment is done by oral hygiene and special diet 3. The tonsils are red and swollen they may be covered with milky white vesicles 4. The incubation period is 4 to 6 days and usually affect children 5. Affects only adults 6. Generalized symptoms are high fever, headache, pain in the neck 7. Has no symptoms 8. The causative organism is the coxsackie A virus 9. Incubation period is three weeks 10. Treatment consists of pencillin 86. Syphilis: 1. Bilateral ulcerated tonisillitis 2. Second stage syphilis lesions vary appear painless silver-gray erosions surrounded by a red periphery 3. The serologic tests for syphilis are positive also dark field illumination is positive 4. The primary stage chancre is seen as firm indurated non painful lesion with superficial ulceration on lip, tonsil, or tongue 5. Treatment with benzathine penicillin G(2.4 mil unit 1.19 biweekly) with erythromycin 6. First stage characterized by painful lesions 7. Have 5 stages 8. Superficial mucosal erosions called mucous patch are characteristic of secondary stage of syphilis 9. Chancre heals in 1 week 10. Dark field illumination test is negative 87. Pharyngitis of mononucleosis: 1. The disease is caused by the Epstein Bar virus 2. The patient has hepatosplenomegaly 3. Incubation period is 16-20 days 4. There may be cranial nerves paralyses (vii/x), serous meningitis and encephalitis, hemolitic anemia, hemorrhagic complications 5. Symptomatic treatment includes oral hygiene and measures to reduce fever, also antibiotics might be given 6. Without hepatosplenomegaly 7. Ampicillin is used in treatment 8. The lymph nodes are hard on palpation 9. Include fever 38 to 39 c marked lymphadenopathy of jugulodigastric group and deep cervical chain, later becoming generalized 10. the patient is asymptomatic 88. The pharyngitis of agranulocytosis: 1. No ulceration or necrosis detected 2. There is regional lymphadenopathy 3. Diagnosis made with serologic test 4. The generalized symptoms include high fever and chills 5. There is ulceration and necrosis of the tonsil and pharynx with blackish exudate 6. Affects only children 7. Treatment consists of only oral hygiene 8. The pharyngitis is often accompanied by an extensive gingivo-stomtitis 9. The disease occurs mainly in older patients and accompanied by ulcero- necrotic pharyngitis 10. Severe injury to the leukopoietic system may be caused by drugs or other toxins 89. Chronic tonsillitis: 1. The systemic effect may declare itself by lowering of resistance, tiredness, unexplained high temperature and loss of appetite 2. Relative Indications include stubborn oral floor as result of excess production of tonsillar plugs 3. The causative organism is usually a mixed flora of aerobic and anaerobic bacteria in which streptococci predominate 4. Relative indication includes pharyngitis sicca 5. Contraindication is chronic tonsillitis 6. Contraindication is peritonsillar abscess 7. Acute or subacute attack of tonsillitis, it is more common in children between the ages of 4 to 15 years old 8. Treatment is not surgical 9. Contraindications include hemophilia malignant tumors, leukemia, tuberculosis and diabetes, cleft palate 10. Affects only old people 90. Chronic non specific pharyngitis: 1. Follicular type- with big blue cyst 2. Mostly asymptomatic 3. There are two clinical types 4. Symptoms are irritation in the throat, constant hawking and snoring 5. Is a rare condition 6. Etiology consists of nasal obstruction, infection, infected gums and teeth, recurrent attacks of acute pharyngitis 7. The uvula can be enlarged or elongated 8. Catarrhal type- with blue congested mucosa 9. This is most common condition especially in patients who have their tonsils removed 10. The clinical atrophic type is usually coexistent with atrophic rhinitis 91. cavity of the larynx: 1. The blood supply of the larynx is divided by the glottis into the two areas (upper and lower) 2. Preepiglottic space is a triangular space lying in front of epiglottis and is bounded by vallecula, hyoid, thyrohyoid membrane. 3. Glottic space is the space between the free margin of the vocal cords and 1 cm inferiorly this space is wide and triangular 4. The subglottic space is down to the lower border of the cricoid cartilage that marks the junction with trachea 5. the cavity of the larynx is divided into 3 parts (supraglottic space, glottic space, subglottic space) 6. Blood supply has one area 7. Preepiglottic space is a square space 8. Subglottic space left to upper bordar 9. Glottic space is narrow and thin 10. The cavity divided into 6 areas 92. Nerve supply of larynx: 1. Inferior laryngeal nerve supplies cricothyroid 2. The superior laryngeal nerve divides extralaryngeally into the internal branch and the external branch 3. Inferior laryngeal nerve supplies sensory innervation 4. The larynx is not supplied by superior laryngeal nerve 5. The smaller external branch gives motor innervation to the cricothyroid muscle and sensory supply to the subglottic area 6. Recurrent nerve never lies posteroinferior 7. Smaller external branch does not give motor innervation 8. The larynx is supplied by the superior laryngeal nerve and the inferior laryngeal nerve that arise from the vagus nerve 9. It has a longer course than the right recurrent laryngeal nerve that turns around the subclavian artery 10. The inferior laryngeal nerve supplies motor innervation to all the intrinsic laryngeal muscles except the cricothyroid and sensory innervation of the subglottic space 93. Protection function of the larynx: 1. The swallowing reflex transmitted in the glossopharyngeal nerve ensures cessation of respiration and closure of the laryngeal inlet. 2. There are 5 sphincters of airway protection 3. Contraction of superior thyroarytenoid in false cords 4. Stimulation of the superior laryngeal nerve produce strong laryngeal adductor responses emphasizing the primitive role of respiratory protection 5. The suprahyoid musculature contracts drawing the larynx anteriorly and superiorly by 2 to 3 cm 6. Surgical removal of epiglottis shows that epiglottis is only of limited necessity for protection of larynx 7. Swallowing reflex is not transmitted in glossopharyngeal nerve 8. Suprahyoid musculature drawing anteriorly 10 to 15cm 9. There are three sphincters of airway protection:(contraction of superior/middle / inferior part of thyroarytenoid 10. Surgical removal is not only of limited necessity 94. Phonation function of the larynx: 1. The vocal cords are positioned near the midline by the isotonic tensing of the cricothyroid muscles. 2. Muscular passive forces exhalation decreases subglottic pressure 3. After neurochronaxic theory each new vibratory cycle is limited by central neuronal impulses via the vagus nerve to the appropriate laryngeal muscle 4. That tone is modified by the movements of the pharynx, tongue, lips and by the resonating chambers of the upper aerodigestive tract. 5. Vocal cords closed in posterior to anterior direction 6. Vocal cords positioned in upperline by isotonic tensing 7. During expiration the air current flows through glottis and the vocal cords vibrate in a concomitant mode 8. During expiration the air current flows through the glottis and the vocal cords vibrate in an alternating mode. 9. Thyroarytenoid muscle does not provide fine isometric contraction 10. When the subglottic air pressure exceeds muscular opposition, the glottis is forced open. 95. Laryngomalacia: 1. The epiglottis is V-shaped 2. Inspiratory stridor begins after 10 weeks postpartum 3. Diagnosis is not established through laryngo-bronchoscopy 4. Treatment - consist of careful observation of the child and reassurance of the parents 5. The stridor is due, in part, to a flaccid supraglottic structure that collapses into the airway with inspiration. 6. Laryngomalacia is a weakness of the supraglottic laryngeal structures (the epiglottis itself, the aryepiglottic fields, arytenoids). 7. Tracheotomy is not required 8. The form and function of vocal cord is not normal 9. The cause lies in abnormal calcium metabolism causing unusual weakness of the supraglottic laryngeal skeleton, particularly the epiglottis. 10. Symptoms: inspiratory stridor begins immediately or within the first few weeks postpartum, in severe cases accompanied by cyanosis. 96. Webs: 1. affects only adults 2. Diagnosis is not made by direct laryngoscopy 3. Small web may be asymptomatic but hoarse cry and cough may be found 4. Adhesions between the anterior ends of either the false cords or the true cords are occasionally seen 5. In atresia, the child presents severe dyspnea at birth 6. sever cases of dyspnea ca not be prevented 7. Symptoms do not depend on degree of glottic closure 8. Webs of the true cords may impair the airway somewhat but also, by shortening the vibration length of the vocal cord makes the voice more high pitched 9. Diagnosis - is made by direct laryngoscopy which shows web of the glottis. 10. Laser surgery is contraindicated 97. Hemangioma: 1. Treatment is not surgical 2. Symptoms contain spontaneous bleeding with aspiration of blood 3. Biopsy is mandatory 4. The biopsy can never be done 5. There is no spontaneous bleeding 6. Symptoms: hoarseness or respiratory obstruction 7. Diagnosis is done by direct laryngoscopy which provides the diagnosis with the tumor can be seen on x-ray film 8. Tumor can not be seen on x-ray 9. Laser surgery is contraindicated 10. Is a vascular tumor with inspiratory stridor at birth or soon after 98. Laryngocele: 1. Laryngocele contains (internal/external laryngocele, epiglottis, hyoid bone, aryepiglottic fold, vestibular fold) 2. Laryngocele may be only internal 3. Treatment is surgical. The sac may be exposed and removed via an external incision 4. External laryngocele is a prolongation of the ventricle through the thyrohyoid membrane to form a palpable cystic mass in the neck 5. The sac is not exposed and removed 6. The diagnosis is made by laryngoscopy, palpation and the tomography (imaging studies) 7. Dyspnea and dysphonia are not present 8. Treatment is not surgical 9. Laryngocele may be only external 10. The internal laryngocele lies within the larynx in the vestibular fold 99. Functional disorders: 1. Only based on nervous disorders 2. Clinically the most important paralysis is that produced by bilateral failure of the recurrent laryngeal nerves function 3. Vocal cords paralysis is not a sing of disease 4. They are characterized by voice disorders such as dysphonia or aphonia and by dyspnea 5. Intermediate position is not seen in paralysis 6. Intermediate position is seen in complete paralysis of both the superior and inferior laryngeal nerves, which thus paralyses all laryngeal muscles 7. Etiology is not a surgical trauma 8. The vocal cords take up different positions during function or in paralyses relative to the imaginary reference line of the sagittal glottic axis 9. It is not a malignant disease 10. These are based on nervous(paralysis), myogenic, articulation or functional causes. 100. Subglottic stenosis: 1. There is no anomaly of cricoid cartilage 2. Diagnosis is made by indirect laryngoscopy 3. Tracheotomy is never used in treatment 4. Subglottic stenosis does not include inflammatory or tumorous distortion of the lumen 5. Tracheotomy maybe be necessary in severe respiratory obstruction the child observed until surgery is possible 6. Etiology is not a surgical trauma 7. Diagnosis is made by direct laryngoscopy 8. Includes inflammatory distortion of lumen 9. Symptoms: inspiratory and expiratory stridor are present 10. Any narrowing of the subglottic airway is by a definition of subglottic stenosis 101. Neck spaces are: 1. Zygomatic space 2. Mandibular space 3. Submandibular space 4. Nasal space 5. Maxillary space 6. Parotid space 7. masticator space 8. lateral pharyngeal space 9. Pharyngeal space 10. Peritonsillar space 102. Which of the following are not true for neck spaces: 1. Parotid space 2. Mandibular space 3. Masticator space 4. Pharyngeal space 5. Lateral pharyngeal space 6. Maxillary space 7. Nasal space 8. Submandibular space 9. Zygomatic space 10. Peritonsillar space 103. Neck spaces are: 1. Zygomatic space 2. Carotid sheath space 3. Pharyngeal space 4. Mandibular space 5. Retro pharyngeal space 6. Danger space 7. Visceral space 8. Nasal space 9. Maxillary space 10. Prevertebral space 104. Which of the following are not true for neck spaces: 1. Zygomatic space 2. Peritonsillar space 3. Nasal space 4. Parotid space 5. Maxillary space 6. Mandibular space 7. Submandibular space 8. Masticator space 9. Pharyngeal space 10. Lateral pharyngeal space 105. Microorganisms in the neck space infections are: 1. Enterococcus 2. Streptococcus pyogenes 3. Haemophilus 4. Hemolytic streptococcus 5. Myxococcus xanthus 6. Bacteroides 7. Klebsiella 8. Neisseria 9. Staphylococcus Aureus 10. Peptostreptococcus 106. Which of the following are not true for microorganisms in the neck space infections: 1. Peptostreptococcus 2. Neisseria 3. Bacteroides 4. Streptococcus pyogenes 5. Myxococcus xanthus 6. Enterococcus 7. Hemolytic streptococcus 8. Haemophilus 9. Klebsiella 10. Staphylococcus aureus 107. Symptoms for peritonsillar abscess are: 1. Patient can not talk 2. Pain irradiates to the ear 3. Temperature is almost at 36C 4. difficulty at swallowing 5. Opening of the mouth is difficult due to trismus 6. Vocal cords are irritated 7. The speech is thick 8. Temperature is normal 9. The patient refuses to eat 10. Bad smell 108. Which of the following are not correct symptoms for peritonsillar abscess : 1. Temperature is almost at 37C 2. Pain irradiates to the ear 3. Patient ca not talk 4. Vocal cords are irritated 5. Opening of the mouth is difficult due to trismus 6. Bad smell 7. The speech is thick 8. Temperature is normal 9. Difficulty at swallowing. 10. The patient refuses to eat 109. Pharyngeal abscess symptoms are: 1. Low temperature 2. Vocal cords are irritated 3. Headache 4. Pyrexia 5. Painful throat 6. Swelling of the neck 7. High temperature, usually more than 39C 8. Apnea 9. Trismus 10. Dysphagia 110. Which of the following are not true for pharyngeal abscess symptoms: 1. Vocal cords are irritated 2. Painful throat 3. Dysphagia 4. Swelling of the neck 5. Headache 6. High temperature, usually more than 39C 7. Apnea 8. Trismus 9. Pyrexia 10. Low temperature 111. Early symptoms of the benign tumors are: 1. purulent otitis 2. tachycardia 3. difficulty swallowing 4. pain of throat 5. fever 6. fullness in ear 7. purulent rhinosinusitis 8. obstruction to nasal respiration 9. voice nasality 10. cough 112. Diagnosis of benign tumors of the pharynx: 1. examination with a mirror 2. electrocardiogram 3. radiography 4. MRI scan 5. CTCP scan 6. biopsy is not recommended 7. CT scan 8. by palpation 9. biopsy can lead to complications 10. blood test 113. Treatment for benign tumors of the pharynx: 1. removal by transpalatal access 2. cryoablation 3. radiotherapy is a palliative measure 4. lateral rhinotomy 5. radiation therapy 6. removal by transmaxillary access 7. targeted drug therapy 8. hormone therapy 9. glossectomy 10. immunotherapy 114. Factors of nasopharynx carcinoma: 1. age 2. environmental exposure 3. Edward syndrome 4. tobacco 5. chronic sinusitis 6. diet low in vitamin Α 7. genetic factors 8. gender 9. poor hygiene 10. Epstein Barr virus 115. Etiologic factors of oropharynx carcinoma: 1. age 2. poor dental care 3. smoking 4. genetic syndrome 5. Klinefelter syndrome 6. alcohol 7. leukemia 8. HPV 9. plumber - Vinson syndrome 10. UP 116. Symptoms of the carcinoma hypopharynx: 1. fever 2. cough 3. dental pain 4. throat pain 5. weight gain 6. dysphagia 7. pain or difficult swallowing 8. appears late 9. headache 10. otalgia 117. Hypopharynx tumor factors: 1. diet low in vitamin A and E 2. poor dental care 3. alcohol 4. EtO4 5. plumer-Vinson syndrome 6. smoking 7. age 8. chronic disease 9. Turner syndrome 10. gender 118. Anatomy of the larynx: 1. median thyroid ligament 2. nasopharynx 3. cricoid cartilage 4. epiglottis 5. conus elasticus 6. the philtrum of the upper lip 7. thyrohyoid membrane 8. laryngopharynx 9. Trachea 10. soft palate 119. Anatomy of the larynx is not: 1. trachea 2. nasal 3. medial nasal 4. cricoid cartilage 5. laryngopharynx 6. conus elasticus 7. nasopharynx 8. soft palate 9. maxilla 10. the philtrum of the upper lip 120. Function of the larynx: 1. fixation of the chest 2. sphincteric closure of laryngeal opening 3. swallowing 4. protection of lower airways 5. respiration 6. produce vocalisation 7. phonation 8. deglutition 9. provides drainage to nose, oral cavity middle ear 10. cough reflex 121. Which is correct about the structure of the pharynx: 1. Layers of the pharynx are mucous membrane, pharyngeal fascia, muscular coat, bucopharyngeal fascia 2. The pharynx has five layer 3. Muscular coat has 3 layers, superficial, external, internal 4. Pharyngeal fascia covers the outer surface of the pharynx 5. Pharyngeal fascia is a discontinuous connective tissue coat in the lateral and posterior walls of the pharynx 6. Lingual tonsils, lies in the tip of the tongue 7. Bucopharyngeal fascia presents a layer in the pharynx and covers the outer surface of the it 8. The pharynx is a fibromuscular tube and it has four main layers 9. Mucous membrane is continuous with the mucous membranes of the Eustachian tube, nasal fossae, mouth, larynx and esophagus 10. Nasopharyngeal tonsils it is a single lateral structure 122. Relations of the pharynx: 1. superiorly – is not related with the nasopharynx 2. anteriorly - it opens into the nasopharynx, mouth and larynx 3. inferiorly - is not continuated by the larynx. 4. superiorly - is related with the base of the skull 5. anteriorly – opens just into the nasopharynx 6. posteriorly - the pharynx is not separated from the bodies of the cervical vertebrae by the prevertebral muscles and prevertebral fascia that covers them 7. inferiorly - is continuated by the esophagus 8. posteriorly - the pharynx is separated from the bodies of the cervical vertebrae by the prevertebral muscles and prevertebral fascia that covers them 9. laterally –do not lie lateropharyngeal space with prestyloid and poststyloid compartments separated by the stylopharyngeal aponevrosis. 10. laterally - lies lateropharyngeal space with prestyloid and poststyloid compartments separated by the stylopharyngeal aponevrosis 123. The main function of the mouth and pharynx: 1. One of the main functions of the mouth and pharynx is speech 2. Storage 3. Carry oxygen 4. Digestion 5. One of the main functions of the mouth and pharynx is deglutition 6. One of the main functions of the mouth and pharynx is taste 7. Protection 8. Pump blood 9. One of the main functions of the mouth and pharynx is respiration 10. One of the main functions of the mouth and pharynx is mastication 124. Which is correct about taste sensations: 1. The sensory nerve supply is provided by the VI-th cranial nerve 2. Situated only on the pharynx. 3. The anterior two-thirds of the tongue are more sensitive to sweet, sour and salt. 4. The taste buds situated on the tongue and also on the hard palate, the anterior faucial pillars, the tonsils, the posterior wall of the pharynx, the oral mucosa and the epiglottis. 5. The posterior one-third of the tongue is most sensitive to bitter and the sensory nerve supply is provided by glossopharyngeal nerve (IX-th cranial nerve). 6. The fine pairs of the taste cells are in contact with fluids in the mouth allowing the sense of taste to be evoked. 7. Sense of smell is not important in tasting food 8. There are four basic taste sensations: sweet, salt, sour and bitter. 9. The anterior two-thirds of the tongue are not sensitive to sweet 10. The posterior one-third of the tongue is not sensitive to bitter 125. Which is correct about respiration: 1. The air passes through the nose and pharynx toward the larynx. 2. The mouth is involved in respiration only as supplementary measure. 3. the cricopharyngeal muscle is not related to the larynx. 4. Closure at the pharyngo-esophageal segment is stable being interrupted only during swallowing, regurgitation, vomiting or eructation. 5. During nasal portal respiration, the pharyngeal palate and tongue are not apposition. 6. During nasal portal respiration, the pharyngeal palate and tongue are in apposition. 7. During respiration the air do not pass through the nose. 8. The mouth is not involved in respiration. 9. The cricopharyngeal muscle participates together with other muscles in holding the larynx in position. 10. The pharyngeal airway is closed during sleep. 126. Positional and immune-specific function of the mouth and pharynx: 1. The mandible is not stabilized by the glenoid fossa. 2. The lymphoepithelial tissue of the mouth and pharynx serves to immunologic surveillance, produces lymphocytes and specific antibodies (all types of immunglobulins occur in the tonsils). 3. The positional mechanism of the tongue is not important. 4. The positional mechanism of the tongue is of importance in pharyngeal participation in respiration, including the maintenance of the pharyngeal airway. 5. The genioglossus muscle is not active in inspiration. 6. The mandible has an important role in position of the mouth, of the pharyngeal airway and more generally of the head and neck. 7. The mandible do not have an important role in position of the mouth. 8. The mandible is stabilized by the glenoid fossa of the temporo- mandibular joint, contributing significantly to the regional sensory resources that control tongue motions. 9. The mandible is not important in position of the head and neck. 10. The genioglossus muscle, in particular, is consistently active during inspiration. 127. Congenital anomalies of the teeth: 1. Represented only by the number of teeth. 2. These are anomalies in size, shape and number of the teeth. 3. Partial anodontia - is more common. 4. Malocclusion of the teeth is not related to local causes. 5. Total anodontia is not rare 6. Malocclusion of the teeth - may be due to local causes absence of one or more teeth, supernumerary teeth or to general causes 7. Supernumerary teeth - additional teeth due to an accessory bud being given of form the dental lamina. 8. Total anodontia - is rare. 9. Partial anodontia is not common. 10. These anomalies are only in size. 128. Congenital malformation of the pharynx: 1. Bifid uvula, stenosis of the pharynx may involve the nasopharyngeal isthmus. If the degree of stenosis is marked it may interfere with speech, smell, swelling and even respiration. 2. A brachial cyst it is usually painful 3. Squamous cell carcinoma is very common. 4. A brachial cyst is usually painless and because fluctuation is difficult to elicit so it is frequently mistaken for tuberculous adenitis. 5. Branchial cysts usually lie deep to the anterior border of the sterno- cleido-mastoidean muscle. 6. Dysphagia may be produced and cannot be relieved 7. Bifid uvula, stenosis of the pharynx, do not involve the nasopharyngeal isthmus. 8. Very rarely a squamous cell carcinoma may develop as a primary tumor in a branchial cyst because squamous epithelium may turn malignant wherever it is found. 9. Stainig the lumen with blue dye before skin incision make dissection harder 10. Web or stricture of the pharynx is a rare affection of the post cricoid region of the laryngopharynx. 129. Acute nasopharyngitis: 1. Clinical features include: localized pain or discomfort, exaggerated by swelling, pyrexia, cervical adenitis. 2. Is an inflammation of the epithelial tissue of the pharynx. 3. Treatment is expectant. Paracetamol may be required in children. 4. Clinical features do not include pain 5. Is not an inflammation. 6. There is no treatment. 7. Can be bacterial - especially by Streptococcus pneumonia and Hemophilus Influenzae or viral - especially by influenza, rhino- and adenoviruses. 8. Is only bacterial. 9. A dry, hot sensation in the nasopharynx is often the first symptom of an acute upper respiratory infection as in the common cold. 10. A wet, cold sensation in the nasopharynx is often the first symptom 130. Adenoids: 1. Adenoid reaches maximum size between the ages of 3 and 7 and then undergoes involution. 2. The adenoid may also obstruct the pharyngeal opening of the Eustachian tube either mechanically or by edema due to a salpingitis caused by the infected adenoid. 3. The hypertrophic adenoids do not obstruct the posterior choanae. 4. A coexistent chronic sinusitis may also contribute to an inflammatory edema of the Eustachian tube. 5. Reaches their maximum size between the ages of 1-3. 6. Are not represented in the nasopharynx. 7. Do not obstruct the pharyngeal opening of the Eustachian tube. 8. The hypertrophic adenoid may obstruct the posterior choanae interfering with nasal respiration and causing stasis of secretions in the nasal cavity. 9. Adenoid tissue is present in the nasopharynx of all normal children amount varying from one child to another and also varying with age. 10. Are not related with age. 131. The functional disorders are represented by: 1. Due to its longer path the left recurrent laryngeal nerve is paralysed in 78% of cases, the right in 16% and both in 6%. 2. Women are three times more affected than men. 3. Clinically the most important paralysis is that produced by bilateral failure of the recurrent laryngeal nerves function. 4. The paramedian position is adopted in phonation. 5. The cadaveric position is a correct term. 6. The etiology of the recurrent laryngeal nerve may be a malignant disease, surgical trauma, idiopathic, inflammatory, nonsurgical trauma or neurological. 7. They are characterized by sleep disorders such as dysphonia or aphonia and by dyspnea. 8. Are not based on nervous, myogenic, articulation or functional causes. 9. The vocal cords take up different positions during function or in paralyses relative to the imaginary reference line of the sagittal glottic axis. 10. The medial position is adopted in phonation. The lateral position of extreme abduction occurs on inspiration. 132. The following statements are true regarding unilateral recurrent nerve paralysis: 1. Laryngoscopy shows the vocal cord to be immobilized in the paramedian position on the side. 2. Tracheotomy is the treatment of choice in all cases. 3. For the professional voice users the treatment should be teflon injection. 4. There is respiratory obstruction but the patient can still sing. 5. There are no later improvements in the voice. 6. If the casual disease cannot be treated satisfactorily the patient is given speech therapy, to achieve compensatory vocal cord closure by action of the still functioning vocal cord. 7. There is no appreciable respiratory obstruction. The patient can no longer sing. 8. It is not a functional disorder. 9. Symptoms include aphonia in the chronic phase. 10. The symptoms include dysphonia in the acute phase, with later improvement in the voice. 133. Regarding bilateral recurrent nerve paralysis the following statements are true: 1. Bilateral abductor paralysis is usually only seen after a tracheotomy. 2. Treatment of bilateral abductor paralysis involves: a tracheotomy for immediate respiratory difficulty. 3. May only be represented by bilateral abductive paralysis. 4. May only be represented by bilateral adductor paralysis. 5. Bilateral abductor paralysis is usually seen after a thyroidectomy; other causes are rare. 6. Symptoms of bilateral abductor paralysis involve the voice is still good but there is stridor on exertion. In the acute situation, stridor may be life threatening and a tracheostomy is required. 7. Bilateral adductor paralysis is a hysterical dysphonia. 8. In the case of bilateral abductor paralysis, a permanent tracheostomy with a speaking valve assures a good airway and a good voice. 9. Bilateral adductor paralysis is usually a hysterical aphonia, less common the cause is organic (a central nervous system disease such as a bulbar paralysis). 10. Tracheotomy is the treatment for late respiratory difficulty. 134. Regarding the traumatisms of the Larynx: 1. Internal traumas are only common in traffic accidents. 2. Injuries of the larynx due to external traumatisms are particularly common in traffic accidents, karate blows, fighting and attempting strangulation. 3. In any patient who is suspected of possible laryngeal injuries the symptoms indicative of some derangement of laryngeal structure includes increasing airway obstruction with dyspnea and stridor, dysphonia or aphonia, cough, hemoptysis, neck pain, dysphagia and odynophagia. 4. Diagnosis of laryngeal trauma is based on CBCT scans. 5. In the case of external trauma to the larynx, the crushing injuries to the larynx force it against the cervical spine and fracture the cricoid and thyroid cartilages. 6. Airway thyroidectomy is the treatment. 7. Laryngeal cartilage fractures must be increased and mobilised. 8. The function of the larynx may be affected by external or internal trauma, foreign bodies, vocal abuse or chemical toxins. 9. Destructive clinical signs of laryngeal injuries do not include subcutaneous emphysema. 10. Diagnosis of trauma to the larynx is based on indirect and direct laryngoscopy, roentgenogram of the neck and chest and the CT scan. 135. Vocal abuse is a traumatism of the larynx represented by the following: 1. People who work in IT commonly develop chronic vocal abuse. 2. Symptoms of acute vocal abuse include dysphagia. 3. Is represented by two forms acute or chronic. 4. Symptoms of chronic vocal abuse include the voice being hoarse and croaking. Singing is difficult or impossible. 5. Is only represented by acute vocal abuse. 6. Patients with chronic vocal abuse develop singer nodules because of chronic overuse, misuse of the voice and in teachers who must talk a lot. Singer nodules are due to unsatisfactory singing technique. 7. Symptoms of acute vocal abuse include dysphonia, or even aphonia, and pain on speaking. 8. Direct or indirect laryngoscopy in chronic vocal abuse shows the nodules at the junction between the anterior and middle thirds of the vocal cord, which is the point of maximum amplitude of the vibration of the vocal cords. They are usually bilateral. 9. Postoperative speech therapy is not necessary in such patients. 10. Treatment does not involve endolaryngeal microsurgery. 136. Intubation injury is a form of traumatism to the larynx and is characterized by the following: 1. Tears of the vocal cord do not require surgery. 2. The acute intubation injury occurs due to repeated or incorrect intubation, a wrong sized tube, a protruding guide wire, intermittent positive pressure respiration, overextension, lead to a myogenic or neurogenic paralysis. 3. Drying of the mucosa due to the premedication facilitates mucosal injury in acute intubation injuries. 4. Treatment of chronic intubation injury is surgical; granulomas are removed by endolaryngeal microsurgery or laser with post-operative speech therapy. 5. Dysphonia or laryngeal dyspnea develops 3 to 5 days after intubation in chronic intubation injuries. 6. Intubation injuries are due to correct intubations. 7. Intubation granulomas are unilateral. 8. Superficial mucosal injuries never heal spontaneously. 9. Symptoms of acute intubation injuries are represented by dysphonia, attacks of coughing, pain and hemoptysis. 10. The symptoms of chronic intubation injuries are represented by dysphonia or laryngeal dyspnea which develop 2 to 8 weeks after intubation. 137. Acute (simple) laryngitis is characterized by the following: 1. Diagnosis is made by history and examination of the respiratory tract. Indirect laryngoscopy can be difficult in the presence of acute infection. 2. Usually caused by coxsackie viruses. 3. Represents the least common form of laryngitis. 4. Symptoms of the disease include: hoarseness, aphonia, pain in the larynx, coughing attacks. The general symptoms depend very much on concomitant infections in the other parts of the respiratory tract. 5. Does not occur as a symptom of a common cold. 6. The etiology is often candida albicans 7. The disease is often associated with and secondary to an acute inflammation of the nose, throat or paranasal sinuses. 8. Steroids are indicated especially in the treatment of children for marked edema. General measures include fluids by mouth, aspirin and steam inhalation. 9. Presence of bacterial infections is usually an indication for antivirals. 10. Treatment depends on the degree of local changes in the larynx and on the presence concomitant infections in the other parts of the respiratory tract. 138. Membranous laryngitis is an inflammation of the larynx represented by: 1. Mild fever, obesity and headaches are symptoms of the disease. 2. A urinalysis will establish the diagnosis and differentiate it with other forms of laryngitis. 3. Tracheotomy is required for reduced dyspnea. 4. The most characteristic sign is the presence of a confluent membrane covering the laryngeal surface. 5. Symptoms of membranous laryngitis are: moderate fever, anorexia and thirst. Swallowing is painful and coughing is usually present. 6. Treatments includes: antitoxin, antibiotics given depending on the sensitivity of the micro-organisms and tracheotomy which is required for increasing dyspnea. 7. It is a common form of laryngitis. 8. Rarely the etiological agent is Corynebacterium diptheriae, usually today membranous laryngitis is caused by Streptococci and Pseudomonas aeruginosa. 9. Laryngoscopy detects greyish white membranes that appear on the larynx; its removal is followed by bleeding. 10. Usually the etiological agent is the Hepatitis B virus. 139. Acute subglottic laryngitis is a very serious acute disease most common between the first and fifth years of life which is represented by: 1. Endotracheal intubation is usually limited to 1-2 weeks. 2. The main intralaryngeal changes, consisting of a substantial swelling of the mucosa are found on the under surface of the true vocal cords and in the subglottic region. 3. Tracheostomy is carried out for mild obstructions. 4. Antibiotics are given to prevent secondary infection. 5. The exact etiology is unknown but the disease is often associated with an infection by one of the influenza viruses. 6. The complete clinical picture develops in a very short period of time and seems alarming. The voice is raw, the dry cough becomes rapidly worse. 7. Recurrent infections in the nasopharynx and nasal obstruction due to clinically inflamed hypertrophied adenoids and tonsils are important in the etiology. 8. Hot weather appears to increase the morbidity. 9. Laryngoscopy shows white membranes that appear on the larynx. 10. Sedatives are always given to the child as treatment. 140. The following statements regarding acute Laryngotracheobronchitis are true: 1. Corynebacterium diptheriae and Pseudomonas aeruginosa are the common etiological agents. 2. The aetiology is probably a virus (Parainfluenza type 1-4); 3. Typically the onset is like an ordinary cold except for the early presence of a croupy cough. 4. The disease occurs in children between the ages of 7-9 years old. 5. The disease occurs in adults usually. 6. Laryngotracheobronchitis is an acute infection of the upper respiratory way. 7. Is an inflammation of the epiglottis. 8. Anorexia and fever are common in the early stages. Restlessness, dehydration and exhaustion may be noted later. 9. Laryngotracheobronchitis is an acute infection of the lower respiratory way extending from the larynx into the smaller subdivisions of the bronchial tree. 10. The pathology of the disease is represented by a descending inflammation of the mucous membrane lining the lower respiratory tract, followed by congestion, edema and exudation. 141. Chronic ethmoiditis is not characterized by : 1. Treatment does not include surgical approach 2. Chronic ethmoiditis is almost symptomless 3. Tomography and endoscopy are required for diagnosis 4. Chronic ethmoiditis presents severe symptoms 5. Is a premalignant lesion 6. Only clinical examination and anamnesis is required for positive diagnosis 7. Always presents pain in the neck 8. May present the following symptoms: nasal obstruction, nasal discharge, nasal polyps and disorders of smell 9. If chronic ethmoiditis does not react satisfactorily to conservative treatment, surgery should be considered 10. The ethmoidal labyrinth can be approached via the nose (Intranasal exenteration of the ethmoidal labyrinth) 142. Chronic frontal sinusitis is not characterized by: 1. The treatment of chronic frontal sinusitis is done only by surgical treatment 2. Is asymptomatic 3. The treatment of chronic frontal sinusitis can include conservative treatment or surgical treatment 4. Symptoms are reduced to a feeling of pressure over the sinus 5. The treatment of chronic frontal sinusitis is done only by conservative treatment 6. Presence of sensitivity of the supraorbital nerve to pressure and nasal discharge 7. The diagnosis is made only by anamnesis 8. The diagnosis is made radiographically 9. Anterior rhinoscopy may show edema of the cheeks 10. Anterior rhinoscopy may show edema of the nasal mucosa and chronic rhinitis 143. Which muscles will not form the mesenchyme tissue of the third branchial arch? 1. brachioradialis 2. stylopharyngeus 3. superior constrictor of pharynx 4. styloglossi 5. triceps brachii 6. flexor carpi ulnaris 7. the lower rim of hyoid. 8. extensor carpi radialis 9. greater horns of hyoid 10. extensor carpi ulnaris 144. Three meatuses (inferior, middle and superior): 1. The superior meatus contains the opening for the posterior ethmoid cells 2. The inferior meatus lies between the middle turbinate and the roof of the nasal cavity. 3. The middle meatus lies between the middle and superior turbinate. 4. Lie under the three turbinates 5. The inferior meatus contains the nasolacrimal duct 6. The middle meatus is the most complex and by far the most important 7. The inferior meatus lies between the inferior turbinate and the floor of the nasal cavity. 8. The superior meatus lies between the inferior and the middle turbinate 9. The superior meatus is the most complex and by far the most important. 10. The superior meatus contains the opening for the posterior ethmoid cells. 145. Paranasal Sinuses are characterized by: 1. The ethmoidal sinus is fully developed at birth. 2. They are lined a mucous membrane. 3. The paranasal sinuses are maxillary, ethmoidal, frontal and sphenoidal sinuses. 4. There are four paranasal sinuses. 5. The are five paranasal sin

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