Head and Neck

???) Regardless of age or sex the most common neck swelling is:
Lymph node enlargement
Goiter
Thyroglossal cyst
Aneurysm of carotid artery
Salivary gland tumor

Answer: 1* Lymph node enlargement

???) A painless soft tissue mass particularly attached to skin with well
defined slippery edge is:
Cystic hygroma
Cavernous hemangioma
Lipoma
Neurofibroma
Fibroma

Answer: 3* Lipoma

Salivary Glands OT30-OT32.

1. Salivary Gland Neoplasms.

???) A painless transparent cystic swelling in the floor of the mouth is
known as:
A. Sublingual dermoid
B. Ranula
C. Lymphangioma
D. Hemangioma
E. Dentigerous cyst

Answer: 2* Ranula

???) A recurrent painfull swelling in the submandibular triangle at meal

times is a characteristic of:
A. Stone in the duct of the submandibular salivary gland
B. TB submandibular lymphadenitis
C. Branchial cyst
D. Thyroglossal cyst
E. Pharyngeal pouch

Answer: 1* Stone in the duct of the submandibular salivary gland

???) Concerning pleomorphic adenoma of the salivary glands all
of the following are true, except:
It is usually of slow growth rate
Most commonly it arises in the submandibular salivary gland
Although it is a benign tumor simple enucleation of the tumor may
result in multi-centric recurrence
After many years a few pleomorphic adenomas will exhibit malignant
change
Superficial parotidectomy is the ideal treatment of cases arising in the
parotid gland

Answer: 2* Most commonly it arises in the submandibular salivary gland

???) Concerning Warthin's tumor, all the following are true

except:
This is a cystic tumor which contains epithelial and lymphoid elements
It is benign tumor, soft and well defined
Slow-growing tumor, which presents as painless swelling over angle of
jaw
It is in parotid glands more than submandibular glands
It is appears in females more than males

Answer: 5* It is appears in females more than males

???) During superficial parotidetomy, one of the following nerves may be

injured:
A. The third cranial nerve oculomotor
B. The fifth cranial nerve trigeminal
C. The seventh cranial nerve facial
D. The ninth cranial nerve glossopharyngeal
E. The eleventh cranial nerve - accessory

Answer: 3* The seventh cranial nerve facial

???) The most common tumor of the parotid gland:

Adenocarcinoma
Mucoepidermoid carcinoma
Pleomorphic adenoma
Squamous cell carcinoma
Monomorphic carcinoma

Answer: 3* pleomorphic adenoma

Congenital Neck Masses OT32-OT34.

???) Swelling in the midline of the neck could be one of the following,
except:
A. Thyroglossal cyst
B. Dermoid cyst
C. Thyroid gland
D. Enlarged lymph node
E. Branchial cyst

Answer: E* Branchial cyst

???) A 3 year old child has a draining lesion in the lower third of the
neck along the anterior border of the sternocleidomastoid muscle. The
most likely diagnosis is:
Atypical mycobacterial infection
Thyroglossal duct sinus
Second branchial clef sinus
Actinomycosis
Epidermal inclusion cyst

Answer: 3* Second branchial clef sinus

???) Concerning branchial cyst, all the following are true except:
It's a remnant of the 2 branchial cleft
It may be associated with sinuses or fistulas
It appears in early adult life
Midline neck lump
Lined by squamous epithelium, their fluid contains cholesterol crystals

Answer: 4* Midline neck lump

???) A 15 years old patient presented with a painless rounded midline

swelling of the anterior aspect of the neck that moves with deglutition
and protrusion of the tongue, is mostly having:
A. Sublingual dermoid
B. Cystic hygroma
C. Thyro-glossal cyst
D. Solitary nodule of the thyroid isthmus
E. Submental lymph node

Answer: 3* Thyro-glossal cyst

???) Soft cystic brilliantly translucent swelling at the side of the

neck appearing at birth or early infancy is:
A. Pharyngeal pouch
B. Branchial cyst
C. Carotid body tumor
D. Cystic hygroma
E. Sternomastoid tumor

Answer: 4* Cystic hygroma

???) After difficult labor the newly born infant found to have a huge
mass in one side of his neck which is softly cystic, partially compressive
and brilliantly translucent, this infant has:
A. Sternomastoid tumor
B. Branchial cyst
C. Cystic hygroma
D. Pharyngeal pouch
E. Cervical rib

Answer: 3* Cystic hygroma

Neoplasms of the Head and Neck OT34-OT38.

???) The malignant thyroid tumor that occurs in young ages, spreads
mainly by lymphatics and has good prognosis is:
A. Papillary carcinoma
B. Follicular carcinoma
C. Lymphoma
D. Medullary carcinoma
E. Anaplastic carcinoma

Answer: 1* Papillary carcinoma

???) The thyroid tumor which is may be associated with

pheochromocytoma is:
A. Papillary carcinoma
B. Medullary carcinoma
C. Follicular carcinoma
D. Anaplastic carcinoma
E. Malignant lymphoma

Answer: 2* Medullary carcinoma

???) The thyroid tumor that spreads mainly by lymphatics is:

A. Papillary carcinoma
B. Medullary carcinoma
C. Follicular carcinoma
D. Anaplastic carcinoma
E. Thyroid sarcoma

Answer: 1* papillary carcinoma

???) Concerning follicular thyroid carcinoma, all the following are true
except:
Less common than papillary carcinoma
The peak incidence is in the 40-60 year age group rather than in young
as in papillary carcinoma
The most common site for distant metastasis in bone
Often multicentric within thyroid gland
Fine-needle aspiration (FNA) can't diagnose follicular thyroid carcinoma

Answer: 3* The most common site for distant metastasis in bone

???) A 45 year old female patient presented with right thyroid nodule
and hoarseness of voice of 6 months duration, the most likely diagnosed
is:
Hashimoto thyroiditis
Papillary thyroid carcinoma
Anaplastic thyroid cancer
Graves disease
Medullary thyroid cancer

Answer: 2* Papillary thyroid carcinoma

???) Regarding multinodular goiter, one is correct:

10-15% of them will be malignant
Surgery is always advisable because of fear of malignancy
The main indication for surgery is pressure symptom or cosmetics
Giving L-thyroxin and inderal is the treatment of choice
Fine needle biopsy is contra-indicated because of possible bleeding

Answer: 3* The main indication for surgery is pressure symptom or

cosmetics

???) The most dangerous complication after thyroid surgery is:

Hypothyroidism
Hypoparathyroidism
Hoarseness of voice
Respiratory obstruction
Wound infection
Answer: 4* Respiratory obstruction

???) The manifestations of para-thyroid insufficiency that occurs

after thyroid surgery starts usually:
Immediately after surgery
Few hours after surgery
2-5 days after surgery
Two months after surgery
Six months after surgery

Answer: 3* 2-5 days after surgery

***) In Thyroid gland, all the following are true except:

A. Located anterior and caudal to the cartilages of larynx
B. Normal weight 20 grams
C. Follicles are the functional secretary units of thyroid gland
D. Most of triidothyronine is secreted by thyroid follicles
E. Thyroglobuline has tyrosine incorporated in its molecule

Answer: D* Most of triidothyronine is secreted by thyroid follicles

???) Buccinator muscle is supplied by:

Oculomotor nerve
Trigeminal nerve
Facial nerve
Hypoglossal nerve
Glossopharyngeal nerve

Answer: 3* Facial nerve

???) The recurrent laryngeal nerve is a branch from the:

A. Cervical plexus
B. Trigeminal nerve
C. Facial nerve
D. Glossopharyngeal nerve
E. Vagus nerve

Answer: 5* Vagus nerve