DEPARTMENT OF ORAL AND

MAXILLOFACIAL SURGERY

GOVERMENT DENTAL COLLEGE &

HOSPITAL, AHMEDABAD.

Swellings, Ulcers And Tumors Of

Head And Neck

Presented by:-Ankita Bhatt

Urmi Fanse

Intern Batch:-2013 14.

1
Que:-1. Cystic hygroma is:

A. A form of hydrocele
B. A branchial cleft cyst
C. Salivary gland enlargement
D. Lymphangioma

Ans:- D . Lymphangioma

Exp.:- Cystic hygroma is the cavernous lymphangioma (lymphangiectasia),

which manifests in the neck of neonates or occasionally present at birth.
The swelling is soft, partially compressible, brilliantly translucent and
increases in size when the child coughs or cries. Definitive treatment is
excision of the cyst at an early stage.

Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

Que:- 2.dermoid cyst is a form of:

A. Cystic hamartoma
B. Cystic teratoma
C. Choriostoma
D. Hamartoma

Ans:- B . Cystic teratoma

Exp.:- Four type of dermoids are.

Teratomaus dermoids: Found in ovary, testis and superior mediastinum etc. They
arise from stem cells containing all three embryonic layers.

Sequestrastration dermoids: Formed by the inclusion of epithelial nests in lines

of embryonic fusion. Found in the midline, external angular process, on the skull
and behind the ear.

Implantation dermoids: Due to implantated epithelial cell in the puncture wounds

of fingers.

Dermoid: Thyroglossal cyst and ependymal cyst in the brain examples.

Ref.:- B & L, 23rd Edition, Page No. 149.
2
Que.:-3. Which of the following statements about a basal cell carcinoma of the
skin is TRUE?

A. It is also called a marjolins ulcer.

B. It metastases to the regional lymph nodes
C. It is radiosensitive
D. None of the above statements is true

Ans :- C . It is radiosensitive

Exp.:-

Ref.:- B & L, 23rd Edition, Page No. 181/ 24th Edition, Page No. 632.

Que:-4. In staging of Hodgkins lymphoma, bilateral involvement of lymph

nodes on either side of diaphragm is:

A. Stage-I
B. Stage-II
C. Stage-III
D. Stage-IV

Ans:- C . Stage-IV

Exp.:-

Involvement of single lymphnode region(or) involvement of single

Stage-I extralymphatic organ

Involvement of two or more lymphnode region on the same side of

Stage-II diaphragm.

Stage-III Involvement of lymphnode regions on both sides of the diaphragm

Stage-IV Multiple or disseminated foci of involvement

Ref.:- S. Das 2nd Edition, Page No. 175.

3
Que:-5. A soft, cystic, fluctuant swelling in a childs neck which is brilliantly
translucent is most likely:

A. Sternomastoid tumour
B. Cystic hygroma
C. Branchial cyst
D. Cold abscess

Ans:- B . Cystic hygroma

Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

Que:-6. Potato tumor is a tumor of:

A. Carotid body
B. Sternocleido mastoid muscle
C. Carotid sinus
D. None of the above

Ans :- A . Carotid body

Exp.:-

Tumor Synonym Location

Carotid body tumor Potato tumor, Beneath the anterior edge
chemodectoma of sternomastoid
Infected,ulcerated Cocks peculiar tumor Scalp
subaseous cyst
Extra dural abscess Potts puffy tumor Skull
Lipoma Ubiquitous tumor Universal (anywhere in
the body )
Cylinderoma Turban tumor Scalp
Sternomastoid tumor Congenital torticollis Middle of the
sternomastoid muscle

Ref.:- S. Das 2nd Edition, Page No. 149.

4
Que:-7. All are true regarding sebaceous cyst except:

A. Is classified as an epidermoid cyst

B. Only occurs on the face and scalp.
C. Can, if ulcerated, becomes a sebaceous horn
D. Characteristically displays a punctum

Ans:- B . Only occurs on the face and scalp.

Exp.:- Epidermoid cyst (or) Sebaceous cyst are common on face, scalp, neck,
chest and scrotum and they display characteristic punctum.

An ulcerated sebaceous cyst resebling squamous carcinoma is called cock

peculiar tumor. Sometimes the contents of the cyst escape from the orifice
and form sebaceous houn. Treatment of sebaceous cyst is surgical excision.

Ref.:- B & L, 23rd Edition, Page No. 173 / 24th Edition, Page No. 415.

Que:-8. All the following are congenital cysts except

A. External angular dermoid cyst

B. Sebaceous cyst
C. Branchial angle
D. Thyroglossal cyst

Ans:- B. Sebaceous cyst

Exp.:- Options A,C and D are congenital cysts while B is acquired cyst.

Congenital cysts Acquired cysts Parasitic cysts

Sequestration Sebaceous cyst Hydatid
dermoid Implantation Cysticercosis
Tubule dermoids dermoids
(Thyroglossal cyst) Retention
Brachial cyst Cystic
Cysts tumors

Ref.:- B & L, 23rd Edition, Page No. 156/ 24th Edition, Page No. 207.

5
Que:-9. Ranula is acondition which occur in:

A. Pre auricular area

B. Medial angle of orbit
C. Nasolabial angle
D. Floor of the mouth

Ans:- D . Floor of the mouth

Ref.:- B & L, 23rd Edition, Page No. 657.

Que:-10. Basal cell carcinomas:

A. Usually metastasize to regional lymph nodes

B. Common on the face and neck
C. Common in females
D. Radio resistant

Ans:- B . Common on the face and neck

Ref.:- B & L, 23rd Edition, Page No. 180/ 24th Edition, Page No. 632.

Que:-11. In a middle aged female swelling that presents in the midline of neck
is mostly originating from:

A. Larynx
B. Trachea
C. Thyroid
D. Hyoid

Ans:- C . Thyroid

Ref.:- B & L, 23rd Edition, Page No. 708.

6
Que:-12. Potts puffy tumor is:

A. A malignant tumor
B. An extradural abscess
C. A tumor or pituitary gland
D. An adrenal gland tumor
Ans:- B . An extradural abscess

Exp.:- Osteomyelitis of the skull which is associated with a subperiosteal swelling

and oedema of the scalp is referred as potts puffy tumor.

Ref.:- B & L, 23rd Edition, Page No. 544.

Que:-13. Cocks peculiar tumour is:

A. Infected squamous cell carcinoma

B. Infected basal cell carcinoma
C. Infected, ulcerated Sebaceous cyst
D. Infected ulcerated dermoid cyst

Ans:- C . Infected, ulcerated Sebaceous cyst

Ref.:- B & L, 23rd Edition, Page No. 173.

Que:- 14. What is sternocledomastoid tumor?

A. Hematoma of sternocledomastoid muscle

B. Malignancy of sternocledomastoid muscle
C. Lymphnodes related to the said muscle
D. Benign tumor of the said muscle

Ans:- A . Hematoma of sternocledomastoid muscle

Exp.:- Aetiology of sternomastoid tumor includes infarction of central portion of

the sternomastoid muscle (or) haematoma formation (or) obliteration of
sternomastoid branch of superior thyroid artery. It is situated in the middle
of the sternomastoid muscle i.e. in the middle third of the neck on its lateral
side.

Ref.:- S. Das 2nd Edition, Page No. 145.

7
Que:-15. The type of ultraviolet radiation (UV) that is known to induce skin
cancer is:

A. UV-A
B. UV-B
C. UV-C
D. UV-D

Ans:- B . UV-B

Exp.:- Ultraviolet radiation is the principle cause of all types of skin cancer.
Melanim plays a protective role against UV radiation. UV rays are divided
as A, B and C according to wavelength. UV C waves do not contribute to
skin cancer because they have short wavelength and are filtered by ozone.
Among UV A and B rays, UV B rays, UV B rays cause more damage.

Ref.:- B & L, 25th Edition, Page No. 596.

Que:-16. Midline swelling is seen in all except:

A. Blind brachial cyst

B. Thyroglossal cyst
C. Submental lymphadenopathy
D. Substernal cyst

Ans:- A . Blind brachial cyst

Exp.:- Brachial cyst develops from the vestigial remnants of the second branchial
cleft. It is usually found at the junction of the upper third and middle third
of the sternomastoid muscle at its anterior border.

Branchial fistula represent persistent second branchial cleft. Its extranal

orifice is situated in the lower third of teh neck near the anterior border of
sternomastoid. Its internal orifice is located on the anterior aspect of
posterior faucial pillar just behind the tonsil.

Ref.:- B & L, 23rd Edition, Page No. 699/ 24th Edition, Page No. 770.

8
Que:-17.all are true about cystic hygroma axcept

A. Pulsatile
B. May cause respiratory obstruction
C. Common in neck
D. Present at birth

Ans:- A . Pulsatile

Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

Que:-18.earliest tumour to appear after birth is:

A. Sternomastoid tumour
B. Cystic hygroma
C. Branchial cyst
D. Lymphoma

Ans:- B . Cystic hygroma

Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

Que:-19. Treatment of cystic hygroma is:

A. Surgical excision
B. Injection of sclerosants
C. Irradiation
D. Masterly inactivity

Ans:- A . Surgical excision

Ref.:- B & L, 23rd Edition, Page No. 701/ 24th Edition, Page No. 771.

9
Que:-20. Commonest site of branchial ayst:

A. Lower 1/3 of sternomastoid on anterior border

B. Lower 1/3 of sternomastoid on posterior border
C. Upper 1/3 of sternomastoid on anterior border
D. Upper 1/3 of sternomastoid on posterior border

Ans:- C . Upper 1/3 of sternomastoid on anterior border

Ref.:- B & L, 23rd Edition, Page No. 699/ 24th Edition, Page No. 770.

Que:-21. The most common site of the internal opening of a branchial fistula
is at the

A. Lateral nasopharyngeal wall

B. Fossa of rosemuller
C. Gingivo-labial sulcus
D. Tonsillar fossa

Ans:- D . Tonsillar fossa

Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

Que:-22. Sebaceous cyst does not occur in the

A. Scalp
B. Scrotum
C. Back
D. Sole

Ans:- D . Scrotum

Ref.:- B & L, 23rd Edition, Page No. 173.

10
Que:-23. The universal tumour refers to

A. Adenoma
B. Papilloma
C. Fibroma
D. Lipoma

Ans:- D . Lipoma

Exp.:- Lipoma is a slowly growing tumour composed of fat cells of adult type.
They occur anywhere in the body where fat found and so called as the
universal tumor or the ubiquitous tumor.

Ref.:- B & L, 23rd Edition, Page No. 151.

Que:-24. Cause of persistence of a sinus or fistulae includes

A. Foreign body
B. Non dependent drainage
C. Unrelieved Obstruction
D. Presence of malignancy
E. All of the above

Ans:- E . All of the above

Exp.:-
Congenital sinuses and fistulas Acquired sinuses and fistulas
Preauricular sinuses Inadequate drainage of an abscess
Branchial fitulas Atreriovenous fitulas caused by
Tracheo- oesophageal fitulas trauma or infection
Reasons for persistence of a sinus or fistulas:

Foreign body
Non dependant drainage
Unrelieved obstruction
Irradiation
Recurrent infection
Presence of malignancy
Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

11
Que:-25. Premalignant condition of the skin include

A. Bowen disease
B. Pagets disease of nipple
C. Leukoplakia
D. Solar keratosis
E. All of the above

Ans:- E . All of the above

Ref.:- B & L, 23rd Edition, Page No. 179.

Que:-26. Marjolins ulcer is:

A. Squamous cell carcinoma from scar

B. Adenoma of scar
C. Tuberculous ulcer
D. Amoebic ulcer

Ans:- A . Squamous cell carcinoma from scar

Exp.:-

Marjolins ulcer Malignant ulcer that develops from a scar or burn

Martorell ulcer Hypertensive ulcer
Bazins ulcer Erythrocyanoid ulcer found in young adolescent girls
Cryopathic ulcer Ulcers due to cold injury and chilblains
Tropathiculcer Bed sore ulcer
Trophic ulcer Ulcer due to infection by vincents organisms
Rodent ulcer Basal cell carcinoma

Squamous cell carcinoma are by far the commonest type of cancer arising from
marjolins ulcer, with basal cell carcinoma coming second.

Ref.:- B & L, 23rd Edition, Page No. 148.

12
Que:-27. Painless ulcer of the tongue is due to

A. Dyspepsia
B. Syphilis
C. Tuberculosis
D. None of the above

Ans:- B . Adenoma of scar

i) Painless ulcers : Syphilis Trophic ulcers

ii) Painful ulcers : TB Terminal stages of malignancy

Ref.:- B & L, 23rd Edition, Page No. 159.

Que:-28. Undermined ulcer is present in:

A. Syphilis
B. TB
C. Basal cell carcinoma
D. Hodgkins lymphoma

Ans:- B . TB

Exp.:-

TB Undermined edge
Syphilis Regular punched out
Apthous Regular punched out
Healing ulcer Sloping
Rodent ulcer Pearly, rolled
Squamous cell Raised, everted and indurated
carcinoma
Traumatic ulcer Irregular margins

Ref.:- B & L, 23rd Edition, Page No. 700/ 24th Edition, Page No. 771.

13
Que:-29. Shotty lymphnodes are seen in

A. Syphilis
B. TB
C. Epithelioma
D. Hodgkins lymphoma

Ans:- A . Syphilis

Exp.:-
Disease Lymphnodes
Syphilis Firm, discrete and shotty
TB Matted
Hodgkins lymphoma Elastic and rubbery
carcinoma Hard and fixed

Ref.:- B & L, 23rd Edition, Page No. 159.

Que:-30. In modified radical neck dissection, structure not preserved is:

A. Sternocleidomastoid
B. Internal jugularvein
C. Accessory nerve
D. Submandibular gland

Ans:- D . Submandibular gland

Exp.:- Classical radical neck dissection- Resection of cervical lymphatics, lymph

nodes, internal jugular vein, accessory nerve, submandibular gland and
sternomastoid muscle.

Modified radical neck dissection- All major lymphnode groups and

lymphatics are excised. One or more preserved, the accessory nerve, the
sternomastoid muscle or the internal jugular vein.

Selective neck dissection- One or more of the major lymph node groups is
preserved along with sternomastoid muscle, accessory nerve and internal
jugular vein.

Ref.:- B & L, 23rd Edition, Page No. 706/ 24th Edition, Page No. 775.
14
Que:-31. Squamous cell carcinoma can arise from

A. Long standing venous ulcers

B. Chronic lupus vulgaris
C. Rodent ulcer
D. All of the above

Ans:- A & B , Long standing venous ulcers, Chronic lupus vulgaris

Exp.:- Squamous cell carcinoma can arise from syphilis, lupus vulgaris, chronic
ulcers, osteomyelitis, long standing venous ulcers or old burns scars.

Ref.:- B & L, 23rd Edition, Page No. 181.

Que:-32. Not a carcinogen for cancer of Head & Neck

A. Alcohol
B. Smoking
C. Tobacco
D. Unflourinated water

Ans:- D . Unflourinated water

Ref.:- B & L, 23rd Edition, Page No. 637/ 24th Edition, Page No. 704.

15
Que:-33. Commonest premalignant condition of oral cancer

A. Leukoplakia
B. Apthous ulcer
C. Syphilitic ulcer
D. Erythroplakia

Ans:- A . Leukoplakia

Exp.:- Premalignant lesions and conditions for oral cancer are:

Leukoplakia
Erythroplakia
Chronic hyperplastic candidiasis
Oral submucous fibrosis
Syphilitic glossitis
Sideropenic dysphagia
Oral lichen planus
Discoid lupus erythematosus

Ref.:- B & L, 23rd Edition, Page No. 637/ 24th Edition, Page No. 704.

Que:-34.treatment of choice for carcinoma of lip of less than 1 cm is:

A. Radiation
B. Chemotherapy
C. Excision
D. Radiation and chemotherapy

Ans:- C . Excision

Exp.:- Carcinoma pf the lip most commonly arises at the vermilion border.
Prognosis is better than any other part of oral cavity because the lymphnode
metastasis occurs very late.

Excision is suitable for tumours up to 2 cm in diameter.

Ref.:- B & L, 23rd Edition, Page No. 644 / 24th Edition, Page No. 712 .

16
Que:-35.predisposing factors for development of oral carcinoma is:

A. Smoking
B. Alcohol
C. Syphilis
D. All of the above

Ans:- D . All of the above

Ref.:- B & L, 23rd Edition, Page No. 637/ 24th Edition, Page No. 704.

Que:-36. Keratoacanthoma is:

A. A type of basal cell carcinoma

B. Infected sebaceous cyst
C. Self healing nodular lesion with central ulceration
D. pre-malignant disease

Ans:- C . Self healing nodular lesion with central ulceration

Exp.:- Keratoacanthoma ( molluscum sebaceum ) is a self healing nodule of

relatively large size, irregular crater shape and keratotic plug. Spontaneous
healing distinguishes it from squamous cell carcinoma.

Ref.:- B & L, 23rd Edition, Page No. 182.

Que:-37.prognosis of malignant melanoma depends on

A. Grade of tumor
B. Spread of tumor
C. Depth of invasion
D. Metastasis

Ans:- A . Grade of tumor

Ref.:- B & L, 23rd Edition, Page No. 183.

17
Que:-38. Which is not true of Carcinoma tongue

A. Lateral border is involved

B. Cervical lymph node involvement
C. Commonly adenocarcinoma
D. Tobacco chewing is a risk factor

Ans:- C . Commonly adenocarcinoma

Exp.:- Majority of tongue cancers occurs in the middle third of the lateral margins
followed by posterior and anterior thirds of the tongue. Early lymph node
metastasis and invasion to floor of the mouth are common. It is mostly
epidermoid carcinoma and accounts for more than half of the intraoral
carcinomas.

Situation Clinical feature Metastasis Treatment

CA . Vermillion Spread laterally Late Surgery
Lip border of lower than infiltrating lymphnode
lip deeply metastasis
CA Lateral border Pain, difficulty in Early < 2 cm
tongue ( common) , speech and lymphnode - Surgery
peosterior and swallowing metastasis > 2 cm
third - Surgery +
- Radio
theraphy
Ref.:- B & L, 23rd Edition, Page No. 640.

Que:-39. Carcinoma tongue less than 2 cm is treated by:

A. Excision
B. Radiotherapy
C. Chemotherapy
D. Excision and Radiotherapy
E. Excision and chemotherapy

Ans:-A . Excision

Exp.:- Lesions of tongue carcinoma less than 2 cms are treated by surgery. Lesions
greater than 2 cm size requires treatment initially by radiation.
Ref.:- B & L, 23rd Edition, Page No. 644, 645 / 24th Edition, Page No. 713.
18
Que:-40. Most severe form of malignant melanoma is:

A. Superficially spreading
B. Nodular infiltrating type
C. Those arising in lower limb
D. Those in choroid

Ans:- B . Nodular infiltrating type

Exp.:- Five types of melanoma are

Lentigo maligna: least malignant also called as Hutchinsons melanotic
freckle
Superficial spreading
Nodular : Most malignant
Acral lentigenous
Amelanotic

Ref.:- B & L, 23rd Edition, Page No. 183/ 24th Edition, Page No. 715.

Que:-41.margins of squamous cell carcinoma is:

A. Inverted
B. Everted
C. Rolled
D. Undermined

Ans:- B . Everted

Ref.:- B & L, 23rd Edition, Page No. 5 / 24th Edition, Page No. 208.

Que:-42. Commonest site of carcinoma tongue:

A. Apical
B. Lateral borders
C. Dorsum
D. Posterior 1/3

Ans:- B . Lateral borders

Ref.:- B & L, 23rd Edition, Page No. 640/ 24th Edition, Page No. 712.

19
Que:-43. Which of the following structures is not removed in redical neck
dissection:

A. Sternocleidomastoid muscle
B. Internal jugular vein
C. Spinal accessory nerve
D. Phrenic nerve

Ans:- D . Phrenic nerve

Ref.:- B & L, 23rd Edition, Page No. 706/ 24th Edition, Page No. 755.

Que:- 44. Functional neck dissection is done usually by preserving:

A. Sternocleido muscle and spinal accessory nerve

B. Sternocleido muscle jugular vein and spinal accessory nerve
C. Spinal accessory nerve alone
D. Sternocleido muscle alone

Ans:- B . Sternocleido muscle jugular vein and spinal accessory nerve

Ref.:- B & L, 23rd Edition, Page No. 706/ 24th Edition, Page No. 755.

Que:-45. Block dissection of lymph nodes along with hemiglossectomy is

called:

A. Radical Neck dissection

B. Commando operation
C. Brachy therapy
D. Teletherapy

Ans:- B . Commando operation

Exp.:-
Commando operation-Block dissection of lymphnodes along with
hemiglossectomy.
Branchytherapy-Interstitial (or) intra cavitary radiotherapy when the
growth is more than 1cm in diameter in the anterior 2/3 rd of tongue.
Teletherapy-External beam radiation used when the growth is more than 2
cm in the posterior third of tongue.
Ref.:- B & L, 23rd Edition, Page No. 69.
20
Que:-46. A 4 cm lesion on the tongue with palpable lymphnodes bilaterally
and distant metastasis is:

A. Stage I
B. Stage II
C. Stage III
D. Stage IV

Ans:- D . Stage IV

Ref.:- B & L, 23rd Edition, Page No. 151.

Que:-47.carcinomatous ulcer is diagnosed by:

A. Everted and indurated borders

B. Everted punched out borders
C. Inverted undermined borders
D. None of the above

Ans:- A . Everted and indurated borders

Ref.:- B & L, 23rd Edition, Page No. 159 / 24th Edition, Page No. 208.

Que:- 48. Glomangioma arises from:

A. Neuroglial cells
B. Nerve cells
C. Cutaneous glomus
D. None of the above

Ans:- C . Cutaneous glomus

Exp.:- Cutaneous glomus is composed of a tortuous arteriole which communicates

with a venule and surrounded by a network of small nerves. They regulate
temperature of the skin and are found in the nail beds. The tumour arising
from cutaneous glomus is called glomangioma or Glomus tumor.

Ref.:- B & L, 23rd Edition, Page No. 153.

21
Que:-49. Loss of differentiation of tumour cells is called

A. Metaplasia
B. Dysplasia
C. Anaplasia
D. Hyperplasia

Ans:- C . Anaplasia

Exp.:-
Hypertrophy-increase in the size of an organ without an increase in cell
numbers.
Hyperplasia-increase in the size of an organ with an increase in cell number
Metaplasia-reversible change of one type of epithelial cell to another type
Dysplasia-Disorder cellular development
Anaplasia-Loss of differentiation of tumor cells from which they arise.
Carcinoma insitu- resembles cancer but without invasion across the
basement membrane.

Ref.:- B & L, 23rd Edition, Page No. 148.

Que:-50.the muscle which is resected in classical neck dissection is:

A. Sternohyoid
B. Stenrothyroid
C. Sterno mastoid
D. Sternocricoid

Ans:- C . Sterno mastoid

Ref.:- B & L, 24th Edition, Page No. 755.

22
Que:-51. A malignant tumour of childhood, that metastasized to bone most
often, is:

A. Wilms tumour
B. Neuroblastoma
C. Adrenal gland tumour
D. Granuloma cell tumour of ovary

Ans:- B . Neuroblastoma

Exp.:- Neuroblastoma is derived from neuroblasts in the adrenal medulla and

sympathetic ganglia, presenting as abdominal or paravertebral mass.
Metastasises to lymphnodes, bones and liver.
Causes elevation of urinary catecholamines.
It can regress spontaneously in infants, if not, excised.

Ref.:- B & L, 24th Edition, Page No. 1435.

Que:-52. Punched out edge is characteristic of which type of ulcer:

A. Tuberculosis
B. Rodent ulcer
C. Syphilitic
D. Non specific

Ans:- C. Syphilitic

Exp.:-

Non-specific ulcer Shelving edge

Tuberculous ulcer Undermined edge
Rodent ulcer Raised, pearly white and beaded
Squamous cell carcinoma Rolled out, everted
Syphilitic ulcer Punched out edge; Base covered with wash leather
slough

Ref.:- B & L, 24th Edition, Page No. 208.

23
Que:- 53. The termpulse granuloma suggests reaction towards the fragments
of foreign material like:

A. Cotton fibres
B. Black silk
C. Silver amalgam
D. Legumes

Ans:- D . Legumes

Que:-54. A patient having tumor of maxillary sinus manifests with excessive

rolling tears from his eyes, likely due to obstruction of:

A. Nasolacrimal duct
B. Conjunctival sac
C. Lacrimal gland
D. None of the above

Ans:- A . Nasolacrimal duct

Ref.:- B & L, 24th Edition, Page No. 669.

Que:-55. The treatment of choice for Nasopharyngeal carcinoma is:

A. Chemotherapy alone
B. Radiotherapy alone
C. Radiotherapy & Surgery
D. Surgery alone

Ans:- B . Radiotherapy alone

Exp.:- Primary treatment is radiotherapy. Elective bilateral external radiotherapy is

given to the skull base and neck in all cases, even when no neck nodes are
apparent.

Ref.:- B & L, 24th Edition, Page No. 749.

24
Que:-56.schwann cells are derived from:

A. Neural crest cell

B. Endoderm
C. Mesoderm
D. Ectoderm

Ans:- A . Neural crest cell

Ref.:- B & L, 24th Edition, Page No. 580.

Que:-57.malignant ulcer is differentiated from benign by:

A. Heaping up of margins
B. Fibrous scars radiating from crater
C. Induration of base
D. Clean base

Ans:- A . Heaping up of margins

Exp.:- Rolled out/everted edge is a characteristic feature of squamous cell

carcinoma or an ulcerated adenocarcinoma. This ulcer is caused by fast
growing cellular disesase, the growing portion at the edge of ulcer
heaps up & spills over the normal skin to produce an everted edge.

Ref.:- S. Das, 2nd Edition, Page No. 125.

Que:-58. The benign neoplasm of brown fat noted in oral/ pharyngeal region
is:

A. Lipoma
B. Hibernoma
C. Teratoma
D. Brown tumor

Ans:- B . Hibernoma

25
Que:- 59. Following ONE is not true of carcinoma of lip:

A. Most common on vermilion border of lower lip

B. A 90% cure rate is possible with surgery or radiotherapy
C. Initially tumor spreads laterally rather than infiltrating deeply
D. Upto one third of the lip cannot be removed

Ans :- D . Upto one third of the lip cannot be removed

Exp.:- Upto one-third of the lip can be removed with primary closure.

Ref.:- B & L, 24th Edition, Page No. 711.

Que:-60. Marjolins ulcer is:

A. Squamous cell carcinoma from scar

B. Trophic ulcer
C. Tuberculous ulcer
D. Rodent ulcer

Ans:- A. Squamous cell carcinoma from scar

Ref.:- B & L, 24th Edition, Page No. 968.

Que:-61. The common site of glomangioma is:

A. Head & neck

B. Chest wall
C. Nail bed
D. Retroperitoneal
Ans:- C . Nail bed

Exp.:- Glomangioma:
Benign, exquisitely painful small tumour of the skin and subcutaneous tissue
Glomus is a specialized arteriovenous anastamosis surrounded by large pale
cells called glomus cells
Present in the region of nail bed at the tips of fingers and toes and the palmar
surface of phalanges.
Function of glomus is supposed to be concerned with heat regulation.
Ref.:- S. Das, Surgery 3rd Edition, Page No. 96.
26
Que:-62. Bedsore is an example of:

A. Tropical ulcer
B. Trophic ulcer
C. Venous ulcer
D. Post thrombotic ulcer

Ans:- B . Trophic ulcer

Exp.:- Bed sores or decubitus ulcer are predisposed by five factors

- Pressure, injury, anaemia, malnutrition, moisture.

Ref.:- B & L, 24th Edition, Page No. 939.

Que:-63. Not compressible swelling is:

A. Meningocele
B. Lymphangioma
C. Mucocele
D. Cystic hygroma

Ans:- B . Lymphangioma

Exp.:- Simple or capillary lymphangioma:

- Soft and spongy
- Size varies from 0.5-4mm in diameter
- Swelling is not compressible.
- Fluctuation, fluid thrill and translucency are positive.
Cystic hygroma:
- Soft and cystic.
- Fluctuation, fluid thrill, translucency are positive.
- Partially compressible but not reducible.
Meningocele:
- It is the protrusion of meninges through the defect in neural arch.
- It contains CSF.
- Common inlumbosacral and skull regions.
- Present since birth.fluctuation, translucency are positive.
- It is compressible.
Ref.:- S. Das, Clinical Surgery 5th Edition, Page No. 39, 40/
S. Das, 4th Edition, Page No. 507, 625.
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Que:-64. Squamous cell carcinoma

A. Spreads through lymphatics

B. Radioresistant
C. Metastasize through blood stream
D. Surgical excision contraindicated

Ans:- A . Spreads through lymphatics

Exp.:- Carcinomas spread through lymphatic supply while sarcomas spread by

blood supply.

Ref.:- S. Das, 4th Edition, Page No. 105.

Que:- 65. Chronic burrowing ulcer is cused by?

A. Microaerophilic streptococci
B. Peptostreptococcus
C. Streptococcus viridians
D. Streptococcus pyogenes

Ans:- A . Microaerophilic streptococci

Exp.:- Chronic burrowing type of ulcer is due to symbiotic action of

microaerophilic non-haemolytic streptococci and haemolytic
staphylococcus aureus. Clinically it is undermined ulcer with lot of
granulation tissue in the floor. This condition is painful, toxaemic and the
general condition of the patient deteriorates without treatment. Radical
drainage is necessary for cure, antibiotics alone being useless.

Ref.:- S. Das, 3rd Edition, Page No. 131.

Que:-66. Quinsy is:

A. Pertonsillar abscess
B. Infratemporal space infection
C. Para pharyngeal space infection
D. Lateral pharyngeal space infection
Ans:- A . Pertonsillar abscess
Ref.:- B & L, 25th Edition, Page No. 711.
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Que:-67. The most common clinical pattern of basal cell carcinoma is:

A. Nodular
B. Prostate
C. Colorectal
D. Keratotic

Ans:- A . Nodular

Exp.:- Nodular and nodulocystic variants of basal cell carcinoma account for 90%
of basal cell carcinomas. The other variants are cystic, pigmwented and
naevoid.

Ref.:- B & L, 25th Edition, Page No. 609.

Que:-68. Malignancies that frequently metastasize to the jaws are:

A. Lung
B. Prostate
C. Colorectal
D. All of the above

Ans:- D . All of the above

Exp.:-It is estimated that 1% of malignant neoplasms metastasize to oral region. In

adults metastases to the jaws most commonly originate from primary
carcinoma of the breast in women and lung in men. Other primary
malignant tumors in order of decreasing frequency are prostate, GIT,
kidney, colon and rectum.

Ref.:- Oral Pathology: Clinical Pathologic Correlations by Joseph A. Regezi,

James J. Sciubba, Richard C.K. Jordan 2012 Edition.

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Que:- 69. Which of the following is NOT a feature of keloids?

A. Never gets worse after 6 months

B. Severe itching is present
C. Margins are tender
D. None of the above

Ans:- A . Never gets worse after 6 months

Exp.:- Clinical features of keloid:

- Always extend beyond the limits of the original wound.
- They are often itchy, tender or painful in early stages.
- The color, shape and size of the scars may change with time.
- They develop rapidly over weeks or months following trauma or other
precipitating factors.
- Persists for more than 12 months.
- Sometimes may undergo central suppurative necrosis.

Ref.:- Keloids: Clinical features and management Part-I. JAPD 2006;16:97-103.

Que:-70..

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