OMSB Part I - 2010

1. Most common organism in otomycosis

a. Candida
b. A.nigar (most common presenting symptom is pruritus)
2. Most common organism in actinomycosis
a. Actinomyces bovis
b. Actinomyces odonti
c. Actinomyces israelii (anaerobic gram-positive)
a. bacterium
3. Actinomycosis infection
a. Rarely caused by A.israelii
b. Actinomyces has been recovered from the normal mouth, from tonsils, and
from carious teeth
c. Gm –ve aerobic
4. Mikulicz cells
a. Rhinosporoidosis
b. Rhinoscleroma
5. Proliferative cells in Eosinophilic Granuloma
a. Histocytes ( Histocytosis) (Langerhan Cell histocytosis)
b. eosinophil
c. Fibroblast
d. Macrophage
st
6. 1 cell to appear in wound healing process
a. Neutrophil
b. Macrophage
c. Monocyte
d. Fibroplast
7. Incision parallel to relaxed skin tension lines
a. Hypertrophic scar
b. No contraction
c. Satisfactory scar (Aim to reduce tension and also can be achieved by using buried deep dermal
and subdermal sutures to lessen tension on the skin sutures.)
8. If you are doing a study regarding patient satisfaction using a questionnaire given
for each patient in your clinic, propagation of the study is
a. Prospective
b. Retrospective
c. Longitudinal
d. Latitudinal
e. Cross sectional
9. HUA, fibronecten, collagen, elastin are secreted by:
a. Macrophage
b. Fibroblast
c. Neutrophil
d. Lymphocyte
10. Laser beam is produced when?
a. Light is refracted between 2 mirrors
 b. Electron is collided by photon to a subthreshold level ( Has two mirror with a medium
in between, electron stimulus is given to initial kinetic energy until more than hald of the photons
produce spontaneous emissions)

Wave Lenghs:
A: Argon lasers wavelengths of 488 and 514 nm
B: KTP 532 nm
C:Carbon Dioxide laser has wavelength of 10.6 μm
11. Septic shock ( Infection with hypotension – commonest organism Gram Negative)
a. 5-10% mortality
b. Multimicrobial organisms
c. Source of infection is usually the GIT
d. Most of mortality is in the elderly
12. Local anaesthetics work through
a. Na channels
b. K channels
c. Lyposomes
13. Longest acting local anaesthetic
a. Lidocaine ( Aminoamide – 60-180 mints , Hyperbaric which means it is mixed with dextrose.
Epinephrine can be added to increase the duration of the action of the short acting anaesthetic agent)
b.Bupovacaine (4h but 8 with epi – Aminoamide 160-180 mints, Isobaric which means it is plain)
c.Tetracaine (3h but 10 with epi)
14. Give mepridine (pethidine) in a renal failure patient
a. Causes liver failure
b. Causes congestive heart failure
c. Leads to ventricular arrhythmia
a. Seizures (Mepridine metabolized to normeperidine, a unique toxic metabolite that can accumulate
and cause seizure-like activity. Elderly patients, patients who are dehydrated, and patients with renal
impairment are particularly vulnerable to this side effect.)
15. Blood supply to Pectoralis Major Flap (Myocutaneous Regional Flap)
a. Pectoral branch of the Thoracoacromial Artery
16. Thoracodorsal artery is the main supply of which flap
a. SCM  There are three dominant vessels: occipital, superior thyroid, and
transverse cervical arteries (need to preserve at least two of the three for muscle
to remain vascularized).
b. Pectoralis Major  thoracoacromial artery which arises from the 2nd portion of
axillary artery
a. Latissimus Dorsi  Thoracodorsal artery and vein
b. Trapezius
a. Deltopectoral  The first four perforators arising from the internal mammary
artery
17. Delayed cellular immunity is mediated by
a.It occurs minutes after antigen exposure.
b. Histamine is released
c. IL-4 can contribute to the cascade of events that comprise the late response.
d. eosinophilic activation
18. Pathogenesity not related to exotoxin
a. E.coli (Entrotoxin which is a part of exotoxin)
b. Staph aurius (Superantigen exotoxin)
c. Clostridia perfengis (Alpha exotoxin)
 d. Clostridia tetani (Neuro exotoxin)
i. (Endotoxin are produced by Gram Negative and are part of cell wall while Exotocin are
produced by Gram Positive and they are intracellular component which are later excreted
outside the cell wall)
19. Patientwith gm+ve, gm-ve and heamophilus infection. Antibiotic of choice is:
a. Ceftrioxone 3 generation cephalosporin
rd

b. Pencillin/clavulinate (Covers only gram + )

c. Flagyl (Covers only anaerobics and protozoa)
d. Doxacyclin
20. Most responsible bacteria for Bacterial Trachitis
a. Staph aurus + heamophilis (Staphylococcus aureus is the most commonly isolated pathogen;
Moraxella catarrhalis and H. influenza can also cause bacterial tracheitis. – Ballenger)
b. Strept pneumonia
c. E.coli
21. Entral nutrition, compared to parental nutrition
a. More expensive
b. Rapid regain of GI function in healthy adults after GI surgery
c. Decrease infectious complications in critically ill patients
(the most common complications of enteral feedings result from solute overload)
22. MVA victim, liver laceration, splenectomy, GI perforations, recived 15 units PRBCs +
4 FFPs + 4L LR is having bleeding oozing from stitch sites, the cause is
a. Platelet dysfunction
b. Thrombocytopenia
c. Factor XI dificency
d. DIC
23. Lesion which stains with Congo Red
a. Sarcoidosis
b. Amyloidosis (amyloid deposits that can be seen in skin and nose)
24. High Tc uptake in Tc scan
a. Oncocytoma ( or Warthan’s tumor)
b. Mucoepidermoid
c. SCC
d. Adenoid cystic
25. Most important ion in secretion of amylase
a. Calcium
b. Phosphate
c. Lithium
d. Zinc
26. Which drug of the following causes Pulmonary Fibrosis
a. Bleomycin
b. Vincristin
c. 5FU ( S-Pahse)
d. Cisplatin ( Break DNS cross link)
27. Lab value which decreases with age
a. WBCs
b. T4
c. ESR
d. BUN/Cr
28. Alloccur in ↑ICP except
a. ↑HR ( features of ICP are High BP and Low Pulse Rate and Respiratory Rate – Cushing Triad)
b. ↑BP
c. Headache
d. Cyanosis and engorgement of face
29. Temporalis muscle attaches to
a. Squamous bone( Inserted in the coronoid process, supplied by V3 and artery is Deep and
superficial temporal artery of the Maxillary artery)
Tympanic bone
b.
c. Zygomatic arch
30. Olfactory neuroblastoma (esthesioneuroblastoma)
a. Large cells with clear cytoplasm and small nucleus
b. Granular cells with different stages of differentiation
c. Small dense cells with high nuclei/cytoplasm ratio

Neuroectoderm tumor
Histopathology: Small Round cell tumor with dense core granulaes. Had uniform cells with scanty cytoplasm
that are slightly larger than lymphocytes. The nuclei are round to oval with minimal pleomorphism,
occasional prominent nucleoli, and either fi ne chromatin (“salt and pepper”)
Can have psammomatoid calcifications

31. Pituitarygland
a. Supplied by ECA
b. Superior to sphenoid sinus ?or optic chaism
c. Separated from olofactory pulb by ... diaphragm
th
d. Suspended into 4 ventricle by ...
e. Lies deep into cavernous sinus
32. Runs in cavernous sinus:
a. V2 ( III, IV, V1 and VI through the sinus)
b. V3 ( Does NOT run along the lateral wall of the Cavernous sinus)
c. CNX
d. CNXI
e. CIX
33. The ptyrigopalatine fossa communicates with the Infratemporal fossa via
a. Pterygomaxillary fissure
b. foramen rotundum ( Communicates with middle cranial fossa)
c. nasapalatine foramen (Communicates with nasal cavity)
d. inferior orbital fissure (Communicates with the Orbit)
e. greater palatine canal (Communicates with the palate)
34. The ptyrigopalatine fossa communicates with the Middle cranial fossa via
a. Pterygomaxillary Fissure
b. Foramen Rotundum
c. Nasapalatine Foramen
d. Inferior Orbital Fissure
e. Greater Palatine Canal
35. Hypothyroidism:
a. Decreased hearing is of a conductive variant
b. High TSH in secondary hypothyroidism
c. Bleeding tendancy is due to factor deficiency (XI or XII)
 d. Bleeding tendance is corrected by thyroxin
e. Primary hypothyroidism is associated with deafness (or bleeding)
36. Cutting chorda tympani affects mostly taste to
a. Bitter
b. Salty
c. Sweet
d. Sour
37. Hearing evaluation for children aged 6-24 months
a. Behavioural audiometry ( for children below 6 months of age)
b. Play audiometry
c. Visual Re-enforcement Audiometry (For children above 6 months of age)
d. Pure Tone Audiometry
38. Inner ear is completely developed by
a. 10 weeks
b. 20 weeks
c. 25 weeks
d. 30 weeks
st
39. Derivative of 1 arch:
a. Mallus (Head of malleus, body of incus and short process and Tensor tympani)
b. Stapes (suprastructure from the 2nd arch with the manubruim and long process of incus)
c. Styloid
nd
40. Derivative of 2 arch:
a. Mallus
b. Incus
c. Posterior belly of digastric
41. Eustachian tube in adults is
a. Osseous
b. Cartilaginous
c. ½ osseous, ½ cartilaginous
d. 1/3 Bony and 2/3 Cartilaginous (posterior third osseous, anterior two-thirds cartilage)
42. Air in middle ear:
a. Similar to atmospheric air
b. ↓O2 ↑CO2
c. ↑O2 ↓CO2
d. ↓O2 ↓CO2
43. Least important in protection of complications of middle ear infections:
a. Eustachian tube
b. Bone and periosteuim
c. Respiratory mucosa
d. Soft tissues and veins ( causes spread of infections and meningitis)
44. What pathology of temporal bone is associated with submucosal and mastoid
hemmorhage and secondary infection
a. Multiple Myloma
b. Leukemia
c. TB
d. Sacroidosis
 e. Cholesterol Granuloma (Obstruction of air cell drainage pathways resulting in infl
ammation/hemorrhage, red blood cell breakdown and foreign body reaction to cholesterol crystals ,
Hyperintense in T1 and T2)
45. Superior boundary of sinus tempani; ( Space between Ponticulus and Subiculum)
a. Scutum
b. Sapeculum
c. Ponticulus
d. LCC
46. Blood supply to saccule and PCC is
a. Post. Vestibular artery ( Which is branch from the main cochlear artery-> Labyrinthine artery ->
AICA -> Basilar Artery)
47. Labrynthine artery is a branch of
a. AICA ( Anterior Inferior Cerebellar Artery which is a branch from the basilar Artery)
48. Closest fluid to CSF is
a. Perilymph ( High Na+ and Low K+ | Semilar to ECF – Subarachnoid space)
b. Endolymph ( High K+ And Low Na+ | Semilar to ICF – Dura)
c. Cortilymph
49. Duct connecting the saccule to cochlea ( Connects vestibular aqueduct with cochlear aqueduct)
a. Ductus reuniens
b. Endolymphatic duct
c. Periotic duct
d. Choclear aqueduct
50. Choclear hair cells
a. inner›outer
b. 90% of innervations is to the outer
c. Inner hair cells don’t reach tactorial membrane
d. 2 chambers
i. Inner Hair Cells: Few in number, does not touch the tectorial membrane and acts as affect.
Rounded and flasked shaped and Single row
ii. Outer Hair Cells: cochlear amplifier + OAE + 3 rows, more in number + touch the tectorial
membrane and has multiple sterocillia + acts like motor
51. Contains marginal, intermediate, basal cells, capillaries and melanin:
a. Organ of corti
b. Stria vasicularis ( Secrets the endolymph )
c. Spiral gangelion
52. Vestibular hair cells
a. Helitropic SCC
b. Ante... SCC
c. ↑resting output if steriocellia moving towards kinocillia
d. ↑resting potential if kinocillis moving towards midline
i. If the steriocellia moves toward the kinocillia, Ion channels open and depolarization occur 
Increase discharge
ii. If the steriocellia moves way from the kinocillia, ion channels closes and Hyperpolarization
happens  Decrease discharge
53. Blood supply to the facial nerve distal to stylomastoid foramen
a. Internal maxillary artery
b. Posterior auricular artery
c. Ascending pharyngeal artery
d. Facial artery
 e.Occipital artery
54. Binaural hearing is dependant upon
a. Bilateral ascending + descending pathways
b. Choclear nuclii integrity
c. Inferior canaliculas integrity
d. Decussating pathways beyond brain stem
55. Primary audotary cortex
a. Anterior occipital
b. Post occipital
c. Superior temporal
d. Inferior temporal
56. Acostic reflex
a. Latency < 5msec ( Reflex decay if more than 10 msec means retrocholear pathology)
b. Attenuation of frequencies < 800Htz
c. Stimulus 40 db hearing level
d. Stapedius and tenson villi palatine are equally important
e. Dicussation only at one side of the pathway
57. Lowest hearing loss that can be detected by Weber’s test
a. 10 db
b. 15 db
c. 20 db
d. 25 db
58. Endochoclear potential:
a. Stria Vascularis ( also secrets the endolymph and absorpt it)
59. Summating potential:
a. OHC ( also called cochlear amplifers and send the OAE)
60. Masking noise:
a. Narrow band filtered ( Mainly for Air-Conduction with difference is 40db or more with the non tested ear
bone conduction)
b.Broad band
61. Eustachian tube function in supine position
a. No change even if inflamed
b. No change except when inflamed
c. Changes due to venous engorgement ( less patent which builds up negative pressure)
62. Responsible to detection of position is static position
a. Utricle – Linear Horizontal position
b. Saccule – Linear Vertical Position
c. Simicurcular canals
d. Lateral vestibular nuclii
63. Most responsible for VOR:
a. MLF ,LATERAL SCC
64. Vestibular nucleaus most related to Vestibulospinal Pathway
a. Superior
b. Medial
c. Lateral
d. Descending ( Also called inferior neucleus)
65. Venous tinnitus is differentiated from arterial tinnitus by being
 a. Pulsatile
b. Coincides with pulse
c. Changes with extreme head position
i. Commonest Arterial cause: Occipital and transver sinus AVM
ii. Commonest Venous casuse: Sigmoid and Transver sinus AVM
iii. Venous tinnitus, reduce after pressing the ipsilateral JV
66. Frontalsinus
a.Developed by 5 years of age
b. Aplastic in 4% of the population
c. Fully developed at birth
67. Upper and lower lateral cartilages mostly
a. Overlap
b. Interlock
68. Lymphatic drainage of external nose
a. Submandubular+digastrics
b. Submental + digastrics
c. Submandibular + submental
69. Commensest sinonasal location of suqmous cell carcinoma:
a. Nose
b. Maxialley
c. Ethmoid ( Adenocarcinoma)
d. Frontal
70. Uncinate process originate from which ehmoidal turbinal
nd
a. 2 ( Uncent is part of the ethmoid bone)
71. Blood supply to middle turbinate
a. Ant ethmoidal
b. Post ethmoidal
c. Sphenopalatine ( Main supply of the lateral wall)
d. Ascending pharyngeal
e. Internal maxillary
72. Abducent nerve
a. Short course(Has long course from Pons to SOF)
b. Doesn’t decussate
c. Supplies medial rectus ( Lateral recus + Dorrelo canal)
d. Leaves from superior orbital fissure
73. Anterior rhinometry
a. ↑resistance in paediatrics than adults
b. ↓resistance in whites
c. ↑resistance in whites
d. Decrease resistance in black
74. Nitric oxide
Reflects nasocilliary function
a.
b. Leads to vasoconstriction
c. Decreases in inflammation
d. Present only in expired air
e. ↑↑ in nasal polyposis
75. Tongue is fully developed by the
th
a. 4 week
 b. 8th week
th
c. 10 week
th
d. 20 week
76. Oral cavity subsites
a. Tonsil
b. Upper alveolus
c. Base of tounge
d. Soft palate
77. TMJ
a. Lower compartment allows gliding movement
b. Lower compartment allows rotational movement
c. Articulate meniscus is not a part of the joint
d. Articulation is between .....
78. Blood supply of
a. occipitofrontalis muscle: (Combination of the internal and external carotid arteries.:
Supratrochlear artery + Supraorbital artery+ Superficial temporal artery+ Posterior auricular artery+
Occipital artery)
b. Temporalis muscle: anterior and posterior deep temporal arteries which are branches of the
internal maxillary artery
79. Submental artery is
a. A Branch Of Facial Artery
80. Compartment of parapharyngeal space anterior to styloid
a. CNX
b. CNXI
c. Parotid
d. IJV
81. Parotid gland
a. Homogenous on T1, hetrogenous on T2
b. Hetrogenous on T1, homogenous on T2
c. Homogenous on both ( Due to high fat content of the parotid tissue)
d. Heterogenous on both
82. Mucoepidermoid CA arises from
a. Striated cells
b. Secretory cells
c. Intercalated cells
d. Myoepithelial cells
83. Cells responsible for ↑salivary flow in parotid gland are located in
a. Optic ganglion
b. Superior salivary nucleus
c. Inferior salivary nuclus
31- Sphenopalatine ganglion gives parasympathetic to
a. lacrimal gland «
b. parotid gland
c. submandibular gland
84. Buccopharyngeal membrane is attached inferiourly to
a. Cricothyroid membrane
b. Superior constrictor muscle
c. ? layer of deep cervical fascia
 d. Visceral and prevertebral fascia
85. Barium pharyngeogram
a. Pooling of contrast in valiculi frequently associated with masses
b. Differentiation between motility disorder and malignancy is easy due to
impregnation in the wall
c. Motility disorders appears is
outpatching in the wall
86. Most common monomorphic
adenoma in the upper aerodigestive
tract
a. Clear cell
b. basal
c. Acinar
d. Mixed cellular
87. Most common minor salivary gland tumor
a. SCC
b. Mucoepidermoid
c. Adenoid cystic
d. Acinar
88. Patient presenting with hoarsness, stridor, aspiration and loss of .....reflex
a. CN X
b. CNXI
c. Anterior horn cell injury
d. CNIX
89. Superior Parathyroid Gland
a. Inferior to Superior Thyroid Artery and Anterior to Recurrent Laryngeal Nerve
b. Superior to the Inferior Thyroid Artery and posterior to the recurrent Laryngeal
Nerve
90. Not a histological change in leukoplakia
a. Anaplasia
b. Keratoplasia
c. Hyperplasia
91. To increase the caloric intake in a patient on parentral nutrition, the following can
be given through a peripheral line
a. D5W
b. D25W
c. Soybean oil
d. Lactulose
92. trautman’s triangle: ( To drain dural abscess)
a. labyrhinth,sigmoid sinus and dura
93. C in picture: