1. Superfical parotidectomy is contraindicated in patients with sialectasis because 1. There is high risk of dry mouth 2.

There is a high risk of fistula formation 3. There is high risk of infection 4. There is risk of facial palsy 2. In superficial parotidectomy 1. Only a part of superfical lobe is removed 2. The whole of superfical lobe and part of deep lobe of the gland is removed 3. The superfical lobe is removed completely 4. The deep lobe is removed completely 3. In patients with diabetes mellitus the parotid gland is 1. Shrunken 2. Enlarged 3. Cystic in nature 4. Fibrosed 4. Carbohydrate-protein substances corresponding to the blood group antigens are not secreted by 1. Parotid glands 2. Submandibular salivary glands

3. Accessory salivary glands 4. Sublingual salivary glands 5. Warthin's tumor is known to develop from 1. Acinar cells 2. Lymphoid tissue within parotid gland 3. Myoepithelial cells 4. Basal cells 6. Anesthesia over parotid gland area is caused by injury to 1. Marginal mandibular nerve 2. Orbital nerve 3. Buccal nerve 4. Greater auricular nerve 7. The antibiotic that is actively secreted in the saliva is 1. Clindamycin 2. Streptomycin 3. Cefixime 4. Ampicillin 8. Parotid gland is a 1. Mucoserous salivary gland 2. Serous salivary gland 3. Protenaceous salivary gland 4. Mucinous salivary gland 9. Technitium pertechnetate scans are useful in the diagnosis of 1. Pleomorphic adenoma

2. Monomorphic adenoma 3. Warthin's tumor 4. Sialadinitis 10. Food stimulates secretion of 1. Sublingual salivary gland 2. Accessory salivary glands 3. Parotid gland 4. Submandibular salivary gland 11. In Bulimia parotid glands are 1. Nodular 2. Enlarged 3. Cystic in nature 4. Shrunken in size 12. Perineural invasion is common in 1. Acinous cell carcinoma 2. Adenoid cystic carcinoma 3. Mucoepidermoid carcinoma 4. Pleomorphic adenoma 13. Benign tumors of superfical lobe of parotid gland takes a very long time to project outwards because 1. Slow rate of tumor growth 2. The styloid process stops the progression of tumor 3. The external surface of the parotid gland is covered by tough parotid fascia

4. Ramus of the mandible stops tumor progression 14. Calcium content of saliva is low in 1. Sublingual salivary gland secretions 2. Submandibular salivary gland secretions 3. Parotid secretions 4. Accessory salivary gland secretions 15. Warthin's tumor is commonly seen in 1. Parotid gland 2. Accessory salivary gland 3. Sublingual salivary gland 4. Submandibular salivary gland 16. Sublingual salivary gland is situated 1. Above the mylohyoid 2. Posterior to the mylohyoid muscle 3. Below the mylohyoid muscle 4. Under the palatopharyngeous muscle 17. The parotid gland is divided into superficial and deep portions by 1. Facial nerve branches 2. Mandible 3. Cartilagenous portion of external auditory canal 4. Internal maxillary artery 18. Parotid gland secretions constitute about

100% of salivary secretion 90% of salivary secretion 1/5 th of salivary secretion 3/4 th of salivary secretion 19. Chemical stimulation maximises the secretion of 1. Parotid gland 2. Accessory salivary gland 3. Sublingual gland 4. Submandibular gland 20. Submandibular salivary gland swelling is differentiated from submandibular lymphadenitis clinically by 1. Movement during swallowing 2. Bidigital palpation 3. Palpation from behind the patient 4. Presence of transillumination in submandibular salivary gland 21. Oncocytoma almost exclusively occurs in 1. Submandibular salivary gland 2. Parotid salivary gland 3. Accessory salivary gland 4. Sublingual salivary gland 22. Acini of parotid glands are formed by 1. Seromucinous cells 2. Serous cells

1. 2. 3. 4.

3. Cloudy cells 4. Mucinous cells 23. Submandibular salivary gland is separated into superficial and deep portions by 1. Mylohyoid muscle 2. Digastric muscle 3. Buccinator muscle 4. Sternomastoid muscle 24. In parotid surgeries the most reliable way of identifying the facial nerve is 1. Searching at the tympanomastoid sulcus 2. By using the tragal pointer 3. By removing the styloid process 4. By tracing it from the mastoid cavity 25. During sleep salivary secretion is maintained by 1. Submandibular gland only 2. Sublingual gland only 3. Submandibular and sublingual salivary glands 4. Parotid gland only 26. Tumors arising from deep lobe of parotid gland extending across the parapharyngeal space is covered on their anterior aspect by

1. Stretched out fibers of middle constrictor muscle 2. Stretched out fibers of superior constrictor muscles 3. Stretched out fibers of medial pterygoid muscle 4. Stretched out fibers of lateral pterygoid muscle 27. In submandibular salivary gland surgery, the branch of facial nerve at risk is 1. Buccal nerve 2. Marginal mandibular nerve 3. Lower zygomatic nerve 4. Upper zygomatic nerve 28. The first salivary gland to develop is 1. Parotid gland 2. Sublingual salivary gland 3. Accessory salivary glands 4. Submandibular salivary gland 29. Sialolithiasis is common in 1. Accessory salivary gland 2. Parotid gland 3. Sublingual salivary gland 4. Submandibular salivary gland 30. All major salivary glands arise from 1. Ectoderm

2. All three embryonal tissue 3. Endoderm 4. Mesoderm 31. Daily average volume of saliva produced in a human being is 1. 3 - 5 litres 2. 1 - 1.5 litres 3. 8 - 10 litres 4. 3 - 4 litres 32. Adenoid cystic carcinoma is known to commonly involve 1. Sublingual salivary gland 2. Minor salivary glands 3. Submandibular salivary gland 4. Parotid gland 33. During sleep the parotid gland is known to secrete about 1. 50% of basal salivary secretion 2. 75% of basal salivary secretion 3. 100% of basal salivary secretion 4. Parotid secretion ceases during sleep 34. The parotid has constant relationship with 1. Lower zygomatic nerve 2. Buccal branch of facial nerve 3. Upper zygomatic nerve 4. Marginal mandibular nerve

35. Multiple cystic lesions inside both the parotid glands in a patient should alert the clinician for a possible diagnosis of 1. Mumps 2. Measles infection 3. HIV infection 4. Malignancy 36. Parotid calculi are diagnosed by 1. Xray skull lateral view 2. Plain radiograph of parotid gland 3. CT scan 4. Plain radiograph occlusal view 37. Sialadenosis commonly involves 1. Accessory salivary gland 2. Submandibular gland 3. Sublingual gland 4. Parotid gland 38. Parotid gland swellings are very painful because 1. The outer layer (parotid fascia) is inelastic and firm 2. The parotid glands suppurate easily 3. The parotid gland is closely related to the external auditory canal 4. There is no outer layer of fascia covering the parotid gland 39. Parotid duct is known as

Stenson's duct Wharton's duct Stylle's duct Finely's duct 40. Salivary fistula is commonly originates from 1. Submandibular salivary glands 2. Accessory salivary glands 3. Sublingual salivary glands 4. Parotid glands

1. 2. 3. 4.

Deep part of Submandibular gland is related to 1-facial nerve 2.lingual nerve 3- Accessary nerve 4- mandibular nerve
1] Following tonsillectomy , a patient noticed loss of general sensation & taste from his posterior third of tongue. Most likely nerve to get injured here : A. Facial B. Glossopharyngeal C. Lingual D. Vagus

Ans : B 2] Diplacusis is due to lesion in : A. Cochlea B. Auditory nerve C. Pontaine glioma D. None of the above

Ans : A 3] Gradinigo syndrome has all the following components except : A. Diplopia B. Headache C. Abducent palsy D. Facial palsy

Ans : C 4] Commonest cause for unilateral muco-purulent discharge in children : A. Rhinitis B. Foreign bodies C. Sinusitis D. Polyp

Ans : B 5] Color of tympanic membrane in otosclerosis A. Red B. Flamingo-pink C. orange D. Pearly grey

Ans : D 1. Which of the following is not true for stridor in young children? a) Croup (Laryngotracheobronchitis) happens mostly in younger children (<2Years). b) Croup always occurs in cluster. c) Acute epiglottis is viral in origin. d) Refer patient to A & E department of nearby acute hospital with ENT support if there is cyanotic or respiratory distress in young children with stridor. e) Apyrexial stridor can be due to foreign body, injury, scald or papilloma. The following are the causes of Acute facial nerve paralysis except: a) Congenital cholesteatoma b) Herpes zoster c) Temporal bone tumour d) Facial laceration e) Otitis externa Treatment of acute severe epistasis includes the following except: a) Monitor vital signs b) Nasal pinching c) Nasal packing d) Refer to acute hospital e) X-ray study

2.

3.

4.

Which of the following statement of Ramsay Hunt Syndrome is not true? a) It is also known as Herpes zoster oticus. b) It is viral in origin. c) It causes intense pain in ear. d) It causes facial paralysis only. e) Treatment includes steroid. Which of the following is not the intracranial complication of ear infection? a) Meningitis b) Lateral sinus thrombosis c) Facial paralysis d) Otitic hydrocephalus e) Extradural abscess

5.

Question Your Answer Correct Answer Q1 b Q2 a Q3 e Q4 d Q5 c Explanations: Acute epiglottis happens in slightly older child (>2years) and occasionally in adult. There is rapid progression of stridor and Q1) drooling of saliva. Hemophilus influenzae is the most common pathogen. Lateral neck X-ray will show swollen

epiglottis (Thumb sign). Causes of Acute facial nerve paralysis include:

Q2)

Intracranial - Meningioma, Congenital cholesteatoma, Acoustic neuroma Intratemporal - Acute and chronic ear infection, Glomus tumours, Herpes zoster, Fracture, Post surgery, Temporal bone tumour, Bell's palsy Extratemporal - Parotid malignancy, Facial laceration

Q3)

Q4)

Treatment of acute severe epistasis includes monitoring of vital signs, control of bleeding by nasal pinching or packing, referring patient to acute hospital if there is massive bleeding, suspected pathology, failed control of bleeding or complication. Herpes zoster oticus (Ramsay Hunt Syndrome) is due to viral infection of spiral /vestibular ganglion in the inner ear or ganglion of facial nerve. There is intense pain in ear with vestibular eruption on pinna and external ear few days later. Patient will suffer from sudden sensorineural hearing loss, vertigo and facial paralysis. Treatment includes care of eye, steroid, antiviral drug and vasodilator. Intracranial complication of ear infection includes meningitis, lateral sinus thrombosis,

Q5)

otitic hydrocephalus, extradural abscess, subdural abscess, brain abscess and cortical thrombophlebitis

the following are true of pleomorphic adenoma of the parotid gland a) they are characteristically of high signal on T2 b) contain epithelial cells c) usually presents with paralysis in the distribution of the facial nerve d) compose less than 50% of all benign parotid tumours e) commonly affect young adults 1. Superfical parotidectomy is contraindicated in patients with sialectasis because 1. There is a high risk of fistula formation 2. There is risk of facial palsy 3. There is high risk of dry mouth 4. There is high risk of infection 2. Calcium content of saliva is low in 1. Sublingual salivary gland secretions 2. Accessory salivary gland secretions 3. Submandibular salivary gland secretions 4. Parotid secretions 3. Salivary fistula is commonly originates from 1. Sublingual salivary glands 2. Accessory salivary glands 3. Parotid glands 4. Submandibular salivary glands

4. In submandibular salivary gland surgery, the branch of facial nerve at risk is 1. Upper zygomatic nerve 2. Buccal nerve 3. Lower zygomatic nerve 4. Marginal mandibular nerve 5. The first salivary gland to develop is 1. Sublingual salivary gland 2. Accessory salivary glands 3. Submandibular salivary gland 4. Parotid gland 6. Adenoid cystic carcinoma is known to commonly involve 1. Parotid gland 2. Sublingual salivary gland 3. Submandibular salivary gland 4. Minor salivary glands 7. Oncocytoma almost exclusively occurs in 1. Accessory salivary gland 2. Submandibular salivary gland 3. Parotid salivary gland 4. Sublingual salivary gland 8. Parotid duct is known as 1. Stylle's duct 2. Finely's duct 3. Stenson's duct 4. Wharton's duct 9. In Bulimia parotid glands are 1. Shrunken in size 2. Nodular 3. Enlarged 4. Cystic in nature

10. by 1. 2. 3. 4.

During sleep salivary secretion is maintained

Sublingual gland only Submandibular gland only Parotid gland only Submandibular and sublingual salivary glands 11. In superficial parotidectomy 1. The whole of superfical lobe and part of deep lobe of the gland is removed 2. The deep lobe is removed completely 3. Only a part of superfical lobe is removed 4. The superfical lobe is removed completely 12. Benign tumors of superfical lobe of parotid gland takes a very long time to project outwards because 1. The external surface of the parotid gland is covered by tough parotid fascia 2. Slow rate of tumor growth 3. The styloid process stops the progression of tumor 4. Ramus of the mandible stops tumor progression 13. Technitium pertechnetate scans are useful in the diagnosis of 1. Monomorphic adenoma 2. Sialadinitis 3. Pleomorphic adenoma 4. Warthin's tumor 14. Submandibular salivary gland swelling is differentiated from submandibular lymphadenitis clinically by 1. Movement during swallowing 2. Bidigital palpation

3. Presence of transillumination in submandibular salivary gland 4. Palpation from behind the patient 15. The antibiotic that is actively secreted in the saliva is 1. Cefixime 2. Ampicillin 3. Clindamycin 4. Streptomycin 16. Sublingual salivary gland is situated 1. Above the mylohyoid 2. Posterior to the mylohyoid muscle 3. Below the mylohyoid muscle 4. Under the palatopharyngeous muscle 17. The parotid has constant relationship with 1. Lower zygomatic nerve 2. Upper zygomatic nerve 3. Marginal mandibular nerve 4. Buccal branch of facial nerve 18. During sleep the parotid gland is known to secrete about 1. 100% of basal salivary secretion 2. Parotid secretion ceases during sleep 3. 50% of basal salivary secretion 4. 75% of basal salivary secretion 19. Acini of parotid glands are formed by 1. Mucinous cells 2. Seromucinous cells 3. Serous cells 4. Cloudy cells 20. Food stimulates secretion of 1. Submandibular salivary gland 2. Accessory salivary glands

3. Parotid gland 4. Sublingual salivary gland 21. Submandibular salivary gland is separated into superficial and deep portions by 1. Buccinator muscle 2. Sternomastoid muscle 3. Mylohyoid muscle 4. Digastric muscle 22. Perineural invasion is common in 1. Pleomorphic adenoma 2. Acinous cell carcinoma 3. Adenoid cystic carcinoma 4. Mucoepidermoid carcinoma 23. Sialadenosis commonly involves 1. Sublingual gland 2. Accessory salivary gland 3. Parotid gland 4. Submandibular gland 24. Parotid calculi are diagnosed by 1. Plain radiograph of parotid gland 2. Xray skull lateral view 3. CT scan 4. Plain radiograph occlusal view 25. In patients with diabetes mellitus the parotid gland is 1. Fibrosed 2. Enlarged 3. Shrunken 4. Cystic in nature 26. Parotid gland swellings are very painful because 1. The parotid glands suppurate easily

2. There is no outer layer of fascia covering the parotid gland 3. The parotid gland is closely related to the external auditory canal 4. The outer layer (parotid fascia) is inelastic and firm 27. Parotid gland secretions constitute about 1. 100% of salivary secretion 2. 3/4 th of salivary secretion 3. 1/5 th of salivary secretion 4. 90% of salivary secretion 28. Sialolithiasis is common in 1. Parotid gland 2. Submandibular salivary gland 3. Sublingual salivary gland 4. Accessory salivary gland 29. The parotid gland is divided into superficial and deep portions by 1. Cartilagenous portion of external auditory canal 2. Facial nerve branches 3. Mandible 4. Internal maxillary artery 30. In parotid surgeries the most reliable way of identifying the facial nerve is 1. By using the tragal pointer 2. By tracing it from the mastoid cavity 3. Searching at the tympanomastoid sulcus 4. By removing the styloid process 31. Tumors arising from deep lobe of parotid gland extending across the parapharyngeal space is covered on their anterior aspect by

1. Stretched out fibers of medial pterygoid muscle 2. Stretched out fibers of superior constrictor muscles 3. Stretched out fibers of lateral pterygoid muscle 4. Stretched out fibers of middle constrictor muscle 32. Parotid gland is a 1. Serous salivary gland 2. Protenaceous salivary gland 3. Mucinous salivary gland 4. Mucoserous salivary gland 33. All major salivary glands arise from 1. Ectoderm 2. All three embryonal tissue 3. Mesoderm 4. Endoderm 34. Multiple cystic lesions inside both the parotid glands in a patient should alert the clinician for a possible diagnosis of 1. HIV infection 2. Measles infection 3. Mumps 4. Malignancy 35. Anesthesia over parotid gland area is caused by injury to 1. Buccal nerve 2. Marginal mandibular nerve 3. Orbital nerve 4. Greater auricular nerve 36. Daily average volume of saliva produced in a human being is

1 - 1.5 litres 8 - 10 litres 3 - 4 litres 3 - 5 litres 37. Carbohydrate-protein substances corresponding to the blood group antigens are not secreted by 1. Submandibular salivary glands 2. Sublingual salivary glands 3. Accessory salivary glands 4. Parotid glands 38. Chemical stimulation maximises the secretion of 1. Sublingual gland 2. Accessory salivary gland 3. Parotid gland 4. Submandibular gland 39. Warthin's tumor is commonly seen in 1. Sublingual salivary gland 2. Parotid gland 3. Submandibular salivary gland 4. Accessory salivary gland 40. Warthin's tumor is known to develop from 1. Myoepithelial cells 2. Lymphoid tissue within parotid gland 3. Acinar cells 4. Basal cells A 54-year-old male smoker notices a slowly enlarging mass over the past 2 years within his right parotid gland. At the time of surgical excision, the mass measures 2.8 cm in diameter and is focally cystic. Microscopic examination reveals a tumor composed of benign

1. 2. 3. 4.

papillary oncocytic epithelial fronds supported by benign lymphoid stroma. Which of the following is the most likely diagnosis? A) acute suppurative sialoadenitis B) adenoid cystic carcinoma C) mucoepidermoid carcinoma D) pleomorphic adenoma E) Warthin tumor (adenolymphoma)

most common ectopic location for salivary gland? a.palate b.over hyoid c.tongue d.pyriform fossa
Which of the following salivary gland tumors shows perineural spread A.Warthin's tumor B.adenoid cystic carcinoma C.carcinoma in pleomorphic adenoma D.mucoepidermoid carcinoma