Thursday, February 12, 2009

47 - oral cavity surgery mcqs - part 4

31q: commonest site of carcinoma tongue is ?


  1. dorsum
  2. ventral aspects
  3. anterior 2/3 rd lateral aspect
  4. tip


answer: c . anterior 2/3 or middle 1/3 rd .


32q: in the reconstruction following excision or previously irradiated cheek , the flap will be ?


  1. local tongue
  2. cervical
  3. forehead
  4. pectoralis major myocutaneous


answer: d . pectoralis major myocutaneous .


33q: true statements about oral cancer is / are ?


  1. most common in buccal mucosa
  2. metastasis is uncommon
  3. respond to radiotherapy
  4. surgery done
  5. syphilis and dental irritation predisposes


answer: b, c , d , e . cancer involving the buccal mucosa is the most common type of oral cancer in India but the most common type of oral cancer in the world is lip cancer .


34q: commonest site of carcinoma tongue ?


  1. apical
  2. lateral borders
  3. dorsum
  4. posterior one third
  5. faucio lingual


answer: b . lateral borders .


35q: which is not true of carcinoma tongue ?


  1. lateral border involved
  2. cervical lymph node involvement
  3. commonly adenocarcinoma
  4. tobacco chewing is a risk factor


answer: c . carcinoma of tongue is most commonly squamous cell carcinoma and not adenocarcinoma .


the most common sites of squamous cell carcinoma are :


  1. skin
  2. head and neck tumor
  3. carcinoma oesophagus
  4. carcinoma cervix
  5. carcinoma bladder


36q: trismus in oral cancer patients is severe in those treated with ?


  1. surgery and radiotherapy
  2. chemotherapy alone
  3. surgery alone
  4. not related to treatment


answer: a . surgery and radiotherapy .


37q: which of the following statements are true about carcinoma tongue ?


  1. occurs most commonly on the lateral border of the middle third of the tongue
  2. metastasize readily to cervical lymph nodes
  3. is usually radiosensitive
  4. treated surgically – should include homolateral neck dissection except for small lesions
  5. all of the above


answer: e . all the above statements are true .


38q: a patient with carcinoma tongue is found to have lymph nodes in the lower neck. The treatment of choice for the lymph nodes is ?


  1. lower cervical neck dissection
  2. suprahyoid neck dissection
  3. teleradiotherapy
  4. radical neck dissection


answer: d . radical neck dissection .


39q: an old man who is edentulous developed squamous cell carcinoma in buccal mucosa that has infiltrated to the alveolus . following is not indicated in the treatment ?


  1. radiotherapy
  2. segmental mandibulectomy
  3. marginal mandibulectomy involving removal of the outer table only
  4. marginal mandibulectomy involving removal of upper half of mandible


answer: c . in marginal mandibulectomy inner table of the mandible is removed and not the outer table . whenever squamous cell carcinoma of the oral cavity involve the mandible mandibulectomy becomes necessary.

                                          Mandibulectomy is of two types . segmental mandibulectomy and marginal mandibulectomy . marginal mandibulectomy is done when the tumor lies within one centimeter of the mandible or abuts the periosteum without evidence of direct bony invasion . if the tumor is greater than one centimeter and has direct bony invasion , then segmental mandibulectomy is done .


40q: a 80 year old patient presents with a midline tumor of the lower jaw , involving the alveolar margin . he is edentulous . what is the treatment of choice ?


  1. hemimandibulectomy
  2. commando operation
  3. segmental mandibulectomy
  4. marginal mandibulectomy


answer: c . segmental mandibulectomy . hemimandibulectomy cannot be done because it is a midline tumor .

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