Thursday, February 12, 2009

48 - oral cavity surgery mcqs - part 5

41q: all are true about cancrum oris except ?


  1. associated with malnutrition and vitamin deficiency
  2. follows chronic infection
  3. involves jaw
  4. treatment is excision and skin grafting with tubed pedicle graft


answer: all the statements are actually true but the answer of exclusion is most probably “ b “  follows chronic infection .


42q: cancrum oris – true statements ?


  1. associated with malnutrition
  2. inflammatory swelling
  3. associated with vitamin deficiency
  4. treatment is excision and skin grafting


answer: all are true .


43q: all are true about carcinoma palate except ?


  1. slow growing
  2. bilateral lymphatic spread
  3. adenocarcinoma
  4. presents with pain


answer: d . presents with pain . carcinoma palate usually gives no symptoms except painless irregularity on the palate felt by tongue .


A few important points about carcinoma palate :


  1. slow growing tumor
  2. remains superficial for prolonged periods before extending into the periosteum
  3. it usually presents as superficial ulcer with rolled out edges
  4. it usually gives no symptoms except painless irregularity on the palate felt by the tongue
  5. lymphatic metastasis is not common , but may spread to submandibular and upper jugular node .
  6. small tumors are resected along with the underlying bone
  7. large tumors are treated with maxillectomy
  8. adjuvant radiotherapy is given for advanced lesions
  9. bilateral lymphatic spread is common in tumors of head and neck like lower lip, supraglottis and soft palate .


44q: treatment of state T3N1 of carcinoma maxilla is ?


  1. radiation therapy only
  2. chemotherapy only
  3. surgery and radiation
  4. chemotherapy and radiation


answer: c . carcinoma maxilla is of two types . squamous cell carcinoma and adenocarcinoma . surgery and radiation is the treatment of choice for any stage of carcinoma maxilla .

                                    adenocarcinoma of maxilla is unresponsive to radiation and so surgery is the only option .


45q: gum tumor with 2 contralateral mobile lymphnodes in cheek come under ?


  1. T3N2M0
  2. T2N2M0
  3. T4N2M0
  4. T3N3M0


Answer: a . T3 N2 M0 . if only one node is involved with less than or equal to 6 cms size above the supraclavicular foss ,then it is N1 . if bilateral metastasis in lymph nodes with less than or equal to 6cms size above the supraclavicular fossa, then it is N2. if the size of metastasis is greater than 6cms to supraclavicular fossa then it is N3 . no other surrounding structures involved so it is T3 and not T4 .


46q: a patient with cheek cancer has a tumor of 2.5 cm located close to and involving the lower alveolus . a single mobile homolateral lymphnode measuring 6 cm is palpable . the TNM staging is ?


Answer: T4 N1 M0. notice that the alveoli involved so it is T4 . as one lymphnode is involved measuring 6 cms , it is N2 .


47q: patient with T3 N2a M0 lower alveolar carcinoma requires ?


    1. surgery
    2. surgery and radiotherapy
    3. radiotherapy
    4. chemotherapy


answer: a . surgery .

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