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 .

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 .