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 .

46 - oral cavity surgery mcqs - part 3

21q: which of the following statements best represents ludwig’s angina ?

 

1. a type of coronary artery spasm
2. an infection of the cellular tissues around submandibular gland
3. oesophageal spasm
4. retropharyngeal infection

 

answer: b . an infection of the cellular tissues around submandibular gland .

 

22q: treatment of choice for carcinoma of lip less than one centimeter ?

 

1. radiation
2. chemotherapy
3. excision
4. radiation and chemotherapy

 

answer: c . excision .

 

23q: carcinoma of tongue less than 2 centimeters is treated by ?

 

1. excision
2. radiotherapy
3. chemotherapy
4. excision and radiotherapy
5. excision and chemotherapy

 

answer: a . excision .

 

24q: a patient presented with a 1 X 1.5 cms growth on the lateral border of the tongue. The treatment indicated would be ?

 

1. laser ablation
2. interstitial brachytherapy
3. external beam radiotherapy
4. chemotherapy

 

answer: b . interstitial brachytherapy .  when u are asked about the management of carcinoma of tongue first observe the size of the tumor , if the size of the tumor is less than 1 cms surgical excision with wide margins is the treatment of choice .

                                                 if the size of the tumor is greater than 1 cm , then radiotherapy is the treatment of choice .

                                                 radiotherapy is of two types , that is interstitial brachytherapy and teletherapy . if the cancer of tongue involves anterior part of the tongue , then interstitial brachytherapy is the treatment of choice and if the cancer involves the posterior part of the tongue then teletherapy is the treatment of choice .

 

25q: tina , a 32 year old female from rural background presented with a history of chronic tobacco chewing since 14 year of age . now she has difficulty in opening her mouth. On oral examination no ulcers are seen . most probable diagnosis  ?

 

1. submucous oral fibrosis
2. carcinoma of buccal mucosa
3. TM joint arthritis
4. Trigeminal nerve paralysis

 

Answer: a . submucous oral fibrosis .

 

26q: metastasis of carcinoma buccal mucosa goes to ?

 

1. regional lymph node
2. liver
3. heart
4. brain

 

answer: a . regional lymph node .

 

27q: all of the following predisposes to oral cancer except ?

 

1. erythroplakia
2. leukoplakia
3. submucosal fibrosis
4. lichen planus

 

answer: d . lichen planus .

 

28q: all of the following predispose to squamous cell carcinoma except ?

 

1. lichen planus of mouth
2. bowen’s disease
3. inverted papilloma of nose
4. chronic irritation or oral mucosa of jagged teeth

 

answer: a . lichen planus of mouth .

 

the predisposing factors for squamous cell carcinoma of oral cavity :

 

1. leukoplakia
2. erythroplakia
3. chronic hyperplastic candidiasis
4. oral submucosal fibrosis
5. syphilitic glossitis
6. sideropenic dysphagia
7. long standing dental ulcer (chronic irritation or oral  mucosa by jagged teeth)

 

29q: impacted wisdom teeth may produce referred pain via ?

 

1. lingual nerve
2. facial nerve
3. branch of the auriculo temporal nerve
4. none

 

answer: c . branch of the auriculo temporal nerve .

 

30q: not a carcinogenic for cancer of head and neck ?

 

1. alcohol
2. smoking
3. tobacco
4. unflourinated water

 

answer: d . unflourinated water .

 

45 - oral cavity surgery mcqs - part 2

11q: a 60 year old man presents with an ulcer on lateral margin of tongue also complaints of ear pain , most probable diagnosis ?

 

1. dental ulcer
2. carcinomatous ulcer
3. tuberculous ulcer
4. syphilitic ulcer

 

answer: b . carcinomatous ulcer. The clue in the question is the site of the ulcer and the age of the patient with pain reference . the most common site of carcinoma of tongue is the anterior 2/3 rd or middle 1/3 rd of the tongue .

 

12q: anatomical structure injured in excision of ranula ?

 

1. lingual vein
2. lingual artery
3. submandibular duct
4. parotid duct

 

answer: c . submandibular duct .

 

13q: areas of carcinoma of oral mucosa can be identified by staining with ?

 

1. 1% zinc chloride
2. 2% silver nitrate
3. Gentian violet
4. 2 % toluidene blue

 

Answer: d . 2 % toluidene blue .

 

14q: radiographic finding of floating teeth can be seen in ?

 

1. ectodermal dysplasias
2. cleidocranial dysplasias
3. osteoporosis
4. histiocytosis – X

 

answer: d . histiocytosis – X .

 

15q: dentigerous cyst arises from ?

 

1. an unerupted tooth
2. apex of an infected tooth
3. nasopalatine cysts
4. solitary bone cysts
5. multi locular keratocytes

 

answer: a . an unerupted tooth .

 

16q: the commonest pre-malignant condition of oral cancer is ?

 

1. leukoplakia
2. apthous ulcer
3. lichen planus
4. erythro-leukoplakia

 

answer: a . leukoplakia .

 

17q: multiple painful ulcers on tongue are seen in all except ?

 

1. apthous ulcers
2. tuberculous ulcers
3. herpes ulcers
4. carcinomatous ulcers

 

answer: d . carcinomatous ulcers are normally painless in the early stages , but in advanced cases due to involvement of surrounding structures they become painful .

 

18q: predisposing factors for development of oral carcinoma is ?

 

1. smoking
2. alcohol
3. syphilis
4. all the above

 

answer: d . all the above .

 

19q: a full thickness loss of middle one third of the upper lip is best reconstructed by?

 

1. nasolabial flap
2. cheek flap
3. abbey flap
4. estlander flap

 

answer: c,d . abbey-estlander flap is most commonly used in the reconstruction of the upper lip .

 

20q: which of the following best represents ranula ?

 

1. a type of epulis
2. a thyroglossal cyst
3. cystic swelling in the floor of mouth
4. forked uvula

 

answer: c . cystic swelling in the floor of mouth .

44 - oral cavity surgery mcqs - part 1

1q: epulis arises from ?

 

1. enamel
2. root of teeth
3. gingiva
4. pulp

 

answer:  c. gingiva or gum .

 

2q: the commonest site of oral cancer among Indian population is ?

 

1. tongue
2. floor of the mouth
3. alveobuccal complex
4. lip

 

answer: c . alveobuccal complex . the most common type of oral cancer in India is buccal mucosa ( 38 % ) followed by anterior tongue secondly ( 16 %) and thirdly lower alveolus ( 15.7 % ) . so when the percentages of buccal mucosa and lower alveolus are combined it is alveobuccal complex ( 53.7 % ) that is the most common type of oral cancer in India .

                                                    worldwide the most common type of oral cancer is the carcinoma of the lip and secondly carcinoma of the tongue .

 

3q: a patient has small, oval  multiple ulcers in oral cavity with red erythematous margins . the diagnosis is ?

 

1. carcinoma
2. apthous ulcer
3. tubercular ulcer
4. syphilitic ulcer

 

answer: b . apthous ulcers .

 

4q: the premalignant condition with the highest probability of progression to malignancy ?

 

1. dysplasia
2. hyperplasia
3. leukoplakia
4. erythroplakia

 

answer: d . erythroplakia . the malignant potential of erythroplakia is 17 times higher than leukoplakia .

 

5q: in carcinoma cheek what is the best drug for single drug chemotherapy ?

 

1. vincristine
2. cyclophosphamide
3. cisplatin
4. daunorubicin

 

answer: c . cisplatin . CISPLATIN is the best drug for single drug chemotherapy in the treatment of carcinoma cheek .

 

6q: painless ulcer of the tongue is due to ?

 

1. dyspepsia
2. syphilis
3. tuberculosis
4. none

 

answer: b . syphilis .

 

7q: most common type of oral cancer ?

 

1. lip
2. cheek
3. tongue
4. palate

 

answer: a . lip . when it is not mentioned in the question about a specific country , assume that it is the most common occurrence in the world and so the answer here is the most common type of oral cancer in the world is lip .

 

8q: commonest cancer of the oral cavity ?

 

1. adenocarcinoma
2. melanoma
3. sarcoma
4. squamous cell carcinoma

 

answer: d . squamous cell carcinoma . most of the cancers of the head and neck are of the squamous cell type .

 

9q: what is ranula ?

 

1. retention cyst of sublingual gland
2. retention cyst of submandibular gland
3. extravasation cyst of sublingual gland
4. extravasation cyst of submandibular gland

 

answer: a . retention cyst of sublingual gland .

 

10q: the most frequent tooth to be impacted is ?

 

1. lower third molar
2. lower canine
3. upper third molar
4. upper premolar

 

answer: a . lower third molar . the second most common type of tooth to be impacted is upper third molar and thirdly the maxillary canine .