1.

Regarding the tonsil, all of the followings are true except: D

A. Palatoglossus lies anterior to the tonsil.
B. The tonsil is supplied by the tonsillar artery, a branch of the facial artery.
C. The internal carotid artery lies 2.5cm behind and lateral to the tonsil.
D. Contains 20 crypts.
E. Lymph drains to the upper deep cervical & jugulodigastric lymph nodes.

2. A 66 year old Chinese man presents with a two month history of neck swelling in
the right posterior triangle. On further questioning he tells you that his hearing
has also declined in the right ear. He also has a blocked nose. What is the likely
diagnosis? B
A. Lymphoma.
B. Metastatic lymph node from a nasopharyngeal carcinoma.
C. Parotid tumour.
D. Lipoma
E. Metastatic lymph node from a oropharyngeal carcinoma.

3. A 21 year old woman presents with two day history of sore throat and
dysphagia. On examination she is pyrexial with halitosis and cervical
lymphadenopathy. What is the likely causative organism for her condition? E
A. Epstein-Barr virus.
B. Agranulocytosis.
C. Corynebacterium diphtheriae.
D. Neisseria gonorrhoea.
E. Group A beta-haemolytic streptococcus (Streptococcus pyogenes).

4. Juvenile angiofibroma: A
A. Patients have often had repeated episodes of epistaxis.
B. It is a tumour of young girls with a mean age of 14 at presentation.
C. Bone erosion of the greater wing of the sphenoid does not occur.
D. Secretary otitis media does not occur.
E. External beam radiotherapy is first line treatment.

5. A 55 year old man presents with a three month history of swelling on the right
side of the neck, which has gradually increased in size. He has also been having
earache and throat pain for the last two weeks. He tells you that the pain in his
ear is so severe that he cannot sleep at night. He has no other symptoms. He is
otherwise fit and well. He smokes 10 cigarettes per day and drinks 15 units of
alcohol per week. Examination of the neck reveals a 4 cm x 4 cm firm, mobile,
non-fluctuant, and non-pulsatile swelling on the right side of the neck. The
overlying skin is normal and the mass is not attached to the skin. ENT
examination is normal. B
A. Branchial cyst.
B. Malignant node containing squamous cell carcinoma.
C. Infective lymph node.
D. Submandibular gland stone.
E. Non-Hodgkin lymphoma.

6. Stridor: E
A. It is only a symptom not a sign.
B. Recession of suprasternal, supraclavicular, intercostal and subcostal space
indicate mild form of respiratory difficulty.
C. Cyanosis indicate early stage.
D. Hemangioma can only be congenital.
E. It is never a diagnosis nor a disease.

7. A 27 year old female patient presented with painful and difficulty swallowing,
 on indirect laryngoscopy, there is pooling of saliva in right pyriform sinus with
swollen right arytenoid, the most likely diagnosis is: E
A. Adenocarcinoma of pyriform sinus.
B. Squamous cell carcinoma of pyriform sinus.
C. Squamous cell carcinoma of posterior pharyngeal wall.
D. Squamous cell carcinoma of larynx.
E. Squamous cell carcinoma of Postcricoid.

8. The first postoperative day, tonsillectomy fossa is: D

A. Red colour.
B. Black colour.
C. Yellow colour.
D. White colour.
E. Flesh colour.

9. Stage ІІІ squamous cell carcinoma of oropharynx is: C

A. Metastatic disease.
B. Locally advanced disease.
C. Tumour present in lymph nodes.
D. Best treated by radiotherapy.
E. Best treated by chemotherapy.

10. Palliative treatment of advanced head and neck malignant tumours involves all
of the following except: E
A. Gastrostomy.
B. Tracheostomy.
C. Pain killers.
D. Nausea and vomiting typically controlled using cyclizine.
E. Antibiotics to treat infections.

11. Radiotherapy is the treatment of choice for: A

A. Nasopharyngeal carcinoma.
B. Stage ІІІ squamous cell carcinoma of larynx.
C. Nasopharyngeal adenocarcinoma.
D. Oropharyngeal carcinoma.
E. Hypopharyngeal adenocarcinoma.

12. Commando operation may be used for the treatment of: D

A. Nasopharyngeal carcinoma.
B. Stage ІІІ squamous cell carcinoma of larynx.
C. Nasopharyngeal adenocarcinoma.
D. Oropharyngeal carcinoma.
E. Hypopharyngeal carcinoma.

13. All of the following may cause tonsillar ulceration except: E

A. Diphtheria.
B. Behget’s syndrome.
C. Vincent’s angina.
D. Agranulocytosis.
E. Papilloma.

14. Early post-tonsillectomy complications include all of the following except: E

A. Oedema of uvula.
B. Secondary bleeding.
C. Pneumonia.
D. Referred otalgia.
E. Anaesthetic complications.

15. All of the following are true regarding adenoids except: E

A. Produces IgM.
B. Attain maximal size between the ages 3 and 8.
C. Produces IgA.
D. Produces IgG.
E. Produces IgD.

16. Laryngomalacia: E
A. The larynx is of an exaggerated adult type.
B. The epiglottis is long and wide and folded backward at each lateral edge.
C. The epiglottis is converted into a delta shaped incomplete cylinder.
D. The glossopharyngeal folds are approximated .
E. None of the above.

17. All are causes of congenital strider except: A

A. Acute epiglottitis.
B. Laryngeal web.
C. Subglottic stenosis.
D. Laryngomalacia.
E. Vascular anomaly.

18. Trauma to posterior pillar during tonsillectomy causes: D

A. Trismus.
B. Bleeding.
C. Infection.
D. Nasal regurgitation.
E. Ankyloglossia.

19. During a hunting trip a bullet affect one of the hunters in his neck by accident,
he developed neck swelling and hoarsed voice, what could be the cause of his
voice change: D
A. Unilateral vocal cord palsy.
B. Bilateral vocal cord palsy.
C. Laryngeal oedema.
D. All the above.
E. None of the above.

20. Which of the following is part of laryngopharynx: D

A. Epiglottis.
B. Cricoids cartilage.
C. Thyroid cartilage.
D. Postcricoid.
E. Arytenoids.

21. Absolute indication of tonsillectomy is: C

A. Chronic tonsillitis.
B. Diptheria carrier.
C. Obstructive sleep apnoea .
D. Glassopharyngeal neurectomy.
E. Rheumatic fever.
22. Which of the following is not a complication of acute tonsillitis? B
A. Peritonsillar abscess.
B. Bezold’s abscess.
C. Acute rheumatism.
D. Acute nephritis.
E. Acute infection of middle ear cleft.

23. Pyriform fossa lies: B

A. Medial to aryepiglottic fold.
B. Lateral to aryepiglottic fold.
C. Inferior to aryepiglottic fold.
D. Superior to aryepiglottic fold.
E. None of the above.

24. A new born baby presented with weak cry and hoarseness, the most probable
diagnosis: D
A. Laryngomalacia.
B. Subglotic stenosis.
C. Subglotic heamangioma.
D. Vocal cord palsy.
E. Tracheomalacia.

25. Which of the following is not a feature of pharyngeal diphtheria?

A. Enlarged tender cervical lymph nodes. C
B. Pyrexia.
C. True membrane.
D. Toxaemia.
E. Bull's neck.

26. Which of the following is not true regarding acute reteropharyngeal abscess: C
A. It is common in children.
B. Produces difficulty in breathing and suckling.
C. It is limited to one side of the midline.
D. Incision and drainage is done from outside through carotid sheath.
E. It forms due to suppuration in reteropharyngeal lymph node

27. A 60- year-old man presents to the clinic with a 5 cm solitary lymph node in the
upper right cervical region and an abnormal-looking right tonsil. Assuming
this is a squamous cell carcinoma nodal metastasis, what is the N classification? B
A. N1.
B. N2a.
C. N2b.
D. N2c.
E. N3.

28. Subglottic edema can prove fatal in a child because: E

A. Mucosa is lax .
B. Mucosa is poorly adherent.
C. Larynx is comparatively small.
D. Subepithelial tissue is lax.
E. All the above.
29. A 70- year-old smokers presents to the ENT clinic with a 3-month history of
dysphagia and weight loss. Flexible nasoendoscopy shows pooling of saliva in the
pyriform fossae, with restricted mobility of the right hemi-larynx. Malignancy is
suspected. You proceed to general anaesthetic endoscopy. At surgery, you find
that he has a 3 cm tumour affecting the right pyriform fossa and extending into
post-cricoid region. According to the TMN staging, what T- stage is this
malignancy? B
A. T1.
B. T2.
C. T2B.
D. T3.
E. T4.

30. A 20- year-old man presents to the ENT clinic with sudden onset high fever of
one day duration, on examination: both tonsils are congested with whitish
membrane over the right tonsil with petichae over the palate and palpable both
jugulodiagastric lymph nodes. What is the most possible diagnosis? B
A. Acute membranous tonsillitis.
B. Infectious mononucleosis.
C. Diphtheria.
D. Quinsy.
E. Leukaemia.

31. The least complication of tonsillectomy is: C

A. Haemorrhage.
B. Pneumonia.
C. Lung abscess.
D. Atelactesis.
E. Subacute bacterial endocarditis.

32. All are functions of the larynx except: D

A. To protect the lungs.
B. To control air flow.
C. Phonation.
D. Generation of speech.
E. To build positive intrathoracic pressure.

33. Stridor: E
A. It is an auditory manifestation of disordered respiratory function due to air
flow changes within the larynx, trachea, or bronchi.
B. It needs investigations in every case.
C. It is due to turbulence of air flow within a partially obstructed respiratory
tract.
D. It can be described in terms of its relationship to the phase of respiratory
cycle.
E. All the above.

34. The most common site of malignant tumours of hypopharynx is: D

A. Postcricoid.
B. Cricoids cartilage.
C. Posterior pharyngeal wall.
D. Piriform sinus.
E. Aryepiglottic fold.

35. Which of the following is not true about nasopharyngeal cancer? E

A. Metastasizes to cervical lymph nodes.
B. Causes unilateral serous otitis media.
C. Treatment of choice is radiotherapy.
D. EB virus is responsible.
E. Most common nerve involved is vagus.

36. Trismus accompanying quinsy is due to spasm of which muscle? C

A. Masseter.
B. Pharyngeal constrictors.
C. Medial pterygoid.
D. Temporalis.
E. Palatopharyngeus.

37. Lymphoid tissue called Waldeyerʼs ring is situated in: B

A. Nasopharynx.
B. Upper tow parts of the pharynx.
C. Oropharynx.
D. Base of tongue.
E. Hypopharynx.

38. A 15-year-old has unilateral nasal obstruction, mass in the cheek and recurrent
epistaxis, the diagnosis is: E
A. Cancer of nasopharynx.
B. Inverted papilloma nose.
C. Maxillary sinusitis.
D. Bleeding tendency.
E. Angiofibroma.

39. A three year old mongol boy get high fever then associated with difficult
swallowing and strider, the child was sitting , cannot sleep and drooling saliva,
the resident pediatrician sent for lateral cervical X-ray then he asked your
opinion about what was looking as a thumb in front of the hypopharynx, your
diagnosis was: D
A. Acute pharyngitis.
B. Acute simple laryngitis.
C. Laryngo-tracheo-bronchitis.
D. Acute epiglottitis.
E. Croup.

40. What is not correct in acute epiglottitis? D

A. Constant supervision in hospital is mandatory.
B. Dyspnea may be progressing and alarming.
C. It is a special form of acute laryngitis, in which the inflammatory changes affect
mainly the loosely attached mucosa of the epiglottis.
D. Systemic antibiotics is not a must to be started immediately.
E. Age incidence is between 1-6 year old.

41. The mouth: D

A. Extends from the incisor teeth to the oropharynx.
B. Contain three salivary glands.
C. Separated from the oropharynx by an anatomical barrier.
D. Consists from two main parts only.
E. The valecula is part of its floor.

42. What is wrong about the pharynx? A

A. Extends from base of the skull to the sixth cervical vertebra at upper border of the cricoid
cartilage.
B. It is the upper part of the respiratory tract.
C. It is the upper part of the digestive tract.
D. About 10 cm in length in adult.
E. The pharyngeal cavity opens in front into the nose, mouth, and larynx.

43. The oral vestibule: D

A. Located between the teeth and alveoli.
B. Located between the lips and cheek.
C. The space enclosed by the teeth and alveoli .
D. It is site of drainage of salivary gland.
E. It communicates posteriorly with the oropharynx through the oropharyngeal
isthmus.

44. The mylohyoid muscle: A

A. It is a depressor of the mandible.
B. It is supplied by maxillary branch of the trigeminal 5th cranial nerve.
C. It is an elevator of the mandible.
D. It is a protractor of the mandible.
E. It is a retractor of the mandible.

45. What is true about lymphatic drainage of the vocal cords? C

A. It has poor lymphatic drainage.
B. It has rich lymphatic drainage.
C. It has no lymphatic drainage.
D. It has a lymphatic drainage only in the anterior half.
E. None of the above.

46. Thornwaldt’s cyst is seen in: C

A. Floor of mouth.
B. Oropharynx.
C. Nasopharynx.
D. Hypopharynx.
E. Larynx.

47. All of the following statements are true about nasopharyngeal tonsil except: A
A. They are lined by squamous epithelium.
B. They are present at birth and disappear by puberty.
C. They are situated in the roof and posterior wall of nasopharynx.
D. They do not have capsule.
E. They do not have crypts.

48. Indications of tracheostomy: D

A. In all cases of acute laryngitis.
B. In any intubated patient within 3 days.
C. Unilateral choanal atresia.
D. Ludwig's angina .
E. If there is suspicion of laryngomalacia.

49. Causes of aspiration pneumonia include all but: A

A. Laryngomalacia.
 B. Myasthenia gravis.
C. Polyneuritis.
D. Tetanus .
E. Cervical cord lesion.

50. Care of tracheostomized patient include: D

A. Humidification by wet gauze.
B. Changing the tube.
C. Care of the inflatable cuff.
D. All the above.
E. None of the above