The pharynx SCQ & EMQ for 5th stage

(Dr. Moyaser A. Yaseen)

SCQ

1- Anatomically the pharynx,

A. Extend from the base of the tongue to the upper end of the oesophagus.
B. It’s about 10 cm in length.
C. It extends to the level of the second tracheal ring.
D. It’s divided into two parts supraglottic & glottic.
E. The pyriform fossa opens directly in the trachea.

2- In the pharynx,
A. The opening of the Eustachian’s tube just behind the posterior end of the
inferior turbinate.
B. We have two nasopharyngeal tonsils (one in each side).
C. An enlarged lingual tonsil indicates possible malignancy.
D. The free surface of the tonsil covered by the respiratory epithelium
E. The tonsil had a capsule that separate it’s deep surface from the inferior
constrictor muscle.

3- Sore throat (pharyngitis).

A. Sore throat & persistent leg pain are features of Adenovirus infection.
B. Azithromycin treatment is the best cove antibiotic in acute pharyngitis.
C. viruses are the commonest cause of acute pharyngitis all over the world.
D. Staphylococcus infection causes small vesicles &ulcerative slough in the oral cavity
& the pharynx.
E. Acute pharyngitis with nasal symptoms, dry cough & pyrexia is of definite
Haemophilus influenzae infection.

4- Clinically patient presented to you with extreme tiredness, fever and severe sore
throat, with hugely enlarged & hyperemic tonsils and whitish membranous
exudate covering the tonsils & the surrounding areas. Infectious mononucleosis
to be a possible cause in which condition?
 A. The disease rapidly improved within few days even without treatment.
B. If there is no any cervical lymph nodes enlargement as its viral infection.
C. If there is generalized cervical lymph nodes enlargement & it’s tender & hard
nodules.
D. If he’s elderly man & edentulous.
E. Typically the disease not responds to antibiotics treatment.

5- A child presented to you with severe sore throat, you will suspect acute
Streptococcal tonsillitis in the following condition?
A. Its acute severe sore throat associated with night pyrexia, the sore throat
improved by food intake.
B. Its sudden, severe & persistent sore throat & pyrexia, associated with
difficulty in swallowing.
C. If he is a known patient of recurrent epileptic attacks.
D. If there is multiple tender lymphadenitis in parotid region.

6- A child presented to you with membranous type acute tonsillitis with severe sore
throat, fever, headache and malaise. After 24 hours from the onset a punctate
erythematous skin rash develops. What is your provisional diagnosis?

A. Scarlet fever.
B. Diphtheria infection.
C. Acute tonsillitis in immune compromised patient.
D. Glandular fever
E. Post Streptococcal rheumatic fever disease.

7- A child with persistent snoring at sleep diagnosed as a case of significant adenoid

hypertrophy. What the next step to do?

A. Associated otitis media with effusion needs to be excluded.

B. Emergency adenoidectomy is important because the risk of adenoid facies.
C. A course of ceftriaxone injection to be given before decision of surgery.
D. Wait till adult hood for spontaneous regression of adenoid in underweight
child.
E. Tonsillectomy is important in addition to adenoidectomy as they are one ring
of immune system.
EMQ

1- The important & a cardinal feature in acute bacterial tonsillitis is?

2- The main investigation in acute bacterial tonsillitis is?
3- The main treatment of acute bacterial tonsillitis is?

A. Snoring & nasal congestion

B. Bed rest with anti-streptococcal antibiotic.
C. Monospot test
D. Tender & enlarged jugulodiagastric lymph nodes.
E. Lateral plain X-ray of pharynx & neck.
F. Locked jaw.
G. Swab for the gram stain & culture sensitivity.
H. Tonsillectomy if it’s membranous type.
I. Full endoscopic evaluation of the pharynx & larynx before start treatment.
 The pharynx SCQ

(Dr. Moyaser A. Yaseen)

SCQ

1- The anatomy of the pharynx.

A. The teeth included in the oropharynx.
B. There is single tubal tonsil in the postnasal space.
C. The adenoid is part of Waldeyer’s ring.
D. Normally the lingual tonsil enlarged with aging.
E. The pyriform fossa is just medial to glottis.

2- The tonsils,
A. Covered by stratified squamous epithelium.
B. Functionally had incomplete capsule.
C. It will totally disappear in aging.
D. Had afferent but no efferent lymphatic vessels.
E. There are more than 30 crypts in each palatine tonsil.

3- In acute streptococcal tonsillitis,

A. There will be unilateral tonsillar enlargement.
B. There is maculopapular skin rash.
C. Non tender enlarged cervical lymph nodes.
D. Sudden, severe & persistent pyrexia may leads to febrile convulsion.
E. Odynophagia associated with dysphonia & dry cough.

4- In diphtheria.

A. There is severe local infection and inflammation in the upper airway and
pharynx.
B. There is a history of long incubation period about 2-4 weeks.
 C. Septicemia is the main cause of death.
D. Ceftriaxone injection is the main treatment.
E. It needs emergency tonsillectomy to prevent systemic spread of disease.

5- A child presented to you with hugely enlarged tonsils. There surgical plan is?

A. Surgery indicated if there is recurrent real tonsillitis more than five attacks a
year.
B. Tonsillectomy indicated if there is snoring & sleep apnea.
C. Surgery indicated after CT scan evaluation of the pharynx.
D. Tonsillectomy indicated only if the child above five years age.
E. An emergency tonsillectomy with possible needs for tracheostomy.

6- A young man with acute severe throat pain mainly unilateral associated with
severe pyrexia, odynophagia & referred otalgia associated with difficulty to open
his mouth.
A. We suspect adenoiditis & adenoid facies complication.
B. Acute tonsillitis of possible viral cause.
C. Glandular fever is possible if there are mouth ulcers.
D. Diphtheria & its associated sequels is another possibilities.
E. Peritonsillar abscess is of high possibility.

7- The child arranged for tonsillectomy. The surgery to be postponed in the

following condition?

A. During upper respiratory tract infection.

B. If there is impacted wax causing conductive deafness.
C. If there is no prepared blood for donation (at least two pints) as it’s a highly
vascular surgery.
D. If the child had kissing tonsils.
E. If there is possible associated middle ear disease.

8- A child presented to you with acute membranous tonsillitis. Your management

plan?

A. Scarlet fever is possible diagnosis in unilateral & hugely enlarged tonsil.

 B. Admission to hospital & start a high dose parenteral steroid to reduce oedema.
C. Associated severe stridor & neck swelling may underlay diphtheria.
D. Emergency tonsillectomy is the best & safest treatment.
E. The streptococcal infection is beyond our diagnosis.

EMQ

1-The important & a cardinal feature of significant adenoid hypertrophy is? E

2-The main investigation in diagnosis adenoid hypertrophy is? H

3-The main treatment of significant adenoid hypertrophy is? B

A. Lateral X-ray of cervical vertebrae.

B. Adenoidectomy & possible myringotomy in associated otitis media with effusion.
C. Persistent cervical lymph nodes enlargement.
D. Rigid endoscopy of the glottis.
E. Persistent nasal obstruction & snoring at sleep.
F. CT scan evaluation to exclude submucous cleft palate before intervention.
G. Adenotonsillectomy.
H. Plain X-ray of the soft tissue of post nasal space with possible endoscopic
evaluation of nasopharynx.
I. Recurrent sore throat & pyrexia.