Head &neck sem2 — Past Paper Questions & Answers

Question 1

A child presents with multiple painful vesicles on the oral mucosa accompanied by fever. The likely cause is:

Accepted Answer

HSV-1 — Painful vesicles on the oral mucosa with fever are characteristic of primary herpetic gingivostomatitis, caused by HSV-1.

Question 2

A fluctuant bluish swelling on the lower lip following trauma is most consistent with:

Accepted Answer

Ranula — A mucocele is a common lesion of the oral mucosa caused by rupture of a salivary gland duct and spillage of mucin into the surrounding soft tissues, often presenting as a fluctuant, bluish swelling after trauma.

Question 3

Which odontogenic cyst is most commonly associated with impacted third molars?

Accepted Answer

Dentigerous cyst — A dentigerous cyst (follicular cyst) develops around the crown of an unerupted or impacted tooth, most commonly the mandibular third molars and maxillary canines.

Question 4

Which complication may arise from chronic sinusitis?

Accepted Answer

Osteomyelitis — Chronic sinusitis can lead to local spread of infection, causing osteomyelitis of adjacent bones (e.g., frontal bone), or orbital and intracranial complications.

Question 5

Nasopharyngeal carcinoma is strongly associated with:

Accepted Answer

EBV — Nasopharyngeal carcinoma is strongly associated with Epstein-Barr Virus (EBV) infection, particularly in endemic regions.

Question 6

Juvenile nasopharyngeal angiofibroma occurs most commonly in:

Accepted Answer

Adolescent males — Juvenile nasopharyngeal angiofibroma is a benign but locally aggressive vascular tumor that almost exclusively affects adolescent males.

Question 7

Otosclerosis leads to hearing loss due to fixation of the:

Accepted Answer

Stapes — Otosclerosis is a condition where abnormal bone growth in the middle ear causes the stapes to become fixed to the oval window, impairing sound transmission and leading to conductive hearing loss.

Question 8

Necrotising otitis media is especially aggressive in:

Accepted Answer

Diabetics — Necrotizing (malignant external) otitis media is a severe, invasive infection of the external auditory canal and skull base, predominantly affecting elderly diabetic or immunocompromised patients.

Question 9

Basal cell carcinoma of the pinna is mainly associated with:

Accepted Answer

EBV — Basal cell carcinoma is the most common skin cancer and is strongly linked to chronic exposure to ultraviolet (UV) radiation, making sun-exposed areas like the pinna (ear) common sites.

Question 10

Carotid body tumours arise from:

Accepted Answer

Thyroid tissue — Carotid body tumors are paragangliomas, which are neuroendocrine tumors arising from paraganglia (chemoreceptor cells) of the carotid body.

Question 11

Succinate dehydrogenase mutations are linked to:

Accepted Answer

Paraganglioma — Mutations in succinate dehydrogenase (SDH) genes (SDHA, SDHB, SDHC, SDHD) are well-established genetic causes of hereditary paragangliomas and pheochromocytomas.

Question 12

The most common salivary gland tumour is:

Accepted Answer

Pleomorphic adenoma — Pleomorphic adenoma (benign mixed tumor) is the most common salivary gland tumor overall, accounting for approximately 60-70% of all major salivary gland tumors.

Question 13

Growth hormone excess in adults causes:

Accepted Answer

Acromegaly — Growth hormone excess occurring after epiphyseal plate closure in adults leads to acromegaly, characterized by enlargement of hands, feet, and facial features. Gigantism occurs if excess GH is present before epiphyseal closure.

Question 14

ADH is produced in the:

Accepted Answer

Hypothalamus — Antidiuretic hormone (ADH), also known as vasopressin, is produced by neurosecretory cells in the supraoptic and paraventricular nuclei of the hypothalamus and then transported to the posterior pituitary for storage and release.

Question 15

Bitemporal hemianopia results from compression of:

Accepted Answer

Optic nerve — Bitemporal hemianopia, the loss of vision in the outer half of both visual fields, is a classic sign of compression of the optic chiasm, often by a pituitary adenoma.

Question 16

The main cause of age-related cataract is:

Accepted Answer

Retinal vascular occlusion — Age-related cataracts are primarily caused by oxidative stress and denaturation of lens proteins, leading to their aggregation and opacification of the lens.

Question 17

Cotton wool spots in the retina represent:

Accepted Answer

Nerve fibre layer infarcts — Cotton wool spots are soft exudates in the retina that represent microinfarcts of the retinal nerve fiber layer, often seen in conditions like severe hypertension or diabetes.

Question 18

The most common primary intraocular malignancy in children is:

Accepted Answer

Melanoma — Retinoblastoma is the most common primary intraocular malignancy in children, typically presenting before the age of five.

Question 19

Painless enlarged thyroid with lymphoid infiltrates suggests:

Accepted Answer

Graves disease — Hashimoto thyroiditis (chronic lymphocytic thyroiditis) is characterized by a painless, often enlarged thyroid gland with extensive lymphocytic infiltration, leading to hypothyroidism.

Question 20

Papillary thyroid carcinoma commonly spreads via:

Accepted Answer

Bloodstream — Papillary thyroid carcinoma typically spreads via lymphatic channels to regional lymph nodes.

Question 21

Orphan Annie nuclei are characteristic of:

Accepted Answer

Follicular carcinoma — Orphan Annie eye nuclei, characterized by clear, empty-appearing nuclei with prominent nucleoli, are a classic histological feature of papillary thyroid carcinoma.

Question 22

Conn syndrome is due to excess:

Accepted Answer

Cortisol — Conn syndrome (primary hyperaldosteronism) is caused by excessive production of aldosterone, usually from an adrenal adenoma.

Question 23

Addison disease results in:

Accepted Answer

Hypertension — Adrenocorticotropic hormone (ACTH) levels are elevated in Addison's disease, leading to increased melanocyte-stimulating hormone (MSH) activity and hyperpigmentation.

Question 24

Pheochromocytoma arises from:

Accepted Answer

Adrenal cortex — Pheochromocytoma is a tumor of the adrenal medulla that produces excessive catecholamines.

Question 25

Recurrent aphthous ulcers are most commonly seen in:

Accepted Answer

Elderly patients only — Recurrent aphthous ulcers typically begin in childhood or adolescence and are most common in the first two decades of life.

Question 26

Which oral lesion is strongly associated with areca nut chewing?

Accepted Answer

Oral submucous fibrosis — Oral submucous fibrosis is a chronic, progressive, premalignant condition strongly associated with areca nut (betel nut) chewing.

Question 27

Which tumour demonstrates a zellballen pattern?

Accepted Answer

SCC — Paragangliomas (including pheochromocytomas) are characterized by a distinctive "zellballen" pattern, where tumor cells are arranged in nests or clusters surrounded by sustentacular cells.

Question 28

Persistent hoarseness in a chronic smoker should raise suspicion of:

Accepted Answer

Vocal cord nodule — Persistent hoarseness, especially in a chronic smoker, is a red flag symptom for laryngeal squamous cell carcinoma (SCC) and warrants urgent investigation.

Question 29

Pleomorphic adenoma is composed of:

Accepted Answer

Pure epithelial cells — Pleomorphic adenoma, also known as mixed tumor, is characterized by a mixture of epithelial and mesenchymal (myoepithelial) components.

Question 30

Warthin tumour is strongly associated with:

Accepted Answer

Alcohol — Warthin tumor (papillary cystadenoma lymphomatosum) is strongly associated with smoking, with smokers having a significantly higher risk.

Head &neck sem2 — Past Paper Questions & Answers

Questions, Answers & Explanations