Page 12 of 14
SU19.1-2,SU20.1-2,SU21.1-2 | Face, Mouth, Oropharynx and Salivary Glands — Graded Quiz
Click any question card to reveal the correct answer.
A baby is born with a cleft involving the lip, the alveolus and the hard and soft palate on one side, extending from the lip right through to the uvula. Using the incisive foramen as the organising landmark, how is this cleft best classified?
Correct. Involvement of lip and alveolus (primary palate, anterior to the incisive foramen) plus hard and soft palate (secondary palate, posterior to it) on one side is a complete unilateral cleft of both primary and secondary palate.
Classification hinges on the incisive foramen: primary palate anterior, secondary palate posterior; clefts may involve either or both, unilaterally or bilaterally.
The incisive foramen separates primary (lip, alveolus) from secondary palate (hard + soft palate). A defect crossing both, on one side, is a complete unilateral cleft of both.
Click to reveal answer
Which principle should guide the timing and conduct of cleft reconstruction in a child who is otherwise well?
Correct. The two overriding principles are: operate when the child is fit, and operate in time to allow normal function, with a staged multidisciplinary timetable.
Cleft care is staged and multidisciplinary; timing follows function, not convenience.
Reconstruction is staged on a biological timetable: operate when fit and in time for function (lip early, palate before speech), within a multidisciplinary team.
Click to reveal answer
Regarding the aetiopathogenesis of oral and oropharyngeal squamous cell carcinoma, which combination of factors is correctly described?
Correct. Tobacco and alcohol act synergistically, smokeless tobacco and areca nut are major drivers in India, and HPV-16 is especially linked to oropharyngeal SCC.
Tobacco + alcohol synergy, smokeless tobacco/areca nut, and HPV-16 (oropharynx) are the key carcinogenic drivers.
Smoking and alcohol are synergistic; smokeless tobacco/areca nut dominate in India; HPV-16 is strongly linked to oropharyngeal (tonsil/base-of-tongue) SCC.
Click to reveal answer
A biopsy-proven oral squamous cell carcinoma is being staged before a tumour-board decision. Which statement about the principles of treatment is correct?
Correct. Management is stage-directed and decided by a tumour board, built on surgery, radiotherapy and chemotherapy used alone or in combination, with appropriate attention to the neck.
Stage-directed, multidisciplinary, tumour-board-led care using surgery/RT/chemo is the core principle.
Head and neck cancer treatment is stage-directed and multidisciplinary; the three modalities (surgery, RT, chemo) are combined according to stage.
Click to reveal answer
After leaving the stylomastoid foramen, the facial nerve enters the parotid gland and divides within it. Why is this anatomical relationship the single most important fact in parotid surgery?
Correct. The facial nerve runs through the parotid, dividing it into superficial and deep lobes; identifying and preserving it is the governing principle of parotid surgery.
Facial nerve preservation is the central principle of parotid surgery; it divides the gland into superficial and deep lobes.
The facial nerve passes through the parotid (superficial vs deep lobe) and is the structure most at risk; its preservation governs parotid surgery. Secretomotor supply is via the auriculotemporal nerve (glossopharyngeal pathway).
Click to reveal answer
A solid parotid mass is suspected of being a tumour. Which investigation sequence best reflects the principle of obtaining a tissue diagnosis before definitive parotid surgery?
Correct. Imaging defines extent and FNAC provides a pre-operative tissue diagnosis; open incisional biopsy of a parotid mass is avoided because of tumour seeding and facial nerve risk.
Tissue diagnosis before surgery is by FNAC, not open incisional biopsy, for parotid masses; imaging defines extent.
For a parotid tumour, clinical assessment + imaging (US/MRI) + FNAC are standard; open incisional biopsy risks seeding and nerve injury and is avoided.
Click to reveal answer
A 60-year-old male smoker has a soft, sometimes bilateral, cystic swelling in the tail of the parotid. FNAC shows oncocytic epithelium with lymphoid stroma. Which benign tumour does this most likely represent?
Correct. Warthin's tumour is a benign parotid tumour, classically in older male smokers, often bilateral, with oncocytic epithelium and lymphoid stroma.
Warthin's tumour: benign, older male smokers, often bilateral; pleomorphic adenoma is the commonest benign salivary tumour overall.
Oncocytic epithelium with lymphoid stroma in an older male smoker, often bilateral and cystic, is the classic Warthin's tumour. Pleomorphic adenoma is the commonest benign tumour but has different histology.
Click to reveal answer
Which statement about the epidemiology and aetiology of cleft lip and palate is correct?
Correct. Cleft lip and palate is the commonest congenital facial anomaly (~1 in 700–1000) with a multifactorial (genetic and environmental) aetiology, occurring both in isolation and as part of syndromes.
Commonest congenital facial anomaly; multifactorial aetiology; arises from failure of embryological fusion.
It is the commonest congenital facial anomaly (~1 in 700–1000) and is multifactorial; most cases are non-syndromic.
Click to reveal answer