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1. The nasal valve region is bounded by all of the following EXCEPT: a. b. c. d. e. The frontal process of the maxilla The anterior inferior turbinate Nasal septum Lower lateral cartilage Pyriform aperture 2. Sensation of nasal obstruction in the absence of anatomic obstruction is primarily due to a. Cold receptors b. Receptors in vestibular skin c. Receptors in caval mucosa d. A and b e. a, b, and c 3. Tests to assess nasal airway cross-sectional area include: a. CT b. Rhinomanometry c. Acoustic rhinometry d. A and c e. All of the above 4 .Tests to assess airstream through nose include: a. Rhinomanometry b. Nasal peak flowmeter c. Acoustic rhinometry d. A and c e. A and b 5. Minimal cross sectional area as measured by acoustic rhinometry: a. The first constriction occurs at the entrance of the bony nasal cavity b. The second constriction occurs at the entrance to valve region c. May change with decongestion d. Decongestion affects the first constriction more than the second e. All of the above statements are incorrect 6. What is the difference between the physiologic MCA and the anatomic MCA? a. The smallest dimension found by rhinomanometry is the anatomic MCA b. The smallest dimension determined by acoustic rhinometry is the physiologic MCA c. A and b d. None of the above 7. Acoustic rhinometry a. Utilizes a sound pulse into the nasal cavity b. Is done after decongestant is applied to the nose c. Curve generated from the sound waves shows estimated distance on the y axis d. Distance is measured at 3 and 6 cm e. There are 2 minimal cross-sectional areas observed. 8. Congestion factor a. Is calculated by comparing CSA before and after decongestion b. May be designated as normal, mild, moderate, severe, or markedly severe c. More than 2 standard deviations from normative values at CSA2 is considered abnormal d. A and b e. All of the above 9. Where are the 3 minimal CSAs in the nose and which changes the most with decongestion? 10. Rhinomanometry a. Measures airflow and transnasal pressure b. Can be used to determine resistance in airflow c. Posterior rhinometry involves measurement of pressure in the oropharynx d. A and b e. A, b, and c 11. What is the difference between active and passive rhinomanometry? 12. Acoustic Rhinometry a. Anterior rhinometry allows direct measurement of total nasal airflow b. Total nasal airflow can be calculated from each side’s measurement c. Posterior rhinometry allows simultaneous measurement of total nasal airflow d. A and b e. B and c 13. Rhinomanometry a. Results are shown on a pressure-flow plot b. More nasal obstruction yields a steeper sigmoid curve c. Nasal resistance is reported as flow per pressure per second d. A and b e. All of the above 15. Nasal resistance a. Is higher during expiration b. Is lower at more distant points along the nasal pressure-flow curve c. Is best correlated with symptoms of obstruction at maximum pressure and flow d. All of the above e. None of the above Uses for objective testing of nasal airway include: a. Challenge testing in allergic rhinitis b. Selection of patients for surgery c. Documentation of change in airway dimension after surgery d. Assessing effect of intranasal medications e. All of the above Normal nasal resistance values • Unilateral – Non-decongested 0.33—0.54 – Decongested 0.15—0.36 • Total – Non-decongested 0.14-0.38 – Decongested 0.08—0.16 Wegener’s granulomatosis a. Has 4 types b. Type 2 disease often has pulmonary and renal involvement c. C-ANCA titers can be used to monitor disease d. Histopathological features include large vessel vasculitis with non-necrotizing granulomas e. Sinonasal Wegener’s is effectively treated with sinus surgery Treatment for Wegener’s include all of the following except: a. b. c. d. e. Methotrexate Cetuximab Bactrim Cyclophosphamide Glucocorticoids Etiology of sarcoidosis may be: a. b. c. d. e. Immune-related Infectious Chemical exposure Allergy-related All of the above Incidence of sarcoidosis is highest in: a. b. c. d. e. Men Blacks Southern Europe A and c All of the above The most common site affected by sarcoid is: a. b. c. d. e. Paranasal sinuses Kidney Liver Bone marrow Lung Pathologic features of sarcoid include: a. b. c. d. Multinucleated giant cells Caseating granulomas Similar features to tuberculous granulomas Central epithelioid cells surrounded by eosinophils e. Fungal hyphae Treatment of sarcoidosis may include: a. b. c. d. e. Corticosteroids Methotrexate No treatment A and b All of the above Churg-Strauss syndrome may include all of the following EXCEPT: a. b. c. d. e. Vasculitis of small and medium vessels Positive c-ANCA Allergic rhinitis and asthma Gastroenteritis Nasal polyposis a. b. c. d. e. The most common neoplastic systemic disease with nasal manifestations is: T-cell lymphoma B-cell lymphoma Hodgkin’s lymphoma Leukemia Multiple myeloma Behcet’s disease includes: a. b. c. d. e. Nasal ulcers Rhinorrhea Oral ulcers A and b All of the above The most commonly involved site in the head and neck by pemphigus vulgaris is: a. b. c. d. e. Nasal septum Nasal dorsum Oropharynx Oral cavity Cervical skin Pemphigoid a. Affects the nose in 80% b. Bullous pemphigoid is most likely to affect the mucosa c. The most common nasal site of involvement is in the nasal valve region d. Cicatricial pemphigoid affects the skin e. Septal perforation is common Primary ciliary dyskinesis a. b. c. d. e. Is associated with Samter’s triad Is associated with infertility Inheritance is autosomal dominant Affects the GI tract Is diagnosed with a saccharin test of greater than 20 minutes Cystic fibrosis a. Affects the lungs, sinuses, and pancreas b. Is inherited as autosomal recessive c. Associated with a mutation on chromosome 7 d. A and b e. All of the above