Department of Surgery

Sohag Faculty of Medicine

The University of Sohag

MSc in ENT

First Part

.................................................................................................................................

General Surgery, 29/4/2017

Time allowed: 2 hours

.................................................................................................................................

Try all questions:

  • Comment on causes, clinical pictures, and outline management of cervical lymphadenopathy? (25 marks)

 

  • Write Short account on:
  • Clinical presentation and management of Ludwig's angina? (10 marks)

 

  • causes and physiological responses to haemorrhagic shock ? (10 marks)

 

  • Types of malignant saliveray gland tumours and their frequencies? (10 marks)

 

  • Zenker' s diverticulum? (10 marks)

 

 

  • Read this case scenario and then try answering the next questions (20 marks)

A seventy two years old male, heavy cigarette smoker, from a well known poor rural area came to the outpatient clinic complaining of painful and rapidly growing tongue ulcer, over the last 2months. In addition to that, the patient noticed multiple lumps in the lateral aspect of the upper neck dated 3 weeks ago prior to his presentation. In addition to that, he has a feeling of progressive dysphagia.

 

  • What is the most likely diagnosis of this case? Explain?
  • What are the essential basic investigations in this case?
  • Mention the most important lines of treatment?

 

  • Choose the correct answer: (10 marks)

 

1-A recurrent Parotid gland lump is most likely due to:

  • Malignant lesions?
  • Benign lesions?
  • Stone of parotid duct?
  • Viral infection?

2-Pain referred to the ear with clicking of the TMJ is most likely a manifestation of:

  • Goitre?
  • Submandibular sialadenitis?
  • parotitis?
  • TMJ Dysfunction?

3- Hypercalcaemia may be a manifestation of:

  • Toxic goitre?
  • Parathyroid adenoma?
  • Disseminated cancer ?
  • All of the above?

4-All the following are true in case of malignant thyroid except:-

  • Possibly associated with bilateral cervical lymphadenopathy?
  • Possibly associated with unilateral cervical lymphadenopathy?
  • May be associated with mediastinal syndrome?
  • Is common to be a follicular carcinoma?

5- The commonest cause of facial ulcers in Upper Egypt among the following is:

  • Melanoma?
  • TB?
  • Squamous cell carcinoma?
  • Idiopathic?

 

 

 

 

 

5- Define which of these sentences is true or false:(one mark for each statment)

 

1- Corticosteroid is harmful in Ludwig' s angina.

2- Post thyroidectomy stridor may be due to reasons other than recurrent laryngeal nerve injury

3- Minor salivary gland tumours are often of malignant nature.

4- The most common cause of oesophageal stricture in children is post corrosive swallowing

5- Caseating TB is clinically similar to Hodgkin's lymphoma.

 

 

...............................................................................................................

 

 

 

Best Wishes

 

 

 

 

 

Professor Dr Kamal El-Sharkawy

Assistant Prof Ashraf Elbadry

.................................................................................................