Review Quiz Chapter 16: Head & Neck

1.

2.

3.

A 55-year-old man with a 100 pack year smoking history has had a chronic cough for 5 years. However, he
has noticed increasing hoarseness for the past 3 months. Yesterday, his sputum was been blood-streaked
after coughing. Which of the following is the most likely diagnosis?
a.

Singers nodules

b.

Herpes simplex virus infection

c.

Laryngeal carcinoma

d.

Juvenile laryngeal papillomatosis

e.

Sjogren Syndrome

A 44-year-old basketball coach has been screaming at players, assistant coaches, referees, and the media
for years. The quality of his voice has changed in the last 5 months. Which of the following lesions has he
most likely developed?
a.

Chronic sinusitis

b.

Laryngeal papilloma

c.

Laryngeal nodule

d.

Laryngeal granuloma

e.

Mucocele

A 15-year-old boy has had problems with hoarseness for the past 8 years, and during that time has
experienced rare episodes of hemoptysis. On physical examination he has had multiple small nodular
masses on the vocal folds, and these have been excised on multiple occasions because of recurrence.
Microscopic examination of the resected lesions has shown finger-like projections of fibrovascular cores
covered by squamous epithelium. Which of the following statements regarding this boy's disease is most
appropriate?
a.

Respond to radiation therapy

b.

Stems from human papilloma virus infection

c.

Single gene mutation

d.

Become malignant

e.

Spontaneously regress

4.

5.

6.

A 56-year-old man has noted a swelling increasing in size on the right side of his face for the past year. For
3 months he has experienced pain in this area. On physical examination there is a 4 cm firm and tender
mass involving the right parotid region. Surgical excision is performed and on microscopic examination is
invading surrounding structures, including the facial nerve. Which of the following neoplasms is this man
most likely to have?
a.

Adenoid cystic carcinoma

b.

Warthins tumor

c.

Squamous cell carcinoma

d.

Pleomorphic ademoma

e.

Metastatic laryngeal carcinoma

A 49-year-old man has used chewing tobacco for the past 25 years. He goes to his dentist for a routine
examination. On physical examination there are several 0.5 cm white plaques on the oral mucous
membrane just lateral to the left lower teeth. These plaques cannot be removed by scraping. This man is at
greatest risk for developing which of the following conditions?
a.

Squamous cell carcinoma of the mouth

b.

Salivary gland duct lithiasis

c.

Sjogren syndrome

d.

Pleomorphic adenoma

e.

Mucocele

A 33-year-old woman, a non smoker, has been bothered by a painful area of swelling in her mouth for the
past 3 months. On physical examination there is a protruding nodular 1.2 cm tender mass on the gingival
margin of her lower right lateral gum. A radiograph reveals that this lesion is eroding adjacent mandible.
The lesion is excised and on microscopic examination is covered by non keratinizing squamous epithelium.
Most of the lesion is composed of fibroblasts, capillaries, and inflammatory cells including lymphocytes,
macrophages, mutlinucleated cells, and neutrophils. This lesion recurs within the next 2 months. Which of
the following is the most likely diagnosis?
a.

Peripheral giant cell fibroma

b.

HSV infection

c.

Lichen planus

7.

d.

Malignant fibrous histiocytoma

e.

Oral hairy leukoplakia

A 50-year-old Asian man has had increasing pain and discomfort on the left side of his face for the past
year. He has had difficulty breathing through his left nostril for the past month. On physical examination
there is erosion of the mucus membrane of the left nostril, with protrusion of focally hemorrhagic tan
nodular tissue into the nasal cavity. A head CT scan reveals a 7 cm mass involving the nasopharyngeal
region and eroding adjacent bone. The mass is biopsied and on microscopic examination is composed of
poorly differentiated squamous cells. The development of this lesion is most likely to be associated with
which of the following infectious agents?
a.

EBV

b.

Mucor

c.

Group A streptococcus

d.

Mycoplasma

e.

Cytomegalovirus

8.

A 22-year-old man has a small red swollen area on his upper lip that, over the course of the past 5 days,
has become a tender vesicle that has now ruptured to leave a painful ulcer. On physical examination there
is a solitary, erythematous, 0.8 cm ulcerated lesion. This lesion resolves in the next week without therapy.
Which of the following conditions is this man most likely to have?

a.

HSV infection

b.

Rhinoscleroma

c.

Thrush

d.

Hairy leukoplakia

e.

Aphthous ulcers

9.

A 15-year-old boy notes a pinpoint white lesion just to the left of the tip of his tongue. Over the course of 3
days, this lesion forms a shallow but very painful 0.3 cm ulceration. The lesion disappears in a week. Which
of the following is the most likely diagnosis?

a.

Leukoplakia

b.

Pemphigus

c.

Thrush

d.

Hairy leukoplakia

e.

Aphthous ulcer

10. A 64 year old male presents with sores on the gums. Oral examination shows multiple gingival abcesses
adjacent to the teeth, gum recession, swollen gums, loosening of teeth with heavy plaque and calculus
deposits. Which of the following is the most likely diagnosis?
a.

Dental caries

b.

Hyperparathyroidism

c.

Osteitis deformans

d.

Periapical granuloma

e.

Periodontal disease