Trauma (7Q-10%)

1.

A 25 year old man is admitted for surgery after RTA with diagnosis of Bilateral Condylar # with
communition of Midface. This condition is a case for
a Absolute indication for Open reduction of the condyles
b Relative indication for Open reduction of the condyles
c Absolute contraindication for Open reduction of the condyles
d Case for MMF

2.

In which condition there is no need for ORIF for ZMC fractures

a. Medial displacement
b. Lateral displacement
c. Inferior displacement
d. No displacement

3.

Indication not to reduce the zygomatic fracture is

a. No displacement
b. Inward displacement
c. Outward displacement

4.

Which is a most relevant finding for a patient in shock

a. Pulse pressure
b. Heart rate
c. Systoic blood pressure
d. Diastolic blood pressure

5.

An 8 year old child has sustained a fracture of the condyle. What is the indication for ORIF
a. Dentoalveolar injury
b. Intarcapsular fracture with middle cranial fracture
c. Inability to open mouth after 1 week of closed reduction
d. The degree of displacement of condyle

6.

Severely displaced condylar fracture in 9 years old pa. with occlusal displacement. The occlusion
could be achieved by manual manipulation, treatment should be:
a. Physical therapy
b. IMF then Physical therapy
c. Open reduction
d. IMF without physical therapy

7.

A 34 year old man has sustained a MVA with fractures of the skull base with orbital fractures. On
examination for consensual light reflex in the right eye, there is a negative response. The same reflex
for the left eye is normal. There is associated ptosis of the left eye. The pt has damage to
a. CN1 on the L; CN 2 R
b. CN2 R and CN3 L
c. CN2 L and CN1 L
d. CN3 R and CN2 L

8.

A patient has sustained head injury after MVA. He has cerebral concussion and is in coma. If the
patient stays in coma for how many hours, will there be residual neurological deficit.
a. 1
b. 2
c. 4
d. 6 OR 8

9.

In surgical shock the patient should be given:

a. Normal Saline
b. Ringers Lactate
c. Plasma
d. D5W

10. What is the CT scan interval for zygomatic fracture: (OBLIQUE PARASAGITTAL VIEW FOR
ORBITAL FRACTURES)
a. 0.5mm
b. 1-1.5mm
c. 15.2.5mm
d. 2.5-3.5
11. In maxillofacial trauma patient with suspected injury to cervical thoracic vertebra, the diagnostic
radiograph is:
a. ?
b. ?
c. ?
d. swimmers view or cross table views
12. Maximum MMF in fracture mandible of 12 year old boy is:
a. One week
b. 2-3 weeks
c. 5-6 weeks
13. Trauma patient with pulse rate =130, BP 100/60, breathing =30/mint, how much blood loss is expected
in this patient
a. Less than 15%
b. 15-30%
c. 40%
d. 30-40 %
Petersons 342
14. In trauma patient the initial pulmonary reaction
a. Tachypnea and decreased CO2 serum
b. Tachypnea and increased CO2 serum
c. Bradypnea and increased CO2 serum
d. Bradypnea and decreased CO2 serum
15. Glasgow comma scale score in trauma patient who is non responsive to verbal communication + can
open the eye + responds to pain stimuli
a. 8
b. 10
c. 12
d. 15
16. Glasgow comma scale indicates:
a. Eye movement
b. Responses
c. Level of consciousness
17. Best plain film for showing zygomatic arches
a. Submentovertix
b. Occipatal
c. PA
18. Townes view is similar to
a. Anteroposterior
b. Posteroanterior
c. Waters
19. Trauma patent to the skull showed (bilateral in another ques) vertical diplopia and torsional diplopia.
The most likely injured nerve
a. II
b. III
c. IV
d. V

20. Trauma patient developed asymmetrical pupil (Not round). The most likely cause
a. Blow out fracture
b. Blow in fracture
c. Perforation of the eye ball
21. Reason of airway obstruction in obtunded patient
a. Bleeding
b. Vomitus
c. Tongue fall
22. Axial CT for zygomatic fracture is done to show
a. Orbit floor involvement
b. Orbital roof
c. lateral nasal wall and zygomatic arches
d. Lateral and medial walls of maxillary sinus
23. Orbital floor trauma which gaze cause diplopia
a. Upward and lateral
b. Upward and medial
c. Downward and lateral
d. Downward and medial
24. 24 year female with angle fracture. Surgeon decides to fix with compression plating technique.
Following is true
a. Less chance of motor and sensory nerve injuries
b. Will need two week IMF postop
c. Should be approached extraorally
d. Will heal by secondary intension
25. Greenstick fracture
a. Fracture of onside of the bone without fracture of other side
b. Incomplete fracture
c. Will cause severe displacement of while fixation
26. Compound fracture
a. Multiple fracture at on site
b. Severe loss of tissue around the fracture
c. External communication through oral cavity
27. Compound fracture means:
a. Fracture + soft tissue injury
28. Ptosis
a.

drop upper eyelid

29. Anisocoria refers to

a. Uneven pupils
b. Corrneal Lacerations
c. Corrneal injury with penetration wound (perforation of cornea)
d. Pupils which does not constrict
30. Best plain film to show maxillary sinus and orbital rim and lateral wall
a. Caldwell view
b. Water view
c. Lateral oblique
d. Towns view
31. Placement of Airway maintenance in a conscious patient
32. Nerve injured commonly in ZMC fracture

33. Medial end of Infraorbital approach :

a. medial canthus
b. medial limit of the pupil
c. lateral limit of the pupil
d. punctum
34. CSF leakage due to:
a. Dura firmly attached and difficult to separate from bone
b. Dura firmly attached and easy to separate from bone
c. Dura loosely attached and difficult to separate from bone
d. Dura loosely attached and easy to separate from bone
35. Medial wall of the orbit formed of
a. Lacrimal
b. Frontal
c. Ethmoidal
d. nasal
Predominant wall of orbit (medial: ethmoid Lateral: zygomatic & gr wing of sphenoid floor: orbital
surface of maxilla - palatine bone and zygoma)
36. Airway technique in spinal injury except
a. head tilt & chin left
37. Miniplates advantage is:
a. used for semi-rigid fixation
b. used for rigid fixation
c. intra-oral fixation
d. un-expensive
38. Decompression plate distance on each side
a. 0.8, 0.4 mm
b. 1.6, 0.8 mm
c. 2.2, 1.1 mm
39. Dynamic compression plate:
a. The holes elongations incline (or decline) toward the upper border of fracture.
b. The holes elongation are perpendicular to the plate
c. The holes elongation are parallel to the fracture line
d. No holes elongations
40. Decompression plate used for
a. Defect fracture
b. Compound fracture
41. Pa. cannot elevate the left eyelid, casuse:
a. Medial canthus trauma
b. lateral canthus truma
c. trochlear nerve injury
42. Lt. symphyseal and para-symphyseal fractures best Fixated by:
a. Two mini-plates for fixation
b. One compression plate
c. One miniplate plate in the inferior border
43. Name of retractor to pull masseter in angle fracture: ?channel retractor, sigmoid notch retractor
44. Most inter positioning between bone ends is achieved by
a. lag screws
b. compression screws

45. Real lag screw is:

a. Threads in the end
b. All threaded
46. Fragment to fracture:
a. Lag screw
b. Compression plate
c. Miniplate
d. Band
47. Floor of mouth ecchymosis indicates:
a. Anterior mandibular fracture
b. Unilateral angle Fracture
c. Bilateral angle fracture
d. Unilateral ramus fracture
48. Aspiration mainly to right lung
49. Battles sign is:
a. Fracture zygoma
b. Fracture anterior cranial fossa
c. Fracture middle cranial fossa
d. Fracture condyle
50. Root fracture of the apical third without tooth mobility
a. Tooth should be extracted
b. Endo Tx
c. No Tx and periodic review
d. None of above
51. In children symphysis unites by:
a. Fibrous joint
b. Synovial joint
c. Fibrous tissue
52. Zygomatic fracture best seen by
a. CT
b. PA
c. Waters view
53. Overlap of bone during 3 screw because:
a. Long screw
b. Forcing screw
c. Plate moving during screw
54. Infra-orbital fracture category 3 means:
a. Blow out fracture
55. Best incision to expose the infra-orbital rim is:
a. Orbital rim incision
b. Subcilliary incision
c. Transconjunctival
56. Which access that gives the approach to the inferior border and floor of orbit through the lateral
canthus:
a. Orbital rim incision
b. Subcilliary incision
c. Transconjunctival

57. Swelling of the orbit, pain, and difficult to move the eye after 6 weeks from NOE fracture:
a. Orbital cellulitis or orbital preseptal
b. Orbital abscess
58. Eyeball down, pupil dilated due to
a. CN II
b. CN III
c. CN IV
d. CN V
59. CT cut in zygomatic bone to determine infra-orbital fracture:
a. 2.5
b. 1.5
c. 0.5
60. What is the CT scan interval for zygomatic fracture:
a. 0.5mm
b. 1-1.5mm
c. 15.2.5mm
d. 2.5-3.5
61. Indication for open reduction in condylar fracture
a. Displacement to the cranial fossa
b. Intra capsular fracture
62. An unconscious patient undergoing CPR, the respiration changes that needs to be made
a. Continue with the same rate of 30 compressions with 2 breaths
b. 12 cycle per minute
63. A 34 year old female patient is rushed to the ER following MVA. Her limbs were cold and clammy.
The following vitals were recorded.
1. BP- 100/60 mm of Hg
2. HR- 100 /min
3. Temperature 35.3 deg centigrade
4. Urine negligible
She should be in which stage of shock?
a. 1
b. 2
c. 3
d. 4
64. After doing CPR to an adult patient the pulse returns but without breath. Management is:
a. Provide rescue breathing at rate of 10-12/mint
b. Provide rescue breathing at rate of 5-6/mint
c. Put the patient in recovery position
65. Nasolacrimal duct opens into
a. superior nasal meatus
b. inferior nasal meatus
c. middle nasal meatus
d. lacrimal lake
66. patient presented with lateral conjunctival hemorrhage, infra-orbital step and diplopia on Rt. Side,
with inability to open mouth, he could have:
a. fracture sub condylar Rt. Side
b. fracture zygomatic Rt. Side
c. Fracture Lefort II Rt. Side
d. Fracture of the floor of orbit

67. A Pa. presented with bilateral infra orbital step, Parasthesia on left cheek region, posterior gagging,
and mobility of maxillary complex at nasal bones, this indicate:
a. Bilateral zygomatic fracture
b. Bilateral lefort II fracture
c. Zygomatic bone fracture Lt. side with bilateral Lefort II
d. Bilateral Sub-condylar fractures and zygomatic fracture Lt side
68. RTA Pa. presented with bleeding from ear & impaired hearing with sign/symptoms of head injury,
there could be a fracture of:
a. Anterior Cranial Fossa
b. Middle Cranial Fossa
c. Posterior Cranial Fossa
d. None of the above
69. A 24 years old Pa. presented with subconjunctival hemorrhage on medial and lateral sides of eye,
history of bleeding from nose and mouth with disturbed occlusion. On mobilizing the maxilla,
mobility was palpable at infra-orbital margins only. This could be suspected to be fracture of:
a. Lefort I
b. Lefort II
c. Lefort III
d. Lefort II and fractured zygoma
70. Suffocation in unconscious Pa. could be due to:
a. Excessive salivation
b. Tongue swallowing
71. CPR Patient after nasopharyngeal intubation: 2 resp 30 push??
72. First step in CPR
a. Administering Oxygen
b. Establishing unresponsiveness
c. Administering a cool towel on the Pa. forehead
73. Respiratory embarrassment could occur in fracture:
a. Angel
b. Para-symphyseal
c. Bilateral Para-symphyseal
d. Bilateral condylar
74. Frontal sinus opening Middle meatus
75. Supraciliar approach
town and reversed town
76. difficulty in eye uppergaze indicates:
a. Blow out fracture
b. Blow in fracture
c. Trochlear nerve edema
d. Medial wall fracture
e. Lateral wall fracture
77. Condylar fracture in adult defer from children in: ??
a. Function
b. Appearance
c. Architecture
78. Indication for open reduction in pediatric pa: displacement into middle cranial fossa
79. The common displacement of the condyle in the condylar neck fracture: anteromesial

80. Facial fractures are of priorities in trauama cases due to: upper airway compromise
2.

Facial nerve and soft tissue management:

1.

Frontal branch and mandibular branch of facial nerve:

a. Frontal branch pass above zygomatic arch below temporal
b. Mandibular branch pass above platysma below facial artry

2.

Related to facial nerve and incorrect

a. It pass with vagus from jugular foramen

3.

In facial nerve injury, when there is normal lacrimation, paralysis of stapidus, and loss of taste:
a. Ipsilateral mesial to glenoid ganglion
b. Contralateral mesial to ganglion
c. Ipsilateral distal to glenoid ganglion
d. Contralateral distal to ganglion

4.

Nerve superficial to parotid gland

a. Auriculo-temporal
b. Great auricular
c. Facial Nerve
d. External carotid plexus

5.

Hericle suture to close wound:

a. Simple interrupted suture
b. Running suture

6.

Suture in Hermitically sealed wound

a. Interrupted suture
b. running suture
c. Subcuticular suture
d. Suture 1-0

7.

The skin over the parotid is supplied by which nerve

a. Facial
b. Auriculotemporal
c. Greater Auricular
d. Branches of the cervical trunk

8.

Buccal branch of facial nerve supplies:

a. Buccinator
b. Buccinator and inferior orbicularis
c. Buccinator and superior orbicularis
d. Buccinator and orbicularis oris
9.
a.

All is true about facial nerve except:

The facial nerve leaves the skull with accessory nerve through the jugular foramen

10. Wrong statement about buccinator:

a. Pierced by The Stensons duct:
b. Pierced by Facial artery inferiory
c. Originates, inserts
d. Buccal aspects of upper and lower posterior teeth
11. Skin below the ear covering the parotid gland is supplied by:
a. Superficial temporal
b. Greater auricular
c. Temporal nerve
12. Nerve through internal acoustic meatus:
a. CN 9
b. CN 10

c. CN 7
d. CN 6
13. Neck injury in region II:
a. Mandatory surgical exploration
14. In a parotid wound, the damage will be in:
a. Facial nerve
b. Auriculo-temporal nerve
c. Corda Tempany nerve
15. In mandibular body or angle fracture,
a. tension forces at the upper border
b. compression forces at the upper border
16. patient with multiple facial fractures, ethmoidal fracture, orbital fracture, the antibiotic that is not
given to him during treatment is:
a. clindamycin
b. ampicillin/subactam
c. ampicillin
17. Bone grain in the lingual side of the lower third molar area is:
a. Anteroposterior
b. Mesiodistal
c. Horizontal
d. Vertical
Grain (Merriam-Webster Dictionary)
the stratification of the wood fibers in a piece of wood
a texture due to constituent particles or fibers <the grainof a rock>
the direction of threads in cloth
tactile quality
injury of facial nerve near its emergence will cause:
paralysis in the lower face

10