MyPasTest: MRCS A Online - Jan Exam 2015
20. Surgical Specialities; Oral and Maxillofacial Surgery (17Qs)
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01. A 3-year-old with leukaemia, presents with excessive salivation, marked halitosis and a grey
discolouration of the mucous membranes of his oral cavity spreading to his palate and nose. What is the
most likely bacteria to be cultured? Select one answer only.
Borrelia vincenti« YOUR ANSWER (Correct Answer)
Klebsiella
Page
Staphylococcus aureus
1274
Staphylococcus epidermidis
Streptococcus pyogenes.
This patient has signs of cancrum oris. 80% of patients with this are younger than 10 years. The signs are
of excessive salivation, grey discolouration of the mucous membranes of the mouth, spreading to the
cheeks, palate and nose, and a strong odour. There are associations between cancrum oris and measles,
TB and whooping cough, amongst others. In the majority of cases Borrelia vincenti and fusiform bacilli
are cultured. Anaerobes are frequently cultured in rapidly progressive cases.
02. THEME: WHITE ORAL LESIONS
A Leucoplakia
B Lichen planus
C Fordyce's granules
D SCC
E Keratosis
F Chronic candidosis
G Hairy leucoplakia.
For each of the cases described below, choose the single most appropriate option from those listed
above. Each option may be used once, more than once, or not at all.
Scenario 1
Lesions resulting from ill-fitting dentures.
A - Leucoplakia« YOUR ANSWER
E - Keratosis« CORRECT ANSWER.
Scenario 2
Low malignant potential, occurs with steroid use.
B - Lichen planus« YOUR ANSWER
F - Chronic candidosis« CORRECT ANSWER.
Scenario 3
Lesions turn white on getting wet.
C - Fordyce's granules« YOUR ANSWER
B - Lichen planus« CORRECT ANSWER.
Scenario 4
Cluster of sebaceous cysts.
D - SCC« YOUR ANSWER
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Dr Mohammed Shamsul Islam Khan, Medical Officer, Clinical Neuro-Surgery, National Institute of Neuro-Sciences and Hospital
Sher-E-Bangla Nagar, Dhaka-1207, Bangladesh. Mobile: +880 1713 455 662, +880 1685 811979. E-mail:
, MyPasTest: MRCS A Online - Jan Exam 2015
20. Surgical Specialities; Oral and Maxillofacial Surgery (17Qs)
-----------------------------------------------------------------------------------------------------------------
C - Fordyce's granules« CORRECT ANSWER.
Scenario 5
Commonly found on the margin of the tongue.
E - Keratosis« YOUR ANSWER
D - SCC« CORRECT ANSWER.
Page
Scenario 6 1275
Associated with HIV infection.
F - Chronic candidosis« YOUR ANSWER
G - Hairy leucoplakia« CORRECT ANSWER.
Lichen planus, leucoplakia and chronic candidosis have a low malignant potential, so differentiation
between these and cancers is important. Frictional keratosis has no true malignant potential. Fordyce‟s
granules are commonly mistaken for carcinoma.
03. Theme: facial pain
A Temporo-mandibular joint (TMJ) dysfunction
B Acute sinusitis
C Trigeminal neuralgia
D Dental abscess
E Acute parotiditis
F Migraine
G Temporal arteritis
H Acute otitis media.
For the scenarios below, choose the most likely diagnosis from the list above. Each diagnosis may be
used once, more than once or not at all.
Scenario 1
Constant otalgia with a clicking jaw.
A - Temporo-mandibular joint (TMJ) dysfunction« CORRECT ANSWER.
Scenario 2
Pain and facial swelling only when eating.
B - Acute sinusitis« YOUR ANSWER
E - Acute parotiditis« CORRECT ANSWER.
Scenario 3
Bi-temporal headache and raised erythrocyte sedimentation rate (ESR).
C - Trigeminal neuralgia« YOUR ANSWER
G - Temporal arteritis« CORRECT ANSWER.
Scenario 4
Sharp pain across the face with wind exposure.
D - Dental abscess« YOUR ANSWER
C - Trigeminal neuralgia« CORRECT ANSWER.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Dr Mohammed Shamsul Islam Khan, Medical Officer, Clinical Neuro-Surgery, National Institute of Neuro-Sciences and Hospital
Sher-E-Bangla Nagar, Dhaka-1207, Bangladesh. Mobile: +880 1713 455 662, +880 1685 811979. E-mail:
20. Surgical Specialities; Oral and Maxillofacial Surgery (17Qs)
-----------------------------------------------------------------------------------------------------------------
01. A 3-year-old with leukaemia, presents with excessive salivation, marked halitosis and a grey
discolouration of the mucous membranes of his oral cavity spreading to his palate and nose. What is the
most likely bacteria to be cultured? Select one answer only.
Borrelia vincenti« YOUR ANSWER (Correct Answer)
Klebsiella
Page
Staphylococcus aureus
1274
Staphylococcus epidermidis
Streptococcus pyogenes.
This patient has signs of cancrum oris. 80% of patients with this are younger than 10 years. The signs are
of excessive salivation, grey discolouration of the mucous membranes of the mouth, spreading to the
cheeks, palate and nose, and a strong odour. There are associations between cancrum oris and measles,
TB and whooping cough, amongst others. In the majority of cases Borrelia vincenti and fusiform bacilli
are cultured. Anaerobes are frequently cultured in rapidly progressive cases.
02. THEME: WHITE ORAL LESIONS
A Leucoplakia
B Lichen planus
C Fordyce's granules
D SCC
E Keratosis
F Chronic candidosis
G Hairy leucoplakia.
For each of the cases described below, choose the single most appropriate option from those listed
above. Each option may be used once, more than once, or not at all.
Scenario 1
Lesions resulting from ill-fitting dentures.
A - Leucoplakia« YOUR ANSWER
E - Keratosis« CORRECT ANSWER.
Scenario 2
Low malignant potential, occurs with steroid use.
B - Lichen planus« YOUR ANSWER
F - Chronic candidosis« CORRECT ANSWER.
Scenario 3
Lesions turn white on getting wet.
C - Fordyce's granules« YOUR ANSWER
B - Lichen planus« CORRECT ANSWER.
Scenario 4
Cluster of sebaceous cysts.
D - SCC« YOUR ANSWER
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Dr Mohammed Shamsul Islam Khan, Medical Officer, Clinical Neuro-Surgery, National Institute of Neuro-Sciences and Hospital
Sher-E-Bangla Nagar, Dhaka-1207, Bangladesh. Mobile: +880 1713 455 662, +880 1685 811979. E-mail:
, MyPasTest: MRCS A Online - Jan Exam 2015
20. Surgical Specialities; Oral and Maxillofacial Surgery (17Qs)
-----------------------------------------------------------------------------------------------------------------
C - Fordyce's granules« CORRECT ANSWER.
Scenario 5
Commonly found on the margin of the tongue.
E - Keratosis« YOUR ANSWER
D - SCC« CORRECT ANSWER.
Page
Scenario 6 1275
Associated with HIV infection.
F - Chronic candidosis« YOUR ANSWER
G - Hairy leucoplakia« CORRECT ANSWER.
Lichen planus, leucoplakia and chronic candidosis have a low malignant potential, so differentiation
between these and cancers is important. Frictional keratosis has no true malignant potential. Fordyce‟s
granules are commonly mistaken for carcinoma.
03. Theme: facial pain
A Temporo-mandibular joint (TMJ) dysfunction
B Acute sinusitis
C Trigeminal neuralgia
D Dental abscess
E Acute parotiditis
F Migraine
G Temporal arteritis
H Acute otitis media.
For the scenarios below, choose the most likely diagnosis from the list above. Each diagnosis may be
used once, more than once or not at all.
Scenario 1
Constant otalgia with a clicking jaw.
A - Temporo-mandibular joint (TMJ) dysfunction« CORRECT ANSWER.
Scenario 2
Pain and facial swelling only when eating.
B - Acute sinusitis« YOUR ANSWER
E - Acute parotiditis« CORRECT ANSWER.
Scenario 3
Bi-temporal headache and raised erythrocyte sedimentation rate (ESR).
C - Trigeminal neuralgia« YOUR ANSWER
G - Temporal arteritis« CORRECT ANSWER.
Scenario 4
Sharp pain across the face with wind exposure.
D - Dental abscess« YOUR ANSWER
C - Trigeminal neuralgia« CORRECT ANSWER.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Dr Mohammed Shamsul Islam Khan, Medical Officer, Clinical Neuro-Surgery, National Institute of Neuro-Sciences and Hospital
Sher-E-Bangla Nagar, Dhaka-1207, Bangladesh. Mobile: +880 1713 455 662, +880 1685 811979. E-mail:
