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Chapter 36. Anatomy, Physiology, and Disorders of the Oral Cavity, Pharynx, and Esophagus

An 88-year-old woman complains of burning mouth. Examination reveals “shiny” tongue. The most likely diagnosis is

A. Xerostomia due to medications

B. Senile atrophy

C. Malabsorption syndrome with essential nutrient deficiency

D. Congenital absence of filiform papillae

A 46-year-old woman is found to have anesthesia of her left hard palate. Sensations in her cheek and upper lip are normal. A CT scan demonstrates a mass in her ipsilateral posterior nasal cavity. Of the following, which is the most likely site of nerve involvement?

A. Incisural foramen

B. Foramen rotundum

C. Descending palatine canal

D. Glossopharyngeal nerve

A 65-year-old woman complains of dysphagia and skin changes. Manometry shows no peristalsis of the lower third of her esophagus and a dilated lower esophageal sphincter.  What is the most likely diagnosis?

A. Achalasia

B. Dermatomyositis

C. Scleroderma

D. Presbyesophagus

A 2-year-old boy presents to the emergency room in the middle of the night after unwitnessed ingestion of a foreign body. He appears to be breathing comfortably with no stridor or evidence of drooling. Radiograph of the neck and chest reveals a thin 2-cm wide round object at the level of C6, with a subtle halo of radiolucency around the circumference. What is the next best step in management?

A. Discharge home with collection cup since the foreign body is likely a coin and will pass on its own

B. Schedule for elective foreign body removal in the morning

C. Observe overnight and take to the OR if he develops respiratory distress or becomes symptomatic

D. Take emergently to the OR for removal of foreign body

A 38-year-old asymptomatic woman is undergoing right thyroid lobectomy. During the procedure the right recurrent laryngeal nerve cannot be identified. Review of the CT scan is likely to demonstrate

A. Aberrant take-off of right subclavian artery, which passes behind the esophagus

B. Anterior displacement of the nerve by an unexpectedly enlarged parathyroid gland


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