Standard airway for Ludwig's Angina

# Standard Airway for Ludwig's Angina is: a) Tracheotomy
b) Cricothyrotomy
c) Nasal intubation
d) Oral intubation

The correct answer is B. Cricothyrotomy.

In Ludwig's angina, cricothyrotomy is always preferred over option A, i.e., Tracheotomy. Tracheotomy is avoided because of the following reasons.
• Identification of landmarks is difficult due to associated massive edema and tissue distortion.
• Sometimes, tracheostomy may lead to spread of infection to deeper tissues.
• May result in Tracheal stenosis in 25 -50% of cases.
• Chances of getting pneumonia will always be there.
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Trotter's Triad

# Trotter's triad is seen in:
a) Angiofibroma
b) Nasopharyngeal carcinoma
c) Laryngeal carcinoma
d) Growth in fossa of Rosenmuller

The correct answer is B. Nasopharyngeal carcinoma.

Trotter's triad:
1) Conductive deafness (Eustachian tube blockade)
2) lpsilateral temporoparietal neuralgia (Cranial Nerve V)
3) Palatal paralysis (Cranial Nerve X)

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Nasopharyngeal carcinoma virus

#The virus associated with nasopharyngeal carcinoma is:
a) Epstein Barr
b) Cytomegalo virus
c) Hepatitis
d) Herpes virus

The correct answer is A. Epstein Barr.

Nasopharyngeal carcinoma affects younger age group and half of the patients will present with secondaries in neck.

Epstein-Barr virus is also implicated as an etiological factor for Burkitts Lymphoma and infectious mononucleosis.

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Punched out edge of ulcer

# Punched out edge is characteristic of which type of ulcer?
a) Tuberculosis
b) Rodent
c) Syphilitic
d) Non specific

The correct answer is C. Syphilitic.

•  Non-specific ulcer = Shelving edge
• Tuberculous ulcer = Undermined edge
• Rodent ulcer = Raised, pearly white and beaded 
• Squamous cell carcinoma = Rolled out, everted 
• Syphilitic = Punched out edge; Base covered with wash leather slough

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