In-service Exam: Cleft Lip & Palate

23 Questions | Total Attempts: 866

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In-service Exam: Cleft Lip & Palate

In-Service Exam: Cleft Lip & Palate


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Questions and Answers
  • 1. 
    A 24-year-old man who underwent repair of isolated cleft lip and palate in infancy and his wife ask about the risk of their children having cleft deformities. The patient’s family history includes isolated cleft lip and palate in his mother. The wife has no congenital deformities and has no known family history of cleft palate. Which percentage best represents the chance that they will have a child with a cleft deformity?
    • A. 

      5%

    • B. 

      10%

    • C. 

      15%

    • D. 

      25%

  • 2. 
    • A. 

      Levator veli palatini

    • B. 

      Muscularis uvulae

    • C. 

      Palatoglossus

    • D. 

      Palatopharyngeus

    • E. 

      Superior pharyngeal constrictor

  • 3. 
    Cleft palate occurs during which weeks of fetal development?
    • A. 

      1-2

    • B. 

      3-4

    • C. 

      5-6

    • D. 

      7-8

    • E. 

      9-10

  • 4. 
    Which is the rotation flap in this preoperatively marked rotation-advancement flap?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

  • 5. 
    Which is the advancement flap in this preoperatively marked rotation-advancement flap?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

  • 6. 
    A 5-year-old boy with submucus cleft palate has velopharyngeal incompetence. Which of the following is the most likely underlying cause?
    • A. 

      Incorrectly positioned levator palatine muscles

    • B. 

      Incorrectly positioned palatoglossus muscles

    • C. 

      Incorrectly positioned palatopharyngeal muscles

    • D. 

      Incorrectly positioned tensor palatine muscles

    • E. 

      Short soft palate

  • 7. 
    During fetal development, a cleft lip results when the maxillary process fails to fuse normally with which of the following processes?
    • A. 

      Lateral nasal

    • B. 

      Frontonasal

    • C. 

      Medial nasal

    • D. 

      Mandibular

  • 8. 
    A 5-year-old boy who underwent cleft palate repair via double opposing Z-plasty 4 years ago has hypernasality indicative of velopharyngeal insufficiency. Direct nasendoscopy shows a coronal closure pattern of the velopharyngeal port and little or no motion of the lateral pharyngeal wall. Which of the following surgical procedures is most appropriate for correction of the velopharyngeal insufficiency?
    • A. 

      Augmentation of the posterior pharynx

    • B. 

      Inferiorly based posterior pharyngeal flap

    • C. 

      Sphincter pharyngoplasty

    • D. 

      Superiorly based posterior pharyngeal flap

    • E. 

      V-Y pushback palatoplasty

  • 9. 
    The firstborn child of a Caucasian couple with no abnormalities has bilateral cleft lip and palate. Which of the following percentages best represents the possibility that this couple’s next child will have cleft lip, with or without cleft palate?
    • A. 

      2

    • B. 

      4

    • C. 

      10

    • D. 

      16

    • E. 

      32

  • 10. 
    In neonates with submucous cleft palate, the zona pellucida results from abnormal morphology of which of the following muscles?
    • A. 

      Levator veli palatini

    • B. 

      Muscularis uvulae

    • C. 

      Palatopharyngeus

    • D. 

      Pharyngeal constrictor

    • E. 

      Tensor veli palatini

  • 11. 
    During normal development of the secondary palate, elevation of the palatal shelf occurs at approximately how many weeks’ gestation?
    • A. 

      4

    • B. 

      8

    • C. 

      12

    • D. 

      16

    • E. 

      20

  • 12. 
    The C flap in the Millard rotation advancement repair of unilateral cleft lip is used to achieve which of the following?
    • A. 

      Columellar lengthening

    • B. 

      Lip lengthening

    • C. 

      Alar flare reduction

    • D. 

      Lip shortening

    • E. 

      Philtral column symmetry

  • 13. 
    A 6-year-old boy with velopharyngeal incompetence is scheduled to undergo sphincter pharyngoplasty, after cleft palate repair in infancy. In the sphincter pharyngoplasty procedure, which of the following muscles is elevated in the posterior tonsillar pillar?
    • A. 

      Levator veli palatini

    • B. 

      Palatoglossus

    • C. 

      Palatopharyngeus

    • D. 

      Stylopharyngeus

    • E. 

      Superior pharyngeal constrictor

  • 14. 
    In neonates with isolated cleft palate, which of the following percentages best represents the incidence of additional anomalies?
    • A. 

      10%

    • B. 

      30%

    • C. 

      50%

    • D. 

      70%

    • E. 

      90%

  • 15. 
    A 10-month-old infant with cleft palate is scheduled to undergo repair via the Veau-Wardill-Kilner V-Y technique. Which of the following structures will NOT be directly manipulated during this repair procedure?
    • A. 

      Levator veli palatini

    • B. 

      Musculus uvulae

    • C. 

      Nasal lining

    • D. 

      Palatopharyngeus

    • E. 

      Tensor veli palatini

  • 16. 
    A 10-year-old boy who underwent bilateral cleft lip repair during infancy has tightness of the upper lip. A photograph is shown above. On physical examination, the philtrum is excessively wide and hypoplastic with absence of muscle competence. Redundancy of the lower lip is also noted. Which of the following is the most appropriate method of flap reconstruction?
    • A. 

      Abbe flap

    • B. 

      Banked fork flaps

    • C. 

      Gilles fan flap

    • D. 

      Karapandzic flap

    • E. 

      Nasolabial flap

  • 17. 
    A 5-year-old child who underwent cleft palate repair in infancy has velopharyngeal insufficiency. Nasoendoscopy shows closure of the central velopharyngeal mechanism with residual openings on the left and right. The patient is scheduled to undergo sphincter pharyngoplasty for reconstruction of the pharynx. This procedure involves transposition of which of the following muscles?
    • A. 

      Buccinator

    • B. 

      Levator veli palatini

    • C. 

      Palatoglossus

    • D. 

      Palatopharyngeus

    • E. 

      Tensor veli palatini

  • 18. 
    • A. 

      Levator veli palatini

    • B. 

      Palatoglossus

    • C. 

      Palatopharyngeus

    • D. 

      Tensor veli palatini

    • E. 

      Uvula

  • 19. 
    In patients with nasal deformities associated with complete unilateral cleft lip, which of the following best describes the displacement of the ala?
    • A. 

      Lateral, inferior, anterior

    • B. 

      Lateral, inferior, posterior

    • C. 

      Medial, inferior, posterior

    • D. 

      Medial, superior, anterior

    • E. 

      Medial, superior, posterior

  • 20. 
    A 6-year-old boy who underwent repair of a right-sided unilateral cleft lip and palate in infancy has an unrepaired alveolar cleft. Which of the following best describes the malocclusion on the cleft side in this patient?
    • A. 

      Angle class II, division I

    • B. 

      Angle class II, division II

    • C. 

      Deep overbite

    • D. 

      Excessive overjet

    • E. 

      Posterior crossbite

  • 21. 
    During embryologic development, which of the following structures arises from the lateral nasal processes?
    • A. 

      Columella

    • B. 

      Nasal bridge

    • C. 

      Nasal tip

    • D. 

      Nasal ala

    • E. 

      Nasal septum

  • 22. 
    A neonate is undergoing evaluation because of airway obstruction. Physical examination shows retrogenia and glossoptosis. Which of the following is the most appropriate initial management of the airway obstruction?
    • A. 

      Prone positioning

    • B. 

      Orotracheal intubation

    • C. 

      Lip-tongue adhesion

    • D. 

      Tracheostomy

    • E. 

      Mandibular distraction osteogenesis

  • 23. 
    During embryologic development, which of the following structures arises from the frontonasal processes?
    • A. 

      Columella

    • B. 

      Nasal bridge

    • C. 

      Nasal septum

    • D. 

      Nasal tip

    • E. 

      Philtrum