Correct Answer - D
Answer- D. Foreign body obstructing airway

Indications of tracheostomy:

Upper respiratory tract obstruction; Laryngeal, supralaryngeal ,and
tracheal causes.( Causes of stridor )

Lower respiratory tract obstruction: (Secretory obstruction, Wet lung
syndrome).

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Correct Answer - D
Ans. is 'd' i.e., Supraglottic carcinoma

Clinical features of supraglottic carcinoma

Pain on swallowing is the most frequent initial symptom
Mass in neck may be the first sign.
Hoarsness is a late symptom.
Pain may be referred to ear by vagus nerve and auricular nerve of
arnold.
Late symptoms include foul breath, dysphagia and aspiration.
Large tumors can cause "hot potato voice/muffled voice".
Hemoptysis, sore throat, shorteness of breath, stridor, otalgia and
aspiration pneumonia may also occur.

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Correct Answer - C
Ans. is 'c' i.e., Glomus tumor

Clinical features of glomus tumor
The earliest symptoms of glomus tumour is pulsatile tinnitus
(earliest) and hearing loss.

Hearing loss is conductive and slowly progressive. These are followed by blood stained otorrhoea and earache.

Before the tympanic membrane (eardrum) is perforated a red
swelling is seen to arise from the floor of middle ear, i.e. "Rising
sun" appearance. This results in a red reflex through the intact
tympanic membrane.

Sometimes, eardrum may be bluish and bulging. o Pulsation sign
(Brown sign) is positive, i.e. when ear canal pressure is raised with
Siegle's speculum, tumor pulsates vigorously and then blanches;
reverse happens with release of pressure.

Aquino sign is positive, i.e. blanching of mass with manual
compression of ipsilateral carotid artery.

When the tumour perforates the eardrum a polypus will be seen in
the meatus and this will bleed profusely if touched.

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Correct Answer - A
Ans. is 'a' i.e., Cricothyroid membrane

Cricothyrotomy or Laryngtomy or Minitracheostomy

It is the procedure to open the airway through the cricothyroid
membrane.

Patient's head and neck are extended, lower border of throid
cartilage and cricoid ring is identified.

Skin in this area is incised
vertically and then cricothyroid membrane is opened with a
transverse incision.

It is an emergency procedure to buy time for the patient to be shifted to the operation theatre.

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Correct Answer - C
Ans. is 'c' i.e., Microtubule associated protein 4

Proteins present in cochlea
Actin-binding and microtubule-associated proteins regulate microfilament and microtubule number, length, organization and location in cells.

In freeze-dried preparations of the guinea pig cochlea, both actin
and tubulin are found in the sensory and supporting cells of the
organ of Corti.

Fodrin (brain spectrin) co-localized with actin in the cuticular plates
of both inner and outer hair cells and along the lateral wall of the
outer hair cells.

Alpha-actinin co-localized with actin in the cuticular plates of the hair cells and in the head and foot plates of the supporting cells.

It was also found in the junctional regions between hair cells and
supporting cells.

o Profilin co-localized with actin in the cuticular plates of the sensory hair cells.

Myosin was detected only in the cuticular plates of the outer hair
cells and in the supporting cells in the region facing endolymph.

Gelsolin was found in the region of the nerve fibers.

Tubulin is found in microtubules in all cells of the organ of Corti.

In supporting cells, microtubules are bundled together with actinmicrofilaments and tropomyosin, as well as being present as individual microtubules arranged in networks.

An intensely stained network of microtubules is found in both outer
and inner sensory hair cells.

The microtubules in the outer hair cells appear to course throughout
the entire length of the cells, and based on their staining with
antibodies to the tyrosinated form of tubulin they appear to be more
dynamic structures than the microtubules in the supporting cells.

The microtubule-associated protein MAP-2 is present only in outer
hair cells within the organ of Corti and co-localizes with tubulin in
these cells. No other MAPs (1,3,4,5) are present.

Tau is found in the nerve fibers below both inner and outer hair cells and in the osseous spiral lamina

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