This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
Supraglottic Ca present with -a) Hot potato voiceb) Aspirationc) Smoking is common risk factord) Pain is MC manifestatione) LN metastasis is uncommon 
Select and explain. 
A. acd, B. acd, C. bcd, D. abd
A: acd
Answer: A: acd 
Explanation: Supraglottic Cancer

It is the second most common laryngeal cancer (most common is glottic cancer)
Most common initial symptom - pain on swallowing. (option d is correct)
Most common / first sign - mass is neck
Small supraglottic lesions not extending to glottis – may present with globus or foreign body sensation and parasthesia
If exophytic they may cause hemoptysis
Large tumors can cause “hot potato voice” (Option ‘a’ is correct)
Hoarseness is a late symptom
Smoking is a risk for all laryngeal carcinomas. (option c is correct)
Lymphatic spread occurs early in case of supraglottic cancer. (as it has rich supply of lymphatics).

NOTE:
Hoarseness of voice is the presenting symptom in glottic carcinoma.