Which of the following conditions is associated with objective tinnitus?
Electrode of cochlear implant is placed in:
Rosen's incision is used for which surgical procedure?
Moure's sign (lateral displacement of the soft palate) is associated with which of the following conditions?
Which objective test is most effective for examining adenoids?
Mucoperichondrial flap in septoplasty is made on?
Trismus is commonly seen in
Telephonophobia refers to -
NEET-PG 2013 - ENT NEET-PG Practice Questions and MCQs
Question 41: Which of the following conditions is associated with objective tinnitus?
- A. Acoustic neuroma
- B. Ear wax
- C. Glomus tumor (Correct Answer)
- D. Ménière's disease
Explanation: ***Glomus tumor*** - A glomus tumor is a **vascular tumor** that can cause turbulent blood flow, leading to a pulsatile, objective tinnitus that can be heard by an examiner. - The sound is often described as a **thumping or whooshing** sound synchronous with the patient's heartbeat. *Ménière's disease* - **Ménière's disease** is associated with subjective tinnitus, a ringing or roaring sensation perceptible only to the patient. - It is characterized by the triad of **vertigo, fluctuating hearing loss, and tinnitus**. *Acoustic neuroma* - An acoustic neuroma (vestibular schwannoma) typically causes **unilateral, subjective tinnitus**, often described as a high-pitched ringing. - It is a benign tumor on the **vestibulocochlear nerve** and is also associated with sensorineural hearing loss and balance issues. *Ear wax* - **Impacted ear wax** can cause subjective tinnitus due to its interference with sound conduction and resonance within the ear canal. - The tinnitus is not typically audible to an examiner, making it a **subjective finding**.
Question 42: Electrode of cochlear implant is placed in:
- A. Horizontal semicircular canal
- B. Scala media
- C. Scala tympani (Correct Answer)
- D. Scala vestibuli
Explanation: ***Scala tympani*** - The electrode array of a **cochlear implant** is carefully inserted into the **scala tympani** of the cochlea. - This placement allows the electrodes to directly stimulate the **spiral ganglion neurons**, bypassing damaged hair cells and transmitting electrical signals to the auditory nerve. *Horizontal semicircular canal* - The **horizontal semicircular canal** is part of the **vestibular system**, responsible for sensing angular head movements, not hearing. - Placing an electrode here would cause **vestibular dysfunction** and would not restore hearing. *Scala media* - The **scala media** (cochlear duct) contains the **organ of Corti** and **endolymph**, which has a high potassium concentration. - Inserting an electrode here would damage the delicate structures essential for natural sound transduction and could lead to electric potential imbalances. *Scala vestibuli* - The **scala vestibuli** is filled with **perilymph** and receives sound vibrations from the stapes. - While it's adjacent to the scala tympani, the **scala tympani** offers a safer and more direct path for optimal electrode insertion with less trauma to the sensory structures.
Question 43: Rosen's incision is used for which surgical procedure?
- A. Septoplasty
- B. Stapedectomy (Correct Answer)
- C. Tonsillectomy
- D. Tympanoplasty
Explanation: ***Stapedectomy*** - **Rosen's incision** is a **curved incision in the posterior ear canal** specifically used for **stapedectomy** surgery. - This incision provides excellent exposure of the **middle ear** and particularly the **stapes footplate** for otosclerosis surgery. - The incision extends from approximately **6 o'clock to 12 o'clock** position in the posterior canal, allowing the tympanomeatal flap to be elevated. *Tympanoplasty* - **Tympanoplasty** (repair of perforated tympanic membrane) can use various incisions including **permeatal**, **endaural**, or **postauricular** approaches. - While transmeatal approaches are used, they are not specifically termed "Rosen's incision," which is reserved for stapes surgery. *Septoplasty* - **Septoplasty** is a nasal procedure for correcting a deviated septum using incisions like **hemitransfixion** or **Killian's incision**. - This procedure involves the **nasal septum**, not the ear canal. *Tonsillectomy* - **Tonsillectomy** is performed entirely through an **oral approach** for removal of palatine tonsils. - No external or ear canal incisions are involved.
Question 44: Moure's sign (lateral displacement of the soft palate) is associated with which of the following conditions?
- A. Laryngeal carcinoma
- B. Peritonsillar abscess (Correct Answer)
- C. Chronic tonsillitis
- D. Acute epiglottitis
Explanation: ***Peritonsillar abscess (Quinsy)*** - **Moure's sign** refers to the **lateral displacement of the soft palate** toward the affected side, which is a classic finding in **peritonsillar abscess**. - This occurs due to the **accumulation of pus** between the tonsillar capsule and the superior constrictor muscle, causing the soft palate to bulge and deviate. - Other features include **severe throat pain**, trismus, drooling, and a "hot potato" voice. *Laryngeal carcinoma* - **Laryngeal carcinoma** presents with **hoarseness**, dysphagia, and potential airway obstruction. - While laryngeal examination may show mass lesions or vocal cord fixation, **soft palate displacement is not a feature** of laryngeal malignancy. *Chronic tonsillitis* - **Chronic tonsillitis** involves recurrent throat infections with tonsillar hypertrophy and cryptic debris. - It does **not cause acute soft palate displacement** like peritonsillar abscess does. *Acute epiglottitis* - **Acute epiglottitis** is characterized by **supraglottic inflammation** causing severe dysphagia, drooling, and stridor. - The pathology is at the **epiglottis level**, not the peritonsillar space, so **Moure's sign is absent**.
Question 45: Which objective test is most effective for examining adenoids?
- A. Posterior rhinoscopy (Correct Answer)
- B. Anterior rhinoscopy
- C. Manual palpation
- D. None of the options
Explanation: ***Posterior rhinoscopy*** - This method allows for **direct visualization of the nasopharynx** where the adenoids are located, using a post-nasal mirror or flexible endoscope. - It provides an **objective assessment** of adenoid size, extent, and any associated obstruction by direct observation. - Among the clinical examination methods listed, this is the most effective for **visualizing adenoid tissue** and assessing hypertrophy. - In modern practice, flexible nasopharyngoscopy has largely replaced mirror examination, but posterior rhinoscopy remains the principle of direct nasopharyngeal visualization. *Anterior rhinoscopy* - This technique examines the **anterior nasal cavity**, nasal septum, and inferior turbinates. - It **cannot visualize the nasopharynx** where adenoids are located due to anatomical limitations. - Useful for anterior nasal pathology but inadequate for adenoid assessment. *Manual palpation* - This is a **subjective, not objective** method that relies on examiner's tactile sensation. - Highly uncomfortable for children, causing gagging and distress. - Carries risks of trauma, bleeding, and infection. - Does not provide measurable or reproducible data, hence not considered an objective test. - Largely abandoned in modern practice due to these limitations. *None of the options* - Incorrect because **posterior rhinoscopy is a recognized objective clinical examination** for adenoids. - It allows direct visualization which can be documented and is superior to subjective methods like palpation. - While radiological methods (lateral neck X-ray) also provide objective data, among the examination techniques listed, posterior rhinoscopy is the correct answer.
Question 46: Mucoperichondrial flap in septoplasty is made on?
- A. Alar cartilage
- B. Septal cartilage (Correct Answer)
- C. Maxillary spine
- D. Sphenoid spine
Explanation: ***Septal cartilage*** - A mucoperichondrial flap is meticulously raised on the **septal cartilage** during septoplasty to access and correct deviations of the nasal septum. - This flap preserves the **perichondrium** and overlying mucosa, which is crucial for nutrient supply and healing of the septal cartilage. *Alar cartilage* - The alar cartilage forms the **lower lateral aspect** of the nose and is not involved in creating a mucoperichondrial flap for septal correction. - Procedures involving alar cartilage typically address **nasal tip projection** or alar rim deformities. *Maxillary spine* - The maxillary spine is a **bony prominence** at the anterior nasal floor and forms part of the underlying support for the septum. - While it can sometimes be a site of septal deviation, a mucoperichondrial flap is not primarily raised over the maxillary spine itself. *Sphenoid spine* - The sphenoid spine is a **bony projection** found on the sphenoid bone, located deep within the cranial base, posterior to the nasal cavity. - It is anatomically distant from the nasal septum and has no role in septoplasty or mucoperichondrial flap creation for septal surgical access.
Question 47: Trismus is commonly seen in
- A. Ludwig's angina
- B. Parapharyngeal abscess
- C. Retropharyngeal abscess
- D. Quinsy (Correct Answer)
Explanation: ***Quinsy*** - **Quinsy (peritonsillar abscess)** is the **most common cause of trismus** among pharyngeal infections. - Trismus occurs due to **inflammation and reflex spasm of the pterygoid muscles** adjacent to the abscess. - The severe pain and swelling in the peritonsillar region directly limit **mandibular movement**, making it difficult or impossible to open the mouth. - **Trismus is one of the cardinal clinical features** of quinsy. *Parapharyngeal abscess* - A **parapharyngeal abscess** can also cause trismus due to direct inflammation and irritation of the muscles of mastication. - However, it is **less common than quinsy** and typically presents with other prominent symptoms like **neck swelling**, lateral pharyngeal bulging, and internal carotid artery involvement risk. *Ludwig's angina* - While Ludwig's angina is a severe infection of the **submandibular and sublingual spaces**, trismus is **less common** and less pronounced compared to peritonsillar abscess. - The primary concern in Ludwig's angina is **airway obstruction** due to tongue elevation and "bull neck" swelling, not typically severe trismus. *Retropharyngeal abscess* - A **retropharyngeal abscess** is located behind the pharynx and typically manifests with **dysphagia**, **odynophagia**, **neck stiffness**, and respiratory distress. - While indirect muscle spasm can occur, **trismus is not a characteristic or common symptom** of retropharyngeal abscess, which primarily affects swallowing and neck mobility.
Question 48: Telephonophobia refers to -
- A. Beating on ears (Correct Answer)
- B. Beating on soles
- C. Beating on palms
- D. Pulling of hair
Explanation: ⚠️ **CRITICAL NOTE**: This question contains a terminology error. "Telephonophobia" in medical literature refers to **fear of telephones** (a specific phobia), NOT a physical symptom involving the ears. However, based on the context of this being a NEET-2013 question with "beating on ears" as the answer, this may be: 1. A mistranslation or historical term no longer in use 2. Confusion with another medical term 3. An error in the original examination **For exam purposes, the marked answer reflects the original question**, but students should note: ***Beating on ears*** (Marked as correct per original question) - This answer suggests the question may have intended to ask about a different term or concept - In modern medical terminology, this is **NOT** the definition of telephonophobia - **Telephonophobia** = irrational fear of making or receiving telephone calls (psychiatric condition) *Beating on soles* - This refers to **bastinado**, a form of corporal punishment - Not related to any phobia terminology *Beating on palms* - A form of corporal punishment - Not a recognized medical terminology for any phobia *Pulling of hair* - This describes **trichotillomania**, a body-focused repetitive behavior - Trichotillomania involves recurrent, irresistible urges to pull out hair from the scalp, eyebrows, or other areas **Recommendation**: This question should be reviewed for medical accuracy. The term "telephonophobia" as used here does not align with standard medical terminology.