NEET-PG 2017 - ENT PYQs Practice Questions

Q: A patient complains of pain and boggy swelling in the frontal region which is warm and tender. He also complains of drowsiness at times. What is the diagnosis?

Pott's puffy tumor. **Pott's puffy tumor** * **Pott's puffy tumor** is characterized by a focal osteomyelitis of the frontal bone, often complicated by a subperiosteal abscess. The description of **pain and boggy swelling in the frontal region, which is warm and tender**, perfectly matches this condition. * The complication of **drowsiness** indicates potential epidural or intracranial extension of the infection, which is a common and severe consequence of Pott's puffy tumor. *Pyogenic granuloma* * A pyogenic granuloma is a **benign vascular lesion** of the skin or mucous membranes. * While it can be warm and tender, it typically presents as an **eruptive, solitary, red papule or nodule** that bleeds easily, and it does not typically cause boggy swelling in the frontal bone or drowsiness. *Orbital cellulitis* * Orbital cellulitis presents with **pain, swelling, redness, and warmth around the eye,** often with proptosis and ophthalmoplegia. * While it is a serious infection, the primary swelling in this case is described in the **frontal region**, not specifically confined to the orbit, and the specific feature of a "boggy" swelling over bone is more indicative of a frontal bone osteomyelitis. *Cavernous sinus thrombosis* * Cavernous sinus thrombosis is characterized by **headache, painful ophthalmoplegia, proptosis, and vision loss**, often with fever and altered mental status. * While **drowsiness** can be a feature, the presentation lacks the prominent **orbital signs** and localizing frontal boggy swelling specific to the described case; instead, it would typically present predominantly with signs related to cranial nerve involvement and venous congestion of the orbit. [Practice more ENT PYQs on OnCourse]

Q: Which of the following is correct about ear speculum insertion?

Pinna : upward, backward and laterally; Tragus: forward. ***Pinna : upward, backward and laterally; Tragus: forward*** - To properly visualize the **tympanic membrane** and ear canal in adults, the **pinna** (auricle) should be gently pulled **upward, backward, and laterally**. This maneuver helps to straighten the **ear canal**. - The **tragus** should be gently pushed **forward** to stabilize the ear and facilitate speculum insertion, minimizing discomfort [1]. *Pinna : downward, backward and laterally; Tragus: forward* - Pulling the **pinna downward** is typically recommended for **children** to straighten their ear canal. - Doing so in adults may not adequately straighten the **ear canal**, hindering visualization. *Pinna : upward, backward and medially; Tragus: forward* - While pulling the pinna **upward and backward** is correct, pulling it **medially** would likely obstruct the view or cause discomfort. - The goal is to open the **ear canal** for better visualization [1]. *Pinna : upward, forward and laterally ; Tragus: forward* - Pulling the pinna **forward** would likely curl the helix and obstruct the **external auditory canal**, making it difficult to insert the speculum. - The correct direction is **backward** to align the cartilaginous and bony parts of the canal [1]. [Practice more ENT PYQs on OnCourse]

Q: The electrode of the hearing implant shown below is placed in:

Scala tympani. ***Scala tympani*** - The electrode array of a cochlear implant is typically inserted into the **scala tympani** to deliver electrical stimulation directly to the auditory nerve fibers. - This placement avoids damage to the delicate **organ of Corti** located in the scala media. *Scala vestibuli* - The scala vestibuli is separated from the scala media by **Reissner's membrane** and contains perilymph. - Inserting the electrode here is not the standard approach and could potentially damage the **cochlear duct**. *Scala media* - The scala media (cochlear duct) contains the **organ of Corti** and endolymph, which is crucial for natural hearing. - Placing an electrode here would likely **destroy the hair cells** and organ of Corti, preventing any residual natural hearing. *Tectorial membrane* - The tectorial membrane lies above the hair cells within the **scala media** and is essential for converting mechanical vibrations into electrical signals in natural hearing. - This membrane is not a fluid-filled space and is too delicate and structurally integral for electrode insertion. [Practice more ENT PYQs on OnCourse]

Q: Which of the following hearing aid or implant is shown below?

Cochlear implant. ***Cochlear implant*** - The image clearly shows an **electrode array** inserted into the **cochlea**, bypassing damaged hair cells and directly stimulating the auditory nerve. - This is characteristic of a **cochlear implant**, which is used for individuals with severe to profound sensorineural hearing loss. *Brainstem auditory implant* - A **brainstem auditory implant** (BAI) electrode is placed on the **cochlear nucleus** in the brainstem, not the cochlea itself. - BAIs are typically used for conditions where the auditory nerve is damaged or absent, such as in cases of **neurofibromatosis type 2** with bilateral acoustic neuromas. *Bone anchored hearing aid* - A **bone-anchored hearing aid** (BAHA) works by transmitting sound vibrations directly to the cochlea via bone conduction, typically through a surgically implanted post or magnet in the **skull bone**. - The image does not depict an external processor or bone conduction mechanism, but rather an internal electrode within the inner ear. *In the canal hearing aid* - An **in-the-canal (ITC) hearing aid** is an external device that sits within the ear canal and amplifies sound acoustically. - The image shows an **invasive internal device** implanted into the cochlea, which is distinct from a non-invasive, external ITC hearing aid. [Practice more ENT PYQs on OnCourse]

Q: Which of the following test is being performed on the patient?

Dix-Hallpike test. ***Dix-Hallpike test*** - The image depicts a patient being moved from an upright sitting position to a supine position with the head turned to one side and extended, which is characteristic of the **Dix-Hallpike maneuver**. - This test is used to diagnose **benign paroxysmal positional vertigo (BPPV)** by provoking vertigo and nystagmus as a result of otoconia displacement in the semicircular canals. *Caloric stimulation test* - This test involves introducing **warm or cold water/air into the ear canal** to induce nystagmus, assessing the vestibular system. - It's typically performed with the patient lying supine with their head elevated at 30 degrees, not involving the specific positional changes shown in the image. *Doll's eye reflex* - Also known as the **oculocephalic reflex**, it assesses brainstem function by rapidly turning the patient's head while observing eye movement. - This reflex is primarily used to evaluate comatose patients and does not involve the complex body and head positioning seen in the image. *Frenzel maneuver* - The Frenzel maneuver is performed during **otoscopy** to check for nystagmus by having the patient gaze through high plus lenses in a dark room. - It is often used to suppress visual fixation and enhance nystagmus, but it does not involve the specific body or head movements depicted. [Practice more ENT PYQs on OnCourse]

Question 1

A patient complains of pain and boggy swelling in the frontal region which is warm and tender. He also complains of drowsiness at times. What is the diagnosis?

Accepted Answer

Pott's puffy tumor

Answer

Pyogenic granuloma

Answer

Orbital cellulitis

Answer

Cavernous sinus thrombosis

Question 2

Which of the following is correct about ear speculum insertion?

Accepted Answer

Pinna : upward, backward and laterally; Tragus: forward

Answer

Pinna : downward, backward and laterally; Tragus: forward

Answer

Pinna : upward, backward and medially; Tragus: forward

Answer

Pinna : upward, forward and laterally ; Tragus: forward

Question 3

The electrode of the hearing implant shown below is placed in:

Accepted Answer

Scala tympani

Answer

Scala vestibuli

Answer

Scala media

Answer

Tectorial membrane

Question 4

Which of the following hearing aid or implant is shown below?

Accepted Answer

Cochlear implant

Answer

Brainstem auditory implant

Answer

Bone anchored hearing aid

Answer

In the canal hearing aid

Question 5

Which of the following test is being performed on the patient?

Accepted Answer

Dix-Hallpike test

Answer

Caloric stimulation test

Answer

Doll's eye reflex

Answer

Frenzel maneuver

Question 6

The test shown in the image is used for identifying a lesion in which cranial nerve?

Accepted Answer

VII

Answer

III

Answer

VI

Answer

VIII

Question 7

MRI Brain of a 40-year-old patient with progressive unilateral SNHL and tinnitus is shown below. Which is the most common extracanalicular nerve to be involved?

Accepted Answer

V

Answer

VI

Answer

VII

Answer

VIII

Question 8

A 40-year-old woman presents with history of recurrent episodes of spinning sensation in horizontal direction with vertigo incapacitating her for hours and resolving with medication. She also report roaring tinnitus during the attacks. Her sequential audiogram done on 11.06.16 and 18.06.16 is given below. Diagnosis is:

Accepted Answer

Meniere's disease

Answer

Migraine variant

Answer

Benign paroxysmal positional vertigo

Answer

Acoustic neuroma

Question 9

The instrument shown below is used in ENT for all except: (Recent NEET Pattern 2016-17)

Accepted Answer

Oculovestibular reflex

Answer

Status of middle ear

Answer

Status of tympanic membrane

Answer

Acoustic reflex

Question 10

Cosmetic reconstruction of this defect is best done at? (Recent NEET Pattern 2016-17)

Accepted Answer

6-10 years

Answer

Birth to 2 years

Answer

3-5 years

Answer

After 12 years

NEET-PG 2017 — ENT