NEET-PG 2017 - ENT Practice Questions

Q: The facial features shown in the image are characteristic of:

Adenoid facies. ***Adenoid facies*** - The image displays characteristic features of adenoid facies, including a **long, open-mouthed face**, a **pinched nose**, and possibly a **high-arched palate** due to chronic mouth breathing from enlarged adenoids. - This chronic condition often leads to a dull expression, sometimes with **strabismus** (crossed eyes) as seen in the image, and a forward head posture. *Frog face deformity* - This deformity is characterized by **ocular hypertelorism** (widely spaced eyes), a **flat nasal bridge**, and a **short nose**, often associated with conditions like Apert syndrome. - While there is some facial dysmorphology, the specific combination of features does not align with a typical frog face. *Ashen grey facies* - This refers to a **pale, grayish complexion**, often indicative of severe cardiovascular compromise like **circulatory collapse** or **shock**. - The child in the image has a normal skin tone for their ethnicity and does not show signs of acute circulatory distress. *Thyrotoxicosis* - **Thyrotoxicosis** (hyperthyroidism) in children can cause symptoms like **exophthalmos** (bulging eyes), **tachycardia**, weight loss, and an enlarged thyroid gland. - While the child's eyes appear wide-set and sometimes strabismic, these are more consistent with the long-term effects of chronic mouth breathing on facial development rather than acute thyroid dysfunction.

Q: The image shows which of the following tests being performed? (Recent NEET Pattern 2016-17)

A= Indirect laryngoscopy, B= Spatula test. ***A= Indirect laryngoscopy, B= Spatula test*** - Image A depicts a mirror being used to visualize the larynx through the oral cavity, which is characteristic of **indirect laryngoscopy**. - Image B shows a spatula being used to apply pressure to the tongue or jaw while observing for a reflex action, which is consistent with the **spatula test** for tetanus. *A= Posterior rhinoscopy, B= Spatula test* - **Posterior rhinoscopy** involves visualizing the nasopharynx via a mirror placed behind the soft palate, which is not what is shown in Image A. - While Image B correctly shows a spatula test, Image A is clearly not a posterior rhinoscopy. *A= Direct laryngoscopy, B= Spatula test* - **Direct laryngoscopy** uses a laryngoscope to directly visualize the larynx without a mirror, often requiring sedation, which differs from the technique in Image A. - Image A shows the use of a mirror for visualization, thus ruling out direct laryngoscopy. *A= Anterior rhinoscopy, B= Spatula test* - **Anterior rhinoscopy** involves examining the anterior nasal cavity using a nasal speculum, which is not depicted in Image A. - Image A shows examination of the oral cavity and pharynx with a mirror, not the anterior nasal cavity.

Q: All of the following are correct about the image shown except:

High pitched expiratory stridor. ***High pitched expiratory stridor*** - The image depicts an **omega-shaped epiglottis** and collapsed aryepiglottic folds, consistent with **laryngomalacia**. - Laryngomalacia typically presents with **inspiratory stridor**, not expiratory, resulting from airway collapse during inspiration. - **This is the EXCEPT answer** - high-pitched expiratory stridor is NOT a feature of laryngomalacia. *Omega shaped epiglottis* - The image clearly shows an **omega-shaped epiglottis**, a characteristic feature of **laryngomalacia**. - This anatomical variation contributes to the collapse of supraglottic structures during inspiration. *Cry is normal* - In laryngomalacia, the **vocal cords** themselves are not affected, so the **cry typically remains normal**. - The abnormal sounds (stridor) arise from the supraglottic structures, not the vocal cord function during crying. *10% cases need surgery due to development of OSA or Cor Pulmonale* - While most cases of laryngomalacia are self-limiting, approximately **10% of infants may require surgical intervention** (supraglottoplasty). - This is usually due to severe symptoms like **obstructive sleep apnea (OSA)**, failure to thrive, or the rare development of **cor pulmonale**.

Q: A 15-year-old female presents with nasal obstruction and occasional profuse epistaxis for last 8 weeks. Nasal speculum view and histopathology of resected lesion is given. All are correct about the diagnosis except:

Best cultured on nasal inoculation in hamster. *Best cultured on nasal inoculation in hamster* - This statement is **incorrect** because *Rhinosporidium seeberi*, the causative agent of rhinosporidiosis (which is indicated by the images and clinical presentation), is an **uncultivable organism** in artificial media or animal models. - Its complex life cycle and specific host requirements make *in vitro* or *in vivo* culture challenging and largely unsuccessful. *Multiple fungal spherules embedded in stroma of connective tissue* - The histopathology image clearly shows characteristic **spherules** of varying sizes, containing numerous endospores, embedded within the connective tissue stroma, which is typical for rhinosporidiosis. - These spherules represent different stages of the organism's life cycle. *Infection originates from stagnant water* - *Rhinosporidium seeberi* is commonly found in **stagnant water** (rivers, ponds) and is often associated with swimming, bathing, or working in such environments. - Exposure to contaminated water is the primary mode of transmission for this rare chronic granulomatous disease. *Surgical excision is best treatment* - **Surgical excision** of the mass with electrocoagulation of the base is considered the most effective treatment for rhinosporidiosis to prevent recurrence. - Anti-fungal medications like dapsone may be used as an adjunct to reduce recurrence rates.

Question 1

All of the following statements regarding this instrument are true except: (Recent NEET Pattern 2016-17)

Accepted Answer

This device is used to administer antibiotics in the middle ear cavity

Answer

Speculum that is used here has a concave lens with a magnification of 2.5 times

Answer

This device is used to assess tympanic membrane mobility

Answer

This device is used to suck out middle ear secretions

Question 2

The facial features shown in the image are characteristic of:

Accepted Answer

Adenoid facies

Answer

Frog face deformity

Answer

Ashen grey facies

Answer

Thyrotoxicosis

Question 3

The volume of the balloons shown in epistaxis balloon is: (Recent NEET Pattern 2016-17)

Accepted Answer

72. (d)

Answer

73. (b)

Answer

74. (b)

Answer

75. (c)

Question 4

The image shows which of the following tests being performed? (Recent NEET Pattern 2016-17)

Accepted Answer

A= Indirect laryngoscopy, B= Spatula test

Answer

A= Posterior rhinoscopy, B= Spatula test

Answer

A= Direct laryngoscopy, B= Spatula test

Answer

A= Anterior rhinoscopy, B= Spatula test

Question 5

All are contraindications to the procedure shown below except:

Accepted Answer

Antral cyst

Answer

Acute maxillary sinusitis

Answer

Fractured maxilla

Answer

Children less than 3 years

Question 6

All of the following are correct about the image shown except:

Accepted Answer

High pitched expiratory stridor

Answer

Omega shaped epiglottis

Answer

Cry is normal

Answer

10% cases need surgery due to development of OSA or Cor Pulmonale

Question 7

All are correct about the procedure performed in the patient except:

Accepted Answer

Skin incision is a vertical midline incision from cricoid cartilage to suprasternal notch

Answer

Skin incision is not sutured to prevent surgical emphysema

Answer

Tracheal incision is a transverse incision starting from the first tracheal ring

Answer

Performed under general anesthesia in infants

Question 8

A 15-year-old female presents with nasal obstruction and occasional profuse epistaxis for last 8 weeks. Nasal speculum view and histopathology of resected lesion is given. All are correct about the diagnosis except:

Accepted Answer

Best cultured on nasal inoculation in hamster

Answer

Multiple fungal spherules embedded in stroma of connective tissue

Answer

Infection originates from stagnant water

Answer

Surgical excision is best treatment

NEET-PG 2017 — ENT