FMGE 2018 - ENT PYQs Practice Questions

Q: All of the following are seen in superior laryngeal nerve palsy except:

Stridor. ***Stridor*** - **Superior laryngeal nerve palsy** primarily affects the **cricothyroid muscle** (external branch) and sensation above the vocal cords (internal branch). - Stridor typically results from severe **airway obstruction**, which is not a direct consequence of superior laryngeal nerve palsy as the **vocal cords** are not paralyzed open or closed to cause obstruction. *Aspiration* - The **internal branch of the superior laryngeal nerve** provides sensory innervation to the **supraglottic larynx**. - Loss of sensation in this region can impair the protective **cough reflex**, leading to an increased risk of aspiration. *Bowed vocal cords* - **Palsy of the cricothyroid muscle**, innervated by the **external branch of the superior laryngeal nerve**, causes a loss of tension in the vocal cord. - This lack of tension can result in a characteristically **bowed appearance** of the affected vocal cord during phonation. *Loss of pitch* - The **cricothyroid muscle** is responsible for tensing and elongating the vocal cords, which is crucial for **raising vocal pitch**. - Paralysis of this muscle due to **superior laryngeal nerve palsy** directly impairs the ability to achieve higher pitches, leading to a **monotone voice** or loss of pitch. [Practice more ENT PYQs on OnCourse]

Q: Tobey-Ayer test is done for:

Lateral sinus thrombosis. ***Lateral sinus thrombosis*** - The **Tobey-Ayer test** is used to detect **lateral (transverse) sinus thrombosis**, a serious complication of otogenic infections. - The test involves **lumbar puncture with CSF manometry** while sequentially compressing each **internal jugular vein**. - In a normal response, compression of either jugular vein causes a **rapid rise in CSF pressure** (within 10 seconds) due to venous obstruction, followed by rapid fall on release. - In **lateral sinus thrombosis**, compression of the jugular vein on the **affected side** produces **no rise or delayed/sluggish rise** in CSF pressure, indicating obstruction of venous drainage. - This is distinct from the Queckenstedt-Stookey test, which tests for spinal subarachnoid block. *Ketosis* - **Ketosis** is a metabolic state with elevated **ketone bodies** in blood, detected by urine dipsticks or blood ketone meters. - It has no relation to the Tobey-Ayer test or ENT pathology. *Acantholysis* - **Acantholysis** is loss of intercellular connections between **keratinocytes**, seen in blistering skin diseases like Pemphigus. - It is a histological dermatological finding, completely unrelated to neurological or ENT examination. *Hemoglobinuria* - **Hemoglobinuria** is the presence of free **hemoglobin** in urine due to intravascular hemolysis. - It is detected by urinalysis and has no connection to CSF manometry or lateral sinus assessment. [Practice more ENT PYQs on OnCourse]

Q: Recruitment phenomenon is seen in:

Meniere's disease. ***Meniere's disease*** - The recruitment phenomenon, characterized by an abnormal increase in the perception of loudness for a given increase in sound intensity, is a classic finding in **cochlear hearing loss**, often seen in conditions like **Meniere's disease**. - This occurs due to damage to the **outer hair cells** in the cochlea, which normally compress the dynamic range of hearing. *Otitis media with effusion* - This condition involves **conductive hearing loss** due to fluid in the middle ear, and typically does not cause the recruitment phenomenon. - The problem lies in sound transmission, not in the processing of loudness within the cochlea. *Otosclerosis* - This condition causes **conductive hearing loss** due to abnormal bone growth around the stapes footplate, impeding sound transmission to the inner ear. - While it affects hearing, it does not directly lead to altered loudness perception or recruitment, as the cochlea itself is often intact. *Acoustic nerve schwannoma* - This tumor affects the **vestibulocochlear nerve (CN VIII)**, causing **sensorineural hearing loss** that is typically retrocochlear (beyond the cochlea). - While it causes hearing loss, recruitment is usually absent or minimal, as the pathology is neural, not cochlear. [Practice more ENT PYQs on OnCourse]

Q: All of the following are seen in Meniere's Disease except:

Ear Pain. ***Ear Pain*** - **Otalgia** (ear pain) is not a typical symptom of **Meniere's disease**. - While patients may experience discomfort due to pressure, sharp or significant pain is generally absent. *Fullness of ear* - A sensation of **aural fullness** or pressure in the affected ear is a characteristic symptom of Meniere's disease, often preceding a vertiginous attack. - This symptom is thought to be due to the buildup of **endolymphatic fluid** within the inner ear. *Vertigo* - **Episodic rotational vertigo** is a hallmark symptom of Meniere's disease, significantly impacting daily activities and often accompanied by nausea and vomiting. - These attacks are typically sudden, severe, and can last from 20 minutes to several hours. *Tinnitus* - **Tinnitus**, often described as a ringing, buzzing, or roaring sound, is a common symptom in patients with Meniere's disease. - It usually fluctuates in intensity and can worsen before or during a vertigo attack. [Practice more ENT PYQs on OnCourse]

Q: Most common cause of sensorineural hearing loss (SNHL)

Presbycusis. ***Presbycusis*** - **Presbycusis**, or age-related hearing loss, is the most common cause of **sensorineural hearing loss (SNHL)**, affecting a significant portion of the elderly population. - It typically results from **degenerative changes** in the inner ear, specifically the hair cells and nerve fibers, leading to a gradual, symmetrical, high-frequency SNHL. *Labyrinthitis* - **Labyrinthitis** is an inflammation of the inner ear that can cause sudden SNHL, often accompanied by **vertigo** and **tinnitus**. - While it causes SNHL, it is an acute condition and not the most common overall cause, especially when considering the prevalence of age-related hearing loss. *Meniere's disease* - **Meniere's disease** is characterized by recurrent episodes of **vertigo, fluctuating low-frequency SNHL, tinnitus**, and aural fullness. - It is a specific condition causing SNHL, but its prevalence is much lower than presbycusis, making it a less common overall cause. *Vestibular Schwannoma* - A **vestibular schwannoma** (acoustic neuroma) is a benign tumor that arises from the Schwann cells of the **vestibulocochlear nerve**. - It can cause **progressive unilateral SNHL**, tinnitus, and balance issues, but it is a relatively rare condition compared to presbycusis. [Practice more ENT PYQs on OnCourse]

Question 1

All of the following are seen in superior laryngeal nerve palsy except:

Accepted Answer

Stridor

Answer

Bowed vocal cords

Answer

Loss of pitch

Answer

Aspiration

Question 2

Tobey-Ayer test is done for:

Accepted Answer

Lateral sinus thrombosis

Answer

Ketosis

Answer

Acantholysis

Answer

Hemoglobinuria

Question 3

Recruitment phenomenon is seen in:

Accepted Answer

Meniere's disease

Answer

Otitis media with effusion

Answer

Otosclerosis

Answer

Acoustic nerve schwannoma

Question 4

All of the following are seen in Meniere's Disease except:

Accepted Answer

Ear Pain

Answer

Fullness of ear

Answer

Vertigo

Answer

Tinnitus

Question 5

Most common cause of sensorineural hearing loss (SNHL)

Accepted Answer

Presbycusis

Answer

Labyrinthitis

Answer

Meniere's disease

Answer

Vestibular Schwannoma

Question 6

Most common malignancy of maxillary antrum:

Accepted Answer

Squamous cell Carcinoma

Answer

Muco-epidermoid Carcinoma

Answer

Adenoid cystic Carcinoma

Answer

Adenocarcinoma

Question 7

Young's operation is done for:

Accepted Answer

Atrophic rhinitis

Answer

Allergic rhinitis

Answer

Vasomotor rhinitis

Answer

Antrochoanal polyp

Question 8

A 15 years old Male presented with history of fever since 2 days, unable to swallow the food with muffled voice. On examination it is noted right tonsil is shifted to midline. What is the diagnosis:

Accepted Answer

Quincy

Answer

Acute tonsillitis

Answer

Parapharyngeal abscess

Answer

Acute retropharyngeal abscess

Question 9

A patient presented with 2 days history of fever. On examination there was a swelling in the neck and one side tonsil was pushed to midline. What is the most likely diagnosis:-

Accepted Answer

Quinsy

Answer

Retropharyngeal abscess

Answer

Parapharyngeal abscess

Answer

Tonsillitis

Question 10

Dip at 4000 Hz in pure tone audiometry indicates:

Accepted Answer

Noise induced hearing loss

Answer

Meniere's disease

Answer

Age related hearing loss

Answer

Otosclerosis

FMGE 2018 — ENT