INI-CET 2023 - ENT PYQs Practice Questions

Q: A South Indian male farmer presents to the ENT OPD with complaints of reddish mass coming out from the nose as shown in the image below and the histopathology examination is also given below. What is the likely diagnosis?

Rhinosporidiosis. **Rhinosporidiosis** - The image shows a **reddish, friable mass** in the nose, and the histopathology reveals **large sporangia** containing endospores, which are characteristic findings of *Rhinosporidium seeberi*, the causative agent of rhinosporidiosis. - The patient's demographic (South Indian male farmer) is also consistent, as rhinosporidiosis is **endemic in India and Sri Lanka** and is often associated with exposure to **stagnant water**. *Nasal polyp* - Nasal polyps are typically **pale, yellowish-grey, glistening, and translucent** masses, contrasting with the reddish appearance in the image. - Histologically, they show **edematous stroma** with inflammatory cells but lack the distinct sporangia seen in the provided image. *Inverted papilloma* - Inverted papillomas are characterized by **endophytic growth** of squamous or transitional epithelium into the underlying stroma. - Although they can be reddish, their histopathology shows **inverted papillary projections**, not fragmented sporangia. *Antrochoanal polyp* - An antrochoanal polyp typically originates from the **maxillary sinus** and extends into the choana and nasopharynx, which may not be overtly visible as a mass presenting anteriorly in the nostril without further examination. - Like other nasal polyps, its histological appearance would be **edematous inflammatory tissue** without the parasitic structures seen here. [Practice more ENT PYQs on OnCourse]

Q: A 14-year-old female patient presents to the ENT OPD and complains that she can hear sounds clearly but has difficulty processing and understanding what is being said. Her Pure tone audiometry and ABR are normal. What is the likely diagnosis in this patient?

Central Auditory Processing Disorder (CAPD). ***Central Auditory Processing Disorder (CAPD)*** - **CAPD** is characterized by difficulty processing and understanding auditory information despite normal peripheral hearing, as indicated by normal pure tone audiometry and ABR. - The patient's inability to comprehend spoken words despite hearing them clearly is a hallmark symptom of **CAPD**. *Auditory cortex lesion* - While an **auditory cortex lesion** could impair sound processing, it would likely result in more profound and specific deficits in sound localization, discrimination, or recognition, rather than just difficulty understanding speech with otherwise normal hearing tests. - **Unilateral lesions** might cause mild or transient auditory issues, but bilateral lesions typically lead to **cortical deafness**, which contradicts the patient's ability to "hear sounds clearly." *Malingering* - **Malingering** involves deliberately fabricating or exaggerating symptoms for secondary gain, which is unlikely given the consistent presentation of difficulty understanding speech despite normal, objective hearing tests like ABR. - There are no indications in the case of **inconsistent test results** or other behaviors suggestive of feigned symptoms. *Sensorineural hearing loss* - **Sensorineural hearing loss** involves damage to the inner ear or auditory nerve, which would result in abnormal pure tone audiometry results and/or abnormal ABR findings. - The patient's **normal pure tone audiometry and ABR** rule out sensorineural hearing loss as the primary cause of her symptoms. [Practice more ENT PYQs on OnCourse]

Question 1

A South Indian male farmer presents to the ENT OPD with complaints of reddish mass coming out from the nose as shown in the image below and the histopathology examination is also given below. What is the likely diagnosis?

Accepted Answer

Rhinosporidiosis

Answer

Nasal polyp

Answer

Inverted papilloma

Answer

Antrochoanal polyp

Question 2

A 14-year-old female patient presents to the ENT OPD and complains that she can hear sounds clearly but has difficulty processing and understanding what is being said. Her Pure tone audiometry and ABR are normal. What is the likely diagnosis in this patient?

Accepted Answer

Central Auditory Processing Disorder (CAPD)

Answer

Auditory cortex lesion

Answer

Malingering

Answer

Sensorineural hearing loss

INI-CET 2023 — ENT