NEET-PG 2019 - ENT PYQs Practice Questions

Q: Inspiratory stridor is found in what kind of lesions:

Supraglottic. ***Supraglottic*** - Lesions in the **supraglottic** region (e.g., epiglottitis, supraglottic foreign body) cause inspiratory stridor due to the collapse of soft tissues above the vocal cords during inspiration. - The narrowed airway during inspiration creates a high-pitched, harsh sound. *Subglottic* - **Subglottic** lesions typically cause a **biphasic stridor**, meaning stridor is present during both inspiration and expiration. - This is because the subglottis is a rigid area; narrowing at this level causes turbulent airflow during both phases of breathing. *Tracheal* - **Tracheal** lesions can produce **biphasic stridor** if they are in the cervical trachea due to fixed airway narrowing. - If the lesion is in the lower, intrathoracic trachea, it might primarily cause **expiratory stridor** or a biphasic stridor depending on the degree of narrowing and its fixity. *Bronchus* - Lesions in the **bronchus** (e.g., foreign body, tumor) typically lead to **expiratory stridor** or wheezing. - Airway narrowing at this level causes air trapping and turbulent flow predominantly during exhalation when the bronchial walls naturally constrict. [Practice more ENT PYQs on OnCourse]

Q: Identify the condition of the given image:

Keratosis obturans. ***Keratosis obturans*** - The image shows a **plug of desquamated keratin** filling the external auditory canal. This is the characteristic appearance of keratosis obturans. - This condition is often associated with severe pain, conductive hearing loss, and sometimes **bone erosion** of the external auditory canal. *Acquired cholesteatoma* - This condition involves a **retraction pocket** or **perforation** of the tympanic membrane with ingrowth of keratinizing squamous epithelium into the middle ear, forming a sac. - The image does not show a retraction pocket or a middle ear mass, which are typical features of acquired cholesteatoma. *Congenital cholesteatoma* - This is a **pearly white mass** located behind an intact tympanic membrane, without any history of ear infections or perforations. - The image shows an external auditory canal filled with a plug, not a middle ear mass behind an intact tympanic membrane. *Rupture of tympanic membrane* - A rupture of the tympanic membrane would present as a **visible defect or perforation** in the eardrum. - The image shows an accumulation of material within the ear canal, and the tympanic membrane itself is not clearly visible or perforated in a manner indicative of rupture. [Practice more ENT PYQs on OnCourse]

Q: Identify the maneuver shown in the image.

Epley. ***Epley*** - The image displays the classic sequence of head and body movements characteristic of the **Epley maneuver**, designed to reposition otoconia from the semicircular canals back into the utricle. - This maneuver involves a series of specific head turns and body positions, often starting in an upright seated position, then lying down while turning the head, and rotating the body, as depicted. *Brandt daroff* - The **Brandt-Daroff exercises** involve rapid, self-administered movements between sitting and lying on one side, then sitting up and lying on the other side. - These exercises are typically performed multiple times a day and differ in their sequence from the repositioning maneuvers shown. *Foster* - The **Foster maneuver**, also known as the "half-somersault maneuver," is a self-administered variant used for posterior canal BPPV, particularly when the Epley maneuver is difficult to perform. - It involves beginning in a kneeling position, looking up, placing the head on the floor, and tucking the chin, which is distinct from the sequence shown. *Semont* - The **Semont maneuver** involves rapid movement from a sitting position to lying on one side with the head turned up, then rapidly moving to lie on the opposite side with the head turned down. - While it is a repositioning maneuver for BPPV, its specific rapid movements and head orientations differ from those illustrated in the image. [Practice more ENT PYQs on OnCourse]

Q: A patient presents with hoarseness and laryngoscopy reveals a warty, cauliflower-like growth on the vocal cord. Identify the most likely lesion.

Laryngeal papilloma. ***Laryngeal papilloma*** - **Hoarseness** and a **warty, cauliflower-like growth** on the vocal cord are classic descriptions of a laryngeal papilloma, often caused by **HPV infection**. - These lesions can be solitary or multiple, and while benign, they can recur and cause voice changes and respiratory obstruction. *Laryngeal malignancy* - While hoarseness is a common symptom of laryngeal malignancy, the description of a **"warty, cauliflower-like growth"** is more characteristic of a papilloma than most typical carcinomas, which might appear more ulcerative or infiltrative. - Malignancies are more commonly associated with risk factors like **smoking and alcohol use**, and often present with other symptoms like dysphagia or weight loss. *Tracheomalacia* - **Tracheomalacia** refers to softening of the tracheal cartilage, leading to airway collapse, typically causing stridor or respiratory distress. - It does not present as a **discrete growth** on the vocal cords but rather as a diffuse structural weakness of the trachea. *Reinke’s edema* - **Reinke's edema** (polypoid corditis) is characterized by a **gelatinous or fluid-filled swelling** of the vocal cords, usually associated with chronic irritation like smoking. - It presents as a swollen, boggy appearance of the vocal cords, not a warty or cauliflower-like growth. [Practice more ENT PYQs on OnCourse]

Q: A patient presented with the following picture of Tympanic Membrane. Most Probable diagnosis (marked with arrow):

Tubercular Otitis Media. ***Tubercular Otitis Media*** - The image exhibits **multiple perforations** in the tympanic membrane, along with **pale granulation tissue**, which are classic clinical features of **tubercular otitis media**. - Tubercular ear infections often present insidiously with **painless otorrhea** and **progressive hearing loss**, eventually leading to multiple perforations as the disease advances. *Syphilitic Otitis Media* - Syphilitic otitis media typically presents as **sensorineural hearing loss**, often sudden, and can be associated with **vestibular symptoms**. - It usually does **not cause multiple perforations** or extensive granulation tissue in the tympanic membrane. *Pseudomonas infection* - **Pseudomonas otitis externa** commonly causes severe pain, swelling, and purulent discharge, often seen in _elderly diabetic_ or _immunocompromised_ patients with potentially **malignant otitis externa**. - While *Pseudomonas* can cause chronic suppurative otitis media (CSOM) with a perforation, it doesn't typically lead to **multiple perforations** in the manner depicted. *Fungal Otitis Media* - Fungal otitis media (otomycosis) is characterized by the presence of **black, white, or yellow fungal debris** and hyphae within the external ear canal and on the tympanic membrane. - While it can cause inflammation and sometimes perforation, the image does not show characteristic **fungal elements** or the extensive **granulation tissue** typical of tubercular disease. [Practice more ENT PYQs on OnCourse]

Question 1

Inspiratory stridor is found in what kind of lesions:

Accepted Answer

Supraglottic

Answer

Subglottic

Answer

Tracheal

Answer

Bronchus

Question 2

Identify the condition of the given image:

Accepted Answer

Keratosis obturans

Answer

Acquired cholesteatoma

Answer

Congenital cholesteatoma

Answer

Rupture of tympanic membrane

Question 3

Identify the maneuver shown in the image.

Accepted Answer

Epley

Answer

Brandt-Daroff

Answer

Foster

Answer

Semont

Question 4

A patient presents with hoarseness and laryngoscopy reveals a warty, cauliflower-like growth on the vocal cord. Identify the most likely lesion.

Accepted Answer

Laryngeal papilloma

Answer

Laryngeal malignancy

Answer

Tracheomalacia

Answer

Reinke’s edema

Question 5

A patient presented with the following picture of Tympanic Membrane. Most Probable diagnosis (marked with arrow):

Accepted Answer

Tubercular Otitis Media

Answer

Syphilitic Otitis Media

Answer

Pseudomonas infection

Answer

Fungal Otitis Media

Question 6

Dohlman surgery in Zenker's diverticulum is:-

Accepted Answer

Endoscopic electrocautery technique

Answer

Endoscopic suturing of pouch

Answer

Laser division of pouch

Answer

Endoscopic stapling of septum

Question 7

Inspiratory stridor is due to lesions of:

Accepted Answer

Subglottis

Answer

Supraglottis

Answer

Trachea

Answer

Bronchi

NEET-PG 2019 — ENT