NEET-PG 2020 - ENT PYQs Practice Questions

Q: What is the surgical procedure for widening of the cartilaginous part of the external auditory canal?

meatoplasty. ***Meatoplasty*** - **Meatoplasty** is a surgical procedure specifically designed to **widen the external auditory canal**, often performed to improve drainage or aid in fitting hearing aids. - This procedure usually involves modifying the **cartilaginous part** of the canal to prevent stenosis or collapse, which can cause conductive hearing loss. *Otoplasty* - **Otoplasty** is a cosmetic surgical procedure primarily focused on reshaping the **external ear (pinna)**, often to correct prominent ears or deformities. - It does not involve widening the external auditory canal. *Myringoplasty* - **Myringoplasty** is a surgical repair of a **perforated tympanic membrane (eardrum)**. - The goal is to close the hole in the eardrum to improve hearing and prevent recurrent infections, without altering the external auditory canal's width. *Tympanoplasty* - **Tympanoplasty** is a broader surgical term that involves the repair of the **tympanic membrane (eardrum)** and/or the **ossicular chain** within the middle ear. - While it addresses middle ear issues and hearing improvement, it typically does not involve widening the external auditory canal as its primary goal. [Practice more ENT PYQs on OnCourse]

Q: A patient presents with fever and dysphagia. An image shows a tonsil that is pushed medially. What is the most likely diagnosis?

Peritonsillar abscess. ***Peritonsillar abscess*** - The image clearly shows **unilateral bulging** of the soft palate and displacement of the tonsil medially, consistent with a peritonsillar abscess. - Patients typically present with **fever**, **dysphagia**, severe sore throat, and a "hot potato" voice. *Parapharyngeal abscess* - A parapharyngeal abscess involves the **deep neck spaces** lateral to the pharynx, often presenting with neck swelling, trismus, and systemic symptoms. - While it can cause pharyngeal bulging, the classic **medial displacement of the tonsil** is more indicative of a peritonsillar abscess. *Retropharyngeal abscess* - This involves the space behind the posterior pharyngeal wall, usually presenting with **dysphagia**, **neck stiffness**, and fever. - Imaging would reveal a **prevertebral soft tissue swelling**, not primarily a medially displaced tonsil. *Ludwig's angina* - Ludwig's angina is a **rapidly spreading cellulitis** of the submandibular and sublingual spaces, typically arising from an odontogenic infection. - It presents with **woody induration** of the neck and floor of the mouth, elevation of the tongue, and potential airway compromise, but not primarily a medially displaced tonsil. [Practice more ENT PYQs on OnCourse]

Q: Partial closure of the nose is performed in which condition?

Atrophic rhinitis. ***Atrophic rhinitis*** - **Partial closure of the nose** (Young's operation or naris plasty) is a surgical procedure used to reduce the size of the nasal passages and improve airflow in patients with atrophic rhinitis. - This condition involves progressive **atrophy of the nasal mucosa** and turbinates, leading to dryness, crusting, paradoxical obstruction, and often a foul odor. *Vasomotor rhinitis* - This condition involves **non-allergic rhinitis** triggered by environmental changes, temperature shifts, or irritants, causing symptoms like sneezing, rhinorrhea, and nasal congestion. - Management typically involves **avoidance of triggers**, nasal corticosteroids, or anticholinergic sprays, not surgical closure of the nose. *Allergic rhinitis* - Caused by an ** IgE-mediated immune response** to airborne allergens, leading to inflammation of the nasal mucosa, sneezing, itching, rhinorrhea, and congestion. - Treatment focuses on **allergen avoidance**, antihistamines, and nasal corticosteroids; surgical modification of nasal passages is not indicated. *Occupational rhinitis* - This form of rhinitis is caused by exposure to **irritants or allergens in the workplace**, leading to nasal symptoms similar to allergic or non-allergic rhinitis. - Management involves **identifying and avoiding the offending agent** at work, and medical treatments like nasal sprays, but not surgical narrowing of the nostrils. [Practice more ENT PYQs on OnCourse]

Q: A 70 year old patient presented with history of fever, repeated aspiration and coughing in the night. On examination there is a swelling on left side of neck which produces gurgling sound on compression. Following is the barium swallow study of the patient. What is the most likely diagnosis?

Zenker's diverticulum. ***Zenker's diverticulum*** - The patient's symptoms of **fever**, **repeated aspiration**, and **coughing at night** are classic for a Zenker's diverticulum, particularly in an older patient. - The presence of a **neck swelling** producing a **gurgling sound on compression** (Boyce's sign) is highly indicative of a Zenker's diverticulum, which is essentially a pharyngeal pouch. The barium swallow image likely shows contrast pooling in such a pouch. *Plummer Vinson syndrome* - Characterized by **dysphagia**, **iron-deficiency anemia**, and **esophageal webs**. - While it causes dysphagia, it does not typically present with a gurgling neck swelling or significant aspiration as described. *Dysphagia Lusoria* - This is a rare condition caused by an **aberrant right subclavian artery** compressing the esophagus. - It primarily causes dysphagia due to extrinsic compression, without the associated neck swelling, gurgling sound, or significant aspiration risk from food pooling within a diverticulum. *Laryngocoele* - A laryngocele is an **abnormal sac** or pouch that arises from the **laryngeal ventricle** and may extend externally, presenting as a neck swelling. - While it can cause a neck swelling, it is **air-filled**, not fluid or food-filled, and therefore would not typically produce a gurgling sound on compression or be clearly visible on a barium swallow as a contrast-filled pouch like in the image provided. [Practice more ENT PYQs on OnCourse]

Q: Tuberculous otitis media of the middle ear has all of the following except:-

Painful otorrhea is seen. ***Painful otorrhea is seen*** - **Tuberculous otitis media** is often characterized by **painless otorrhea**, making painful otorrhea an unlikely finding. - The absence of pain is attributed to the **insidious** and slow-growing nature of the infection, which often delays diagnosis. *Multiple perforations are seen* - **Multiple tympanic membrane perforations** are a classic sign of tuberculous otitis media, differentiating it from other chronic otitis media forms. - These perforations are often **small and non-healing**, contributing to persistent discharge. *Pale granulomas are seen* - The presence of **pale granulomas** in the middle ear is a histological hallmark of tuberculosis, reflecting the characteristic **caseating granulomatous inflammation**. - These granulomas can lead to **ossicular erosion** and subsequent conductive hearing loss. *ATT should be started* - **Anti-tubercular treatment (ATT)** is the definitive therapy for tuberculous otitis media, targeting the underlying Mycobacterium tuberculosis infection. - Early initiation of ATT is crucial to prevent further **destruction** of middle ear structures and hearing loss. [Practice more ENT PYQs on OnCourse]

Question 1

What is the surgical procedure for widening of the cartilaginous part of the external auditory canal?

Accepted Answer

meatoplasty

Answer

otoplasty

Answer

myringoplasty

Answer

tympanoplasty

Question 2

A patient presents with fever and dysphagia. An image shows a tonsil that is pushed medially. What is the most likely diagnosis?

Accepted Answer

Peritonsillar abscess

Answer

Parapharyngeal abscess

Answer

Retropharyngeal abscess

Answer

Ludwig's angina

Question 3

Partial closure of the nose is performed in which condition?

Accepted Answer

Atrophic rhinitis

Answer

Vasomotor rhinitis

Answer

Allergic rhinitis

Answer

Occupational rhinitis

Question 4

A 70 year old patient presented with history of fever, repeated aspiration and coughing in the night. On examination there is a swelling on left side of neck which produces gurgling sound on compression. Following is the barium swallow study of the patient. What is the most likely diagnosis?

Accepted Answer

Zenker's diverticulum

Answer

Plummer vinson syndrome

Answer

Dysphagia Lusoria

Answer

Laryngocoele

Question 5

Tuberculous otitis media of the middle ear has all of the following except:-

Accepted Answer

Painful otorrhea is seen

Answer

Multiple perforations are seen

Answer

Pale granulomas are seen

Answer

ATT should be started

Question 6

A 3-year-old boy presents with fever, throat pain, and difficulty swallowing. On examination, there is unilateral tonsillar swelling with deviation of the uvula. What is the most likely diagnosis?

Accepted Answer