Practice Paper of NEET PG: Important Questions of ENT

  Ear, nose, and throat (ENT) specialists diagnoses and treats disorders of the ear, nose, throat, and  neck, including:

• Hearing or balance, ear infections, and disorders of the outer and inner ear
• Problems with the nasal cavity and sinuses, including allergies, adenoids, problems with smelling, and difficulties with breathing through the nose
• The voice box (or larynx) and upper esophagus, including the voice, tonsils, and problems with breathing and swallowing.

 The Important Questions of ENT for NEET PG exam Part 1:

 

1. Lyre sign in seen in

A. Grave’s disease

B. Meniere’s disease

C. Lateral sinus thrombosis

D. Carotid body tumour

  Correct answer : D. Carotid body tumour

 1) Lyre sign is an angiographic finding seen in carotid body tumour of the neck.

2) There is splaying apart of internal and external carotid arteries on angiogram.

 

2. The incision used in endomeatal approach to the ear is?

A. Lempert I incision

B. Rosen’s incision

C. Lempert II incision

D. Wilde’s incision

   Correct answer : B. Rosen’s incision

1) Tympanomeatal flap is raised to expose the middle ear in endomeatal approach.

2) Rosen’s incision is used in the endomeatal approach for stapedectomy.

3) It is also used for exploratory tympanotomy.

 

3. Hitzelberger’s sign is?

A. Reduced corneal sensitivity

B. Hypoesthesia of the posterior meatal wall

C. Paraesthesia of face

D. Delayed blink reflex

   Correct answer : B. Hypoesthesia of the posterior meatal wall

Acoustic neuroma – MRI scan

1) Hitzelberger’s sign is seen in acoustic neuroma.

2) It occurs due to involvement of the 7th cranial nerve.

3) There is early involvement of the sensory fibers which causes hypoesthesia of the posterior meatal wall.

4) Paraesthesia of face and reduced corneal sensitivity occurs due to involvement of 5th cranial nerve.

 

4. Orbital apex syndrome involves?

A. Olfactory nerve

B. Ophthalmic division of trigeminal nerve

C. Maxillary division of trigeminal nerve

D. Mandibular division of trigeminal nerve

   Correct answer : C. Maxillary division of trigeminal nerve

Nerves of the orbit

1) Orbital apex syndrome is a complication of paranasal sinus infection.

2) Superior orbital fissure syndrome along with involvement of maxillary division of trigeminal nerve and optic nerve is known as orbital apex syndrome.

3) In superior orbital fissure syndrome, there is progressive paralysis of abducent, oculomotor and trochlear nerves.

5. All are true regarding mucocele of frontal sinus except?

A. Cystic tender swelling

B. Egg shell crackling can be elicited

C. Displaces the eyeball downward and laterally

D. Treatment is frontoethmoidectomy

   Correct answer : A. Cystic tender swelling

Paranasal sinuses – Frontal Sinus (1), Ethmoid Sinus (2), Sphenoid Sinus (3), Maxillary Sinus (4)

1) Mucocoele of the frontal sinus is a cystic non tender swelling.

2) It can displace the eyeball forward, downward and laterally.

3) The patient presents with headache, diplopia and proptosis.

4) Treatment is frontoethmoidectomy which facilitates free drainage of frontal sinus into the middle meatus.

 

6. Prussak’s space is bounded below by?

A. Fibers of lateral malleolar fold

B. Shrapnell’s membrane

C. Short process of malleus

D. Neck of malleus

  Correct answer : C. Short process of malleus 

Anatomy of middle ear

Boundaries of Prussak’s space:

 -Superior – Fibers of lateral malleolar fold

 -Inferior – Short process of malleus

 -Lateral – Shrapnell’s membrane

 -Medial – Neck of malleus

 

7. Pain in tonsillar fossa and upper neck is characteristic of?

A. Eagle’s syndrome

B. Apert’s syndrome

C. Sickler’s syndrome

D. Usher’s syndrome

   Correct answer : A. Eagle’s syndrome

Eagle’s syndrome – bilateral ossification of stylohyoid ligaments

1) Eagle’s syndrome is characterised by pain in tonsillar fossa and upper neck.

2) Pain radiates of ipsilateral ear.

3) There is aggravation of pain on swallowing.

4) It is caused by calcification of stylohyoid ligament / elongation of styloid process.

 

8. Ipsilateral immobility of soft palate is seen in?

A. Lermoyez syndrome

B. Ortner’s syndrome

C. Costen’s syndrome

D. Trotter’s syndrome

    Correct answer : D. Trotter’s syndrome

PET CT scan of a case of nasopharyngeal carcinoma. FDG positive primary site is visualised.

1) Trotter’s syndrome is seen in nasopharyngeal carcinoma when it spreads laterally and involves the sinus of Morgagni.

2) There is conductive hearing loss, ipsilateral immobility of soft palate and neuralgic pain.

3) Ortner’s syndrome is characterised by paralysis of recurrent laryngeal nerve and cardiomegaly.

4) Costen’s syndrome occurs due to defective bite resulting in temporomandibular joint abnormality.

5) Lermoyez syndrome is a form of Meniere’s disease.

 

9. The following is true for Gradenigo’s syndrome?

A. Mastoid tenderness

B. Retro-orbital pain

C. Hearing loss

D. Sagging of posterosuperior meatal wall

    Correct answer : B. Retro-orbital pain

 

1)Gradenigo’s syndrome is seen in petrositis.

2)It is characterised by lateral rectus palsy, persistent ear discharge and deep seated ear or retro-orbital pain.

3)Mastoid tenderness, hearing loss and sagging of posterosuperior meatal wall are seen acute mastoiditis.

 

10. All are true regarding Reinke’s oedema except?

A. Usually caused by vocal abuse

B. There is collection of oedema fluid in the subepithelial space

C. There is asymmetrical swelling of vocal cords

D. Vocal cord stripping is the treatment

      Correct answer : C. There is asymmetrical swelling of vocal cords

 

Reinke’s oedema – diffuse symmetrical swelling of both vocal cords

1) Reinke’s oedema is caused by vocal abuse or smoking.

2) There is diffuse symmetrical swelling of both vocal cords.

3) Vocal cord stripping is the treatment of choice.

4) Enough mucosa should be preserved for epithelialization.

 

11. All are true regarding the use of sodium fluoride in otosclerosis except?

A. It inhibits proteolytic enzymes in the cochlea

B. It’s use is contraindicated in patients with chronic nephritis

C. It acts by inhibition of osteoblastic activity

D. It is used in patients with positive Schwartz sign

     Correct answer : C. It acts by inhibition of osteoblastic activity

USE OF SODIUM FLUORIDE IN OTOSCLEROSIS

Mechanism of action

 -Sodium fluoride promotes osteoblastic activity and inhibits osteoclastic activity

 -This helps to decrease the bone remodelling taking place in the otosclerotic lesions and promotes recalcification

 -It also inhibits proteolytic enzymes in the cochlea and helps prevent sensorineural deafness

Indications

 -Progressive sensorineural hearing loss

 -Radiological evidence of a lesion

 -Positive Schwartz sign

Contraindications

 -Pregnancy / lactation

 -Fluoride allergy

 -Skeletal fluorosis

 -Children before completion of skeletal growth

 -Chronic rheumatoid arthritis

 -Chronic nephritis

 

12. Secondary haemorrhage after tonsillectomy is most commonly seen?

A. 6 hours after surgery

B. 24 hours after surgery

C. 6 days after surgery

D. 14 days after surgery

     Correct answer : C. 6 days after surgery

 

Oropharynx 1 day after tonsillectomy

HAEMORRHAGE AFTER TONSILLECTOMY

Haemorrhage following tonsillectomy can be of 3 types:

 1)Primary haemorrhage (Immediate haemorrhage)

 -Occurs during surgery.

 2)Reactionary haemorrhage (Early haemorrhage)

 -Occurs within 24 hours of surgery.

 -It is due to the presence of a clot which prevents the compressive action of superior constrictor muscle on the blood vessels.

 -It can also occur due to slipping of a ligature / dislodgement of clot.

3)Secondary haemorrhage (Delayed haemorrhage)

 -Seen more than 24 hours after surgery.

 -Usually seen 5 to 10 days after surgery.

 -Occurs due to infection / premature separation of membrane.

 

13. Most common site of origin of vestibular schwannoma is?

A. Cochlear nerve

B. Superior vestibular nerve

C. Inferior vestibular nerve

D. Facial nerve

     Correct answer : B. Superior vestibular nerve

SITE OF ORIGIN OF VESTIBULAR SCHWANNOMA

 -Most common site of origin of vestibular schwannoma is Superior vestibular nerve ( 50-60% ).

 -It also occurs in the inferior vestibular nerve ( 40-50% ) and cochlear nerve ( 10% ).

 

14. Pain pathway from ethmoid sinus is via?

A. Nasociliary nerve

B. Lacrimal nerve

C. Lateral pterygoid nerve

D. Frontal nerve

     Correct answer : A. Nasociliary nerve

1) Pain sensation from the ethmoid sinus is transmitted by the anterior and posterior ethmoidal branches of the nasociliary nerve, which in turn is a branch of the trigeminal nerve (ophthalmic division).

2) The other branches of the nasociliary nerve are:

 – Long ciliary nerves

 -Infratrochlear nerve

 -Communicating branch to the ciliary ganglion (long root of the ciliary ganglion)

3) Frontal nerve carries sensations from the forehead, frontal sinus mucosa, and the upper eyelid. It has 2 branches – supraorbital nerve and supratrochlear nerve.

4) Lacrimal nerve innervates the lacrimal gland, conjunctiva, and the lateral upper eyelids.

5) Lateral pterygoid nerve supplies the lateral pterygoid muscle.

15. Endolymphatic hydrops is characteristic of:

A. Cholesteatoma

B. Meniere’s disease

C. Otosclerosis

D. Gradenigo’s syndrome

     Correct answer: B. Meniere’s disease

ENDOLYMPHATIC HYDROPS

1) It is another name for Meniere’s disease

2) In this condition, the endolymphatic sac in the inner ear is distended

3) This is either due to increased production of endolymph by the Stria vascularis or decreased absorption through the endolymphatic sac

4) More commonly seen in males

5) Clinical features – Vertigo, tinnitus, fluctuating hearing loss, aural fullness

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