Download PGIMER (Post Graduate Institute of Medical Education & Research, Chandigarh) 2020 May ENT Solved Question Paper
a)Innerearmalformation
b)Predisposestorecurrentmeningitisinchildren
c)Mostlyoccursasanisolatedentity
d)MaybeassociatedwithPenderdandDiGeorgesyndromes
e)Cochlearimplantsareusedintreatment
CorrectAnswer-A:B:C:D:E
Answer-A,B,C,D,E
Itisanabnormalityoftheinnerearthatisassociatedwith
sensorineuralhearingloss.
Mondinidysplasiacanalsopredisposetorecurrentmeningitis.
Mondinidysplasiausuallyoccurssporadicallyasanisolated
abnormalitybutitcanbeassociatedwithavarietyofsyndromes
includingKlippelFeilsyndrome,Pendredsyndrome,DiGeorge
syndrome,Wildervancksyndrome,Fountainsyndrome,Johanson-
Blizzardsyndrome.
Treatmentincludessurgerytorepairthedefecttopreventrecurrent
meningitis,prophylacticantimicrobialtherapyandconjugate-
pneumococcalvaccination,hearingamplificationaids&cochlear
implants.
2.Trueregardingrhinitismedicamentosa
is/are?
a)Causedby132-agonistsprays
b)Causedbycorticosteroidsspray
c)Sprayitselfcancauseterbinatehypertrophy
d)Thereisinferiorterbinatehypertrophy
e)Redmucosaischaracteristic
CorrectAnswer-D
Answer-D.Thereisinferiorterbinatehypertrophy
Itisaconditioncharacterizedbynasalcongestionthatistriggered
bytheextendeduseoftopicaldecongestantsandcertainoral
medicationsthatconstrictbloodvesselsintheliningofthenose:
recreationaluseofintranasalcocainemaltalsocauseasimilar
condition.
TheclassicPresentationisthatthenasalmucousmembranes
appear"beefy-red,"inflamed,andmayshowareasofpunctate
bleedingandscantmucus.
TheswellingofthenasalPassagescausedbyreboundcongestion
mayeventuallyresultinpermanentturbinatehypertrophy.
ToPicalintranasalcorticosteroidsaPPeartohavebeneftinrhinitis
medicamentosatocontroltheinflammationcausedbychronic
vasoconstrictoruse.
3.TrueregardingCald-Well-Lucsurgery
is/are?
a)Approachformaxillaryantrum
b)Antrostomythroughinferiormeatus
c)SublabialApproachleadingtoopeningofmandibularantrum
d)Openingofmaxillaryantrumthroughgingivolabialapproach
e)Openingthemaxillaryantrumthroughcaninefossa
CorrectAnswer-A:B:D:E
Answer-A,B,D,E
Caldwell-Lucoperationisaprocessofopeningthemaxillaryantrum
(maxillarysinusthroughcaninefossabysublabialapproachand
dealingwiththepathologyinsidetheantrum.
Antrumisreachedthroughanincisioningingivolabialsulcus.
Duringthesurgeryanoso-antralwindowismade(antrostomy)
throughtheinferiormeatus.
4.Trueregardingotosclerosisis/are?
a)Morecommoninmen
b)Involvesstapes/ovalwindow
c)Flamingopinkhuebehindeardrum
d)Carhart'snotchisat4000Hz
e)Hearsbetterinnoisyenvironment
CorrectAnswer-B:C:E
Answer-B,C,E
Inotosclerosis-50%caseshavepositivefamilyhistory.
Femalesareaffectedmorethanmales.
Bilateralconductivedeafnessseeninotosclerosisisnotirreversible
asitcanbesuccessfullytreatedbystapedectomy/Stapedotomy.
Sensorineuralhearinglossoccurswhenlaterinthecourseoftime
osteoscleroticfocusreachesthecochlearendosteumbutactually
mostcommonhearinglossseenisconductivetype.
Carhartsnotchisseeninboneconductioncurveat2000Hz.
5.Clinicalfeaturesofzygomaticfracture
include?
a)Hypoesthesiaalongthedistributionofinfra-orbitalnerve
b)Flatface
c)Malocclusionofteeth
d)Flatteningofmalarprominences
e)Stepdeformity
CorrectAnswer-A:D:E
Answer-A,D,E
Clinicalfeaturesofzygomafracture
Considerableswellingoverzygomaticarchiscommonandmakes
clinicaldiagnosismoredifficult.
Flatteningofmalarprominence.
Step-deformityofinfraorbitalmargin.
Anaesthesiainthedistributionofinfraorbitalnerve.
Trismus.
Thecheekmayappearflattened;comparedsymmetrywiththe
oppositeside.
6.Trueregardingtheuseofheadmirror
is/are?
a)Appliedonrighteye
b)Focalpointshouldbewithin6inches
c)Oneeyeshouldbeclosedwhileexamining
d)Botheyeshouldbeopenwhilefocusing
e)Alloftheabove
CorrectAnswer-A
Answer-A.Appliedonrighteye
Twotypesofilluminationisusedinotolaryngologcial
examination:
1. SemimobileilluminationliketheBull'slamp
2. MobileilluminationliketheClair'sheadlight,orcoldlightbased
headbands.
Bull'slamp:isasemimobilesourceofillumination.
Theapproximatefocallengthofthemirrorisaboutl0inches.
Themirrorisfuredovertherighteyeinsuchawaypartofthemirror
touchesthenose.
Theminorisadiustedwhilekeepingthelefteyeclosedandtheright
eyeiskeptopentofocus.Thenbotheyesareopenedwhile
examining.
7.Tonedecaytestisusedfor
a)Meinneirsdisease
b)Otosclerosis
c)Cochleardeafness
d)Sensoryneuraldeafness
e)Middleearperforation
CorrectAnswer-D
Answer-D.Sensoryneuraldeafness
ThresholdtonedecaytestisusedforretrocochleartypeofSNHL.
8.Allistrueaboutforeignbodyimpactionin
earexcept-
a)Objectslocatedmedialtoisthmusofcanalisdifficulttoremove
b)Syringingisusedforremovalofvegetativeforeignbody
c)Syringingusesroomtemperaturewater
d)Blunthookisusedtoremoveroundedforeignbody
e)GAispreferredinchildrentoremoveforeignbodies
CorrectAnswer-B
Answer-B.Syringingisusedforremovalofvegetativeforeign
body
Methodsofremovingaforeignbodyinclude:forcepsremoval,
syringingsuction,microscopicremovalwithspecialinstrumentsand
postauralapproach.
Foreignbodiesofvegetableoriginsuchasnuts,peasandbeans,
arehygroscopicandshouldnotbesyringed.
Noattemptsshouldbemadetoremovesmoothsphericalobjects
suchasbeadsbyforceps.
Beadswhichhaveadiameterlessthanthatoftheisthmuscanbe
syringed;largeronesarebetterremoved,withahook.
9.Allaretrueaboutepistaxisexcept:
a)Keisselbach'splexusissourcein90%cases
b)Ifanteriorpackingisleftinnoseformorethan48hrsantibiotic
coverageisgiven
c)Anteriornasalpackiseasytoinsertandlesstraumaticthan
balloontemponade
d)Trottermethodisfirstaidmethod
e)Cauteristaionisdoneinrefractorycasesundergeneral
anaesthesia
CorrectAnswer-C
Answer-C.Anteriornasalpackiseasytoinsertandless
traumaticthanballoontemponade
Keisselbach'splexus:Thisplexusisthecommonestsiteofbleeding
(90%ofcases)
Anteriornasalpacking-Prophylacticantibodiesshouldbeusedit
packisinaplaceformorethan24hours.
Aballoontamponademaybeusedasanalternativetoanterior
nasalpackingandThisislesstraumaticasitisbestsuitedfpr
epistaxis.
Trotter'smethod-Patientmayputinthesittingpositionwiththehead
bendingforwardswithmouthopen.
Nasalendoscopyassistedbipolarcauterizationundergeneral
anaesthesiamaybedonetocoagulatethebleederincase
ofepistaxlsisrefractorytoconservativemeasures.
10.TrueaboutSecretoryotitismedia:
a)TypeCtympanogrammaybeseeninearlystageofotitismedia
witheffusion
b)Flattympanogramispresent
c)Leadstoconductivedeafness
d)Presenceofcleftpalatereducesitschance
e)MostcommoncauseisEustachiantubedysfunction
CorrectAnswer-A:B:C:E
Answer-A,B,C,E,TypeCtympanogrammaybeseeninearly
stageofotitismediawitheffusion(B)Flattympanogramis
present(C)Leadstoconductivedeafness(E)Mostcommon
causeisEustachiantubedysfunction
Thisisaninsidiousconditioncharacterizedbyaccumulationofnon-
purulenteffusioninthemiddleearcleft.
Eustachiantube(ET)dysfunctionisconsideredthemajoretlologic
factorinthedevelopmentofmiddleeardisease.
TypeBtympanogram:Aflatordome-shaped,graph.Seeninmiddle
earfluidorthicktympanicmembrane.
TypeCtympanogram:SeeninEustachiantubeobstructionorearly
stageofotitismediawitheffusion.
Hearingloss-Hearinglossisofconductivetypeof20-40dB.
MalfunctioningofEustachiantube(causesincludepalataldefects
e.gcleftpalate,palatalparalysis)andincreasedsecretoryactivityof
middleearmucosa.
11.Whichcausereddishlesionontongue:
a)Medianrhomboidglossitis
b)Hairyleukoplakia
c)Lichenplanus
d)Geographictongue
e)Fordyce'sspots
CorrectAnswer-A:D
Answer-A,D,Medianrhomboidglossitis(D)Geographic
tongue
RedLesionsofOralCavitylesion-
Papillomas
Pemphigoid
Erythroplakia
Granular-celltumour
Epulides
Hemangioma
12.TrueStatementregardingwaxinear-
a)Syringingandinstrumentalmanipulationaregenerallydoneto
removeimpactedwax
b)Ifwaxishardandimpacted,ceromiilyticsubstancesisusedto
softenwax
c)Insyringingfluidisinjectedalongthelowerwallofthemeatus
d)Waxhasantibacterialproperty
e)None
CorrectAnswer-A:B:D
Answer-A,B,D,Syringingandinstrumentalmanipulationare
generallydonetoremoveimpactedwax(B)Ifwaxishardand
impacted,ceromiilyticsubstancesisusedtosoftenwax
(D)Waxhasantibacterialproperty
WaxhasacidicpHandisbacteriostaticandfungistatic.
Ifwaxistoohardandimpacted,toberemovedbysyringeor
instrument,itshouldbesoftenedbydropsof5%sodiumbicarbonate
inequalpartsofglycerineandwater.
Hydrogenperoxide,liquidparaffinoroliveoilmayalsoachieve
thesameresult.Commercialdropscontainingceruminolyticagent
paradichlorobenzene2%canalsobeused.
Waxisremovedeitherbyinstrumentalmanipulationorbysyringe.
Theauricleispulledupwardsandbackwardstostraightenoutthe
meatus,andthefluidisinjectedalongtheupperwallofthemeatus.
13.Trueaboutantrochoanalpolyp-
a)Startsasedemaofmaxillarysinusmucosa
b)Suppressedbysteroids
c)Comesoutviaaccessoryostiumandgrowsinthechoanaand
nasalcavity
d)Morecommoninadultsthanchildren
e)Commonlypresentsasunilateralnasalobstruction
CorrectAnswer-A:C:E
Answer-A,Startsasedemaofmaxillary...C,Comesoutvia
accessoryostium...E,Commonlypresentsasunilateral...
Age-Commoninchildren
Aetiology-Infection
Number-Solitary
Laterality-Unilateral
Origin-Maxillarysinusneartheostium
Growth-Growsbackwardstothechoana;mayhangdownbehind
thesoftpalate
Sizeandshape-Trilobedwithantral,nasalandchoanalparts.
Choanalpartmayprotrudethroughthechoanaandfillthe
nasopharynxobstructiongbothsides
Recurrence-Uncommon,ifremovedcompletely
Treatment-Polypectomy;endoscopicremovalorCaldwellLuc
operationifrecurrent.
14.Feature(s)ofperitonsillarabscess:
a)Foulbreath
b)Hotpotatovoice
c)Shiftingofuvulainoppositeside
d)Difficultyinswallowingevenownsaliva
e)Alwayspresentsasb/1severepaininthroat
CorrectAnswer-A:B:C:D
Answer-A,FoulbreathB,HotpotatovoiceC,Shiftingofuvulain
oppositesideD,Difficultyinswallowingevenownsaliva
Clinicalfeaturesaredividedinto:?
General:Theyareduetosepticaemiaandresembleanyacute
infection.
Theyincludefever(upto104?F),chillsandrigors,generalmalaise,
bodyaches,headache,nauseaandconstipation.
Local:
Severepaininthroat.Usuallyunilateral.
Odynophagia.Itissomarkedthatthepatientcannotevenswallow
hisownsalivawhichdribblesfromtheangleofhismouth.Patientis
usuallydehydrated.
Muffledandthickspeech,oftencalled"Hotpotatovoice".
Foulbreathduetosepsisintheoralcavityandpoorhygiene.
Ipsilateralearache.ThisisreferredpainviaCNIXwhichsupplies
boththetonsilandtheear.
Trismusduetospasmofpterygoidmuscleswhichareinclose
proximitytothesuperiorconstrictor.
15.Trueaboutspasmodicdysphonia-
a)Aneurologicalproblem
b)Mostlypsychogenicinorigin
c)Hyperadductionofvocalcordmaybeseen
d)Botulinumtoxinrelivesspasm
e)Speechtherapyisbeneficial
CorrectAnswer-A:C:D:E
Answer-A,C,D,E,Aneurologicalproblem(C)Hyperadduction
ofvocalcordmaybeseen(D)Botulinumtoxinrelivesspasm
(E)Speechtherapyisbeneficial
"spasmodicdysphoniaisaneurologicaldisorderaffectingthevoice
musclesinthelarynx,orvoicebox.
Etiologyisunknownbutltisusuallystress-related.
Botulinumtoxinlnjectionintothelaryngealmuscleshasbeentriedin
thetreamentofspasticdysphonia.
Voicetherapyisusefultoimprovevoiceonlywhencombinedwith
injection
16.Vocalcordissuppliedby-
a)Internallaryngealnerve
b)Superiorlaryngealnerve
c)Recurrentlaryngealnerve
d)Vagusnerve
e)Glossopharyngealnerve
CorrectAnswer-A:B:C:D
Answer-(A)Internallaryngealnerve(B)Superiorlaryngeal
nerve(C)Recurrentlaryngealnerve(D)Vagusnerve
Themaincranialnerveinnervatingthelarynxisthevagusnervevia
itsbranches;superiorlaryngealnerve(SLN)and
Recurrentlaryngealnerve(RLN).
Abovethevocalcordsthesensoryinnervationoflarynxisvia
internallaryngealnerve.
17.Inbilateralrecurrentlaryngealnerve
paralysis,whichofthefollowingis/areis
seen-
a)Paramedianvocalcord
b)Dyspneaisseen
c)Stridorisseen
d)Noeffectonvoice
e)Tracheostomymayberequired
CorrectAnswer-A:B:C:D:E
Answer-(A)Paramedianvocalcord(B)Dyspneaisseen
(C)Stridorisseen(D)Noeffectonvoice(E)Tracheostomymay
berequired
BilateralRLNparalysis(Bilateralabductorparalysis)-
Thisisthemostdangerousparalysisasboththecordsarein
medianorparamedianposition,obstructingtheairway.
Thereisdyspneaandstridor.
Treatment
Tracheostomy
Lateralizationofcord
Kashimaoperation
18.Trueabouttubercularotitismediaareall
except?
a)Spreadsthrougheustachiantube
b)Causespainlesseardischarge
c)Maycausemultipleperforations
d)Usuallyaffectsbothears
e)None
CorrectAnswer-D
Answer-D.Usuallyaffectsbothears
Tuberculosisofmiddleearisacomparativelyrareentityusually
seeninassociationwithorsecondarytopulmonarytuberculosis,
infectionreachesthemiddleearthrougheustachiantube.
Clinicalfeatures
Generally,tuberculosisofmiddleearisunilateral.
Itischaracterizedbypainlessotorrhoeawhichfailstorespondtothe
usualantimicrobialtreatment.Thereispainlesswateryotorrhea.
Singleormultipleperforationoftympanicmembrane.
19.Clinicalfeatureoffacialpalsyareall
except-
a)Lossofforeheadwrinkling
b)Difficultyinclosingeye
c)Lossoftastesensationfromtongue
d)Paralysisofstapediusmuscle
e)LossofGagreflexes
CorrectAnswer-A:B:C:D
Answer-(A)Lossofforeheadwrinkling(B)Difficultyinclosing
eye(C)Lossoftastesensationfromtongue(D)Paralysisof
stapediusmuscle
Weaknessofthemuscleofthefacialexpressionandeye
closure
1. Absenceofnasolabialfold
2. Widepalpablefissure
3. Epiphora
4. Droopingofangleofmouth
5. Lossofwrinklesofforehead
6. Thefacesagsandisdrawnacrosstotheoppositesideonsmiling.
7. Voluntaryeyeclosuremaynotbepossibleandcanproducedamage
20.Contraindicationofcochlearimplantation
is/are-
a)Mondinideformity
b)Intracochlearossification
c)Chronicsuppurativeotitismedia
d)Agenesisofcochlearnerve
e)All
CorrectAnswer-C:D
Answer-(C)Chronicsuppurativeotitismedia(D)Agenesisof
cochlearnerve
Absolute
1. Activemiddleearinfection:ASOM,CSOM,mastoiditis
2. Agenesisofcochleaand/orCochlearnerve
3. Mentalretardion:Patientcannotcooperatewithspeechtraining
21.Trueaboutschwartz'ssign-
a)Seeninoticcapsule
b)Indicatesactivedisease
c)SurgeryistheTreatment
d)Causessensory-neuraldeafness
e)Morecommoninpregnancy
CorrectAnswer-A:B:C:D:E
Answer-(A)Seeninoticcapsule(B)Indicatesactivedisease
(C)SurgeryistheTreatment(D)Causessensory-neural
deafness(E)Morecommoninpregnancy
Schwartz'ssign,alsoknownasFlemingo'sflushsignorRisingsun
signisbelievedtobeassociatedwithotopongiosiswhichisthe
activephaseofthedisease,usuallyinpregnancy.
Schwartz'ssignwhichreferstoareddishdiscolorationoverthe
Promontoryseenbeyondtheintacttympanicmembrane.
surgeryrernainsatherapeuticoption.
22.Whichofthefollowingis/aretrueabout
schwartzsign-
a)Signofinactivedisease
b)Indicationforsurgery
c)Morecommonduringpregnancy
d)Reddishhueoverthepromontory
e)Seenintheearlystagesoftheotoscelerosis
CorrectAnswer-B:C:D:E
Answer-(B)Indicationforsurgery(C)Morecommonduring
pregnancy(D)Reddishhueoverthepromontory(E)Seeninthe
earlystagesoftheotoscelerosis
Schwartzsign(Flemingo'sflushsign)-
In10%ofcasesflamingo-pinkblushisseenthroughthetympanic
membranecalledasSchwartzsign
Itisseeninearlyandactivestageofthedisease.
Thesignischaracterizedbypinkblushseenthroughthetympanic
membranecausedbyreddishhueoverpromontoryduetoincreased
vascularityofthepromontory.
ThissignindicatesactiveostosclerosisusuallyduringPregnancy
Itseemsthatthesurgeryremainsatherapeuticoption,whenthe
activephaseofthediseaseisstabilizedevenfollowingashort
courseofpharmacologicaltherapy.
23.Deformitiesoccurringinleprosypatients
is/are-
a)Faciesleonina
b)Lowsetear
c)Saddlenose
d)Lagophthalmos
e)Microganthia
CorrectAnswer-A:C:D
Answer-(A)Faciesleonina(C)Saddlenose(D)Lagophthalmos
Face-
Maskface,faciesleonina,Saddlenose,saggingface,
lagophthalmos,lossofeyebrows,perforatednose,depressednose,
eardeformities.
24.Whichofthefollowingis/aretrueabout
lefortsfracture
a)Itisfractureofzygomaticbone
b)MaycauseCSFrhinorrhea
c)Type1:completeseparationoffacialbonesformthecranial
bones
d)Classifiedastypes1to5
e)None
CorrectAnswer-B
Answer-B.MaycauseCSFrhinorrhea
LeFortI(transverse)-crosseslowerpartofnasalseptum,maxillary
antraandthepterygoidplates.
LeFortII(pyramidal)-passesthroughtherootofnose,lacrimal
bone,flooroforbit,upperpartofmaxillarysinusandpterygoidplates
LeFortIII(craniofacialdysjunction)-Thereiscompleteseparation
offacialbonesfromthecranialbones.
Clinicalfeaturesofmaxillaryfracture-
Malocclusionofteeth
Mobilityinthemaxilla
CSFrhinorrhoea.
25.Trueaboutforeignbodiesofairpassage
inchildrenexcept-
a)Vegetableforeignbodiesarenotcommon
b)Trachealobstructioncancausessuddendeath
c)Morecommoninrightbronchus
d)Morecommoninchildrenoflessthan4yrofage
e)CTscanofchestisdoneinallcases
CorrectAnswer-A:B:E
Answer-(A)Vegetableforeignbodiesarenotcommon
(B)Trachealobstructioncancausessuddendeath(C)More
commoninrightbronchus
Themostcommonagegroupis6monthsto4years.
Mostcommonforeignbodyaspiratedisnuts(peanuts).
Mostairwayforeignbodieslodgeinabronchus(rightmorethan
left).
Thechildpresentswithacuteonsetofcough-(most-common),
Chockinggagging,wheezing,respiratorydistress,aphonia,drooling
andstridor.
Bronchoscopyisdiagnosticaswellastherapeutic.
26.Trueaboutdevelopmentofcochlea
a)Cochleastartdevelopingfrom3rdweekofgestation
b)Semicircularcanalsdevelopaftercochlea
c)Cochleadevelopmentcompletesby20weekofgestation
d)Cochleadevelopmentcompletesat2yearofage
e)All
CorrectAnswer-A:C
Answer-A,Cochleastartdevelopingfrom3rdweekof
gestationC,Cochleadevelopmentcompletesby20weekof
gestation
Developmentofcochleastartsat3weeksandcompletesat20-22
weeksofintrauterinelife.
Semicircularcanaldevelopsearlierthancochlea.
27.Whichofthefollowingis/aretrueabout
theT-stageofmaxillarysinuscarcinoma-
a)StageT4a-frontalsinusinvolvement
b)StageT3-ethmoidsinusinvolvement
c)StageT2-sphenoidsinusinvolvement
d)StageT2-boneoftheposteriorwallofmaxillarysinus
e)None
CorrectAnswer-A:B
Answer-(A)StageT4a-frontalsinusinvolvement(B)StageT3-
ethmoidsinusinvolvement
T4a-Tumourinvadesanteriororbitalcontents,skinofcheek,
pterygoidplates,infratemporalfossa,cribiformplates,sphenoidor
frontalsinus.
T3-Tumourinvadesanyofthefollowing-boneoftheposteriorwall
ofmaxillarysinus,subcutaneoustissues,floorormedialwallorbit,
pterygoidfossaandethmoidsinuses.
T2-Tumourcausingboneerosionordestructionincludingextension
intothehardpalateandmiddlenasalmeatus,exceptextensionto
posteriorwallofmaxillarysinusandpterygoidplates.
28.TrueaboutReinke'soedema:
a)Usuallyunilateral
b)Commoninsmoker
c)Corticosteroidismainstayoftreatment
d)Involvewholeofmembranouspartofthevocalcords
e)Patienthaslowpitchvoice
CorrectAnswer-B:D:E
Answer-B,CommoninsmokerD,Involvewholeofmembranous
partofthevocalcordsE,Patienthaslowpitchvoice
Itisbilateralsymmetricalswellingofthewholeofmembranouspart
ofthevocalcords.
Thisisduetooedemaofthesubepithelialspace(Reinketspace)
ofthevocalcords.
Etiology-
Heavysmoking,
Chronicsinusitis&
Laryngopharyngealreflex
C/F-
Patientusesfalsecordsforvoiceproduction&thisgiveshimalow-
pitched&roughvoice.
Treatment-
Decorticationofthevocalcordsi.e.,removalofstripofepithelium,is
donefirstononeside&3-4weeksalterontheother.
29.Feature(s)ofScheibe'ssyndromeis/are:
a)Semicircularcanalfistula
b)Abnormalityinbonylabyrinth
c)Dysplasiaofcochlea
d)Middleearanaomaly
e)All
CorrectAnswer-C
Answer-C.Dysplasiaofcochlea
Itismostcommoninnerearanomaly.
Dysplasiaisseeninthecochlea&saccule;hencealsocalled
cochleosacculardysplasia.
Itisinheritedasanautosomalrecessivenonsyndromictrait.
30.Trueaboutnasopharyngealcarcinoma:
a)Level4cervicallymphnodenotinvolved
b)Radiotherapyistreatmentofchoice
c)Alsoc/aGuangdongtumour
d)MayassociatedwithU/Lotitismedia
e)AssociatedwithEBV
CorrectAnswer-A:B:C:D:E
Answer-A,Level4cervicallymphnodenot
involvedB,RadiotherapyistreatmentofchoiceC,Alsoc/a
GuangdongtumourD,MayassociatedwithU/Lotitis
mediaE,AssociatedwithEBV
Itismostlyseeninfifthtoseventhdecades.
Malesarethreetimesmorepronethanfemale.
Epstein-Barrvirusiscloselyassociatedwithnasopharyngeal
carcinoma.
DuetoobstructionofEustachiantube,thereisconductivehearing
loss,serousorsuppurativeotitismedia.
Radiotherapy:Itistreatmentofchoicefornasopharyngeal
carcinoma.
31.EvidencebasedtherapyofBell'spalsy
include(s):
a)Facialnervemassage
b)Facialnervestimulation
c)Steroid
d)Acyclovir
e)All
CorrectAnswer-C
Answer-C.Steroid
1.Medicaltreatment
Prednisolone(steroid)isthedrugofchoiceandisstartedatinitial
visit.Initiationoftherapyduringfirst24hoursofsymptomconfersa
higherlikelihoodofrecovery.
Antiviraltherapy(Acyclovir)isaneweradjunctintreatingacute
facialpalsyofviralorigin(bothBell'spalsyandRamsayhunt
syndrome).
Mostsurgeonsthesedaysadvocatecombinationofsteroidsand
antiviraldrugs.
32.ApersonhasvertigowithoutCNS
involvement.Causesis/are:
a)Perilymphfistula
b)Otolithiasis
c)Vestibularneuritis
d)Meniere'sdisease
e)Multiplesclerosis
CorrectAnswer-A:B:C:D
Answer-A,PerilymphfistulaB,OtolithiasisC,Vestibular
neuritisD,Meniere'sdisease
Peripheral(Lesionsofendorgansvestibularnerve)
Meniere'sdisease
Benignparoxysmalpositional
vertigo
Vestibularneronitis
Labyrinthitis
Vestibulotoxicdrugs
Headtrauma
Perilymphfistula
Syphilis
Acousticneuroma
33.WhichistrueaboutTuningforktestin
hearingloss:
a)Rinnetestisnegativeinconductivedeafness
b)Webertest-lateralizedtotheworstearinsensorineural
deafness
c)LateralizationofsoundinWebertestwithatunningforkof512
Hzimpliesaconductivelossof15-20dBinipsilateralear
d)NegativeRinnetestindicatesaminimumair-bonegapof15-20
dB
e)ARinnenegativeforallthethreetunningforksof256,512&
1024Hzindicatesair-bonegapof30-45
CorrectAnswer-A:C:D
Answer-(A)Rinnetestisnegativeinconductive
deafness(C)LateralizationofsoundinWebertestwitha
tunningforkof512Hzimpliesaconductivelossof15-20dBin
ipsilateralear(D)NegativeRinnetestindicatesaminimumair-
bonegapof15-20dB
RinneTest
Anegativetest(BC>AC)isseeninconductivedeafness.
NegativeRinneindicatesaminimumair-bonegapof15-20dB.
Apredictionofair-bonegapcanbemadeiftuningforksof256,512
&1024Hzareused
ARinnenegativeforallthethreetunningforksof256,512&1024
Hzindicatesair-bonegapof45-60dB
WeberTest-
Itislateralizedtotheworstearinconductivedeafness&tothe
betterearinsensorineuraldeafness.
34.Whichofthefollowingcauseslower
motorneuron(LMN)typeoffacialnerve
paralysis:
a)Bellpalsy
b)Parotidtumor
c)Guillain-Barresyndrome
d)Middlecerebralarteryinfarct
e)Multiplesclerosis
CorrectAnswer-A:B:C
Answer-(A)Bellpalsy(B)Parotidtumor(C)Guillain-Barre
syndrome
1.Idiopathic(Bell'spalsy)
Pregnancy-3xmorecommon.
Diabetesmellitus
2.lnfective
Herpesvirus
Herpeszoster(RamsayHuntsyndrome)
Epstein-Barrvirus
3.Neurological
Guillain-Barresyndrome.
Mononeuropathy-e.g.duetodiabetesmellitus,sarcoidosisor
amyloidosis
4.Parotidglandtumours.
35.Trueabouttympanometry:
a)Flatinossicculardiscontinuity
b)Astypeinotosclerosis
c)Domeshapedindicatesfluidinmiddleear
d)Adtypeinossicculardiscontinuity
e)Ctypeineustachiantubeobstruction
CorrectAnswer-B:C:D:E
Answer-(B)Astypeinotosclerosis(C)Domeshapedindicates
fluidinmiddleear(D)Adtypeinossicculardiscontinuity(E)C
typeineustachiantubeobstruction
A-Normal
As-Reducedcomplianceatambientpressure(otosclerosis).
's'standsforshallowtympanogrambutrememberforstiffness
AD-Increasedcomplianceatambientpressure(ossicular
discontinuity).'d'standsfordeepqrmpanogram.
B-Flatordome-shaped(fluidinmiddleear).
C-Maximumcomplianceatpressuresmorethan-200mmH2O
36.Trueaboutbilateralabductorparalysis:
a)Voiceisgood
b)Stridorispresent
c)Cordslieinabductedposition
d)Urgenttracheostomyisneeded
e)None
CorrectAnswer-A:B:D
Answer-A,VoiceisgoodB,StridorispresentD,Urgent
tracheostomyisneeded
Trecheostomy
Transyersecordotomy
Partialarytenoidectomy
Reinnervationprocedures
ThyroplastyII
Woodman'soperation(Externalarytenoidectomy)isdoneinb/l
abductorparalysis.
Endoscopiclaserarytenoidectomy&IsshikitypeIIthyroplastyis
doneforlateralizationofcoril(inbilateralabductorparalysis).
37.Allaretrueaboutmandiblefracture
except:
a)Condylarneckismostcommonsite
b)Malocclusionofteethmayoccur
c)Anteriorsuperioralveolarnerveismostcommonlyinjured
d)Panorexradiographsareusefulfordiagnosis
e)Malunion&non-unionarecomplications
CorrectAnswer-C
Answer-C.Anteriorsuperioralveolarnerveismostcommonly
injured
Thecondylarneckistheweakestpartofthemandibleand,isthe
mostfrequentsiteoffracture.
Traumatotheinferioralveolarnerveleadstopermanentnumbness
ofthelowerlipandteethontheaffectedside.
Fracturesofthecoronoidprocessofthemandiblecanresultin
trismus
Infractureofcondyle,displacedfragmentsleadstomalocclusionof
teeth&deviationofjawtotheoppositesideonopeningthemouth.
X-raysusefulinmandibularfracturesarePAviewoftheskull(for
condyle),right&leftobliqueviewofmandible&panorexview.
Condylarandsubcondylarmandiblefracturesaremostoftentreated
byIMFalone.
Delayedunionandnonunionoccurinapproximately3%offractures.
38.Trueaboutchronicsuppurativeotitis
media(CSOM):
a)Foulsmellingdischargeinatticoantralvariety
b)Facialnerveinvolvementintubotympanicvariety
c)Atticoantralvarietyisassociatewithcholestetoma
d)Maycausehearingloss
e)All
CorrectAnswer-A:C:D
Answer-(A)Foulsmellingdischargeinatticoantralvariety
(C)Atticoantralvarietyisassociatewithcholestetoma(D)May
causehearingloss
Types
Differencesbetweenatticoantralandtubotympanictypeof
CSOM
Tubotympanic(safe)
atticoantral(unsafe)
scantypurulentfoul
Discharge
profusemucoid
smell
Perforation
central
Marginal
Granulation
uncommon
Common
Polyp
Pale
Red,fleshy
Cholesteatoma Absent
Present
Complications Rare
Common
Mildtomoderateconductive Conductiveormixed
Audiogram
deafness
deafness
39.Trueaboutranula:
a)Mucousretentioncyst
b)Seeninfloorofmouth
c)Marsupializationforlargecyst
d)Parotidismostcommonsiteoforigin
e)Arisesfromsublingualsalivarygland
CorrectAnswer-A:B:C:E
Answer-(A)Mucousretentioncyst(B)Seeninfloorof
mouth(C)Marsupializationforlargecyst(E)Arisesfrom
sublingualsalivarygland
Itisathinwalledbluishretentioncyst.
Seeninthefloorofmouthononesideofthefrenulum.
Itarisesduetoobstructionofductofsublingualsalivarygland.
Itisalmostalwaysunilateral.
ClinicalFeatures
Seenmostlyinchildrenandyoungadults.
Onlycomplain--swellinginthefloorofmouth
Cystmayrupturespontaneouslybutrecurrenceiscommon
Treatmentiscompletesurgicalexcisionifsmallormarsupialization,
iflarge
40.Trueaboutgrommetinsertion:
a)Smallplastictubeaeratingmiddleear
b)Maximumdurationofgrommetinsertionis5month
c)Healingoccursmorequicklyafterextrusionthanafterremoval
d)Itisplacedanteriorlyontympanicmembrane
e)Surgeryisalwaysneededtoremoveit
CorrectAnswer-A:C:D
Answer-(A)Smallplastictubeaeratingmiddleear(C)Healing
occursmorequicklyafterextrusionthanafterremoval(D)Itis
placedanteriorlyontympanicmembrane
Ifagrommetisinserteditmaybeplacedposteriorlyoranteriorly
dependinguponthepreferenceofthesurgeon.
Thegrommetiseitherrejectedspontaneouslyormayberemoved,
preferablyunderananaatheticbecausethisismomentarilyPainful.
Atthesecondorcertainlyatthethirdmyringotomy,mostsurgeon
willinsertagrommet.
Tympanoscelerosisisseenmuchmorefrequentlyinchildren.
Extrusionofthetube,themajorityofiatrogenicTMperforationswill
heal.
41.TrueaboutVasomotorrhinitis:
a)Itisatypeofallergicreaction
b)Clinicallysimulatenasalallergy
c)Nasalmucosagenerallycongested&hypertrophic
d)Hypertrophyofinferiorturbinateiscommonlypresent
e)Anti-histaminics&oralnasaldecongestantareusedin
treatment
CorrectAnswer-B:C:D:E
Answer-(B)Clinicallysimulatenasalallergy(C)Nasalmucosa
generallycongested&hypertrophic(D)Hypertrophyofinferior
turbinateiscommonlypresent(E)Anti-histaminics&oral
nasaldecongestantareusedintreatment
Itisnonallergicrhinitisbutclinicallysimulatingnasalallergywith
symptomofnasalobstruction,rhinorrhoea(sneezing).
Allthetestsofnasalallergyarenegative
"VMR:Swelling(orhypertrophy)ofinferiorturbinateisfrequently
seen
Clinicfeatures-
Paroxysmalsneezingexcessiverhinorrhoea,nasalobstruction&
postnasaldrip
Nasalmucosaovertheturbinatesisgenerallycongested&
hypertrophic
Treatment-
anti-histaminics,oralnasaldecongestant;systemicsteroidSurgical
treatment:Relievingofnasalobstruction&vidianneurectomy.
42.
Structurespreservedinradicalneck
dissection-
a)Internaljugularvein
b)CarotidArtery
c)Accessorynerve
d)Brachialplexus
e)Sternocleidomastiodmuscle
CorrectAnswer-B:D
Answer-(B)CarotidArtery(D)Brachialplexus
Cervicallymphaticsandlymphnode
Internaljugularvein
Accessorynerve
Submandibulargland
Sternocleidomastiodmuscle
Tailofparotid
Omohyoidmuscle
43.FeatureofGranulomatosiswith
polyangiitis:
a)Nasalpolyp
b)PerforatedNasalseptum
c)Persistantsinus
d)Crustingofnasalmucosa
e)Collapseofnasalbridge
CorrectAnswer-B:C:D
Answer-(B)PerforatedNasalseptum(C)Persistantsinus
(D)Crustingofnasalmucosa
Granulomatosiswithpolyangiitis(Wegener)isadistinct
clinicopathologicentitycharacterizedbygranulomatousvasculitisof
theupperandlowerrespiratorytractstogetherwith
glomerulonephritis.
Disseminatedvasculitisinvolvingbothsmallarteriesandveinsmay
occur.
Nasalfindingsincludecrustinggranulations,septalperforation&a
saddlenose
Destructionoftheseptumwithacharacteristicimplosionofthenasal
bridge.
44.Trueaboutvestibularschwanomma:
a)U/1hearinglossiscommonpresentation
b)Mostlymalignant
c)MostcommontumourofCPangle
d)Sensorineuraldeafness
e)Uncapsulated
CorrectAnswer-A:C:D
Answer-(A)U/1hearinglossiscommonpresentation(C)Most
commontumourofCPangle(D)Sensorineuraldeafness
Benignencapsulated,extremelyslowgrowingtumors.
80%ofallCerebello-pontineangletumors.
Earliestsymptoms-Unilateralsensorineuraldeafness.
Thethreemostcommonpresentingsymptomsincludeinsidious
hearingloss,high-pitchedtinnitus,anddisequilibrium.
Superiordivisionofvestibularnerve?mostcommonsiteofAN.
45.Tensorofvocalcordincludes:
a)Arytenoid
b)Thyroarytenoid
c)Interarytenoid
d)Posteriorcricoarytenoid
e)Cricothyroid
CorrectAnswer-E
Answer-E.Cricothyroid
MuscleofLarynx-
AbductorPosteriorcricoarytenoid
Adductor(3musclegiveninDhingra):Lateralcricoarytenoid,
Interarytenoid(Transversethyroarytenoid)
TensorCricothyroid&vocalis
AllmuscleoflarynxaresuppliedbyRecurrentLaryngealnerves.
ThelatterreceiveitsinnervationfromExternalLaryngealnerve.
Sensory-
Abovevocalcords-InternalLaryngealnerveabranchofSuperior
Laryngealnerve.
Belowvocalcords-RecurrentLaryngealnerve
46.Allaretrueaboutvocalcordnodule
except:
a)Causedbyphonotrauma
b)CommonlyoccuratJunctionofmiddle&posterior1/3
c)CommonatjunctionofA1/3withP2/3
d)Commoninteachers
e)Treatmentisspeechtherapy
CorrectAnswer-B
Answer-B.CommonlyoccuratJunctionofmiddle&posterior
1/3
Vocaltraumawhenpersonspeaksinunnaturallowtonesfor
prolongedperiodsorathighintensities.
Patientscomplainsofhoarseness.
Vocalfatigue&painintheneckonprolongedphonationareother
commonsymptoms.
Theymostlyaffectteachers,actors,vendorsorpopsingers
Surgeryisrequiredforlargenodulesornodulesoflongstandingin
adults.
Speechtherapy&re-educationinvoiceproductionareessentialto
preventtheirrecurrence.
Theyappearsymmetricallyonthefreeedgeofvocalcord,atthe
junctionofanteriorone-third,withtheposteriortwo-third.
47.Trueaboutallergicfungalsinusitis:
a)Fungalhyphaeispresentinallergicmucinwhichispathological
hallmark
b)Invasionofthesinusmucosawithfungus
c)Allergicreactiontofungus
d)Antifungaltreatmentleadtoimprovementofsymptom
e)Surgicalclearanceismainstayoftreatment
CorrectAnswer-A:C:E
Answer-(A)Fungalhyphaeispresentinallergicmucinwhichis
pathologicalhallmark(C)Allergicreactiontofungus
(E)Surgicalclearanceismainstayoftreatment
Itisanallergicreactiontothecausativefungus&presentswith
sinunasalpolyposis&mucin.
Thereisnoinvasionofthesinusmucosawithfungus.
Usuallymorethanonesinusareinvolvedononeorbothsides.
Featuresofrefractorysinusitisandnasalpolyposisarepresent.
aGellandCoombstypeI(lgE-mediated)immuneresponseto
fungalantigens.TypeIIIandIVimmuneresponsesmayalsobe
involved.
Itconsistofconsistingofeosinophils,Charcot-Leydencrystals,and
scatteredfungalhyphae.
Diagnosis
CTscanshowsmucosalthickeningwithhyperdenseareas
ThediagnosisofAFSisconfrmedbydemonstrationofallergic
mucinandcultureofthefungus.
Treatment-
Surgicaldebridementandaerationoftheinvolvedsinusfollowedby
theuseofsystemicandtopicalintranasalcorticosteroids.
theuseofsystemicandtopicalintranasalcorticosteroids.
48.Trueaboutconductivehearingloss:
a)Presbycusis
b)Cholestetoma
c)Acousticneuroma
d)Perforationoftympanicmembrane
e)Serousotitismedia
CorrectAnswer-B:D:E
Answer-(B)Cholestetoma(D)Perforationoftympanic
membrane(E)Serousotitismedia
Causedbyanydiseaseprocessinterferingwithconductionofsound
fromtheexternaleartothestapedio-vestibularjoint.
CommonestcauseofhearinglossinchildrenisChronicsecretory
otitismedia.
Perforationoftympanicmembrane.
Disruptionofossicles-traumatoossicularchain,CSOM,
cholesteatoma
Fixationofossicles-otosclerosis,tympanosclerosis
Eustachiantubeblockage
49.TrueaboutAndyGumpdeformity:
a)Occursduedefectsoftheanteriormandibulararch
b)Hemimandibulectomycancause
c)Marginalmandibulectomycancause
d)Treatmentisadequatereconstructionofanteriormandibular
archwithplate&graft
e)None
CorrectAnswer-A:B:D
Answer-(A)Occursduedefectsoftheanteriormandibulararch
(B)Hemimandibulectomycancause(D)Treatmentisadequate
reconstructionofanteriormandibulararchwithplate&graft
Analteredfacialprofileduetoamisinglowerjawbone,ormandible
Resectionoftheanteriormandibulararchproducesthe"Andy
Gump"deformity.
Causes
Marginalmandibulectomy
Segmentalmandibulectomy
Archpreservingmandibulectomy
Hemimandibulectomy
50.Foreignbodyintrachea&bronchuscan
cause:
a)Bronchiectasis
b)Atelectasis
c)Subcutaneousemphysema
d)Pneumothorax
e)All
CorrectAnswer-A:B:C:D
Answer-(A)Bronchiectasis(B)Atelectasis(C)Subcutaneous
emphysema(D)Pneumothorax
Trachea-
Choking,stridor,wheeze,cough,palpatorythud,audibleslap.
Bronchi-
Cough,wheeze&diminishedairentrytolungformsatriad
Respiratorydistresswithswellingofforeignbody
Lungcollapse,emphysemo,pneumonitis,bronchiectosisorlung
obscessarelatefeature.
51.Notselfretaininghandheldretractor(s)
is/are:
a)Mollison'smastoidretractor
b)Jansen'smastoidretractor
c)Lempert'sendauralretractor
d)DavisRetractor
e)All
CorrectAnswer-D
Answer-D.DavisRetractor
Theseretractorsdonotneedanassistanttoholdtheminplace.
Itholdtissueapartandlockitinplace.
Handheldretractor-
HohmannRetractor
LaheyRetractor
SennRetractor
Blair(Rollet)Retractor
RigidRake
FlexibleRake
RagnellRetractor
Linde-RagnellRetractor
DavisRetractor
52.Trueaboutcroup:
a)CausedbyH.influenzae
b)X-rayPAviewshowssteeplesignofsubglotticnarrowing
c)Stridorispresent
d)Supraglotticedemaispresent
e)Commonlypresentin6month-3yearagegroup
CorrectAnswer-A:B:C:E
Answer-(A)CausedbyH.influenzae(B)X-rayPAviewshows
steeplesignofsubglotticnarrowing(C)Stridorispresent
(E)Commonlypresentin6month-3yearagegroup
Croup(Laryngotracheobronchitis)
Laryngotracheobronchitisisthemostcommoninfectiouscauseof
obstructioninchildrenusuallyoccurringbetweentheagesof6
monthsand3years.
Malechildren(boys)arecharacteristicallymorefrequentlyinvolved
thanfemales(girls)
Etiology
ItisaviralinfectionmostfrequentlycausedbyParainfluenzavirus.
Pathology
Themostcharacteristicpathologicalfeatureisedemaformationin
thesubglotticarea.
Presentation
Gradualonsetwithaprodromeofupperrespiratorysymptoms
Hoarsenessandbarkingcough(croupycough)
Stridor(initiallyinspiratorythanbiphasic)
Feverisusuallylowgrade(orabsent)althoughmayoccasionallybe
highgrade
Droolingsischaracteristicallyabsentandthereisnodysphagia
(seeninepiglottitis)
Imaging(Xray)
Symmetric'steeple'or'funnelshaped'narrowingofthesubglottic
region(steeplesign)
Hypopharyngealwideningordistension
Normalepiglottisandaryepiglotticfolds
53.Whichofthefollowingstatement(s)is/are
trueaboutlabyrinthitis:
a)Initiallyquickcomponentofnystagmusoccurtowarddiseased
earbutinlaterstageshifttowardhealthyear
b)Mayoccurasacomplicationofchronicsuppurativeottitismedia
c)Resolvespontaneouslyin1-6wk
d)Medicaltreatmentaloneissufficient
e)Vertigomaybepresent
CorrectAnswer-A:B:E
Answer-(A)Initiallyquickcomponentofnystagmusoccur
towarddiseasedearbutinlaterstageshifttowardhealthyear
(B)Mayoccurasacomplicationofchronicsuppurativeottitis
media(E)Vertigomaybepresent
Thisisacommoncomplicationofotitismedia.
Therearethreetypesr
Circumscribed(fistulaoflabyrinth)
Diffuseserous&
Diffusesuppurativelabyrinthitis
Mildcasecomplainofvertigo&nausea.
Surgicaltreatmentincludes:Myringotomy
54.TrueaboutMobiussyndrome:
a)10thCNinvolvement
b)7thCNinvolvement
c)Abductiondefect
d)Esotropia
e)6thCNinvolvement
CorrectAnswer-B:C:D:E
Answer-(B)7thCNinvolvement(C)Abductiondefect
(D)Esotropia(E)6thCNinvolvement
"Itischaracterizedbybilateralfacialweakens(i.eVIICN),whichis
oftenassociatedwithabducensnerveparalysis(i.e.VICN)
Facialpalsyiscommonlybilateral,frequentlyasymmetric.
Ectropion,epiphora,andexposurekeratopathymaydevelop.
Theabductiondefectmaybeunilateralorbilateral.
ThecranialnervesVandVIIIareaffected.
Esotropiaiscommon.
Surgicalcorrectionoftheesotropiaisindicated
55.TrueaboutEthmoidalsinus:
a)Fullydevelopedby25yr
b)Consistsof3-18sinusoneachside
c)Absentatbirth
d)Laminapapyraceaseparatefromorbit
e)Anteriorethmodalgroupcells-openintosuperiormeatus
CorrectAnswer-B:D
Answer-(B)Consistsof3-18sinusoneachside(D)Lamina
papyraceaseparatefromorbit
Ethmoidalcellsaredividedintoanteriorethmoidalgroupwhich
apeasintothemiddlemeatus&posteriorethmoidalgroup.
Presentatbirth
Reachadultsizeby12years
Theirnumbervariesfrom3to18
Thethinpaperlikelaminaofbone(laminapapyracea)separatingair
cellsfromtheorbit.
56.Allaretrueaboutnasopharyngealfibroma
except:
a)Mostcommonageofpresentationis20-50yr
b)Radioresistanttumour
c)Highlyvascular
d)Benigninnature
e)Surgeryistreatmentofchoice
CorrectAnswer-A:B
Answer-(A)Mostcommonageofpresentationis20-50yr
(B)Radioresistanttumour
Itisararetumour,thoughitisthecommonestofallbenigntumours
ofnasopharynx
Itislocallyinvasive&destroystheadjoiningstructures
Tumourisseenalmostexclusivelyinmalesinagegroupof10-20
years.
Rarely,itmaybeseeninolderpeople&females
Mostcommonpresentation:profuse6recurrentepistaxis
Itismadeupofvascular&fibroustissue.Mostly,thevesselsare
justendothelium-linedspaceswithnomusclecoat
Surgicalexcisionisnowthetreatmentofchoice
Radiotherapyhasbeenusedasaprimarymodeoftreatment
57.Complicationofmodifiedradical
mastoidectomyinclude(s):
a)Conductivehearingloss
b)Facialnerveinjury
c)Changeintastesensation
d)Sensoryhearingloss
e)All
CorrectAnswer-E
Answer-E.All
Facialparalysis
Perichondritisofpinna
Injurytoduraorsigmoidsinus
Labyrinthitis,ifstapesgetsdisclosed
Severeconductivedeafnessof50dBormore.Thisisdueto
removalofallossicla&tympanicmembnne
Cavityproblems
58.Whichofthefollowingfeature(s)of
rhinoscleromais/aretrueexcept:
a)Atrophyofnasalmucosa
b)Causedbyfungus
c)Treatmentbyantifungaldrug
d)Causedbybacteria
e)Causativeorganismmaybeculturedfrombiopsymaterial
CorrectAnswer-B:C
Answer-(B)Causedbyfungus(C)Treatmentbyantifungaldrug
Rhinoscleromaisarare,slowlyprogressinggranulomatousdisease
oftheupperrespiratorytractcausedbyKlebsiellarhinoscleromatis.
Nasaldiseasepresentswiththreetypicalstages:(1)catarrhal(2)
proliferative(3)cicatrical.
Rhinoscleromamaybefoundinallagegroups,buttypicallyyoung
adults20?30yearsoldaremostfrequentlyaffected.
Airbornetransmissioncombinedwithpoorhygiene,crowdedliving
conditions,andpoornutritioncontributestoitsspread.
Bothstreptomycin&tetracyclinearegiventogether
59.Whichofthefollowingistrueregarding
mandibularfracture:
a)Inferioralveolarnervedamagemayoccur
b)Panorexradiographisveryhelpfulinmanagement
c)Ramusisthemostcommonsiteoffracture
d)Condylarfracturehealsspontaneously&requirenoactive
intervention
e)Condylarfractureismostcommonsite
CorrectAnswer-A:B:E
Answer-(A)Inferioralveolarnervedamagemayoccur
(B)Panorexradiographisveryhelpfulinmanagement
(E)Condylarfractureismostcommonsite
Condylarprocessfracturesofthemandiblearemostcommon.
Clinicalfeatures
Pain,Swelling,Deformitywithtrismusormalocclusionofteeth.
ManyPatientswithmandibularfracturesexperiencetraumatothe
inferioralveolarnerve.
Treatment:
Thefractureisreducedandfixedby:
ClosedreductionorOpenreduction.
60.Trueaboutchoanalatresia:
a)Unilateralatresiashouldbeoperatedwithin6monthofage
b)Occurd/tpersistenceofbucconasalmembrane
c)B/1atresiausuallypresentswithrespiratorydifficulties
d)Bilateralatresiamaycausecyanosis
e)Diagnosedbyfailuretopassacatheterfromnosetopharynx
CorrectAnswer-B:C:D:E
Answer-(B)Occurd/tpersistenceofbucconasalmembrane
(C)B/1atresiausuallypresentswithrespiratorydifficulties
(D)Bilateralatresiamaycausecyanosis(E)Diagnosedby
failuretopassacatheterfromnosetopharynx
Choanalatresiaisanabnormalityofcanalizationduring
developmentofthenasalpassages.
Itinvolvesboneand/orsofttissueandmayresultineitherpartial
(choanalstenosis)orcompleteobstructionoftheposteriornasal
airway.
Themostwidelyacceptedmechanismforthedevelopmentof
choanalatresiaisthepersistenceofthebucconasalmembrane
beyondthesixthweekofgestation.
ChoanalatresiaisassociatedwithCHARGEsyndrome:Coloboma
ofeye,Heartdefects,ChoanalAtresia,Retardedgrowth,Genital
defectsandEardefects.
B/LatresiaPresentswithrespiratoryobstructionasthenewborn
laterdevelopscyanosis.
Operativecorrectionofunilateralobstructionmaybedifferedfor
severalyears.
61.Stridoris/arecausedbyallexcept:
a)Vocalcordpalsy
b)Stenosisaftertracheostomy
c)Ludwigangina
d)Retropharyngealabscess
e)None
CorrectAnswer-E
Answer-None
Itisnoisyrespirationproducedbyturbulentairflowthroughthe
narrowedairpassage.
Inspiratorystridor:Oftenproducedinobstructivelesionsof
supraglottisorpharynx
Expiratorystridor:Itisproducedinlesionsofthoracictrachea,
primary&secondarybronchi
Biphasicstridor:Itisseeninlesionsofglottis,subglottis&cervical
trachea
62.TobyAyer'stestis/areusedfor:
a)CSFrhinorrhoea
b)Lateralsinusthrombosis
c)Sigmoidsinusthrombosis
d)Tocheckpatencyofeustachiantube
e)None
CorrectAnswer-B:C
Answer-(B)Lateralsinusthrombosis(C)Sigmoidsinus
thrombosis
TheTobey?Ayertestisusedforlateralsinusthrombosisby
monitoringcerebrospinalfluidpressureduringalumbarpuncture.
Tobey-Ayertest&Crowe-Becktestareperformedinlateralsinus
thrombosis(Sigmoidsinusthrombosis)
63.Trueaboutpresbycusis:
a)DegenerationofouterHaircelloforganofCortiinsensorytype
b)Highfrequencyisaffectedfirstinsensorytype
c)Canbetreatedwithhearingaids
d)Usuallyunilateralhearinglossoccurs
e)None
CorrectAnswer-A:B:C
Answer-(A)DegenerationofouterHaircelloforganofCortiin
sensorytype(B)Highfrequencyisaffectedfirstinsensorytype
(C)Canbetreatedwithhearingaids
Presbycusis,orage-relatedhearingloss,isthecumulativeeffectof
agingonhearing.
Itisaprogressiveandirreversiblebilateralsymmetricalage-related
sensorineuralhearinglossresultingfromdegenerationofthe
cochleaorassociatedstructuresoftheinnerearorauditorynerves.
Patientsofpresbycusiscanbehelpedbyahearingaid.
64.Trueaboutpuretoneaudiometry:
a)Thefrequencytestedis2000-9000Hz
b)Doneinsilentroom
c)Airconductionforrightearisrepresentedonaudiogramby
symbol'X'
d)Airconductionforleftearisrepresentedonaudiogramby
symbol'0'
e)All
CorrectAnswer-B
Answer-(B)Doneinsilentroom
Inasoundproofroom,thepatient'sabilitytohearpuretonesinthe
frequencyrangeofabout125to8000Hzismeasured.
Red"O"representsairconductionfortherightearwhileblue"X"
representsairconductionfortheleftear.
65.AllaretrueaboutMeniere'sdisease
except:
a)Triadofrecurrentvertigo,fluctuatingsensorineuralhearingloss,
andtinnitusarefound
b)Treatmentconsistsofuseofthiazide
c)Dropattackoccurs
d)Onsetonlyafter>50year
e)None
CorrectAnswer-D
Answer-(D)Onsetonlyafter>50year
Meniere'sdiseaseisadiseaseoftheinnerear,characterizedbythe
clinicaltriadofrecurrentvertigo,fluctuatingsensorineuralhearing
loss,andtinnitus.
Diseaseisseenintheagegroupof35-60years.
Malesareaffectedmorethanfemales.
Thetinnitusisusuallylow-pitchedandroaring&isaggravated
duringacuteattacks.
AuralfullnessisamanifestationalwayspresentinMeniere'sattack.
Patientswithseverehydropsshouldbetreatedwithdiuretics,salt
restriction.
66.Whichofthefollowingistrue?
a)Internallaryngealnerve:supplycricothyroidmuscle
b)Internallaryngealnerve-sensorysupplybelowvocalcord
c)Internallaryngealnerve-tensevocalcord
d)Externallaryngealnerve-tensevocalcord
e)Internallaryngealnerve-sensorysupplyabovevocalcord
CorrectAnswer-D:E
Answer-(D)Externallaryngealnerve-tensevocal
cord(E)Internallaryngealnerve-sensorysupplyabovevocal
cord
Allthemusclewhichmovethevocalcords(abductors,adductorsor
tensor)aresuppliedbyRecurrentLaryngealnerve.
Abovevocalcords-InternalLaryngealnerveabranchofSuperior
Laryngealnerve
Belowvocalcords-RecurrentLaryngealnerve
Cricothyroidmuscle-ExternalLaryngealnerve
67.Whichofthefollowingis/aretrueabout
posteriorepistaxis:
a)Posteriorpackingisdone
b)Oftenduetochronichypertension
c)Persistentcase-ligationofanteriorethmoidalartery
d)Severebleedingincomparisonwithanteriorepistaxis
e)Morecommonlyoccurinelderly
CorrectAnswer-A:B:D:E
Answer-(A)Posteriorpackingisdone(B)Oftenduetochronic
hypertension(D)Severebleedingincomparisonwithanterior
epistaxis(E)Morecommonlyoccurinelderly
Itislesscommon.
Itismostlyseenfromposterosuperiorpartofnasalcavity.
Seenafter40yearsofage
Causedduetohypertensionorarteriosclerosis
Featuresshowbleedingissevere
Treatedbypostnasalpackoftenrequired
This post was last modified on 11 August 2021