Download PGI PG 2020 May ENT Solved Question Paper

1.TrueregardingMondini'sdiseaseis/are?
a)Innerearmalformation
b)Predisposestorecurrentmeningitisinchildren
c)Mostlyoccursasanisolatedentity
d)MaybeassociatedwithPenderdandDiGeorgesyndromes

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e)Cochlearimplantsareusedintreatment
CorrectAnswer-A:B:C:D:E
Answer-A,B,C,D,E
Itisanabnormalityoftheinnerearthatisassociatedwith
sensorineuralhearingloss.

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Mondinidysplasiacanalsopredisposetorecurrentmeningitis.
Mondinidysplasiausuallyoccurssporadicallyasanisolated
abnormalitybutitcanbeassociatedwithavarietyofsyndromes
includingKlippelFeilsyndrome,Pendredsyndrome,DiGeorge
syndrome,Wildervancksyndrome,Fountainsyndrome,Johanson-

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Blizzardsyndrome.
Treatmentincludessurgerytorepairthedefecttopreventrecurrent
meningitis,prophylacticantimicrobialtherapyandconjugate-
pneumococcalvaccination,hearingamplificationaids&cochlear
implants.

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2.Trueregardingrhinitismedicamentosa
is/are?
a)Causedby132-agonistsprays
b)Causedbycorticosteroidsspray
c)Sprayitselfcancauseterbinatehypertrophy

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d)Thereisinferiorterbinatehypertrophy
e)Redmucosaischaracteristic
CorrectAnswer-D
Answer-D.Thereisinferiorterbinatehypertrophy
Itisaconditioncharacterizedbynasalcongestionthatistriggered

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bytheextendeduseoftopicaldecongestantsandcertainoral
medicationsthatconstrictbloodvesselsintheliningofthenose:
recreationaluseofintranasalcocainemaltalsocauseasimilar
condition.
TheclassicPresentationisthatthenasalmucousmembranes

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appear"beefy-red,"inflamed,andmayshowareasofpunctate
bleedingandscantmucus.
TheswellingofthenasalPassagescausedbyreboundcongestion
mayeventuallyresultinpermanentturbinatehypertrophy.
ToPicalintranasalcorticosteroidsaPPeartohavebeneftinrhinitis

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medicamentosatocontroltheinflammationcausedbychronic
vasoconstrictoruse.

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3.TrueregardingCald-Well-Lucsurgery
is/are?
a)Approachformaxillaryantrum

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b)Antrostomythroughinferiormeatus
c)SublabialApproachleadingtoopeningofmandibularantrum
d)Openingofmaxillaryantrumthroughgingivolabialapproach
e)Openingthemaxillaryantrumthroughcaninefossa
CorrectAnswer-A:B:D:E

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Answer-A,B,D,E
Caldwell-Lucoperationisaprocessofopeningthemaxillaryantrum
(maxillarysinusthroughcaninefossabysublabialapproachand
dealingwiththepathologyinsidetheantrum.
Antrumisreachedthroughanincisioningingivolabialsulcus.

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Duringthesurgeryanoso-antralwindowismade(antrostomy)
throughtheinferiormeatus.

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4.Trueregardingotosclerosisis/are?
a)Morecommoninmen
b)Involvesstapes/ovalwindow

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c)Flamingopinkhuebehindeardrum
d)Carhart'snotchisat4000Hz
e)Hearsbetterinnoisyenvironment
CorrectAnswer-B:C:E
Answer-B,C,E

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Inotosclerosis-50%caseshavepositivefamilyhistory.
Femalesareaffectedmorethanmales.
Bilateralconductivedeafnessseeninotosclerosisisnotirreversible
asitcanbesuccessfullytreatedbystapedectomy/Stapedotomy.
Sensorineuralhearinglossoccurswhenlaterinthecourseoftime

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osteoscleroticfocusreachesthecochlearendosteumbutactually
mostcommonhearinglossseenisconductivetype.
Carhartsnotchisseeninboneconductioncurveat2000Hz.

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5.Clinicalfeaturesofzygomaticfracture
include?

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a)Hypoesthesiaalongthedistributionofinfra-orbitalnerve
b)Flatface
c)Malocclusionofteeth
d)Flatteningofmalarprominences
e)Stepdeformity

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CorrectAnswer-A:D:E
Answer-A,D,E
Clinicalfeaturesofzygomafracture
Considerableswellingoverzygomaticarchiscommonandmakes
clinicaldiagnosismoredifficult.

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Flatteningofmalarprominence.
Step-deformityofinfraorbitalmargin.
Anaesthesiainthedistributionofinfraorbitalnerve.
Trismus.
Thecheekmayappearflattened;comparedsymmetrywiththe

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oppositeside.

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6.Trueregardingtheuseofheadmirror
is/are?
a)Appliedonrighteye
b)Focalpointshouldbewithin6inches

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c)Oneeyeshouldbeclosedwhileexamining
d)Botheyeshouldbeopenwhilefocusing
e)Alloftheabove
CorrectAnswer-A
Answer-A.Appliedonrighteye

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Twotypesofilluminationisusedinotolaryngologcial
examination:
1. SemimobileilluminationliketheBull'slamp
2. MobileilluminationliketheClair'sheadlight,orcoldlightbased
headbands.

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Bull'slamp:isasemimobilesourceofillumination.
Theapproximatefocallengthofthemirrorisaboutl0inches.
Themirrorisfuredovertherighteyeinsuchawaypartofthemirror
touchesthenose.
Theminorisadiustedwhilekeepingthelefteyeclosedandtheright

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eyeiskeptopentofocus.Thenbotheyesareopenedwhile
examining.

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7.Tonedecaytestisusedfor
a)Meinneirsdisease
b)Otosclerosis

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c)Cochleardeafness
d)Sensoryneuraldeafness
e)Middleearperforation
CorrectAnswer-D
Answer-D.Sensoryneuraldeafness

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ThresholdtonedecaytestisusedforretrocochleartypeofSNHL.

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8.Allistrueaboutforeignbodyimpactionin
earexcept-
a)Objectslocatedmedialtoisthmusofcanalisdifficulttoremove
b)Syringingisusedforremovalofvegetativeforeignbody

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c)Syringingusesroomtemperaturewater
d)Blunthookisusedtoremoveroundedforeignbody
e)GAispreferredinchildrentoremoveforeignbodies
CorrectAnswer-B
Answer-B.Syringingisusedforremovalofvegetativeforeign

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body
Methodsofremovingaforeignbodyinclude:forcepsremoval,
syringingsuction,microscopicremovalwithspecialinstrumentsand
postauralapproach.
Foreignbodiesofvegetableoriginsuchasnuts,peasandbeans,

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arehygroscopicandshouldnotbesyringed.
Noattemptsshouldbemadetoremovesmoothsphericalobjects
suchasbeadsbyforceps.
Beadswhichhaveadiameterlessthanthatoftheisthmuscanbe
syringed;largeronesarebetterremoved,withahook.

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9.Allaretrueaboutepistaxisexcept:
a)Keisselbach'splexusissourcein90%cases
b)Ifanteriorpackingisleftinnoseformorethan48hrsantibiotic
coverageisgiven
c)Anteriornasalpackiseasytoinsertandlesstraumaticthan

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balloontemponade
d)Trottermethodisfirstaidmethod
e)Cauteristaionisdoneinrefractorycasesundergeneral
anaesthesia
CorrectAnswer-C

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Answer-C.Anteriornasalpackiseasytoinsertandless
traumaticthanballoontemponade
Keisselbach'splexus:Thisplexusisthecommonestsiteofbleeding
(90%ofcases)
Anteriornasalpacking-Prophylacticantibodiesshouldbeusedit

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packisinaplaceformorethan24hours.
Aballoontamponademaybeusedasanalternativetoanterior
nasalpackingandThisislesstraumaticasitisbestsuitedfpr
epistaxis.
Trotter'smethod-Patientmayputinthesittingpositionwiththehead

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bendingforwardswithmouthopen.
Nasalendoscopyassistedbipolarcauterizationundergeneral
anaesthesiamaybedonetocoagulatethebleederincase
ofepistaxlsisrefractorytoconservativemeasures.

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10.TrueaboutSecretoryotitismedia:

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a)TypeCtympanogrammaybeseeninearlystageofotitismedia
witheffusion
b)Flattympanogramispresent
c)Leadstoconductivedeafness
d)Presenceofcleftpalatereducesitschance

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e)MostcommoncauseisEustachiantubedysfunction
CorrectAnswer-A:B:C:E
Answer-A,B,C,E,TypeCtympanogrammaybeseeninearly
stageofotitismediawitheffusion(B)Flattympanogramis
present(C)Leadstoconductivedeafness(E)Mostcommon

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causeisEustachiantubedysfunction
Thisisaninsidiousconditioncharacterizedbyaccumulationofnon-
purulenteffusioninthemiddleearcleft.
Eustachiantube(ET)dysfunctionisconsideredthemajoretlologic
factorinthedevelopmentofmiddleeardisease.

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TypeBtympanogram:Aflatordome-shaped,graph.Seeninmiddle
earfluidorthicktympanicmembrane.
TypeCtympanogram:SeeninEustachiantubeobstructionorearly
stageofotitismediawitheffusion.
Hearingloss-Hearinglossisofconductivetypeof20-40dB.

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MalfunctioningofEustachiantube(causesincludepalataldefects
e.gcleftpalate,palatalparalysis)andincreasedsecretoryactivityof
middleearmucosa.

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11.Whichcausereddishlesionontongue:
a)Medianrhomboidglossitis

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b)Hairyleukoplakia
c)Lichenplanus
d)Geographictongue
e)Fordyce'sspots
CorrectAnswer-A:D

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Answer-A,D,Medianrhomboidglossitis(D)Geographic
tongue
RedLesionsofOralCavitylesion-
Papillomas
Pemphigoid

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Erythroplakia
Granular-celltumour
Epulides
Hemangioma

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12.TrueStatementregardingwaxinear-

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a)Syringingandinstrumentalmanipulationaregenerallydoneto
removeimpactedwax
b)Ifwaxishardandimpacted,ceromiilyticsubstancesisusedto
softenwax
c)Insyringingfluidisinjectedalongthelowerwallofthemeatus

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d)Waxhasantibacterialproperty
e)None
CorrectAnswer-A:B:D
Answer-A,B,D,Syringingandinstrumentalmanipulationare
generallydonetoremoveimpactedwax(B)Ifwaxishardand

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impacted,ceromiilyticsubstancesisusedtosoftenwax
(D)Waxhasantibacterialproperty
WaxhasacidicpHandisbacteriostaticandfungistatic.
Ifwaxistoohardandimpacted,toberemovedbysyringeor
instrument,itshouldbesoftenedbydropsof5%sodiumbicarbonate

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inequalpartsofglycerineandwater.
Hydrogenperoxide,liquidparaffinoroliveoilmayalsoachieve
thesameresult.Commercialdropscontainingceruminolyticagent
paradichlorobenzene2%canalsobeused.
Waxisremovedeitherbyinstrumentalmanipulationorbysyringe.

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Theauricleispulledupwardsandbackwardstostraightenoutthe
meatus,andthefluidisinjectedalongtheupperwallofthemeatus.

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13.Trueaboutantrochoanalpolyp-
a)Startsasedemaofmaxillarysinusmucosa
b)Suppressedbysteroids

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c)Comesoutviaaccessoryostiumandgrowsinthechoanaand
nasalcavity
d)Morecommoninadultsthanchildren
e)Commonlypresentsasunilateralnasalobstruction
CorrectAnswer-A:C:E

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Answer-A,Startsasedemaofmaxillary...C,Comesoutvia
accessoryostium...E,Commonlypresentsasunilateral...
Age-Commoninchildren
Aetiology-Infection
Number-Solitary

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Laterality-Unilateral
Origin-Maxillarysinusneartheostium
Growth-Growsbackwardstothechoana;mayhangdownbehind
thesoftpalate
Sizeandshape-Trilobedwithantral,nasalandchoanalparts.

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Choanalpartmayprotrudethroughthechoanaandfillthe
nasopharynxobstructiongbothsides
Recurrence-Uncommon,ifremovedcompletely
Treatment-Polypectomy;endoscopicremovalorCaldwellLuc
operationifrecurrent.

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14.Feature(s)ofperitonsillarabscess:
a)Foulbreath
b)Hotpotatovoice
c)Shiftingofuvulainoppositeside
d)Difficultyinswallowingevenownsaliva

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e)Alwayspresentsasb/1severepaininthroat
CorrectAnswer-A:B:C:D
Answer-A,FoulbreathB,HotpotatovoiceC,Shiftingofuvulain
oppositesideD,Difficultyinswallowingevenownsaliva
Clinicalfeaturesaredividedinto:?

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General:Theyareduetosepticaemiaandresembleanyacute
infection.
Theyincludefever(upto104?F),chillsandrigors,generalmalaise,
bodyaches,headache,nauseaandconstipation.
Local:

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Severepaininthroat.Usuallyunilateral.
Odynophagia.Itissomarkedthatthepatientcannotevenswallow
hisownsalivawhichdribblesfromtheangleofhismouth.Patientis
usuallydehydrated.
Muffledandthickspeech,oftencalled"Hotpotatovoice".

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Foulbreathduetosepsisintheoralcavityandpoorhygiene.
Ipsilateralearache.ThisisreferredpainviaCNIXwhichsupplies
boththetonsilandtheear.
Trismusduetospasmofpterygoidmuscleswhichareinclose
proximitytothesuperiorconstrictor.

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15.Trueaboutspasmodicdysphonia-
a)Aneurologicalproblem
b)Mostlypsychogenicinorigin
c)Hyperadductionofvocalcordmaybeseen
d)Botulinumtoxinrelivesspasm

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e)Speechtherapyisbeneficial
CorrectAnswer-A:C:D:E
Answer-A,C,D,E,Aneurologicalproblem(C)Hyperadduction
ofvocalcordmaybeseen(D)Botulinumtoxinrelivesspasm
(E)Speechtherapyisbeneficial

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"spasmodicdysphoniaisaneurologicaldisorderaffectingthevoice
musclesinthelarynx,orvoicebox.
Etiologyisunknownbutltisusuallystress-related.
Botulinumtoxinlnjectionintothelaryngealmuscleshasbeentriedin
thetreamentofspasticdysphonia.

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Voicetherapyisusefultoimprovevoiceonlywhencombinedwith
injection

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16.Vocalcordissuppliedby-
a)Internallaryngealnerve
b)Superiorlaryngealnerve

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c)Recurrentlaryngealnerve
d)Vagusnerve
e)Glossopharyngealnerve
CorrectAnswer-A:B:C:D
Answer-(A)Internallaryngealnerve(B)Superiorlaryngeal

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nerve(C)Recurrentlaryngealnerve(D)Vagusnerve
Themaincranialnerveinnervatingthelarynxisthevagusnervevia
itsbranches;superiorlaryngealnerve(SLN)and
Recurrentlaryngealnerve(RLN).
Abovethevocalcordsthesensoryinnervationoflarynxisvia

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internallaryngealnerve.

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17.Inbilateralrecurrentlaryngealnerve
paralysis,whichofthefollowingis/areis
seen-
a)Paramedianvocalcord

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b)Dyspneaisseen
c)Stridorisseen
d)Noeffectonvoice
e)Tracheostomymayberequired
CorrectAnswer-A:B:C:D:E

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Answer-(A)Paramedianvocalcord(B)Dyspneaisseen
(C)Stridorisseen(D)Noeffectonvoice(E)Tracheostomymay
berequired
BilateralRLNparalysis(Bilateralabductorparalysis)-
Thisisthemostdangerousparalysisasboththecordsarein

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medianorparamedianposition,obstructingtheairway.
Thereisdyspneaandstridor.
Treatment
Tracheostomy
Lateralizationofcord

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Kashimaoperation

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18.Trueabouttubercularotitismediaareall
except?
a)Spreadsthrougheustachiantube
b)Causespainlesseardischarge

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c)Maycausemultipleperforations
d)Usuallyaffectsbothears
e)None
CorrectAnswer-D
Answer-D.Usuallyaffectsbothears

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Tuberculosisofmiddleearisacomparativelyrareentityusually
seeninassociationwithorsecondarytopulmonarytuberculosis,
infectionreachesthemiddleearthrougheustachiantube.
Clinicalfeatures
Generally,tuberculosisofmiddleearisunilateral.

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Itischaracterizedbypainlessotorrhoeawhichfailstorespondtothe
usualantimicrobialtreatment.Thereispainlesswateryotorrhea.
Singleormultipleperforationoftympanicmembrane.

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19.Clinicalfeatureoffacialpalsyareall
except-

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a)Lossofforeheadwrinkling
b)Difficultyinclosingeye
c)Lossoftastesensationfromtongue
d)Paralysisofstapediusmuscle
e)LossofGagreflexes

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CorrectAnswer-A:B:C:D
Answer-(A)Lossofforeheadwrinkling(B)Difficultyinclosing
eye(C)Lossoftastesensationfromtongue(D)Paralysisof
stapediusmuscle
Weaknessofthemuscleofthefacialexpressionandeye

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closure
1. Absenceofnasolabialfold
2. Widepalpablefissure
3. Epiphora
4. Droopingofangleofmouth

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5. Lossofwrinklesofforehead
6. Thefacesagsandisdrawnacrosstotheoppositesideonsmiling.
7. Voluntaryeyeclosuremaynotbepossibleandcanproducedamage

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20.Contraindicationofcochlearimplantation
is/are-

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a)Mondinideformity
b)Intracochlearossification
c)Chronicsuppurativeotitismedia
d)Agenesisofcochlearnerve
e)All

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CorrectAnswer-C:D
Answer-(C)Chronicsuppurativeotitismedia(D)Agenesisof
cochlearnerve
Absolute
1. Activemiddleearinfection:ASOM,CSOM,mastoiditis

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2. Agenesisofcochleaand/orCochlearnerve
3. Mentalretardion:Patientcannotcooperatewithspeechtraining

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21.Trueaboutschwartz'ssign-
a)Seeninoticcapsule
b)Indicatesactivedisease

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c)SurgeryistheTreatment
d)Causessensory-neuraldeafness
e)Morecommoninpregnancy
CorrectAnswer-A:B:C:D:E
Answer-(A)Seeninoticcapsule(B)Indicatesactivedisease

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(C)SurgeryistheTreatment(D)Causessensory-neural
deafness(E)Morecommoninpregnancy
Schwartz'ssign,alsoknownasFlemingo'sflushsignorRisingsun
signisbelievedtobeassociatedwithotopongiosiswhichisthe
activephaseofthedisease,usuallyinpregnancy.

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Schwartz'ssignwhichreferstoareddishdiscolorationoverthe
Promontoryseenbeyondtheintacttympanicmembrane.
surgeryrernainsatherapeuticoption.

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22.Whichofthefollowingis/aretrueabout
schwartzsign-

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a)Signofinactivedisease
b)Indicationforsurgery
c)Morecommonduringpregnancy
d)Reddishhueoverthepromontory
e)Seenintheearlystagesoftheotoscelerosis

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CorrectAnswer-B:C:D:E
Answer-(B)Indicationforsurgery(C)Morecommonduring
pregnancy(D)Reddishhueoverthepromontory(E)Seeninthe
earlystagesoftheotoscelerosis
Schwartzsign(Flemingo'sflushsign)-

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In10%ofcasesflamingo-pinkblushisseenthroughthetympanic
membranecalledasSchwartzsign
Itisseeninearlyandactivestageofthedisease.
Thesignischaracterizedbypinkblushseenthroughthetympanic
membranecausedbyreddishhueoverpromontoryduetoincreased

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vascularityofthepromontory.
ThissignindicatesactiveostosclerosisusuallyduringPregnancy
Itseemsthatthesurgeryremainsatherapeuticoption,whenthe
activephaseofthediseaseisstabilizedevenfollowingashort
courseofpharmacologicaltherapy.

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23.Deformitiesoccurringinleprosypatients
is/are-
a)Faciesleonina
b)Lowsetear
c)Saddlenose

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d)Lagophthalmos
e)Microganthia
CorrectAnswer-A:C:D
Answer-(A)Faciesleonina(C)Saddlenose(D)Lagophthalmos
Face-

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Maskface,faciesleonina,Saddlenose,saggingface,
lagophthalmos,lossofeyebrows,perforatednose,depressednose,
eardeformities.

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24.Whichofthefollowingis/aretrueabout
lefortsfracture

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a)Itisfractureofzygomaticbone
b)MaycauseCSFrhinorrhea
c)Type1:completeseparationoffacialbonesformthecranial
bones
d)Classifiedastypes1to5

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e)None
CorrectAnswer-B
Answer-B.MaycauseCSFrhinorrhea
LeFortI(transverse)-crosseslowerpartofnasalseptum,maxillary
antraandthepterygoidplates.

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LeFortII(pyramidal)-passesthroughtherootofnose,lacrimal
bone,flooroforbit,upperpartofmaxillarysinusandpterygoidplates
LeFortIII(craniofacialdysjunction)-Thereiscompleteseparation
offacialbonesfromthecranialbones.
Clinicalfeaturesofmaxillaryfracture-

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Malocclusionofteeth
Mobilityinthemaxilla
CSFrhinorrhoea.

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25.Trueaboutforeignbodiesofairpassage
inchildrenexcept-

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a)Vegetableforeignbodiesarenotcommon
b)Trachealobstructioncancausessuddendeath
c)Morecommoninrightbronchus
d)Morecommoninchildrenoflessthan4yrofage
e)CTscanofchestisdoneinallcases

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CorrectAnswer-A:B:E
Answer-(A)Vegetableforeignbodiesarenotcommon
(B)Trachealobstructioncancausessuddendeath(C)More
commoninrightbronchus
Themostcommonagegroupis6monthsto4years.

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Mostcommonforeignbodyaspiratedisnuts(peanuts).
Mostairwayforeignbodieslodgeinabronchus(rightmorethan
left).
Thechildpresentswithacuteonsetofcough-(most-common),
Chockinggagging,wheezing,respiratorydistress,aphonia,drooling

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andstridor.
Bronchoscopyisdiagnosticaswellastherapeutic.

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26.Trueaboutdevelopmentofcochlea
a)Cochleastartdevelopingfrom3rdweekofgestation
b)Semicircularcanalsdevelopaftercochlea

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c)Cochleadevelopmentcompletesby20weekofgestation
d)Cochleadevelopmentcompletesat2yearofage
e)All
CorrectAnswer-A:C
Answer-A,Cochleastartdevelopingfrom3rdweekof

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gestationC,Cochleadevelopmentcompletesby20weekof
gestation
Developmentofcochleastartsat3weeksandcompletesat20-22
weeksofintrauterinelife.
Semicircularcanaldevelopsearlierthancochlea.

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27.Whichofthefollowingis/aretrueabout
theT-stageofmaxillarysinuscarcinoma-
a)StageT4a-frontalsinusinvolvement
b)StageT3-ethmoidsinusinvolvement
c)StageT2-sphenoidsinusinvolvement

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d)StageT2-boneoftheposteriorwallofmaxillarysinus
e)None
CorrectAnswer-A:B
Answer-(A)StageT4a-frontalsinusinvolvement(B)StageT3-
ethmoidsinusinvolvement

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T4a-Tumourinvadesanteriororbitalcontents,skinofcheek,
pterygoidplates,infratemporalfossa,cribiformplates,sphenoidor
frontalsinus.
T3-Tumourinvadesanyofthefollowing-boneoftheposteriorwall
ofmaxillarysinus,subcutaneoustissues,floorormedialwallorbit,

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pterygoidfossaandethmoidsinuses.
T2-Tumourcausingboneerosionordestructionincludingextension
intothehardpalateandmiddlenasalmeatus,exceptextensionto
posteriorwallofmaxillarysinusandpterygoidplates.

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28.TrueaboutReinke'soedema:

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a)Usuallyunilateral
b)Commoninsmoker
c)Corticosteroidismainstayoftreatment
d)Involvewholeofmembranouspartofthevocalcords
e)Patienthaslowpitchvoice

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CorrectAnswer-B:D:E
Answer-B,CommoninsmokerD,Involvewholeofmembranous
partofthevocalcordsE,Patienthaslowpitchvoice
Itisbilateralsymmetricalswellingofthewholeofmembranouspart
ofthevocalcords.

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Thisisduetooedemaofthesubepithelialspace(Reinketspace)
ofthevocalcords.
Etiology-
Heavysmoking,
Chronicsinusitis&

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Laryngopharyngealreflex
C/F-
Patientusesfalsecordsforvoiceproduction&thisgiveshimalow-
pitched&roughvoice.
Treatment-

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Decorticationofthevocalcordsi.e.,removalofstripofepithelium,is
donefirstononeside&3-4weeksalterontheother.

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29.Feature(s)ofScheibe'ssyndromeis/are:
a)Semicircularcanalfistula
b)Abnormalityinbonylabyrinth

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c)Dysplasiaofcochlea
d)Middleearanaomaly
e)All
CorrectAnswer-C
Answer-C.Dysplasiaofcochlea

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Itismostcommoninnerearanomaly.
Dysplasiaisseeninthecochlea&saccule;hencealsocalled
cochleosacculardysplasia.
Itisinheritedasanautosomalrecessivenonsyndromictrait.

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30.Trueaboutnasopharyngealcarcinoma:

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a)Level4cervicallymphnodenotinvolved
b)Radiotherapyistreatmentofchoice
c)Alsoc/aGuangdongtumour
d)MayassociatedwithU/Lotitismedia
e)AssociatedwithEBV

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CorrectAnswer-A:B:C:D:E
Answer-A,Level4cervicallymphnodenot
involvedB,RadiotherapyistreatmentofchoiceC,Alsoc/a
GuangdongtumourD,MayassociatedwithU/Lotitis
mediaE,AssociatedwithEBV

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Itismostlyseeninfifthtoseventhdecades.
Malesarethreetimesmorepronethanfemale.
Epstein-Barrvirusiscloselyassociatedwithnasopharyngeal
carcinoma.
DuetoobstructionofEustachiantube,thereisconductivehearing

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loss,serousorsuppurativeotitismedia.
Radiotherapy:Itistreatmentofchoicefornasopharyngeal
carcinoma.

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31.EvidencebasedtherapyofBell'spalsy
include(s):

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a)Facialnervemassage
b)Facialnervestimulation
c)Steroid
d)Acyclovir
e)All

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CorrectAnswer-C
Answer-C.Steroid
1.Medicaltreatment
Prednisolone(steroid)isthedrugofchoiceandisstartedatinitial
visit.Initiationoftherapyduringfirst24hoursofsymptomconfersa

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higherlikelihoodofrecovery.
Antiviraltherapy(Acyclovir)isaneweradjunctintreatingacute
facialpalsyofviralorigin(bothBell'spalsyandRamsayhunt
syndrome).
Mostsurgeonsthesedaysadvocatecombinationofsteroidsand

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antiviraldrugs.

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32.ApersonhasvertigowithoutCNS
involvement.Causesis/are:
a)Perilymphfistula
b)Otolithiasis

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c)Vestibularneuritis
d)Meniere'sdisease
e)Multiplesclerosis
CorrectAnswer-A:B:C:D
Answer-A,PerilymphfistulaB,OtolithiasisC,Vestibular

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neuritisD,Meniere'sdisease
Peripheral(Lesionsofendorgansvestibularnerve)
Meniere'sdisease
Benignparoxysmalpositional
vertigo

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Vestibularneronitis
Labyrinthitis
Vestibulotoxicdrugs
Headtrauma
Perilymphfistula

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Syphilis
Acousticneuroma

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33.WhichistrueaboutTuningforktestin
hearingloss:
a)Rinnetestisnegativeinconductivedeafness

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b)Webertest-lateralizedtotheworstearinsensorineural
deafness
c)LateralizationofsoundinWebertestwithatunningforkof512
Hzimpliesaconductivelossof15-20dBinipsilateralear
d)NegativeRinnetestindicatesaminimumair-bonegapof15-20

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dB
e)ARinnenegativeforallthethreetunningforksof256,512&
1024Hzindicatesair-bonegapof30-45
CorrectAnswer-A:C:D
Answer-(A)Rinnetestisnegativeinconductive

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deafness(C)LateralizationofsoundinWebertestwitha
tunningforkof512Hzimpliesaconductivelossof15-20dBin
ipsilateralear(D)NegativeRinnetestindicatesaminimumair-
bonegapof15-20dB
RinneTest

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Anegativetest(BC>AC)isseeninconductivedeafness.
NegativeRinneindicatesaminimumair-bonegapof15-20dB.
Apredictionofair-bonegapcanbemadeiftuningforksof256,512
&1024Hzareused
ARinnenegativeforallthethreetunningforksof256,512&1024

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Hzindicatesair-bonegapof45-60dB
WeberTest-
Itislateralizedtotheworstearinconductivedeafness&tothe

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betterearinsensorineuraldeafness.

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34.Whichofthefollowingcauseslower

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motorneuron(LMN)typeoffacialnerve
paralysis:
a)Bellpalsy
b)Parotidtumor
c)Guillain-Barresyndrome

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d)Middlecerebralarteryinfarct
e)Multiplesclerosis
CorrectAnswer-A:B:C
Answer-(A)Bellpalsy(B)Parotidtumor(C)Guillain-Barre
syndrome

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1.Idiopathic(Bell'spalsy)
Pregnancy-3xmorecommon.
Diabetesmellitus
2.lnfective
Herpesvirus

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Herpeszoster(RamsayHuntsyndrome)
Epstein-Barrvirus
3.Neurological
Guillain-Barresyndrome.
Mononeuropathy-e.g.duetodiabetesmellitus,sarcoidosisor

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amyloidosis
4.Parotidglandtumours.

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35.Trueabouttympanometry:
a)Flatinossicculardiscontinuity
b)Astypeinotosclerosis

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c)Domeshapedindicatesfluidinmiddleear
d)Adtypeinossicculardiscontinuity
e)Ctypeineustachiantubeobstruction
CorrectAnswer-B:C:D:E
Answer-(B)Astypeinotosclerosis(C)Domeshapedindicates

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fluidinmiddleear(D)Adtypeinossicculardiscontinuity(E)C
typeineustachiantubeobstruction
A-Normal
As-Reducedcomplianceatambientpressure(otosclerosis).
's'standsforshallowtympanogrambutrememberforstiffness

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AD-Increasedcomplianceatambientpressure(ossicular
discontinuity).'d'standsfordeepqrmpanogram.
B-Flatordome-shaped(fluidinmiddleear).
C-Maximumcomplianceatpressuresmorethan-200mmH2O

---

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36.Trueaboutbilateralabductorparalysis:
a)Voiceisgood
b)Stridorispresent
c)Cordslieinabductedposition
d)Urgenttracheostomyisneeded

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e)None
CorrectAnswer-A:B:D
Answer-A,VoiceisgoodB,StridorispresentD,Urgent
tracheostomyisneeded
Trecheostomy

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Transyersecordotomy
Partialarytenoidectomy
Reinnervationprocedures
ThyroplastyII
Woodman'soperation(Externalarytenoidectomy)isdoneinb/l

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abductorparalysis.
Endoscopiclaserarytenoidectomy&IsshikitypeIIthyroplastyis
doneforlateralizationofcoril(inbilateralabductorparalysis).

---

37.Allaretrueaboutmandiblefracture
except:

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a)Condylarneckismostcommonsite
b)Malocclusionofteethmayoccur
c)Anteriorsuperioralveolarnerveismostcommonlyinjured
d)Panorexradiographsareusefulfordiagnosis
e)Malunion&non-unionarecomplications

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CorrectAnswer-C
Answer-C.Anteriorsuperioralveolarnerveismostcommonly
injured
Thecondylarneckistheweakestpartofthemandibleand,isthe
mostfrequentsiteoffracture.

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Traumatotheinferioralveolarnerveleadstopermanentnumbness
ofthelowerlipandteethontheaffectedside.
Fracturesofthecoronoidprocessofthemandiblecanresultin
trismus
Infractureofcondyle,displacedfragmentsleadstomalocclusionof

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teeth&deviationofjawtotheoppositesideonopeningthemouth.
X-raysusefulinmandibularfracturesarePAviewoftheskull(for
condyle),right&leftobliqueviewofmandible&panorexview.
Condylarandsubcondylarmandiblefracturesaremostoftentreated
byIMFalone.

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Delayedunionandnonunionoccurinapproximately3%offractures.

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38.Trueaboutchronicsuppurativeotitis
media(CSOM):
a)Foulsmellingdischargeinatticoantralvariety
b)Facialnerveinvolvementintubotympanicvariety

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c)Atticoantralvarietyisassociatewithcholestetoma
d)Maycausehearingloss
e)All
CorrectAnswer-A:C:D
Answer-(A)Foulsmellingdischargeinatticoantralvariety

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(C)Atticoantralvarietyisassociatewithcholestetoma(D)May
causehearingloss
Types
Differencesbetweenatticoantralandtubotympanictypeof
CSOM

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Tubotympanic(safe)
atticoantral(unsafe)
scantypurulentfoul
Discharge

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profusemucoid
smell
Perforation
central
Marginal

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Granulation
uncommon
Common
Polyp
Pale

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Red,fleshy
Cholesteatoma Absent
Present
Complications Rare
Common

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Mildtomoderateconductive Conductiveormixed
Audiogram
deafness
deafness

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39.Trueaboutranula:

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a)Mucousretentioncyst
b)Seeninfloorofmouth
c)Marsupializationforlargecyst
d)Parotidismostcommonsiteoforigin
e)Arisesfromsublingualsalivarygland

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CorrectAnswer-A:B:C:E
Answer-(A)Mucousretentioncyst(B)Seeninfloorof
mouth(C)Marsupializationforlargecyst(E)Arisesfrom
sublingualsalivarygland
Itisathinwalledbluishretentioncyst.

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Seeninthefloorofmouthononesideofthefrenulum.
Itarisesduetoobstructionofductofsublingualsalivarygland.
Itisalmostalwaysunilateral.
ClinicalFeatures
Seenmostlyinchildrenandyoungadults.

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Onlycomplain--swellinginthefloorofmouth
Cystmayrupturespontaneouslybutrecurrenceiscommon
Treatmentiscompletesurgicalexcisionifsmallormarsupialization,
iflarge

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40.Trueaboutgrommetinsertion:

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a)Smallplastictubeaeratingmiddleear
b)Maximumdurationofgrommetinsertionis5month
c)Healingoccursmorequicklyafterextrusionthanafterremoval
d)Itisplacedanteriorlyontympanicmembrane
e)Surgeryisalwaysneededtoremoveit

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CorrectAnswer-A:C:D
Answer-(A)Smallplastictubeaeratingmiddleear(C)Healing
occursmorequicklyafterextrusionthanafterremoval(D)Itis
placedanteriorlyontympanicmembrane
Ifagrommetisinserteditmaybeplacedposteriorlyoranteriorly

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dependinguponthepreferenceofthesurgeon.
Thegrommetiseitherrejectedspontaneouslyormayberemoved,
preferablyunderananaatheticbecausethisismomentarilyPainful.
Atthesecondorcertainlyatthethirdmyringotomy,mostsurgeon
willinsertagrommet.

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Tympanoscelerosisisseenmuchmorefrequentlyinchildren.
Extrusionofthetube,themajorityofiatrogenicTMperforationswill
heal.

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41.TrueaboutVasomotorrhinitis:
a)Itisatypeofallergicreaction

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b)Clinicallysimulatenasalallergy
c)Nasalmucosagenerallycongested&hypertrophic
d)Hypertrophyofinferiorturbinateiscommonlypresent
e)Anti-histaminics&oralnasaldecongestantareusedin
treatment

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CorrectAnswer-B:C:D:E
Answer-(B)Clinicallysimulatenasalallergy(C)Nasalmucosa
generallycongested&hypertrophic(D)Hypertrophyofinferior
turbinateiscommonlypresent(E)Anti-histaminics&oral
nasaldecongestantareusedintreatment

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Itisnonallergicrhinitisbutclinicallysimulatingnasalallergywith
symptomofnasalobstruction,rhinorrhoea(sneezing).
Allthetestsofnasalallergyarenegative
"VMR:Swelling(orhypertrophy)ofinferiorturbinateisfrequently
seen

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Clinicfeatures-
Paroxysmalsneezingexcessiverhinorrhoea,nasalobstruction&
postnasaldrip
Nasalmucosaovertheturbinatesisgenerallycongested&
hypertrophic

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Treatment-
anti-histaminics,oralnasaldecongestant;systemicsteroidSurgical
treatment:Relievingofnasalobstruction&vidianneurectomy.

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42.

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Structurespreservedinradicalneck

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dissection-
a)Internaljugularvein
b)CarotidArtery
c)Accessorynerve
d)Brachialplexus

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e)Sternocleidomastiodmuscle
CorrectAnswer-B:D
Answer-(B)CarotidArtery(D)Brachialplexus
Cervicallymphaticsandlymphnode
Internaljugularvein

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Accessorynerve
Submandibulargland
Sternocleidomastiodmuscle
Tailofparotid
Omohyoidmuscle

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43.FeatureofGranulomatosiswith
polyangiitis:
a)Nasalpolyp
b)PerforatedNasalseptum
c)Persistantsinus

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d)Crustingofnasalmucosa
e)Collapseofnasalbridge
CorrectAnswer-B:C:D
Answer-(B)PerforatedNasalseptum(C)Persistantsinus
(D)Crustingofnasalmucosa

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Granulomatosiswithpolyangiitis(Wegener)isadistinct
clinicopathologicentitycharacterizedbygranulomatousvasculitisof
theupperandlowerrespiratorytractstogetherwith
glomerulonephritis.
Disseminatedvasculitisinvolvingbothsmallarteriesandveinsmay

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occur.
Nasalfindingsincludecrustinggranulations,septalperforation&a
saddlenose
Destructionoftheseptumwithacharacteristicimplosionofthenasal
bridge.

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44.Trueaboutvestibularschwanomma:
a)U/1hearinglossiscommonpresentation
b)Mostlymalignant
c)MostcommontumourofCPangle
d)Sensorineuraldeafness

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e)Uncapsulated
CorrectAnswer-A:C:D
Answer-(A)U/1hearinglossiscommonpresentation(C)Most
commontumourofCPangle(D)Sensorineuraldeafness
Benignencapsulated,extremelyslowgrowingtumors.

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80%ofallCerebello-pontineangletumors.
Earliestsymptoms-Unilateralsensorineuraldeafness.
Thethreemostcommonpresentingsymptomsincludeinsidious
hearingloss,high-pitchedtinnitus,anddisequilibrium.
Superiordivisionofvestibularnerve?mostcommonsiteofAN.

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45.Tensorofvocalcordincludes:
a)Arytenoid
b)Thyroarytenoid
c)Interarytenoid
d)Posteriorcricoarytenoid

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e)Cricothyroid
CorrectAnswer-E
Answer-E.Cricothyroid
MuscleofLarynx-
AbductorPosteriorcricoarytenoid

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Adductor(3musclegiveninDhingra):Lateralcricoarytenoid,
Interarytenoid(Transversethyroarytenoid)
TensorCricothyroid&vocalis
AllmuscleoflarynxaresuppliedbyRecurrentLaryngealnerves.
ThelatterreceiveitsinnervationfromExternalLaryngealnerve.

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Sensory-
Abovevocalcords-InternalLaryngealnerveabranchofSuperior
Laryngealnerve.
Belowvocalcords-RecurrentLaryngealnerve

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46.Allaretrueaboutvocalcordnodule

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except:
a)Causedbyphonotrauma
b)CommonlyoccuratJunctionofmiddle&posterior1/3
c)CommonatjunctionofA1/3withP2/3
d)Commoninteachers

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e)Treatmentisspeechtherapy
CorrectAnswer-B
Answer-B.CommonlyoccuratJunctionofmiddle&posterior
1/3
Vocaltraumawhenpersonspeaksinunnaturallowtonesfor

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prolongedperiodsorathighintensities.
Patientscomplainsofhoarseness.
Vocalfatigue&painintheneckonprolongedphonationareother
commonsymptoms.
Theymostlyaffectteachers,actors,vendorsorpopsingers

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Surgeryisrequiredforlargenodulesornodulesoflongstandingin
adults.
Speechtherapy&re-educationinvoiceproductionareessentialto
preventtheirrecurrence.
Theyappearsymmetricallyonthefreeedgeofvocalcord,atthe

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junctionofanteriorone-third,withtheposteriortwo-third.

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47.Trueaboutallergicfungalsinusitis:
a)Fungalhyphaeispresentinallergicmucinwhichispathological
hallmark
b)Invasionofthesinusmucosawithfungus

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c)Allergicreactiontofungus
d)Antifungaltreatmentleadtoimprovementofsymptom
e)Surgicalclearanceismainstayoftreatment
CorrectAnswer-A:C:E
Answer-(A)Fungalhyphaeispresentinallergicmucinwhichis

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pathologicalhallmark(C)Allergicreactiontofungus
(E)Surgicalclearanceismainstayoftreatment
Itisanallergicreactiontothecausativefungus&presentswith
sinunasalpolyposis&mucin.
Thereisnoinvasionofthesinusmucosawithfungus.

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Usuallymorethanonesinusareinvolvedononeorbothsides.
Featuresofrefractorysinusitisandnasalpolyposisarepresent.
aGellandCoombstypeI(lgE-mediated)immuneresponseto
fungalantigens.TypeIIIandIVimmuneresponsesmayalsobe
involved.

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Itconsistofconsistingofeosinophils,Charcot-Leydencrystals,and
scatteredfungalhyphae.
Diagnosis
CTscanshowsmucosalthickeningwithhyperdenseareas
ThediagnosisofAFSisconfrmedbydemonstrationofallergic

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mucinandcultureofthefungus.
Treatment-
Surgicaldebridementandaerationoftheinvolvedsinusfollowedby
theuseofsystemicandtopicalintranasalcorticosteroids.

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theuseofsystemicandtopicalintranasalcorticosteroids.

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48.Trueaboutconductivehearingloss:
a)Presbycusis
b)Cholestetoma
c)Acousticneuroma
d)Perforationoftympanicmembrane

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e)Serousotitismedia
CorrectAnswer-B:D:E
Answer-(B)Cholestetoma(D)Perforationoftympanic
membrane(E)Serousotitismedia
Causedbyanydiseaseprocessinterferingwithconductionofsound

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fromtheexternaleartothestapedio-vestibularjoint.
CommonestcauseofhearinglossinchildrenisChronicsecretory
otitismedia.
Perforationoftympanicmembrane.
Disruptionofossicles-traumatoossicularchain,CSOM,

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cholesteatoma
Fixationofossicles-otosclerosis,tympanosclerosis
Eustachiantubeblockage

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49.TrueaboutAndyGumpdeformity:
a)Occursduedefectsoftheanteriormandibulararch

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b)Hemimandibulectomycancause
c)Marginalmandibulectomycancause
d)Treatmentisadequatereconstructionofanteriormandibular
archwithplate&graft
e)None

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CorrectAnswer-A:B:D
Answer-(A)Occursduedefectsoftheanteriormandibulararch
(B)Hemimandibulectomycancause(D)Treatmentisadequate
reconstructionofanteriormandibulararchwithplate&graft
Analteredfacialprofileduetoamisinglowerjawbone,ormandible

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Resectionoftheanteriormandibulararchproducesthe"Andy
Gump"deformity.
Causes
Marginalmandibulectomy
Segmentalmandibulectomy

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Archpreservingmandibulectomy
Hemimandibulectomy

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50.Foreignbodyintrachea&bronchuscan
cause:
a)Bronchiectasis

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b)Atelectasis
c)Subcutaneousemphysema
d)Pneumothorax
e)All
CorrectAnswer-A:B:C:D

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Answer-(A)Bronchiectasis(B)Atelectasis(C)Subcutaneous
emphysema(D)Pneumothorax
Trachea-
Choking,stridor,wheeze,cough,palpatorythud,audibleslap.
Bronchi-

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Cough,wheeze&diminishedairentrytolungformsatriad
Respiratorydistresswithswellingofforeignbody
Lungcollapse,emphysemo,pneumonitis,bronchiectosisorlung
obscessarelatefeature.

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51.Notselfretaininghandheldretractor(s)

--- Content provided by FirstRanker.com ---

is/are:
a)Mollison'smastoidretractor
b)Jansen'smastoidretractor
c)Lempert'sendauralretractor
d)DavisRetractor

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e)All
CorrectAnswer-D
Answer-D.DavisRetractor
Theseretractorsdonotneedanassistanttoholdtheminplace.
Itholdtissueapartandlockitinplace.

--- Content provided by FirstRanker.com ---

Handheldretractor-
HohmannRetractor
LaheyRetractor
SennRetractor
Blair(Rollet)Retractor

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RigidRake
FlexibleRake
RagnellRetractor
Linde-RagnellRetractor
DavisRetractor

--- Content provided by FirstRanker.com ---

---

52.Trueaboutcroup:
a)CausedbyH.influenzae
b)X-rayPAviewshowssteeplesignofsubglotticnarrowing
c)Stridorispresent
d)Supraglotticedemaispresent

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e)Commonlypresentin6month-3yearagegroup
CorrectAnswer-A:B:C:E
Answer-(A)CausedbyH.influenzae(B)X-rayPAviewshows
steeplesignofsubglotticnarrowing(C)Stridorispresent
(E)Commonlypresentin6month-3yearagegroup

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Croup(Laryngotracheobronchitis)
Laryngotracheobronchitisisthemostcommoninfectiouscauseof
obstructioninchildrenusuallyoccurringbetweentheagesof6
monthsand3years.
Malechildren(boys)arecharacteristicallymorefrequentlyinvolved

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thanfemales(girls)
Etiology
ItisaviralinfectionmostfrequentlycausedbyParainfluenzavirus.
Pathology
Themostcharacteristicpathologicalfeatureisedemaformationin

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thesubglotticarea.
Presentation
Gradualonsetwithaprodromeofupperrespiratorysymptoms
Hoarsenessandbarkingcough(croupycough)
Stridor(initiallyinspiratorythanbiphasic)

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Feverisusuallylowgrade(orabsent)althoughmayoccasionallybe
highgrade

---

Droolingsischaracteristicallyabsentandthereisnodysphagia
(seeninepiglottitis)
Imaging(Xray)

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Symmetric'steeple'or'funnelshaped'narrowingofthesubglottic
region(steeplesign)
Hypopharyngealwideningordistension
Normalepiglottisandaryepiglotticfolds

---

53.Whichofthefollowingstatement(s)is/are

--- Content provided by FirstRanker.com ---

trueaboutlabyrinthitis:
a)Initiallyquickcomponentofnystagmusoccurtowarddiseased
earbutinlaterstageshifttowardhealthyear
b)Mayoccurasacomplicationofchronicsuppurativeottitismedia
c)Resolvespontaneouslyin1-6wk

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d)Medicaltreatmentaloneissufficient
e)Vertigomaybepresent
CorrectAnswer-A:B:E
Answer-(A)Initiallyquickcomponentofnystagmusoccur
towarddiseasedearbutinlaterstageshifttowardhealthyear

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(B)Mayoccurasacomplicationofchronicsuppurativeottitis
media(E)Vertigomaybepresent
Thisisacommoncomplicationofotitismedia.
Therearethreetypesr
Circumscribed(fistulaoflabyrinth)

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Diffuseserous&
Diffusesuppurativelabyrinthitis
Mildcasecomplainofvertigo&nausea.
Surgicaltreatmentincludes:Myringotomy

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54.TrueaboutMobiussyndrome:

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a)10thCNinvolvement
b)7thCNinvolvement
c)Abductiondefect
d)Esotropia
e)6thCNinvolvement

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CorrectAnswer-B:C:D:E
Answer-(B)7thCNinvolvement(C)Abductiondefect
(D)Esotropia(E)6thCNinvolvement
"Itischaracterizedbybilateralfacialweakens(i.eVIICN),whichis
oftenassociatedwithabducensnerveparalysis(i.e.VICN)

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Facialpalsyiscommonlybilateral,frequentlyasymmetric.
Ectropion,epiphora,andexposurekeratopathymaydevelop.
Theabductiondefectmaybeunilateralorbilateral.
ThecranialnervesVandVIIIareaffected.
Esotropiaiscommon.

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Surgicalcorrectionoftheesotropiaisindicated

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55.TrueaboutEthmoidalsinus:
a)Fullydevelopedby25yr
b)Consistsof3-18sinusoneachside
c)Absentatbirth

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d)Laminapapyraceaseparatefromorbit
e)Anteriorethmodalgroupcells-openintosuperiormeatus
CorrectAnswer-B:D
Answer-(B)Consistsof3-18sinusoneachside(D)Lamina
papyraceaseparatefromorbit

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Ethmoidalcellsaredividedintoanteriorethmoidalgroupwhich
apeasintothemiddlemeatus&posteriorethmoidalgroup.
Presentatbirth
Reachadultsizeby12years
Theirnumbervariesfrom3to18

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Thethinpaperlikelaminaofbone(laminapapyracea)separatingair
cellsfromtheorbit.

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56.Allaretrueaboutnasopharyngealfibroma
except:
a)Mostcommonageofpresentationis20-50yr

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b)Radioresistanttumour
c)Highlyvascular
d)Benigninnature
e)Surgeryistreatmentofchoice
CorrectAnswer-A:B

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Answer-(A)Mostcommonageofpresentationis20-50yr
(B)Radioresistanttumour
Itisararetumour,thoughitisthecommonestofallbenigntumours
ofnasopharynx
Itislocallyinvasive&destroystheadjoiningstructures

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Tumourisseenalmostexclusivelyinmalesinagegroupof10-20
years.
Rarely,itmaybeseeninolderpeople&females
Mostcommonpresentation:profuse6recurrentepistaxis
Itismadeupofvascular&fibroustissue.Mostly,thevesselsare

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justendothelium-linedspaceswithnomusclecoat
Surgicalexcisionisnowthetreatmentofchoice
Radiotherapyhasbeenusedasaprimarymodeoftreatment

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57.Complicationofmodifiedradical
mastoidectomyinclude(s):

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a)Conductivehearingloss
b)Facialnerveinjury
c)Changeintastesensation
d)Sensoryhearingloss
e)All

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CorrectAnswer-E
Answer-E.All
Facialparalysis
Perichondritisofpinna
Injurytoduraorsigmoidsinus

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Labyrinthitis,ifstapesgetsdisclosed
Severeconductivedeafnessof50dBormore.Thisisdueto
removalofallossicla&tympanicmembnne
Cavityproblems

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58.Whichofthefollowingfeature(s)of

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rhinoscleromais/aretrueexcept:
a)Atrophyofnasalmucosa
b)Causedbyfungus
c)Treatmentbyantifungaldrug
d)Causedbybacteria

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e)Causativeorganismmaybeculturedfrombiopsymaterial
CorrectAnswer-B:C
Answer-(B)Causedbyfungus(C)Treatmentbyantifungaldrug
Rhinoscleromaisarare,slowlyprogressinggranulomatousdisease
oftheupperrespiratorytractcausedbyKlebsiellarhinoscleromatis.

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Nasaldiseasepresentswiththreetypicalstages:(1)catarrhal(2)
proliferative(3)cicatrical.
Rhinoscleromamaybefoundinallagegroups,buttypicallyyoung
adults20?30yearsoldaremostfrequentlyaffected.
Airbornetransmissioncombinedwithpoorhygiene,crowdedliving

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conditions,andpoornutritioncontributestoitsspread.
Bothstreptomycin&tetracyclinearegiventogether

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59.Whichofthefollowingistrueregarding
mandibularfracture:
a)Inferioralveolarnervedamagemayoccur

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b)Panorexradiographisveryhelpfulinmanagement
c)Ramusisthemostcommonsiteoffracture
d)Condylarfracturehealsspontaneously&requirenoactive
intervention
e)Condylarfractureismostcommonsite

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CorrectAnswer-A:B:E
Answer-(A)Inferioralveolarnervedamagemayoccur
(B)Panorexradiographisveryhelpfulinmanagement
(E)Condylarfractureismostcommonsite
Condylarprocessfracturesofthemandiblearemostcommon.

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Clinicalfeatures
Pain,Swelling,Deformitywithtrismusormalocclusionofteeth.
ManyPatientswithmandibularfracturesexperiencetraumatothe
inferioralveolarnerve.
Treatment:

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Thefractureisreducedandfixedby:
ClosedreductionorOpenreduction.

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60.Trueaboutchoanalatresia:
a)Unilateralatresiashouldbeoperatedwithin6monthofage
b)Occurd/tpersistenceofbucconasalmembrane

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c)B/1atresiausuallypresentswithrespiratorydifficulties
d)Bilateralatresiamaycausecyanosis
e)Diagnosedbyfailuretopassacatheterfromnosetopharynx
CorrectAnswer-B:C:D:E
Answer-(B)Occurd/tpersistenceofbucconasalmembrane

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(C)B/1atresiausuallypresentswithrespiratorydifficulties
(D)Bilateralatresiamaycausecyanosis(E)Diagnosedby
failuretopassacatheterfromnosetopharynx
Choanalatresiaisanabnormalityofcanalizationduring
developmentofthenasalpassages.

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Itinvolvesboneand/orsofttissueandmayresultineitherpartial
(choanalstenosis)orcompleteobstructionoftheposteriornasal
airway.
Themostwidelyacceptedmechanismforthedevelopmentof
choanalatresiaisthepersistenceofthebucconasalmembrane

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beyondthesixthweekofgestation.
ChoanalatresiaisassociatedwithCHARGEsyndrome:Coloboma
ofeye,Heartdefects,ChoanalAtresia,Retardedgrowth,Genital
defectsandEardefects.
B/LatresiaPresentswithrespiratoryobstructionasthenewborn

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laterdevelopscyanosis.
Operativecorrectionofunilateralobstructionmaybedifferedfor
severalyears.

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61.Stridoris/arecausedbyallexcept:
a)Vocalcordpalsy

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b)Stenosisaftertracheostomy
c)Ludwigangina
d)Retropharyngealabscess
e)None
CorrectAnswer-E

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Answer-None
Itisnoisyrespirationproducedbyturbulentairflowthroughthe
narrowedairpassage.
Inspiratorystridor:Oftenproducedinobstructivelesionsof
supraglottisorpharynx

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Expiratorystridor:Itisproducedinlesionsofthoracictrachea,
primary&secondarybronchi
Biphasicstridor:Itisseeninlesionsofglottis,subglottis&cervical
trachea

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62.TobyAyer'stestis/areusedfor:

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a)CSFrhinorrhoea
b)Lateralsinusthrombosis
c)Sigmoidsinusthrombosis
d)Tocheckpatencyofeustachiantube
e)None

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CorrectAnswer-B:C
Answer-(B)Lateralsinusthrombosis(C)Sigmoidsinus
thrombosis
TheTobey?Ayertestisusedforlateralsinusthrombosisby
monitoringcerebrospinalfluidpressureduringalumbarpuncture.

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Tobey-Ayertest&Crowe-Becktestareperformedinlateralsinus
thrombosis(Sigmoidsinusthrombosis)

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63.Trueaboutpresbycusis:
a)DegenerationofouterHaircelloforganofCortiinsensorytype
b)Highfrequencyisaffectedfirstinsensorytype

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c)Canbetreatedwithhearingaids
d)Usuallyunilateralhearinglossoccurs
e)None
CorrectAnswer-A:B:C
Answer-(A)DegenerationofouterHaircelloforganofCortiin

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sensorytype(B)Highfrequencyisaffectedfirstinsensorytype
(C)Canbetreatedwithhearingaids
Presbycusis,orage-relatedhearingloss,isthecumulativeeffectof
agingonhearing.
Itisaprogressiveandirreversiblebilateralsymmetricalage-related

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sensorineuralhearinglossresultingfromdegenerationofthe
cochleaorassociatedstructuresoftheinnerearorauditorynerves.
Patientsofpresbycusiscanbehelpedbyahearingaid.

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64.Trueaboutpuretoneaudiometry:
a)Thefrequencytestedis2000-9000Hz

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b)Doneinsilentroom
c)Airconductionforrightearisrepresentedonaudiogramby
symbol'X'
d)Airconductionforleftearisrepresentedonaudiogramby
symbol'0'

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e)All
CorrectAnswer-B
Answer-(B)Doneinsilentroom
Inasoundproofroom,thepatient'sabilitytohearpuretonesinthe
frequencyrangeofabout125to8000Hzismeasured.

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Red"O"representsairconductionfortherightearwhileblue"X"
representsairconductionfortheleftear.

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65.AllaretrueaboutMeniere'sdisease
except:
a)Triadofrecurrentvertigo,fluctuatingsensorineuralhearingloss,

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andtinnitusarefound
b)Treatmentconsistsofuseofthiazide
c)Dropattackoccurs
d)Onsetonlyafter>50year
e)None

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CorrectAnswer-D
Answer-(D)Onsetonlyafter>50year
Meniere'sdiseaseisadiseaseoftheinnerear,characterizedbythe
clinicaltriadofrecurrentvertigo,fluctuatingsensorineuralhearing
loss,andtinnitus.

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Diseaseisseenintheagegroupof35-60years.
Malesareaffectedmorethanfemales.
Thetinnitusisusuallylow-pitchedandroaring&isaggravated
duringacuteattacks.
AuralfullnessisamanifestationalwayspresentinMeniere'sattack.

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Patientswithseverehydropsshouldbetreatedwithdiuretics,salt
restriction.

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66.Whichofthefollowingistrue?
a)Internallaryngealnerve:supplycricothyroidmuscle
b)Internallaryngealnerve-sensorysupplybelowvocalcord

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c)Internallaryngealnerve-tensevocalcord
d)Externallaryngealnerve-tensevocalcord
e)Internallaryngealnerve-sensorysupplyabovevocalcord
CorrectAnswer-D:E
Answer-(D)Externallaryngealnerve-tensevocal

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cord(E)Internallaryngealnerve-sensorysupplyabovevocal
cord
Allthemusclewhichmovethevocalcords(abductors,adductorsor
tensor)aresuppliedbyRecurrentLaryngealnerve.
Abovevocalcords-InternalLaryngealnerveabranchofSuperior

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Laryngealnerve
Belowvocalcords-RecurrentLaryngealnerve
Cricothyroidmuscle-ExternalLaryngealnerve

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67.Whichofthefollowingis/aretrueabout
posteriorepistaxis:

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a)Posteriorpackingisdone
b)Oftenduetochronichypertension
c)Persistentcase-ligationofanteriorethmoidalartery
d)Severebleedingincomparisonwithanteriorepistaxis
e)Morecommonlyoccurinelderly

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CorrectAnswer-A:B:D:E
Answer-(A)Posteriorpackingisdone(B)Oftenduetochronic
hypertension(D)Severebleedingincomparisonwithanterior
epistaxis(E)Morecommonlyoccurinelderly
Itislesscommon.

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Itismostlyseenfromposterosuperiorpartofnasalcavity.
Seenafter40yearsofage
Causedduetohypertensionorarteriosclerosis
Featuresshowbleedingissevere
Treatedbypostnasalpackoftenrequired

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