ENT ANSWERS

Ans: c Caloric test has

Slow + Fast components. It is done using hot and cold water

Ans: b Carhart’s notch is characteristically seeh at

2000hz . It is used in assessing hearing

Ans: d Gradenigo’s syndrome does not consist of

Palatal palsy. It contains all the rest

Ans: c In Acoustic neuroma the following is not seen

Motor aphasia. It is a cp angle tumor

Ans: a Myringotomy is done on the Postero inferior

quadrant of the tympanic membrane for drainage of ous

Ans: c In unsafe CSOM with cholesteatoma and sensorineural deafness treatment choice

radical mastoidectomy
7

Ans:a Organ of corti is situated in

scala media. Which is in the inner ear

Ans: d Endolymphatic hydrops is associated with

Presbycusis which occurs in old age

9.

Ans: d Positive Rinnetest is seen in

Presbycusis

10

Ans: c Pulsatile otorrhea seen in

ASOM

11

Ans: b Commonest cause of deafness in childhood is

CSOM which is due to infection

12

Ans: b Otosclerosis is associated with all except

common in males. It is commone in females

13

Ans: a Common cause of facial palsy is

Bell’s palsy. It is idiopathic.

14

Ans: c The land mark on the lateral surface of temporal bone which acts as a guide to surgeryto

the antrum is the

suprameatal spine of Henle

15

Ans: b Destruction of right labyrinth causes nystagmus to

Left side

16

Ans: a The secretomotor nerve fibres of sphenopalatine ganglion supply the

Lacrimal gland

17

Ans: a In conductive deafness Weber test is lateralized to:

deaf ear

18

Ans: d Hyposthesia of the posterior aspect of the external auditory canal may be an early sign of
acoustic neuroma

19

Ans: d Pulsatile tinnitus in ear is due to

glomus jugulare tumour

20

Ans: d Impairment of hearing due to noise starts at

4000 Hz

21

Ans: b Management of otogenic cerebral abscess is

) drainage of abscess followed by mastoidectomy

22

Ans: b Absolute bone conduction test (ABC) is shortened in

perceptive deafness

23

Ans: d All of the following are the features of cholesteatoma except

lymphatic permeation

24

Ans: a In majority of the cases with otosclerosis the tympanic membrane is

normal

25

Ans: a The syndrome of sensorineural hearing loss together with hereditary nephritis is

alports syndrome

26.

Ans: d Ototoxic drugs are all except

ampicillin

27

Ans: d A patient hears better in Noise the diagnosis is

Paracusis. This is the definition .

28 Ans: a Dryness of eyes is caused by injury to facial nerve at

chorda tympani

29

Ans: a The aost mobile part at the tympanic membrane

Central as it is loose.

30 Ans: c The commonest site of otogenic brain abscess occurring due to CSOM is

temporo petrosal lobe

30

Ans: a

In blast injury most common organ affected

eardrum

32. Condition where a pulsatile tumour is found in external auditory meatus which bleeds to

Ans: c

33

Ans: b Organ of corti is arranged along the inner edge of

Basilar membrane

34

Ans: a Cochlear implant used in

sensory neural deafness

35

Ans: c Tone decay test is done to find out

Retrocochlear lesions
36

Ans: a Which of the following statement regarding eustachian tube dysfunction is wrong?

Un Distorted light image on the anterior quadrant of tympanic membrane

37

Ans: c Bell’s palsy not responding to steroid , the further line of management is surgical

decompression

38.

Ans: d The facial nerve is

Medial wall of the middle ear

39

Ans: d Otosclerosis occurs in the

Medial wall of the ear

40.

Ans: b Acute suppurative otitis media is treated using

penicillin

41

Ans: d Before attempting tympanoplasty operation the surgeon must look for

cochlear reserve
42.

Ans: a A patient of CSOM with cholesteatoma present with acute onset of vertigo treatment is

Immediate exploration

43

Ans: c Monoaural diplacusis is present in a lesion of

cochlea

44

Ans: b Blue drum is seen in

secretory otitis media due to discharge accumulated in middle ear

45.

Ans: a Nerve supply of tympanic membrane is

auriculo temporal

46

Ans: c Appreciation of sound occurs in

cochlear nuclei

47

Ans: d Meniers disease is associated with

Mixed deafness
48

Ans: d Acoustic neuroma commonly affects the cranial nerve

8th

49

Ans: a Common cause of eustachian tube disease is due to

adenoids

50

Ans: a A 3year old child presents with fever and earache on examination there is congested

tympanic membranae with slight bulge .

the treatment of choice is

myringotomy with penicillin

51

Ans: c Not a feature of acute mastoiditis

outward and downward displacement of pinna

52

Ans: c Medication which may prevent rapid progress of cochlear otosclerosis is

Fluorides

53

Ans: a The commonest extra cranial complication following mastoidectomy includes

facial nerve palsy

54

Ans: b At birth the following structures are of adult size except

Mastoid antrum

55

Ans: b Commonest occurrence of acoustic neuroma is in

superior vestibular nerve

56

Ans:

A Fungus causing otomycosis most commonly Is

Aspergillus fumigatus

57

Ans: a Mastoid infection which erodes through die outer cortex of bone results in

sub periosteal abscess

58

Ans: c The normal length of external auditory meatus is

24mm both in males and females

59

Ans: d Meniers disease is manifested by all of the symptoms except

otorrhoea

60

Ans: d An Ushaped

audiogram suggests

Congenital deafness

61

Ans: b Mc Evans triangle is the landmark for:

Mastoid antrum

62

Ans: c Macewen’s triangle (suprameatal triangle) can be felt through the

Cymba conchae

63.

Ans: c In a classical case of Meniere’s disease which one of the following statements is true:

Low frequency sensory neural deafness is often seen in pure tone audiogram

64

Ans: d Stapedial reflex is mediated by

VII and VII nerves

65.

Ans: a In Monoaural diplacusis the lesion is in the

Auditory nerve

66

Ans: b Sensory nerve supply of middle ear cavity is provided by

Glossopharyngeal

67.

Ans: a The Kobrak test is used for:

Minimal caloric stimulation

68.

Ans: b Most reliable landmark in otoscopy is

Umbo

69

Ans: a The feature of Gradenigo’s triad is

Abducent nerve palsy

70

Ans: b Treatment of choice in deafness associated with Attico antra! perforation

Modified radical mastoidectomy

71

Ans: d Myringoplasty is plastic repair of

Tympanic membrane

72

Ans: a Increased threshold of air conduction and decreased direshold of bone conduction aie

associate with

Middle ear disease

73

Ans: b Bezolds abscess is located in

Sternomastoid muscle

74

Ans: d Myringitis bullosa is caused by

Virus

75

Ans: c Caloric test. This testr is done using hot and cold water.

76

Ans: a Unsafe otitis media in a child with high fever and convulsion, the diagnosis is

Temporal lobe abscess

77

Ans: a In the external auditory meatus, the cartilaginous portion is

Smaller than bony portion

78

Ans: b cholesteatoma

Erodes bone

79

Ans: b The prominent eminence seen over medial wall of middle ear is

Cochlea (basal turn)

80.

Ans: b Rinne’s test negative is seen in

CSOM

81

Ans: b Mastoid tip appears at the age of:

2years

82

Ans: c Scantly, purulent offensive discharge from the ear is due to

Atticoantral disease
83.

Ans: c Malignant Otitis externa is caused by

P.aeroginosa

84

Ans:

B Commonest cause of suppurative otitis media is

Pneumococcus

85.

Ans: a 8 year old child with bilateral conductive deafness, the diagnosis is

Glue ear

86

Ans: a Fitzgerald’s caloric test uses temperature at

30″cand44°c

87.

Ans: b The most common cause of cerebrospinal otorrhoea is:

Fracture or petrous ridge

88

Ans: b The usual location of glomus jugulare tumour is:

Hypotympanum

89.

Ans: a Acute otitis media can be very serious in children if associate with

Infection by pneumococcus

90

Ans: a Commonest complication in CSOM is

Conductive deafness

91.

Ans: a Tobey Ayer test is useful for diagnosing

Lateral sinus thrombosis

92

Ans: b True Statement about malignant external otitis is

Common in diabetics & Old age

93

Ans: b Flat tympanogram is a feature of

Serous otitis media

94

Ans: d Acute mastoiditis is characterized by all except

Outward & downward deviation of the pinna

95

Ans: d Foot plate of stapes

96

Ans: b None of the above

97.

Ans: b Commonest indication for myringotomy is

Serous otitis media

98

Ans: b Processes cochleaformis attaches to

Basal turns of helix

99.

Ans: c Early symptom of an Acoustic nerve tumor is

Unilateral hearing loss

100

Ans: c Multiple perforations of Tympanic membrane

Pseudomonas
101. Ans: (c) (Torus palatine)

102 Ans: (c) (Quinsy) It is an abscess

103. Ans: (a) (Parapharyngeal abscess) It occurs lateral to pharynx

104. Ans: (b) (Parapharyngeal space) It occurs lateral to pharynx

105. Ans: (a) (Quinsy) It is an abscess

106. Ans: (a) (Tonsil) Kissing tonsil occur in infectious mononucleosis

107. Ans: (Cricopharynx) It is a part of pharynx

108. Ans: (a) (Pain during swallowing) Its called dysphagia

109. Ans: (c) (Vents)

110. Ans: (d) (Extensive consolidation of lung) Air bronchogram is seen in consolidation.

111. Ans: (b) (Infection)

112. Ans: (d) (TB lymphadenitis) It is non painful generally.

113. Ans: (a) (Immediate removal of the tracheostomy tube)

114. Ans: (d) (Removal of stenosed part with anastomosis)

115. Ans: (b) (Medially, the pterygopalatine fossa communicates

through the pterygomaxillary fissure with the infratemporal
fossa)

116. Ans: (c) (Addison’s disease) It causes pigmentation

117. Ans: (c) (Ludwig’s angina) It is a type of abscess

118. Ans: (b) (Bleeding occurs if the membrane is tried to remove)

119. Ans: (d) (TB lymphadenitis) It is non painful generally.

120. Ans: (a) (Croup) Its also called laryngotracheobronchitis.

121. Ans: (a) (Erythromycin) Its safe in pregnancy

122. Ans: (b) (It is diffuse cellulitis affecting the floor of the mouth)

123. Ans: (a) (Ludwig’s angina) It is a type of abscess

124. Ans: (a) (Vagus nerve) Can cause vasovagal synciope

125. Ans: (b) (Multiple sclerosis) Its has dawsons fingers

126. Ans: (c) (3,1,2)

127. Ans: (b) (Triple endoscopy)

128. Ans: (b) (Nasopharyngeal carcinoma) Common in young people

129. Ans: (c) (CECT) Contrast enhanced CT

130. Ans: (b) (CECT) Contrast enhanced CT

131. Ans: (b) (Choanal atresia)

132. Ans: (a) (Tensor palati)

133. Ans: (c) (Stylopharyngeus)

134. Ans: (b) (Palatoglossus)

135. Ans: (d) (All)

136. Ans: (a), (b)

137. Ans: (c) (Upper third of anteromedial border of sternocleidomastoid

138. Ans: (d) (Ranula) It opccurs in midline

139. Ans: (d) (Geniculate ganglion)

140. Ans: (d) (Interferons) They are used in hep C

141. Ans: (a) (Neo adjuvant chemotherapy)

142. Ans: (d) (Iridium) It’s a rare earth

143. Ans: (a) (Zenker’s diverticulum)

144. Ans: (a) (The tumor blends with bifurcation of carotid artery)

145. Ans: (b) (True cut biopsy is investigation of choice)

146. Ans: (c) (CECT) Contrast enhanced CT

147. Ans: (a) (Excision of tumor)

148. Ans: (d) (Relaxes ahead of the peristaltic wave)

1495. Ans: (a) Barium Swallow . Barium sulphate is used

150. Ans: (b) (Hiatal disorders)

151. Ans: (b) (Achalasia) Its occur in young

152. Ans: (b) (Carcinoma esophagus)

153. Ans: (a) (Candidial oesophagitis) Occurs in HIV

154. Ans: (a) (Carcinoma of Esophagus) Occur in old

155. Ans: (c) (Diffuse esophageal spasm) Spiral pattern is seen on barium

156. Ans: (d) (Compression of esophagus by aberrant blood vessel)

157. Ans: (a) (Abnormal origin of left subclavian artery)

158. Ans: (d) (Diffuse esophageal spasm) Spiral pattern is seen on barium

159. Ans: (b) (Laparoscopic myotomy)

160. Ans: (a) (Lower oesophagus lined by columnar epithelium)

161. Ans: (a) (Barrett’s esophagus) Occurs in GERD

162. Ans: (b) (Middle third)

163. Ans: (d) (Compression by aberrant blood vessels)

164. Ans: (c) (Myotomy with excision of the sac)

165. Ans: (b) (Excision of the diverticulum with cricopharyngomyotomy)

166. Ans: (a) (Stomach) Stomach is site of ulcers commonly

167. Ans: (a) (Achlasia cardia)

168. Ans: (a) (Zenker’s diverticulum)

169. Ans: (d) (Common in elderly male)

170. Ans: (d) (Benzene therapy)

171. Ans: (d)(Ca Esophagus) Commonest is adenocarcinoma

172. Ans: (a) (Barrett’s Esophagus) Occurs in GERD

173. Ans: (b) (Barrett’s esophagus) Occurs in GERD

174. Ans: (b)(Middle third)

175. Ans: (a) (Cisplatin) Its made of platinum

176. Ans: (a) (Acute tubular necrosis) Occurs with contrasts.

177. Ans: (a) 10 cm

178. Ans: (a), (b), (c), (d)

179. Ans: (a) (Oesophagitis)

180. Ans: (d) Valeculae

181 Answer : (b) Infundibulum

Reference: PL Dhingra 3rd Edition Page

182Answer : (a) Cricothyroid

Reference: Gray 38th Edition Page 1645

*Action of Intrinsic Muscles of Larynx

- Varying the Rima Glottidis
- The posterior crico-arytenoids are the only laryngeal muscles which open the glottis, rotating
the arytenoid cartilages laterally around an axis passing through the crico-arytenoid joints, thus
separating the vocal processes and the attached vocal folds. They also pull the arytenoids
backwards, assisting the cricothyroids to tense the vocal folds. The most lateral fibres draw the
arytenoids laterally, so the rima

glottidis becomes triangular when the posterior crico-arytenoid muscles contract.

- The lateral crico-arytenoids close the glottis by rotating the arytenoids medially, to approximate
their vocal processes. The transverse arytenoid pulls the arytenoid cartilages towards each other,
closing the posterior (intercartilaginous) part of the rima glottidis.
- Regulating Tension in the Vocal Ligaments
- The cricothyroids stretch the vocal ligaments by tilting the thyroid cartilage forwards and
downwards on the cricoid. Because the arytenoid cartilages are anchored to the cricoid lamina,
the sagittally directed rotation of the thyroid cartilage increases the distance between their vocal
processes and the anterior angle of the thyroid, so lengthening the vocal ligaments. The cricoid is
usually held immovably against the vertebral column by the cricopharyngeus during phonation
so that under these conditions it is the thyroid cartilage which moves. During swallowing,
however, the cricopharyngeus relaxes, allowing the cricoid to tilt forwards during laryngeal
closure.
- The thyro-arytenoids draw the arytenoids towards the thyroid cartilage, shortening and relaxing
the vocal ligaments. At the same time, they rotate the arytenoids medially to approximate the
vocal folds. Their deeper fibres, the vocales, relax the posterior parts of the vocal ligaments, their
anterior parts remaining tense and thus raising the vocal pitch. For details of arytenoid
movements consult Sellars.
- Modifying the Laryngeal Inlet
- The oblique arytenoids and aryepiglottic act as a sphincter of the laryngeal inlet by adducting
the aryepiglottic folds and approximating the arytenoid cartilages to the tubercle of the epiglottis.
- The thyro-epiglottic muscles widen the inlet by their action on the aryepiglottic folds.

183Answer : (a) Radiotherapy

Reference: PL Dhingra 3rd Edition Page 305 and Bailey and Love 24th Edition Page 749, 750

184Answer : (d) All of these

Reference: PL Dhingra 3rd Edition Page 386

185Answer : (C ) Palatine Tonsil

Reference: Gray 3rd Edition Page 1729

186Answer : (a) Basilar Membrane

Reference: Gray 38th Edition Page 1387

187Answer : (a) Hearing Loss

Reference: PL Dhingra 3rd Edition Page 144

188Answer : (b) Middle Meatus

Reference: Basak 3rd Edition Page 302

189Answer : a) Juvenile Nasopharyngeal angiofibroma

Reference: Dhingra 3rd Edition Page 299

190Answer : a) Left hilar bronchial carcinoma

Reference: Dhingra 3rd Edition Page 360.

191c. Parainfluenza virus

The answer is c.
(Levinson, pp 230–231.) Parainfluenza viruses are important causes of respiratory diseases in
infants and young children. The spectrum of disease caused by these viruses ranges from a mild
febrile cold to croup, bronchiolitis, and pneumonia. Parainfluenza viruses contain RNA in a
nucleocapsid encased within an envelope derived from the host cell membrane. Infected
mammalian cell culture will hemabsorb red blood cells owing to viral hemagglutinin on the
surface of the cell.

192d. Incision, drainage, and pressure bandage

(Sabiston, 15/e, pp 1277–1278.) A subperichondrial hematoma in the pinna of the ear may lead
to avascular necrosis of the cartilage with shriveling of the pinna and fibrosis and calcification of
the hematoma. The result is the deformity known as “cauliflower ear.” Appropriate treatment
consists of evacuation of the hematoma by incision and tight packing of the skin and
perichondrium onto the cartilage with a pressure dressing. Needle aspiration does not effect
adequate drainage. Ice packs may be helpful early, but are not sufficient to prevent the
deformity; antibiotics are not indicated for this lesion. Since the hematoma is subperichondrial,
excision of the hematoma would remove the perichondrium and lead to cartilage deformities.

193(B) Cerumen impaction. Cerumen prevents water from entering ears.

194a. Foreign body. Commonest Fb in child is peanut

195d. Voice strain. Occcurs in singers and teachers

196e. Foreign body in the esophagus. FB has to be removed by endoscopy.

197d. Has conductive or sensorineural hearing loss

198a. Conductive. Conductive hearing loss is common in elderly.

199a. It has an unusually high incidence among Chinese. Japanese have high gastric carcinoma
200d. Tinnitus. Menieres disease has tinnitus. It generally occurs in pregnant females.