Subject: ENT Paper:

Q-1 MCQs.
1. An elderly poorly controlled diabetic presents with fever and a large firm, ovoid
shaped tender, hyperemic neck swelling at upper lateral neck below and behind the
angle of mandible. The most likely diagnosis is:-
a. Ludwig’s angina
b. Retropharyngeal abscess
c. Peritonsillar abscess
d. Parapharyngeal abscess
e. Acute parotitis

2. A 50 years old male presents with history of nasal obstruction and occasional
epistaxis. On examination, unusually wide nasal cavities with foul smelling crusts
are seen. The most likely diagnosis is:-
a. Infective rhinitis
b. Allergic rhinitis
c. Hypertrophic rhinitis
d. Atrophic rhinitis
e. Rhinitis medicamentosa

3. In a patient with facial paralysis where the upper half of face is spared, the level of
lesion is most likely:-
a. In the vertical part below the chorda tympani nerve
b. In the internal auditory canal
c. In the horizontal tympanic part
d. In the cerebello pontine angle
e. Central lesion

4. A 35 yeas old female patient presents to you with two days history of complete loss
of voice, normal cough and no respiratory distress or dysphagia. Indirect
laryngoscopy is unremarkable. The most likely condition is:-
a. Spasmodic dysphania
b. Functional aphonia
c. Gastroesophageal reflux disease
d. Globus hysterious
e. Acute laryngitis

5. A 45 years old male patient presents with persistent unilateral middle ear effusion.
The optimal management principle in such a clinical situation is:-
a. Screen and treat any nasal allergies
b. Exclude nasopharyngeal carcinoma
c. Myrinogotomy with long stay ventilation tube placement
d. Provision of hearing aid & reassurance
e. Long term systemic nasal decongestants & anti histamines

6. New onset non resolving persistent hoarseness in a heavy smoker requires :-

a. Broad spectrum antibiotics with systemic decongestants
b. Immediate cessation of smoking
c. Steam inhalations and complete voice rest
d. Speech therapy, voice rest and close regular follow up
e. X ray chest , panendoscopy and biopsy

7. A 7 years old girl develops acute earache during an upper respiratory tract
infection. The most likely cause of the pain is:-
a. Acute otitis media
b. Boil ear
 c. Herpes zoster otitis
d. Otitis media with effusion
e. CSOM

8. A 10 years old boy presents on 6 th post operative day of tonsillectomy with

complaints of fever, throat pain and bleeding from right tonsillar fossa. The most
probable diagnosis is:-
a. Injury to tonsillar pillar
b. Secondary haemorrhage
c. Primary haemorrhage
d. Reactionary haemorrhage
e. All of the above

9. A middle-aged male patient describes increasing dysphagia for one year. He also
describes regurgitation of undigested food and cough. Clinically he is grossly
malnourished with a bad chest. Rest of otolaryngologic examination is
unremarkable. The first investigation of choice in such a situation is:-
a. Blood complete picture
b. Esophagoscopy
c. Ultrasound neck
d. Barium swallow
e. X-ray neck lateral view

10. Persistent unilateral foul smelling nasal discharge in a child is pathognomonic of :-

a. Foreign body nose
b. Rhinolith
c. Unilateral choanal atresia
d. Antrochoanal polyp
e. Nasal vestibulitis

11. A 10 year old girl presents with a painless swelling in the midline of the
neck just below the hyoid bone which moves with protrusion of tongue. The
most probable diagnosis is :-
a. Cystic hygroma
b. Thyroglossal duct cyst
c. Lipoma
d. Branchial cyst
e. Laryngocele

12. Which of the following is indicative of foreign body in tracheobronchial

tree?
a. History of coughing , choking and gagging
b. X.ray chest with hyperinflated lung on one side
c. X ray chest with unilateral atelectasis
d. All of above
e. None of above

13. A mother brings a 7 year old child with complaints of fluctuating hearing
loss, occasional mild earache and a deteriorating school performance for
several months. There is no history of any ear discharge. On examination
 both tympanic membranes are dull, opaque and immobile. The most
probable diagnosis is:-
a. Acute mastoiditis
b. Acute otitis media
c. CSOM
d. Otitis media with effusion
e. Chronic otitis externa

14. A 25 year old lady underwent SMR. Nasal packs were removed after 24 hrs.
Two days later she reports again with bilateral complete nasal obstruction
with no local pain or fever. The most probable diagnosis is:-
a. Retained foreign body
b. Septal abscess
c. Septal hematoma
d. Intra nasal adhesions /scar bands
e. None of the above

15. The most appropriate management option in a non healing unilateral tongue
ulcer of one month duration is:-
a. Antibiotics
b. Topical steroids
b. Observation
d. Biopsy
e. CT scan

16. Second constriction of esophagus lies at the level of:-

a. 15 cm from incisor
b. 20 cm from incisor
c. 25 cm from incisor
d. 30 cm from incisor
e. 40 cm from incisor

17. The recommended screening test for hearing in a neonate is:-

a. Pure tone audiometery
b. Otoacustic emissions
c. Behavior observational audiometery
d. Tympanometery
e. Distraction techniques

18. The most common presentation of clinical AIDS in head and neck is :-
a. Non resolving rhinosinusitis
b. CSOM
c. Bilateral cervical lymphadenopathy
d. Kaposi’s sarcoma
e. Candidal esophagitis

19. The highest probability of cervical nodal metastases is from a squamous cell
carcinoma arising in:-
a. Oropharynx
 b. Hypopharynx
c. Larynx
d. Oral cavity
e. Nasal cavity

20. The most important management principle in a patient with severe

midfacial trauma is :-
a. Immobilization of cervical spine
b. Control of epistaxis
c. Reducing and fixing fractures
d. Treatment of hypovolemic shock
e. Securing the airway

21. In lower motor neuron facial paralysis with intact taste sensation at the anterior 2/3
of tongue the level of lesion is
a. In the internal auditory canal
b. In the horizontal tympanic part
c. In the vertical part below the chorda tympani
d. None of above

22. The following drug causes irreversible ototoxicity:-

a. Aspirin
b. Erythromycin
c. Vancomycin
d. Amikacin

23. In tracheostomy, bleeding and injury to vital structures is most likely to occur in case
of :-
a. Improper patient position
b. When abnormalities of cervical spine exist
c. Systemic co-morbid conditions
d. When dissection is not limited to midline

24. A young lady with sudden onset of inability to speak but with normal cough, no
respiratory distress and unremarkable indirect laryngoscopy most likely suffers from:-

a. Functional aphonia
b. Spasmodic dysphonia
c. Laryngopharyngeal reflux with secondary acid laryngitis
d. Globus pharyngeus

25. Which condition is characterized by vertigo when the head is placed in a certain
critical position without hearing loss:-
a. Meniere’s disease
b. Benign paroxysmal positional vertigo
c. Vestibulotoxic drugs
d. Vestibulitis

26. The following condition is not considered a premalignant condition in the oral
cavity :-
 a. Aphthous ulcer
b. Leukoplakia
c. Erythroplakia
d. Erosive type of lichen plannus

27. The thick grey coloured pseudomembrane typical of diphtheria is because of:-

a. Secondary bacterial infection by other oropharyngeal flora

b. Secondary fungal infections
c. Neutrophils, fibrin necrotic mucosa and bacteria
d. Neutrophils , macrophages and inflammatory mediators

28. The optimal management principle in an adult patient presenting with persistent
unilateral middle ear effusion is:-
a. Perform tests of Eustachian tube function
b. Exclude a nasopharyngeal cancer
c. Myringotomy with cytology of fluid
d. Myringotomy with long stay ventilation tube.

29. All the following are true about Malignant Otitis Externa except :-
a. Caused by Psuedomonas Aeroginosa
b. Usually affects diabetics
c. Old age is mostly affected
d. It is a potentially fatal malignant tumor

30. Most commonly used graft material for tympanoplasty is:-

a. Fascia lata
b. Colle’s fascia
c. Sural vein
d. Temporalis fascia

31. All the following paranasal sinuses open in middle meatus except:-
a. Frontal sinus
b. maxillary sinus
c. anterior ethmoidal cells
d. sphenoidal sinus

32. A firm nodular swelling in upper neck in the midline which does not move on
swallowing or tongue protrusion is most likely :-
a. Delphian lymph node enlargement
b. Benign salivary gland tumour
c. Dermoid cyst
d. Thyroglossal duct cyst

33. The most prominent feature of tuberculosis otitis media is :-

a. Multiple perforation
b. Cholesteatoma
c. Central perforation
d. Raised ESR

34. In a patient with conductive deafness of left ear, his tuning fork test will be:-
 a. Rinnes negative in right ear
b. Rinnes positive in left ear
c. Weber lateralized to right ear
d. Weber lateralized to left ear

35. A 5 year old child is brought by his mother with complaints that the child is a mouth
breather, snores at night and has impaired hearing. Pure tone audiometery shows
conductive deafness in both ears and tympanometery shows a flat curve (typeB). The
most likely diagnosis is:-
a. Acute otitis media
b. Otitis media with effusion
c. Ossicular discontinuity
d. Perforation of the tympanic membrane
36. Treatment of Plummer Vinson syndrome is:-
a. Iron supplementation
b. Blood transfusion
c. Antibiotics
d. All of Above
37. A 45 year old lady comes with history of nasal obstruction and occasional epistaxis.
On examination she has wide nasal cavities with foul smelling crusts. The most likely
diagnosis is:-
a. Atrophic rhinitis
b. Allergic rhinitis
c. Hypertrophic rhinitis
d. Infective rhinitis

38. A 43 years obese man was operated upon for mucormycosis of the paranasal sinuses.
On removal of packs he complained of dripping of clear fluid from the nose especially
on getting up in the morning. What diagnostic test would you advise to the patient:-
a. β2 transferrin estimation of the fluid
b. Culture of the fluid
c. CT scan of the paranasal sinuses
d. Fluid routine examination

39. Tympanic membrane in Otosclerosis, in most of the cases is:-

a. Pink
b. Yellow
c. Retracted
d. Normal

40. A 22 year old male was operated for deflected nasal septum. Post operatively his
nasal packs were removed after 24 hours and he was discharged. 2 days later he
reported back with complaints of complete nasal obstruction on both sides. The most
probable diagnosis is:-
a. Allergic rhinitis
b. Hypertrophied turbinates
c. Post operative crusts
d. Septal haematoma
 41. An adult presented with acute onset dysphagia, edema of the uvula and palate,
medially pushed tonsil and trismus is most likely to have:-
a. Acute submandibular abscess
b. Acute retropharyngeal abscess
c. Peritonsillar abscess
d. Prevertebral abscess
42. The most common cause of reactionary post- adenoidectomy bleeding is
a. Adenoid remnant
b. Adenoid enlargement
c. Hypertension
d. Fever

43. Hump nose is managed by

a. Reduction rhinoplasty
b. Augmentation rhinoplasty
c. Nasal tip reconstruction
d. All of the above
44. Medial wall of middle ear is formed by
a. Tympanic membrane
b. Promontory
c. Eustachian tube
d. None of above

45. Unilateral nasal obstruction can be the result of following except

a. Unilateral choanal atresia
b. Antro choanal polyp
c. Marked septal deviation
d. Septal performation

MCQs Key

D D B A
D C A A
E D C B
B C B D
B B D C
E C D A
A A D A
B E C B
D C A D
A D B
B D B
D A A