Free NEET PG & INI-CET ENT MCQs

Explanation

Otitis externa, infection of the external ear canal, causes pain aggravated by tragal pressure or pulling the pinna, with canal swelling and discharge. Otitis media, by contrast, is not worsened by moving the pinna. Treatment includes aural toilet and topical antibiotic drops.

Explanation

Streptococcus pneumoniae is the most common cause of acute otitis media, followed by Haemophilus influenzae and Moraxella catarrhalis. It presents with ear pain, fever, and a bulging red tympanic membrane.

Explanation

Otitis media with effusion ('glue ear') is a collection of fluid in the middle ear without acute infection, causing conductive hearing loss and a dull, retracted drum. It is a common cause of hearing impairment and speech delay in children; persistent cases may need grommets.

Explanation

Cholesteatoma is a collection of keratinising squamous epithelium in the middle ear, presenting with chronic foul-smelling discharge and an attic or marginal retraction. It is locally destructive, eroding bone and ossicles, and requires surgery such as mastoidectomy.

Explanation

Otosclerosis is abnormal bone remodelling fixing the stapes footplate at the oval window, causing progressive conductive hearing loss with an intact drum, often in young adults. Treatment is a hearing aid or stapedectomy.

Explanation

Acute mastoiditis presents with post-auricular swelling, redness, and tenderness that push the pinna forward and downward, following acute otitis media. It is a serious complication needing IV antibiotics and often cortical mastoidectomy.

Explanation

A central perforation with mucoid discharge and no cholesteatoma indicates the safe (tubotympanic) type of chronic suppurative otitis media, which rarely causes serious complications. The unsafe (atticoantral) type involves cholesteatoma and is dangerous.

Explanation

A live insect in the ear should first be immobilised or killed with oil or lignocaine drops to prevent painful movement, then removed under vision. Syringing is avoided if perforation is suspected.

Explanation

In conductive hearing loss the Weber test lateralises to the affected ear, because masking of ambient noise enhances bone conduction on that side. In sensorineural loss it lateralises to the normal ear. Rinne is negative, with bone conduction better than air conduction, in conductive loss.

Explanation

A positive Rinne, with air conduction better than bone conduction, is found in normal hearing and in sensorineural hearing loss. A negative Rinne, with bone conduction better than air conduction, indicates a conductive hearing loss in that ear.

Explanation

Meniere disease features episodic vertigo, tinnitus, and fluctuating sensorineural hearing loss, often with aural fullness, attributed to endolymphatic hydrops. Management includes salt restriction, diuretics, and betahistine.

Explanation

BPPV causes brief episodes of vertigo triggered by changes in head position, from displaced otoconia in the semicircular canals. The Dix-Hallpike test is diagnostic, and the Epley repositioning manoeuvre is the treatment.

Explanation

An acoustic neuroma (vestibular schwannoma) is a benign tumour of the vestibular nerve at the cerebellopontine angle, causing progressive unilateral sensorineural hearing loss, tinnitus, and imbalance. MRI is the investigation of choice.

Explanation

Presbycusis is bilateral, symmetrical, age-related sensorineural hearing loss that affects high frequencies first, making speech in noise hard to follow. Hearing aids are the mainstay of management.

Explanation

Aminoglycosides such as gentamicin and streptomycin are classically ototoxic, damaging cochlear and vestibular hair cells and causing hearing loss and imbalance. Other ototoxic agents include high-dose loop diuretics, cisplatin, and quinine.

Explanation

Most anterior nosebleeds arise from Little's area (Kiesselbach's plexus) on the anterior nasal septum, where several arteries anastomose. First aid is firm pinching of the soft part of the nose with the head forward.

Explanation

Allergic rhinitis is an IgE-mediated response to allergens, causing sneezing, watery rhinorrhoea, itching, and congestion, frequently seasonal. Treatment includes antihistamines, intranasal corticosteroids, and allergen avoidance.

Explanation

The maxillary sinus is most commonly affected in adults, partly because its ostium is positioned high, hindering drainage. Sinusitis presents with facial pain or pressure, nasal congestion, and purulent discharge.

Explanation

Bilateral nasal polyps are associated with allergy, asthma, and aspirin sensitivity (Samter's triad), and with cystic fibrosis in children. They cause nasal obstruction and loss of smell; treatment is intranasal steroids and, if needed, polypectomy. A unilateral polyp warrants exclusion of malignancy.

Explanation

Juvenile nasopharyngeal angiofibroma is a benign but locally aggressive, highly vascular tumour occurring almost exclusively in adolescent males, causing recurrent severe epistaxis and nasal obstruction. Biopsy is avoided due to bleeding risk; imaging guides diagnosis and surgery.

Explanation

CSF rhinorrhoea is leakage of cerebrospinal fluid through a skull-base defect, often post-traumatic. Beta-2 transferrin in the fluid is highly specific for CSF. It risks meningitis and may need surgical repair if it does not resolve.

Explanation

Nasopharyngeal carcinoma is strongly linked to Epstein-Barr virus and is more common in Southeast Asia. It may present with a neck node, nasal obstruction, epistaxis, or unilateral otitis media with effusion from Eustachian tube blockage.

Explanation

Rhino-orbital mucormycosis is an aggressive fungal infection in diabetics, especially in ketoacidosis, and in the immunocompromised, causing a black necrotic eschar and rapid orbital and intracranial spread. It is an emergency needing urgent surgical debridement and antifungals.

Explanation

Rhinitis medicamentosa is rebound nasal congestion from overuse, beyond about 5 to 7 days, of topical decongestant sprays such as oxymetazoline. Management is stopping the spray, with intranasal steroids to ease the rebound.

Explanation

Atrophic rhinitis (ozaena) features progressive atrophy of the nasal mucosa and turbinates, producing a wide nasal cavity, foul-smelling crusts, and anosmia in the patient, though others notice the odour. Treatment focuses on nasal hygiene and moisturisation.

Explanation

Group A beta-haemolytic Streptococcus (Streptococcus pyogenes) is the most common bacterial cause of acute tonsillitis. Prompt treatment matters because of possible complications such as rheumatic fever and glomerulonephritis.

Explanation

A peritonsillar abscess (quinsy) causes severe unilateral sore throat, trismus, a muffled 'hot potato' voice, and deviation of the uvula away from the swelling. Treatment is drainage, by aspiration or incision, plus antibiotics.

Explanation

Adenoid hypertrophy causes nasal obstruction with mouth breathing, snoring, and hyponasal speech, an 'adenoid facies', and recurrent otitis media from Eustachian tube obstruction. Adenoidectomy is considered when symptoms are significant.

Explanation

A retropharyngeal abscess in young children causes fever, neck stiffness or extension, drooling, dysphagia, and a posterior pharyngeal wall bulge. It can threaten the airway and spread to the mediastinum, needing prompt drainage and antibiotics.

Explanation

Polysomnography, an overnight sleep study, is the gold standard for diagnosing obstructive sleep apnoea, quantifying apnoeas and hypopnoeas. Management ranges from weight loss and CPAP to surgery for anatomical obstruction.

Explanation

Ludwig angina is a bilateral cellulitis of the submandibular and sublingual spaces, usually from a dental source, causing tongue elevation and a firm swollen floor of the mouth. It is an airway emergency requiring urgent airway protection, antibiotics, and drainage.

Explanation

Hoarseness persisting beyond 2 to 3 weeks, especially in a smoker or drinker, is a red flag for laryngeal carcinoma and requires laryngoscopy. Early glottic cancer presents with hoarseness and has a good prognosis if caught early.

Explanation

Vocal cord nodules result from chronic vocal abuse or misuse, common in singers, teachers, and children who shout, forming at the anterior-middle third junction. First-line treatment is voice therapy and vocal rest.

Explanation

The recurrent laryngeal nerve supplies most intrinsic laryngeal muscles; its injury, for example during thyroidectomy, causes vocal cord palsy and hoarseness. Bilateral injury can cause stridor and airway obstruction.

Explanation

Laryngomalacia, a soft collapsing supraglottis, is the most common cause of congenital stridor, giving inspiratory stridor worse on feeding or crying and usually resolving by 18 to 24 months. Severe cases may need surgery.

Explanation

Tobacco smoking is the strongest risk factor for laryngeal carcinoma, with alcohol acting synergistically. Most laryngeal cancers are squamous cell carcinomas; presenting features include hoarseness, dysphagia, and a neck mass.

Explanation

A thyroglossal cyst is a midline neck swelling that moves up with both swallowing and tongue protrusion, because of its attachment to the hyoid and tongue base via the thyroglossal tract. Treatment is Sistrunk's operation.

Explanation

A branchial cyst typically presents as a smooth, fluctuant swelling at the junction of the upper and middle thirds of the anterior border of sternocleidomastoid, usually in young adults. Treatment is surgical excision.

Explanation

A cystic hygroma (lymphangioma) is a soft, compressible, brilliantly transilluminant neck swelling of infancy, usually in the posterior triangle, arising from lymphatic malformation. Management may include sclerotherapy or excision.

Explanation

Fine-needle aspiration cytology is the first-line investigation for a suspicious neck lump, being quick and minimally invasive. Open (excisional) biopsy of a node is generally avoided early, as it can complicate later definitive surgery for metastatic squamous carcinoma.

Explanation

Pleomorphic adenoma, or benign mixed tumour, is the most common salivary gland tumour, usually in the parotid. It is treated by superficial parotidectomy rather than enucleation to avoid recurrence, with care to preserve the facial nerve.

Explanation

Sialolithiasis, a salivary stone, is most common in the submandibular gland and Wharton's duct, causing pain and swelling that worsen at mealtimes when salivary flow is stimulated but obstructed. Small stones may pass; larger ones need removal.

Explanation

Mumps is a viral (paramyxovirus) infection causing bilateral painful parotid swelling, fever, and malaise, preventable by the MMR vaccine. Complications include orchitis, meningitis, and pancreatitis.

Explanation

Bell's palsy is an idiopathic lower motor neuron facial (VII) nerve palsy affecting the whole side of the face, including the forehead, unlike a central or upper motor neuron lesion, which spares the forehead. Early corticosteroids improve recovery.

Explanation

Ramsay Hunt syndrome (herpes zoster oticus) is reactivation of varicella-zoster virus in the geniculate ganglion, causing facial palsy with painful vesicles in the ear canal or pinna, often with hearing loss and vertigo. Treatment is antivirals plus steroids.

Explanation

An inhaled foreign body most commonly lodges in the right main bronchus, which is wider, shorter, and more vertical than the left. It presents with sudden coughing, choking, and possible unilateral wheeze or reduced breath sounds.

Explanation

Acute epiglottitis, classically caused by Haemophilus influenzae type b, presents with rapid-onset fever, drooling, a muffled 'hot potato' voice, and a tripod or sniffing posture, without the barking cough of croup. It is an airway emergency — do not examine the throat, and secure the airway urgently.

Explanation

Tracheostomy is indicated for upper airway obstruction, the need for prolonged mechanical ventilation, and to aid pulmonary toilet in patients unable to clear secretions. It bypasses the upper airway and reduces dead space.

Explanation

Sudden sensorineural hearing loss is treated urgently, commonly with corticosteroids, because early intervention improves the likelihood of hearing recovery. It also warrants MRI to exclude a retrocochlear cause such as acoustic neuroma.

Explanation

A septal haematoma must be identified and drained promptly after nasal trauma, because the collection strips the perichondrium from the cartilage, risking avascular necrosis and a saddle-nose deformity, and can become infected.