ENT ModuleExam Sem7 2015

ENT Module Questions 2015

(Do confirm the answers if any doubt, the ones marked here were majority’s opinion when we discussed the Qs , some references are also mentioned) 1. As regards impedance matching function of the middle ear, the least important factor is: a. Intact ossicular chain b. Patent eustachean tube c. Presence of air in middle ear cavity d. Intact tympanic membrane e. Functioning cochlea 2. Antimicrobial activity of beta lactam antibiotics depend upon the intact beta lactam ring. Destruction of the ring by acids or beta lactamase (penicillinase) destroys the antimicrobial activity. Which drug protects the beta lactam antibiotics from the destruction by beta lactamases and are often given the penicillins. a. Sulfamethaxole b. Amikacin c. Clavulanic acid d. Doxycycline e. trimethoprim 3. A 45 years old healthy male presents with sudden onset of acute incapacitating vertigo lasting for hours for last 5 days, associated with nausea, vomiting. He denies suffering from tinnitus or deafness. There is unidirectional spontaneous nystagmus. The most likely diagnosis is: a. Syphilitic labyrinthitis b. Vestibular neuronitis c. Perilymph fistula d. Meniere’s disease e. labyrinthitis 4. The premalignant condition having the most potential conversion rates to malignancy is: a. Leuko-erythroplakia b. Erythroplakia (BASIS) c. Leukoplakia d. Lichen planus e. Submucosal fibrosis 5. The confirmatory test for the diagnosis of Benign Paroxysmal Positional Vertigo (BPPV) is: a. CT scan b. Romberg test c. Dix-Hallpike Maneuver (DHINGRA) d. Finger-nose test e. MRI scan 6. Epley maneuver (Canalith repositioning procedure) is the treatment of choice for:’ a. Perilymph fistula

b. Menieres disease c. Labyrinthitis d. Vestibular neuronitis e. Benign paroxysmal positional vertigo (BPPV) (DHINGRA) 7. Patient with abrupt onset of signs/symptoms of middle ear inflammation and effusion , a known case of beta lactam allergy. The following is most appropriate choice to treat the infection . a. Cefpodoxim b. Clarithromycin c. Cefdinir d. Amoxicillin/clavulanate e. High-dosage amoxicillin 8. A 55 years old female presents with bouts of episodic vertigo lasting for 30 seconds since last night,induced by change in head position after a delay of few seconds, not associated with nausea, vomiting or deafness. The most likely diagnosis is: a. Labyrinthine fistula b. Benign paroxysmal positional vertigo (BPPV) c. Labyrinthitis d. Menieres disease e. Perilymph fistula 9. A two year old child presented to ER with pain, fever and discharge from his left ear. The organism least likely to be involved is: a. Group A streptococcus b. Streptococcus pneumonia c. M. Catarrhalis d. Pseudomonas aeruginosa e. Haemophilus inflenzae 10. The most common organism isolated from chronic discharging ears is: a. Proteus b. Streptococcus c. Klebsella d. Pneumococcus e. Pseudomonas 11. Laryngocele arises from? a. Thyrohyoid membrane b. Paraglottic space c. Pre-epiglottic space d. Laryngeal ventricle (DHINGRA) e. Reinke’s space 12. Recurrent painful ulcer in oral cavity. On examination the multiple mucosal ulcer with pale yellow centre with red halo, what is the best statement suited to this condition. a. Autoimmune etiology is implicated b. Aphthous ulcer is the probable diagnosis c. These are very painful ulcer d. Nutritional deficiency is the cause e. It runs in family 13. A 34 year old female diagnosed as case of squamous cell carcinoma of lateral border of tongue (T2NoMo). the appropriate treatment strategy would be: a. Hemiglossectomy with functional dissection + radiotherapy

b. Hemiglossectomy c. Hemiglossectomy with functional neck dissection d. Partial glossectomy e. Hemiglossectomy with chemo + radiotherapy 14. Ranula is a: a. Retention cyst of minor salivary gland of palate b. Retention cyst formed in submandibular gland c. Retention cyst of sublingual gland (DHINGRA) d. Retention cyst formed in parotid gland e. Retention cyst of minor salivary gland of li 15. A 3 years old child present with acute otalgia and high grade fever, otoscopy reveals red bulging left tympanic membrane. The most appropriate measure to relieve symptoms is: a. Analgesics and antipyretics b. Oral antibiotics c. Myringotomy and aspiration d. Parenteral antibiotics e. Aural toilet 16. A 5 years old child with the complains of earache and diagnosed as suppurative otitis media, which of the following antibiotics should be avoided? a. Amoxicillin/clavulanate b. Clarithromycin c. Cefuroxime d. Ampicillin e. Tetracycline 17. Location of the osteomeatal complex: a. Middle meatus (DHINGRA) 18. Bilateral swelling of the nasal septum, pain, fever. Diagnosis? a. Septal abscess 19. Removal of nasal packing after 48 hours yields severe bleeding. Management? a. Repack for 48-72 hours (DHINGRA) 20. Classification of fracture of the nasal bone? a. Classes I, II, III (UDAIPURWALA) b. Le forte class I, II, III 21. 15 Y/O presents with a mass in the right nostril which causes frequent obstruction and bleeds when touched. Diagnosis? a. Angiofibroma 22. Patient with symptoms of URTI, odynophagia, torticollis, dribbling saliva, with the pharyngeal wall pushed medially. Diagnosis? a. Parapharyngeal abscess 23. Investigation of choice for suspected nasopharyngeal angiofibroma? a. CT scan head with contrast (DHINGRA) b. CT scan head 24. Most important etiological factor for Ludwig’s angina? a. Dental infection (DHINGRA) 25. Throatache, earache, trismus, odynophagia, dribbling of saliva, uvula pointing in the opposite direction. Diagnosis? a. Quinsy 26. Stage of OM in which the tympanic membrane shows prominence of the lateral process of the malleus with loss of the light reflex? a. Stage of tubal occlusion (DHINGRA) b. Stage of presuppuration c. Stage of suppuration 27. A child presents with unilateral nasal obstruction associated with a purulent discharge. Diagnosis?

a. Foreign body 28. Blockage of Eustachian tube, falling out of tooth, radiopacity in the maxillary sinus. Diagnosis? a. Rhinolith b. Adenocarcinoma c. foreign body d. squamous cell carcinoma 29. A female presents with a 2-day history of sneezing, fever, itching, headache, bodyache. Diagnosis? a. Acute rhinitis b. atrophic rhinitis c. acute maxillary sinusitis d. chronic rhinitis e. acute primary rhinitis 30. Appearance of the inferior turbinate mucosa of a male with allergic rhinitis on anterior rhinoscopy? a. Pale, fibrosed b. red, swollen c. red, congested d. pale, swollen 31. A woman presents with dysphagia, koilonychia, iron-deficiency anemia, esophageal webbing. Diagnosis? a. Patterson-Kelly-Brown syndrome 32. A person has developed a malignancy in the left buccal mucosa which is seen to extend towards the gums. Which investigation should be done to visualize mandibular involvement? a. MRI b. OPG (UDAIPUUR chap 40 bcq no 5, chap 57 bcq no 5) c. X ray (AP and lateral views) 33. A person develops swelling on the right parotid gland. Biopsy shows the lesion to be malignant. Probable diagnosis: a. Mucoepidermoid carcinoma b. adenoid cystic carcinoma 34. A person develops a swelling on the left buccal mucosa. Biopsy shows the lesion to be malignant. Probable diagnosis: a. Squamous cell carcinoma b. Adenocarcinoma c. adenoid cystic carcinoma d. mucoepdermoid carcinoma e. anaplastic carcinoma 35. A person with esophageal cancer suddenly develops stridor. What intervention will be done? a. Conventional tracheostomy b. high tracheostomy 36. Most common cause of septal perforation: a. Trauma (DHINGRA) 37. Gold standard test for diagnosing CSF rhinorrhea: a. B2 transferrin in nasal secretions 38. Gold standard test for detecting site of leakage in CSF rhinorrhea: a. Cisternography b. coronal CT scan

39. A person suffering meniere's disease is having severe symptoms for which all medical measures have failed. What next step should be done for the management of the disease? a. Labyrinth destruction b. shunt procedures c. sacculotomy 40. Sensory supply of posterior one third of tongue is by a branch of: a. glossopharyngeal nerve (DHINGRA) 41. Most common midline swelling: a. thyroid b. thyroglossal cyst. c. Dermoid cyst

42. Most important pre-operative Investigation for a case of presumptive suprahyoid thyroglossal cyst? a. thyroid profile b. technetium scan c. ultrasound d. FNAC 43. Most important presentation of DNS: a. recurrent sinusitis b. nasal blockage c. headache 44. Treatment of choice for stage I laryngeal cancer: a. Radiotherapy b. Chemotherapy c. laryngectomy 45. Confirmatory test for meniere's disease: a. Glycerol(dehydration) test 46. secondary sjogren syndrome: a. keratoconjunctivitis sicca+xerostomia+connective tissue disease (DHINGRA) b. xerophthalmia+xerostomia c. keratoconjunctivitis sicca+xerostomia+xerophthalmia 47. Patient in OPD presented with hoarseness of voice. Which technique will help the doctor visualize the vocal cords: a. indirect laryngoscopy b. flexible laryngoscopy c. rigid laryngoscopy 48. Most fearsome complication of excision of lymphangioma: a. Hemorrhage b. damage to vagus, accessory nerves 49. Laryngeal crepitus is seen in: a. normal persons 50. most common complication of Tracheostomy tube? a. Blockage b. decannulation c. subglottic stenosis 51. ranula management? a. Excision b. marsupialization 52. hoarseness of voice for hours, after pop singing is due to: a. laryngeal spasm b. laryngeal edema c. vocal nodule 53. why do we use tracheostomy in ICU pts? a. Assisted ventilation b. Clearance of bronchial secretions 54. Wrong statement about Ludwig’s angina? a. prevertebral area is also involved 55. Little’s area is situated at? a. anterior inferior part of nasal septum (DHINGRA) 56. Young adult comes with complain of epistaxis, most common site: a. Little’s area

57.

What percentage of saliva is contributed by submandibular gland? a. 70% (GUYTON) b. 50% c. 30% 58. wrong about zenker’s diverticulum? a. Anticholinergics are the treatment of choice 59. Most common tumor arising from skin of nose? 60. True about diphtheria? a. Dirty grey membrane seen on the surface of tonsils b. Dirty grey membrane seen on the posterior tongue 61. A female patient with koilonychia and dysphagia, her report will show: a. raised TIBC b. decreased TIBC c. increased iron 62. 25 year old male patient presents with globular neck swelling present on upper part of neck anterior to sternocleidomastoid is: a. branchial cyst b. metastatic lymph nodes 63. If left recurrent laryngeal nerve is injured which of the muscles is not affected? a. Cricothyroid (DHINGRA) b. Posterior cricoarytenoid 64. Most common abscess as a result of mastoiditis? a. Postauricular abscess (DHINGRA) b. Bezold abscess c. Citelli’s abscess 65. Most common site of leukoplakia? a. Buccal mucosa (DHINGRA) b. Floor of mouth 66. Body builder with fluctuating hearing loss? a. Meniere’s disease 67. Most common benign tumor of nose and sinuses? a. Squamous papilloma b. Inverted papilloma c. angiofibroma 68. Commonest fungus of ear? a. Aspergillus b. candida 69. Prominence of adam’s apple is due to? a. thyroid cartilage b. cricoid 70. Polychondritis of pinna is due to? a. autoimmune 71. A school driver comes with complains of rhinorrhea and associated symptoms. Which of these anti histamines will be most appropriate for him? 72. For uncontrollable posterior epistaxis : a. ligation of maxillary artery (DHINGRA) 73. midline swelling that moves with tongue protrusion : a. thyroglossal cyst (DHINGRA) 74. nasal polyps symptoms triad of: a. nasal mass, headache, nasal obstruction (DHINGRA)

75.

Modified radical dissection preserves which structures : a. CN XI, IJV, sternocleidomastoid (DHINGRA) 76. Removing oral thrush leaves: a. an erythematousbase (DHINGRA) 77. Reducible swelling in midline: a. Laryngocele (DHINGRA) 78. Treatment of a pt with CSOM and Choleasteatoma? a. Modified Radical Mastoidectomy (DHINGRA) 79. Treatment of choice of Juvenile Squamous Papilloma? a. CO2 Laser (DHINGRA) 80. Thumb sign on x ray is seen in? a. acute epiglottitis 81. Fatiguable Nystagmus is seen in: a. BPPV 82. A persons ct scan shows dilation of ventricles, normal CSF composition. Diagnosis: a. otitic hydrocephalus b. temporal lobe abscess 83. Which of these anti-emetics inhibits nasal secretions? a. Metoclopramide b. butyrophenone, 84. A trumpet blower has a swelling on left neck reason? a. Layngocele (DHINGRA) 85. Calculi of salivary glands are most commonly seen at? a. Submandibular glands (BASIS) 86. Mucocele most commonly occurs at? a. Lower lip (BASIS) b. upper lip c. tongue d. floor of mouth 87. Frey’s syndrome is due to? a. Parotid surgery (DHINGRA) 88. cause of Post-tonsillectomy hemorrhage on 7th day: a. Infection (DHINGRA) b. slipping of ligature 89. Supraglottic tumor drains to: a. Upper deep cervical nodes b. middle deep cervical nodes c. lower deep cervical nodes d. pretracheal and paratracheal nodes e. do not metastasize to nodes 90. Glottic tumor drains to a. Upper deep cervical nodes b. middle deep cervical nodes c. lower deep cervical nodes d. pretracheal and paratracheal nodes e. do not metastasize to nodes 91. A person had symptoms suggestive of enlarged adenoids. Investigation: a. X ray(lateral view) b. Water's view 92. A person who has a posteriorsuperior perforation in the tympanic membrane

with a history of discharge from ear has developed unilateral headache and diplopia on the right side. Diagnosis: a. CSOM with cholesteatoma, b. CSOM with cerebral abscess, c. CSOM with cerebellar abscess, d. petrous apex abscess

Questions Contributed by: Students of DUHS batch’17 Compiled and edited by: Uzair Yaqoob