FMGE 2018 - ENT PYQs Practice Questions

Q: All of the following are seen in superior laryngeal nerve palsy except:

Stridor. ***Stridor*** - **Superior laryngeal nerve palsy** primarily affects the **cricothyroid muscle** (external branch) and sensation above the vocal cords (internal branch). - Stridor typically results from severe **airway obstruction**, which is not a direct consequence of superior laryngeal nerve palsy as the **vocal cords** are not paralyzed open or closed to cause obstruction. *Aspiration* - The **internal branch of the superior laryngeal nerve** provides sensory innervation to the **supraglottic larynx**. - Loss of sensation in this region can impair the protective **cough reflex**, leading to an increased risk of aspiration. *Bowed vocal cords* - **Palsy of the cricothyroid muscle**, innervated by the **external branch of the superior laryngeal nerve**, causes a loss of tension in the vocal cord. - This lack of tension can result in a characteristically **bowed appearance** of the affected vocal cord during phonation. *Loss of pitch* - The **cricothyroid muscle** is responsible for tensing and elongating the vocal cords, which is crucial for **raising vocal pitch**. - Paralysis of this muscle due to **superior laryngeal nerve palsy** directly impairs the ability to achieve higher pitches, leading to a **monotone voice** or loss of pitch. [Practice more ENT PYQs on OnCourse]

Q: Most common cause of facial nerve palsy:

Idiopathic Bell's palsy. ***Idiopathic Bell's palsy*** - **Bell's palsy** is the most common cause of **facial nerve palsy**, accounting for approximately 60-75% of cases. - It is an **idiopathic** condition, meaning its exact cause is unknown, although it is often linked to viral infections (e.g., herpes simplex virus). [1] *Mastoid surgery* - **Iatrogenic facial nerve injury** during mastoidectomy is a known complication, but it is a relatively rare cause of facial nerve palsy. - While it can cause significant palsy, the incidence is low compared to Bell's palsy. *Herpes zoster oticus* - This condition, also known as **Ramsay Hunt syndrome**, is a cause of facial nerve palsy associated with a **vesicular rash** (zoster) in the ear canal or on the face. - While it is a significant cause of viral-induced facial palsy, it is less common than idiopathic Bell's palsy. *Chronic suppurative Otitis media* - **Chronic otitis media** can, in rare cases, lead to facial nerve palsy due to persistent inflammation spreading to the facial nerve. [2] - This is a less common etiology than Bell's palsy and would typically present with a history of recurrent ear discharge and hearing loss. [Practice more ENT PYQs on OnCourse]

Q: Tobey-Ayer test is done for:

Lateral sinus thrombosis. ***Lateral sinus thrombosis*** - The **Tobey-Ayer test** is used to detect **lateral (transverse) sinus thrombosis**, a serious complication of otogenic infections. - The test involves **lumbar puncture with CSF manometry** while sequentially compressing each **internal jugular vein**. - In a normal response, compression of either jugular vein causes a **rapid rise in CSF pressure** (within 10 seconds) due to venous obstruction, followed by rapid fall on release. - In **lateral sinus thrombosis**, compression of the jugular vein on the **affected side** produces **no rise or delayed/sluggish rise** in CSF pressure, indicating obstruction of venous drainage. - This is distinct from the Queckenstedt-Stookey test, which tests for spinal subarachnoid block. *Ketosis* - **Ketosis** is a metabolic state with elevated **ketone bodies** in blood, detected by urine dipsticks or blood ketone meters. - It has no relation to the Tobey-Ayer test or ENT pathology. *Acantholysis* - **Acantholysis** is loss of intercellular connections between **keratinocytes**, seen in blistering skin diseases like Pemphigus. - It is a histological dermatological finding, completely unrelated to neurological or ENT examination. *Hemoglobinuria* - **Hemoglobinuria** is the presence of free **hemoglobin** in urine due to intravascular hemolysis. - It is detected by urinalysis and has no connection to CSF manometry or lateral sinus assessment. [Practice more ENT PYQs on OnCourse]

Q: Angiofibroma bleeds profusely because:

Vessels lack a contractile component. ***Vessels lack a contractile component*** - The distinctive feature of angiofibroma is the presence of **abundant, thin-walled blood vessels** that lack the typical muscular or elastic contractile layers found in normal arteries. - This structural deficiency prevents effective **vasoconstriction** and vessel closure, leading to severe and prolonged bleeding when injured. *It has multiple sites of origin* - While angiofibromas typically arise from the **nasopharynx**, their propensity to bleed is not related to having multiple sites of origin. - Their origin site does not inherently determine the vascular structure or bleeding risk. *It lacks a capsule* - The absence of a capsule can make surgical resection challenging and contribute to incomplete excision, but it does not directly explain the **profuse bleeding** from within the tumor itself. - Bleeding is primarily due to the internal vascular architecture rather than the presence or absence of a surrounding capsule. *None of the options* - This option is incorrect because the statement "Vessels lack a contractile component" accurately explains why angiofibromas bleed profusely. - The other options are not the primary reason for the extensive bleeding characteristic of these tumors. [Practice more ENT PYQs on OnCourse]

Q: Recruitment phenomenon is seen in:

Meniere's disease. ***Meniere's disease*** - The recruitment phenomenon, characterized by an abnormal increase in the perception of loudness for a given increase in sound intensity, is a classic finding in **cochlear hearing loss**, often seen in conditions like **Meniere's disease**. - This occurs due to damage to the **outer hair cells** in the cochlea, which normally compress the dynamic range of hearing. *Otitis media with effusion* - This condition involves **conductive hearing loss** due to fluid in the middle ear, and typically does not cause the recruitment phenomenon. - The problem lies in sound transmission, not in the processing of loudness within the cochlea. *Otosclerosis* - This condition causes **conductive hearing loss** due to abnormal bone growth around the stapes footplate, impeding sound transmission to the inner ear. - While it affects hearing, it does not directly lead to altered loudness perception or recruitment, as the cochlea itself is often intact. *Acoustic nerve schwannoma* - This tumor affects the **vestibulocochlear nerve (CN VIII)**, causing **sensorineural hearing loss** that is typically retrocochlear (beyond the cochlea). - While it causes hearing loss, recruitment is usually absent or minimal, as the pathology is neural, not cochlear. [Practice more ENT PYQs on OnCourse]

Question 1

All of the following are seen in superior laryngeal nerve palsy except:

Accepted Answer

Stridor

Answer

Bowed vocal cords

Answer

Loss of pitch

Answer

Aspiration

Question 2

Most common cause of facial nerve palsy:

Accepted Answer

Idiopathic Bell's palsy

Answer

Mastoid surgery

Answer

Herpes zoster oticus

Answer

Chronic suppurative Otitis media

Question 3

Tobey-Ayer test is done for:

Accepted Answer

Lateral sinus thrombosis

Answer

Ketosis

Answer

Acantholysis

Answer

Hemoglobinuria

Question 4

Angiofibroma bleeds profusely because:

Accepted Answer

Vessels lack a contractile component

Answer

It has multiple sites of origin

Answer

It lacks a capsule

Answer

None of the options

Question 5

Recruitment phenomenon is seen in:

Accepted Answer

Meniere's disease

Answer

Otitis media with effusion

Answer

Otosclerosis

Answer

Acoustic nerve schwannoma

Question 6

All of the following are seen in Meniere's Disease except:

Accepted Answer

Ear Pain

Answer

Fullness of ear

Answer

Vertigo

Answer

Tinnitus

Question 7

Cold water is not used for ear cleaning because

Accepted Answer

Caloric stimulation caused by cold water

Answer

Damage to tympanic membrane

Answer

It will cause infection

Answer

It will make the wax hard

Question 8

Most common cause of sensorineural hearing loss (SNHL)

Accepted Answer

Presbycusis

Answer

Labyrinthitis

Answer

Meniere's disease

Answer

Vestibular Schwannoma

Question 9

Most common malignancy of maxillary antrum:

Accepted Answer

Squamous cell Carcinoma

Answer

Muco-epidermoid Carcinoma

Answer

Adenoid cystic Carcinoma

Answer

Adenocarcinoma

Question 10

Young's operation is done for:

Accepted Answer

Atrophic rhinitis

Answer

Allergic rhinitis

Answer

Vasomotor rhinitis

Answer

Antrochoanal polyp

FMGE 2018 — ENT