Following is true regarding rhinitis medicamentosa

A. It is caused by steroid drops

B. There is atrophy of inferior turbinate

C. It is caused by oral pseudoephidrine

D. Septoplasty is treatment of choice

E. It is caused by vasoconstrictive drops

Following are causes of epistaxis except

A. Trauma

B. Ostler,s disease

C. Nasal polyp

D. Septal perforation

E. Idiopathic

A patient has been put on IV heparin for pulmonary embolism .He started nose bleed . His PT is 50 seconds. His treatment is

A. Give adrenaline

B. Give normal saline

C. Give protamine sulphate

D. Give blood transfusion

E. Give transamine

A young boy of ten years age went for swimming. Next day he developed nasal congestion, fever and headache .He deteriorated over next twenty four hours and developed redness and edema of both eyelids on left side. His likely diagnosis is

A. Acute maxillary sinusitis

B. Cavernous sinus thrombosis

C. Meningitis

D. Erysipelas

E. Acute ethmoiditis

Allergic rhinitis

A. Is a type 1 IgE mediated hypersensitivityreaction

B. Is a type 2 IgM mediated reaction

C. IgA antibodies are produced in desensitization process which block IgE

D. Total serum IgE levels have to be checked before starting immunotherapy

E. Is very common in old age

A young woman was on contraceptive pills due to which she developed deep vein thrombosis .She was placed on warfarin .She started bleeding from nose. The best test to check her coagulation status

is A. Bleeding time

B. Clotting time

C. Platelet count

D. Activated partial thromboplastin time

E. Hess test

A young boy was involved in road traffic accident and broke his nose. Next day he noticed a watery fluid coming from his left nostril.Which test will you do to confirm the nature of fluid.

A. Blood sugar

B. Blood sugar in the fluid collected from nose

C. Leukocyte count in fluid

D. Do biochemical analysis of fluid and match the findings with findings of specimen collected by lumbar puncture

E. Protein levels in nasal fluid

A 40 year old man who is on steroids developed boil in the nose .Two days later he developed swelling of eye lids on one side with chemosis and opthalmoplegia of extraoccular muscles . He also has fever. Which investigation will clinch the diagnosis

A. Total leukocyte count

B. ESR

C. X-ray Para nasal sinuses

D. MRI scan

E. Quickenstead,s test

A young girl has developed saddling of nose after trauma .The best thing

to do is

A. Septoplasty

B. Tip plasty

C. SMR

D. Augmentation rhinoplasty

E. septorhinoplasty

Following are measures for house dust mite avoidance in allergic

rhinitis exceptA. Do dry dusting

B. Avoid carpets in bed room

C. Use polythine bedcovers for mattress

D. Wash bed linen in boiling water

E. Do not do dusting in the morning

A young footballer presented in casualty with broken nose. On examination his nose is deviated with swelling and bruising. The best time to fix the nose is

A. Straight away

B. One week later

C. Two weeks later when swelling has subsided

D. One month later

E. Six months later

The skeleton of nasal tip is formed by

A. Caudal end of the septal cartilage

B. Lower lateral cartilage

C. Upper lateral cartilage

D. Sesamoid cartilage

E. Hyaline cartilage

A two year old child is having unilateral nasal discharge which is foul smelling and purulent the likely diagnosis is

A. Adenocarcinoma of nose

B. Foreign body nose

C. Sinusitis

D. Nasal polyp

E. Rhinitis

The salient feature of nasal vestibular lining is

A. It contains sebacious glands

B. It contains mucous glands

C. It contains ceruminous glands

D. It contains salivary glands

E. It contains hair follicle

The best treatment for recurrent nasal polyps is

A. Intranasal polypectomy

B. Transantral ethmoidectomy

C. Functional endoscopic sinus surgery

D. Steroids

E. Transantral ethmoidectomy with postoperative inhaled steroids

The bone which takes part in formation of nasal septum is

A. Nasal bone

B. Lacrimal bone

C. Frontal bone

D. Perpendicular plate of ethmoid bone

E. Perpendicular plate of platine bone

Major portion of nasal cavity is lined by

A. Columnar epithelium (respiratory type)

B. Olfactory epithelium

C. Squamous epithelium

D. Skin

E. Cuboidal epithelium

Following structures open into middle meatus

A. Frontal sinus

B. Nasolacrimal duct

C. Sphenoid sinus

D. Posterior ethmoid cells

E. Hiatus semilunaris

A young man has peculiar nasal obstruction, that he can breath in but can not breath out. On examination he has a mass in left nostril. Likely diagnosis is

A. Rhinolith

B. Antrochoanal polyp

C. Unilateral ethmoidal polyp

D. Nasopharyngeal fibroma

E. Bleeding polypus of septum

The middle turbinate

A. Is part of ethmoid bone

B. Is part of maxilla

C. Is a separate bone

D. It is only mucosal structure

E. It contains cartilage and bone covered with mucosa

The patient has developed traumatic CSF rhinorrhoea .The best way to localize the site of leak is

A. CT scan

B. MRI scan

C. Radioisotope scan

D. Use florescence dye intrathecally and examine nose with blue nasoendoscope

E. Examine nose with endoscope

Ethmoid sinuses

A. Are more than thirty air cells

B. Ethmoid bulla belongs to superior ethmoid sinuses

C. Basal lamella divides ethmoid sinuses into anterior and posterior group

D. Posterior ethmoid cells drain into sphenoethmoidal recess

E. Have no relation with optic nerve

Which cranial nerve lies in cavernous sinus as lateral relation of sphenoid sinus

A. Trochlear nerve

B. Facial nerve

C. Vidian nerve

D. Sphenoplatine nerve

E. Mandibular division of maxillary nerve

Skeletal support to columella is provided by

A. Caudal end of quadrilateral cartilage

B. Middle crura of allay cartilage

C. Medial crura of allar cartilage

D. Medial crural feet of allar cartilage

E. Anterior nasal spine

The floor of maxillary sinus is closely related to

A. Canine teeth

B. Molar teeth

C. Premolar teeth

D. Second premolar and first molar

E. All of above

A young patient has severe nose bleed . On examination he has multiple bleeding spots on nasal septum. He also has multiple telangectasia on tongue. His father also had similar problem. His bleeding is due to

A. Idiopathic varicosities

B. Nasal picking

C. Hypertension

D. Osteler-Weber-Rendu syndrome

E. Liver cirrhosis

A patient has been started on intravenous heparin for pulmonary embolism.. He started bleeding from nose. Best treatment for him is

A. Give transamine

B. Give adrenaline

C. Give IV normal saline

D. Give blood transfusion

E. Give protamine sulphate

Little,s area is situated on

A. Anterior inferior part of septum

B. Posterior part of the septum

C. Lateral wall of nose

D. Posterior nares

E. Floor of nose

Concha bullosa is

A. A big air cell in the septum

B. A big air cell in the middle turbinate

C. A big air cell in the superior turbinate

D. A big air cell in the middle meatus

E. A big air cell in the inferior turbinate

Which statement is true regarding frunculosis of external auditory meatus

A. It forms in deeper portion of EAM

B. It is sterptococcal infection of hair follicle

C. Incision and drainage is treatment of choice

D. Cold sponging helps

E. Augmentin ( amoxill +c alvulonic acid ) is drug of choice

Which statement is true regarding perichondritis of pinna

A. Pus has bluish tinge

B. Is painless

C. Caused by staphylococcus

D. There is no necrosis of cartilage

E. Penicillin is drug of choice

Malignant otitis externa

A. Intravenous aminoglycosides are very effective in treatment

B. Is caused by staphylococcal infection in a diabetic patient

C. MRI is diagnostic

D. Radiotherapy is indicated

E. Is a malignancy of external ear

A young boy was involved in road traffic accident . He developed vertigo when he tried to move about . On examination he had blue ear drum and facial palsy on right side. Audiogram done two weeks later confirmed sensorineural hearing loss. The likely diagnosis is

A. Transverse fracture of temporal bone

B. Longitudinal fracture of temporal bone

C. Ossicular chain disruption

D. Disruption of spiral ganglion

E. Brain contusion

A two year old child is suffering from acute otitis media. His pain is not relieved in spite of adequate treatment .The best treatment in this situation is

A. Change antibiotic

B. Increase analgesic dose

C. Do hot fomentation

D. Give lignocaine ear drops

E. Do myringotomy

The posterior meatal wall is left intact in

A. Cortical mastoidectomy

B. Modified radical mastoidectomy

C. Radical mastoidectomy

D. Fenestration operation

E. Mastectomy

A fifty year old lady sustained head injury and had bleeding from her left ear. She also had perforation in the ear drum which healed in two weeks time .How ever she kept complaining of hearing loss in the same ear. Audiogram showed 60dB conductive hearing loss with high compliance depicted on tympanogram . The diagnosis is

A. Fracture temporal bone

B. Ossicular chain disruption

C. Scarred ear drum

D. Tympanosclerosis

E. Stapedius tendon disruption

Whish of the following is not a clinical feature of baurotraumatic otitis media

A. Otalgia

B. Deafness

C. Tinnitus

D. Blue ear drum

E. Purulent ear discharge

Which of the following statements is false regarding wax in ear

A. Wax is a mixture of ceruminous and pilosebacious glands

B. Ceruminous glands are situated in bony part of meatus

C. Normally wax is expelled from ear canal in flakes

D. Wax is removed by ear syringing

E. Hard wax is made soft prior to removal

Tensor tympani muscle is attached to

A. Neck of stapes

B. Neck of malleus

C. Head of malleus

D. Body of incus

E. Long process of incus

The patient complains of reduced hearing .The tuning fork test show positive Rinne test on right side and Weber test lateralizing to same side. This means

A. Conductive deafness on right side

B. Perceptive deafness on right side

C. Sensorineural deafness on right side

D. Cochlear hydrops on right side

E. Cochlear otosclerosis on right side

Which of the following is not included in the treatment of perichondritis of pinna

A. Local antibiotics

B. Systemic antibiotics

C. Incision and drainage

D. Removal of necrotic cartilage

E. Subsequent plastic surgery

Which of the following statements is not true regarding auricle (pinna )A. It has framework of cartilage

B. There is no cartilage in ear lobule

C. The skin is loosely adherent to perichondrium

D. It has antitragus

E. Sometimes antihelix is not formed properly giving rise to bat ears

Which of the following is not part of osseous labyrinth

A. Vestibule

B. Saccule

C. Superior semicircular canal

D. Posterior semicircular canal

E. Bony cochlea

Which of the following is not true regarding membranous labyrinth

A. It consists of Saccule and utricle in bony vestibule

B. It has membranous semicircular ducts in bony semicircular canals

C. Cochlear duct in bony cochlea

D. The endolymph has a very high concentration of sodium ions

Which of the following is not included in the contents of middle ear

A. Stapes

B. incus

C. Air

D. Process cochleariformis

E. Facial nerve

Which of the following do not open into anterior wall of middle ear cavity

A. Canal for tensor plati muscle

B. Canal for tensor tympani muscle

C. Eustachian tube

D. Glaserian fissure

E. Canal of Huguier

Paracusis willsi is seen in

a) Meiner,s disease

b) Otosclerosis

c) Tympanosclerosis

d) Cholesteatoma

e) Vestibular schwanoma

Which statements is true regarding external auditory meatus

A. It is 2.5 cm long

B. It is 2.5 inches long

C. Straight in adults

D. Its outer one third is bony

E. Its deeper part contains hair

Middle ear cleft consists of

A. Eustachian tube

B. Eustachian tube and internal auditory meatus

C. Eustachian tube ,internal auditory meatus and external auditory meatus

D. Eustachian tube and tympanic cavity

E. Eustachian tube ,middle ear cavity and mastoid air cell system

A young girl was being syringed for removal of wax. Suddenly she developed severe vertigo .The

reason for her vertigo is

A. Too cold water has been used for syringing

B. There was perforation in the ear drumC. There was healed perforation in the ear

drumD. The patient was already suffering from

labyrinthitisE. Deep auricular branch of vagus has been

stimulated

A nine months old baby has put a plastic bead in her ear. On otoscopy it is present in deeper portion of meatus and totally occluding the meatus. The best

way to remove this bead is

A. Remove it with foreign body hook

B. Remove it with crocodile forceps

C. Remove it with suction

D. Remove it with ear syringing

E. Remove it under general anesthesia using microscope

The best treatment for traumatic perforation of drum is

A.Local antibiotic drops

B.Suction toilet and local antibiotic drops

C.Myringoplasty

D.Put a piece of gel foam on perforation

E.Observe for spontaneous healing and consider myringoplasty in case of failure

A young girl is having difficulty in hearing for last one year. On otoscopy ear drum is dull with air fluid level. Pure tone audiogram shows 40 dB conductive loss in lower treatment for her is

A.Grommet insertion

B.Adenoidectomy

C.Tonsillectomy and adenoidectomy

D.Grommet insertion with adenoidectomy

E.Myringoplasty

An old man is having long standing ear discharge. Recently has started having severe pain the same ear . On examination there is granulation tissue along with ear discharge in the external auditory meatus and middle ear cavity .The investigation of choice in this case is

A. CT scan

B. X-ray mastoids

C. ESR

D. Biopsy of granulations

E. MRI

A thirty year old lady had flue which was followed by severe otalgia and tinnitus. One day later she had blood stained discharge from ears and on otoscopy had reddish vesicles on ear drum. She is suffering fromA. Malignant otitis externa

B. Otitis externa hemorrhagica

C. Ramsay-Hunt syndrome

D. Hemotympanum

E. Acute otitis media

A two year child is very slow in developing language. On otoscopy he has dull ear drum.Investigation of choice is

A. Audiogram

B. X-ray mastoids

C. Tympanogram

D. Serum bilirubin

E. Nystagmogram

A fifty year old diabetic patient has developed itching in his ears. On otoscopy there is debris with black specks in EAM. The treatment of choice in this case is

A. Otosporin ear drops

B. Gentamycine ear drops

C. Salicylic acid in spirit drops

D. Repeated suction toilet with antifungal drops

E. Oral anti fungal drugs

Hematoma auris if treated badly leads to

A. Bat ear

B. Carrot ear

C. Relapsing chondritis

D. Cholesteatoma

E. Cauliflower ear

Keratosis obturans

A. Is collection of wax and cholesterol in EAM

B. Is painless

C. Is easily removed by ear syringing

D. Causes erosion and widening of meatus

E. Is associated with otitis media with effusion

Following are characteristics of discharge in unsafe chronic supurative otitis media except

A. Thick discharge

B. Scanty discharge

C. Odorless discharge

D. Blood stained discharge

E. Purulent discharge

A 20 year old boy had long standing foul smelling ear discharge. Recently he has developed otalgia, fever, headache and

vomiting .The likely diagnosis is

A. Brain abscess

B. Bezolds abscess

C. Perilabyrinthine fistula

D. Otitis externa

E. Meningitis

Which of the following is not a cause of hoarseness

A. Carcinoma of right bronchus

B. Acute laryngitis

C. Thyroidectomy

D. Hypothyroidism

E. Carcinoma of larynx

Which of the following is not true regarding tracheobronichial foreign body in the children

A. The child presents with breathing difficulty

B. The foreign body usually lodges in left bronchus

C. The foreign body is best removed using rigid bronchoscope

D. X-ray chest will show expiratory emphysema on involved side

E. Cheat X-ray will show Mediastinal shift to involved side

A thirty year old lady has five children. She is complaining of hoarseness for last one month which is not improving. She never had any surgery .Her probable diagnosis is

A. Carcinoma of larynx

B. Vocal cord nodules

C. Reinke,s edema

D. Hypothyroidism

E. Recurrent laryngeal nerve palsy

A six months old baby has strider which gets worse on crying and improves on lying in prone position .He is suffering fromA. Laryngeal web

B. Subglottic stenosis

C. Laryngomalscia

D. Congenital paralysis of vocal cord

E. Vocal cord polyp

A four year old child presents in casualty with severe strider. He feels somewhat comfortable only in sitting position .He has high grade fever. The x-ray of neck lateral view shows positive thumb sign .The antibiotic of choice in this case is

A. Penicillin

B. Ampicilline

C. Augmentin (amoxicillin +calvulonic acid )

D. Amoxicillin

E. Tetracycline

Which laryngeal cartilage makes complete ring in larynx

A. Arytenoid

B. Cricoid

C. Epiglottis

D. Corniculate

E. Cuneiform

During tracheostomy one should not injure which tracheal ring

A. Second tracheal ring

B. First tracheal ring

C. Third tracheal ring

D. Fourth tracheal ring

E. Fifth tracheal ring

A patient who has tracheostomy will find difficulty in

A. Micturation

B. Deification

C. Lifting heavy weight

D. Breathing

E. swallowing

A fifty year old man who is chronic smoker complains of cough with hemoptysis and has developed progressive hoarseness. Examination shows left vocal cord paralysis. The likely diagnosis is

A. Carcinoma of larynx

B. Carcinoma of left bronchus

C. Pulmonary tuberculosis

D. Chronic bronchitis

E. Mediastinal lymphoma

A young girl has swallowed hydrochloric acid six months ago. Now she complains of dysphagia for solids. The best thing to do for her is

A. Esophagoscopy and dilatation

B. Barium swallow

C. CT scan

D. Esophagoscopy

E. Resection and anastmosis of strictured part of esophagus

An old lady is suffering from dysphagia for solids for last six months .She also complains of epigastric pain. On examination she is very pale and has koilonychia .Her Hb. is 6 gram percent. Her anemia is due to

A. Iron deficiency

B. Vitamin B12 deficiency

C. Folate deficiency

D. Bone marrow suppression

E. Iron and Folate deficiency

A child with laryngeal diphtheria presents in casualty with severe strider. First thing to do

is

A. Start antitoxin

B. Remove membrane from throat

C. Start IV antibiotics

D. Do throat swab for gram staining

E. Do tracheostomy

Adenoids if left untreated leads to

A. Chronic supurative otitis media

B. Chronic adhesive otitis media

C. Adenoid faces

D. Difficulty in speech

E. Difficulty in swallowing

A 4 year old child was playing with his friends. He developed a sudden spell of choking ,

cough & went blue. he settled down & was left with dry cough. The best thing to do is

A. Do chest X-ray

B. Start antibiotics

C. Do bronchoscopy

D. Give bronchodilators

E. Give cough suppressants

Absolute indication of tonsillectomy is

A. Chronic tonsillitis

B. Diptheria carrier

C. Obstructive sleep apnoea

D. Glassopharyngeal neurectomy

E. Rheumatic fever

Absolute indication for tonsillectomy is

A. Chronic tonsillitis

B. Rheumatic fever

C. Diphtheria carrier

D. Obstructive sleep apnea

E. Glassopharyngeal neurectomy

There are many anatomical constrictions in the esophagus .Which of the following is not true about these

A. First constriction is at the 15 cm. from the upper incisor teeth

B. Second constriction is at 25 cm. from upper incisor teeth

C. Third constriction is at 35 cm. from upper incisor teeth

D. Last constriction is at 40 cm. from upper incisor teeth

E. All these constrictions need to be negotiated carefully during Esophagoscopy

Which of the following statements is not rue regarding oropharyngeal herpes zoster

A. Vesicles appear in the distribution of ninth and tenth cranial nerves

B. Vesicles are unilateral

C. Pharyngeal condition may be associated with geniculate herpes

D. Healing occurs leaving scarring

E. Acyclovir when used early is helpful

Which of the following is not a clinical feature of adenoid hypertrophy

A. Nasal obstruction

B. Snoring

C. Eustachian tube obstruction

D. Nocturnal cough

E. Chronic suppurative otitis media

Which of the following is not a complication of acute tonsillitis

A. Peritonsillar abscess

B. Citilli,s abscess

C. Acute rheumatism

D. Acute nephritis

E. Acute infection of middle ear cleft

Which of the following arteries do not supply palatine tonsils

A. Descending pharyngeal artery

B. Descending palatine artery

C. Ascending palatine artery

D. Branch from lingual artery

E. Tonsillar artery

Which of the following is not a feature of Vincent's angina

A. Marked pain

B. Fetor oris

C. No fever

D. Cervical adenitis

E. Gray membranous slough

Which of the following is not a feature of pharyngeal diptheria

A. Enlarged tender cervical lymph nodes

B. Pyrexia

C. Toxaemia

D. Pseudomembrane

E. Rare albumiuria

Which of the following is not true regarding acute reteropharyngeal abscess

A. It is limited to one side of the midline

B. It forms due to suppuration in reteropharyngeal lymph node

C. Produces difficulty in breathing and suckling

D. It is common in children

E. Incision and drainage is done from outside trough carotid sheath