MISSION

NEET-PG INICET
LAP-2
DAY 2
21-4-25 ENT
OTORHINOLARYNGOLOGY
INFECTIOUS CONDITIONS OF NOSE
RHINOSCLEROMA
RHINOSPORIDIOSIS
 ENT - INICET MAY 2022 By
Dr Praneeth

A gentleman presents to the OPD with a saddle nose deformity. He gives a past history of cough,
on/off fever, and hemoptysis. On examination, septal perforation is present with pale granuloma. His
chest x-ray showed multiple cavitary lesions, and the biopsy showed granuloma, multinucleated giant
cells, and caseous necrosis. What would be the probable cause?

A. Wegener's granulomatosis

B. Tuberculosis

C. Syphilis

D. Sarcoidosis
OTHER CONDITIONS OF NOSE
I N V E RT E D PA P I L LO M A
 ENT - FMGE JAN 2023 By
Dr Praneeth

A patient presents with complaints of unilateral nasal obstruction and bleeding. A diagnosis of inverted
papilloma is made. What is the true statement regarding the diagnosis?

A. Malignant

B. Benign and locally invasive

C. Benign and non-invasive

D. Malignant and locally invasive

PNS
MAXILLARY
 ENT - FMGE DEC 2020 By
Dr Praneeth

Identify the sinus marked in the image?

A. Frontal sinus

B. Pyriform sinus

C. Ethmoid sinus

D. Maxillary sinus
ETHMOID
F R O N TA L
SPHENOID
 ENT - INICET NOV 2022 By
Dr Praneeth

What is the site of drainage of the marked structure?

A. Superior meatus

B. Middle meatus

C. Inferior meatus

D. Sphenoethmoidal recess
 ENT - FMGE JUN 2022 By
Dr Praneeth

• What is occipitomental view also known as?

A. Water's view CALDWELL VIEW

WATER VIEW
RHESE
SUBMENTOVERTICAL
FRONTAL
VIEW
/ BASAL VIEW
SINUS
MAXILLARY
SPHENOID SINUS
ETHMOID SINUS
B. Towne's view

C. Law's view

D. Stenver's view
 ENT - INICET NOV 2020 By
Dr Praneeth

The radiograph presented below has been taken to enhance the evaluation of the frontal sinus. What
is the widely used term for this particular perspective?
A. Water's view

B. Caldwell view

C. Pierre's view

D. Towne's view
 ENT - FMGE DEC 2020 By
Dr Praneeth

• What is this view called in which frontal sinus is seen best?

A. Caldwell's view CALDWELL VIEW

WATER VIEW
RHESE
SUBMENTOVERTICAL
FRONTAL
VIEW
/ BASAL VIEW
SINUS
MAXILLARY
SPHENOID SINUS
ETHMOID SINUS
B. Towne's view

C. Law's view

D. Stenver's view
SINUSITIS
 ENT - NEET 2022 By
Dr Praneeth

A patient comes with a history of asthma and sinusitis. On looking into his medical records, you notice
this has been attributed to Samter's triad. Which drug should be avoided in this patient?

A. Cotrimoxazole

B. Co-amoxiclav

C. Aspirin

D. Chloramphenicol
 ENT - FMGE JAN 2023 By
Dr Praneeth

A 35-year-old female took aspirin for headache and she developed wheezing and breathlessness.
She will be associated with?

A. Nasal polyp

B. Increased IgE

C. Extrinsic asthma

D. Drug interaction
FUNGAL SINUSITIS
 ENT - FMGE JUN 2022 By
Dr Praneeth

• Which of the following fungal infection is most commonly seen in the maxillary sinus?

A. Blastomycosis

B. Aspergillosis

C. Candidiasis

D. Histoplasmosis
 ENT - NEET 2022 By
Dr Praneeth

A post-COVID patient, who is a known diabetic, develops unilateral facial pain and loosening of teeth.
Which investigation would you do to confirm the diagnosis on this patient?

A. MRI

B. Biopsy with histopathologic examination

C. Serum ferritin

D. HbA1c
 ENT - FMGE JUN 2022 By
Dr Praneeth

An elderly diabetic female who was treated with steroids and remdesivir for COVID now presented
with a black, foul-smelling discharge from the nose. On examination, blackish necrotic mass filling the
nasal cavity and eroding the septum and hard palate. What is the most probable diagnosis?

A. Aspergillosis

B. Mucormycosis

C. Foreign body

D. Rhinosporidiosis
FESS
 ENT - FMGE JUNE 2021 By
Dr Praneeth

• Gold standard investigation before FESS (Functional Endoscopic Sinus Surgery) is?

A. MRI scan

B. Xray

C. Antral lavage

D. CT scan
C O M P L I C AT I O N S
 ENT - INICET MAY 2022 By
Dr Praneeth

A 35-year-old female patient presents with complaints of nasal obstruction and post-nasal drip. There
is a past history of FESS for failed conservative management 5 years ago. Uncinectomy and maxillary
ostium dilation was done during the previous FESS. A DNE done now shows patent ostia and
mucosal edema of the maxillary sinus lining. What is the next best step in management?

A. Repeat surgery

B. Macrolides for 4 months

C. Steroid irrigation and antihistamines

D. Biological therapy
N A S A L P O LY P O S I S
DODD / CRESCENT SIGN
 MALIGNANCY OF SINUSES
Most common site – maxillary

Exposure to nickel → squamous cell carcinoma,

Exposure to hard wood dust → Adeno Ca (wood worker’s Ca)

Patient can present with nasal mass, epistaxis, cheek swelling.

If infraorbital nerve damaged → loss of sensation over cheek area,

If orbital invasion → proptosis and even loss of vision (optic nerve involvement)

Rx – Total maxillectomy + Radiotherapy. (Incision – weber ferguson).

Tumours above ohngren’s line (from medial canthus of eye to angle of mandible)
have poor prognosis and those below this line have good prognosis.
TRAUMA FACE
L E F O RT #
MANDIBLE #
ZYGOMA #
 ENT - INICET MAY 2022 By
Dr Praneeth

A 35-year-old female patient presents with complaints of nasal obstruction and post-nasal drip. There
is a past history of FESS for failed conservative management 5 years ago. Uncinectomy and maxillary
ostium dilation was done during the previous FESS. A DNE done now shows patent ostia and
mucosal edema of the maxillary sinus lining. What is the next best step in management?

A. Repeat surgery

B. Macrolides for 4 months

C. Steroid irrigation and antihistamines

D. Biological therapy
 ENT - FMGE JUN 2022 By
Dr Praneeth

• A patient with a history of trauma, presented with diplopia, epistaxis and restricted eye movements. Looking
at the CT image given below, what will be your diagnosis?

A. Le- fort fracture

B. Fracture maxilla

C. Fracture zygomatic

D. Blow out fracture

 CSF RHINORRHOEA

Cause –
Clinical feature –
Reservoir sign –
Double ring sign / target sign / halo sign –
Handkerchief test –
Beta-2 transferrin
High glucose levels
Localising test –
Cisternography
Treatment – bed rest, elevating the head of the bed, stool softeners, and
avoidance of nose blowing, sneezing and straining. Surgical repair
through endoscopic or external route done if medically not resolved
 ENT - FMGE AUG 2020 By
Dr Praneeth

A 23-year-old male presents to you with a nasal discharge, which has the following appearance on a
handkerchief. Presence of which of the following features helps you in diagnosing the condition as
CSF rhinorrhea?

A. Halo sign

B. Handkerchief sign

C. Schwartz sign

D. Phelp’s sign
CONGENITAL CONDITIONS OF
NOSE
C H O A N A L AT R E S I A
M E N I N G O (E N C E P H A LO ) CE L E
NASAL GLIOMA
LARYNX
F R A M E W O R K O F L A RY N X
A N AT O M Y
O S S I F I C AT I O N
 ELASTIC
EPIGLOTTIS

CUNEIFORM
CORNICULATE

ARYTENOID
THYROID

CRICOID

HYALINE
 ENT - FMGE DEC 2020 By
Dr Praneeth

Which of the following laryngeal cartilages is least likely to be calcified?

• Thyroid

• Cricoid

• Arytenoid

• Epiglottis
AEF
ENDOSCOPIC VIEW
VESTIBULE / SACCULE
LARYNGOCELE
LARYNGOCELE
 ENT - FMGE DEC 2020 By
Dr Praneeth

• A young male who is a professional trumpet blower presented with a swelling on the left side of the
neck. On examination, there is a sound when compressing the swelling. As the X-ray neck was
inconclusive, a CT neck was taken, which is shown below. What is the most likely diagnosis?
A. Pharyngeal pouch

B. Laryngocele

C. Tracheoesophageal fistula

D. Tonsillar cyst
MUSCLES OF LARYNX
ABDUCTORS / ADDUCTORS / TENSORS
PCA
LCA
IA - T
TA
CT
NERVES OF LARYNX
RLN , SLN – IB & EB
 ENT - FMGE JAN 2023 By
Dr Praneeth

Which nerve gives sensory supply to the larynx above the glottis?

A. Internal branch of superior laryngeal nerve

B. External branch of superior laryngeal nerve

C. Recurrent laryngeal nerve

D. Superior laryngeal nerve

 ENT - INICET MAY 2022 By
Dr Praneeth

Foreign body entry into the laryngeal inlet is prevented by the cough reflex. This reflex is sluggish in
alcohol ingestion and some other conditions. Which nerve is likely injured?

A. Internal laryngeal nerve

B. Glossopharyngeal nerve

C. External laryngeal nerve

D. Recurrent laryngeal nerve

VC POSITIONS
U / L R L N + S L N PA L S Y
B / L R L N PA L S Y
ISSHIKI THYROPLASTIES
PUBERPHONIA
FUNCTIONAL APHONIA
 ENT - NEET 2021 By
Dr Praneeth

Following total thyroidectomy, a patient started having difficulty in breathing, and repeated attempts to
extubate were unsuccessful. The most probable cause is:

A. Superior laryngeal nerve injury

B. Unilateral recurrent laryngeal nerve injury

C. Bilateral recurrent laryngeal nerve injury

D. Hematoma
VOCAL CORDS
STRUCTURE
 FUNCTIONS OF LARYNX

Protection of lower airways

Respiration
Fixation of the chest
Phonation
VC NODULE
 ENT - FMGE JAN 2023 By
Dr Praneeth

A teacher presented with complaints of hoarseness of voice. On examination, bilateral swelling was
noted on anterior 1/3rd and posterior 2/3rd. What is the probable diagnosis?

A. Vocal polyp

B. Vocal nodule

C. Vocal cyst

D. Reinke edema
V C P O LY P
VC REINKE’S OEDEMA
VC G R A N U LO M A
VC LEUKOPLAKIA
INFECTIONS OF LARYNX
ACUT E EPIG LOTTITIS
CROUP
 ENT - FMGE JUN 2022 By
Dr Praneeth

• A 4-year-old boy presents with low-grade fever, inspiratory stridor, and barking cough for the past 5
days. Examination reveals a hoarse voice, a moderately inflamed pharynx, and a slightly increased
respiratory rate. His chest X-ray showed subglottic narrowing appearing like a steeple. Which
among the following is not indicated in the treatment of this condition?

A. Nebulized racemic epinephrine

B. Parenteral cefotaxime

C. Helium oxygen mixture

D. Intramuscular dexamethasone
 ENT - FMGE AUG 2020 By
Dr Praneeth

All of the following organisms can cause croup except?

A. Parainfluenza 1
Parainfluenza 1 and 2.
B. Parainfluenza 2 Parainfluenza virus 3, influenza A and B, measles,

C. Rhinovirus adenovirus, and respiratory syncytial virus (RSV).

D. RSV
DIPHTHERIA
 ENT - FMGE DEC 2021 By
Dr Praneeth

• A worried mother brought her 6-year-old unimmunized child to the ER with complaints of fever,
cough, and shortness of breath. On examination, a pseudo membrane was noted over the tonsils
which bleed on trying to remove and a bull-neck appearance of the neck. Which of the following is
the most likely diagnosis?

A. Infectious mononucleosis

B. Tonsillitis

C. Diphtheria

D. Candidiasis
TB
PA P I L LO M AT O S I S
 A D U LT V S I N F A N T L A R Y N X
Luminal shape
Position
Epiglottis
Narrowest part
CONGENITAL CONDITIONS
OF LARYNX
LARYNGOMALACIA
 ENT - FMGE AUG 2020 By
Dr Praneeth

A child is brought to you with complaints of noisy breathing. On examination, you notice inspiratory
stridor in the child and laryngeal examination is as below. Which of the following is the most likely
diagnosis?

A. Vocal cord paralysis

B. Subglottic stenosis

C. Laryngeal papilloma

D. Laryngomalacia
LARYNGEAL WEB
S U B G LOT T I C S T E N O S I S
 ENT - NEET 2021 By
Dr Praneeth

The image of a drug is given below. It is used in which of the following conditions?

A. Subglottic stenosis

B. Rhinocerebral mucormycosis

C. Adenoidectomy

D. Tympanoplasty
CANCER LARYNX
G LOT TIC CA
 ENT - FMGE JUNE 2021 By
Dr Praneeth

• A patient presents with hoarseness of Voice. On examination an ulcero-proliferative Mass is seen

on Right Vocal Cord, Cord was however mobile. There is no lymph node involvement and no
metastasis. Which of the following is the best treatment modality for this patient?

A. Total laryngectomy

B. Radiotherapy

C. Conservative laryngectomy

D. Chemotherapy
S U P R AG LOT T I C C A
S U B G LOT T I C C A
 C O M P L I C AT I O N S A F T E R
TOTAL LARYNGECTOMY

Permanent tracheostome – upper end of trachea is directly

sutured to skin for the patient to breathe

Speech difficulties – To help patient speak after removal of

larynx, there are various techniques. Oesophageal speech –
patient is taught to swallow air and release which vibrates
pharyngo-oesophageal segment and produces a very low
sound. Tracheo-oesophageal speech – most effective, artificial
prostheses like blom-singer valve / provox / Groningen are
inserted. Electrolarynx – electrical device held on the skin of
the neck vibrates and produce voice

Loss of smell and decreased taste sensation

Swallowing difficulty
 ENT - INICET MAY 2020 By
Dr Praneeth

The image given shows a patient who has undergone total laryngectomy due to laryngeal cancer.
Identify the method of voice generation for this patient, as depicted in the provided image.

A. Electro-larynx

B. Chicago implant

C. Tracheoesophageal prosthesis

D. Esophageal speech
TRACHEOSTOMY
 ENT - FMGE AUG 2020 By
Dr Praneeth

The image below shows a procedure that was done in the patient. What is the procedure?

A. Endotracheal intubation

B. Needle cricothyroidotomy

C. Tracheostomy

D. Oropharyngeal airway
 ENT - FMGE JUN 2022 By
Dr Praneeth

• A patient presented with surgical emphysema, after an emergency tracheostomy. What is the most likely
reason?

A. High tracheostomy

B. Tear in posterior tracheal wall

C. Block in tracheostomy tube

D. Tight suture around tracheostomy site

 ENT - NEET 2022 By
Dr Praneeth

An adult man in a restaurant suddenly begins choking on his food. He is conscious. The following procedure
was performed. Identify the procedure:
A. Heimlich's maneuver

B. Back slap

C. Chest thrust

D. Blind insertion of finger

PHARYNX
A N AT O M Y
WA L D E Y E R R I N G
MUSCLES
ZENKER DIVERTICULUM
 ENT - FMGE JUNE 2021 By
Dr Praneeth

• A 65-year-old male presented with history of dysphagia, halitosis and aspiration pneumonia. A
barium swallow was done and is given below. What is the diagnosis?

A. Diffuse esophageal spasm

B. Achalasia cardia

C. Zenker's diverticulum

D. Esophageal cancer
 ENT - FMGE AUG 2020 By
Dr Praneeth

Dolman's procedure is for:

A. Meckel's diverticulum

B. Zenker's diverticulum

C. Bochdalek hernia

D. Menetrier's disease
R E T R O P H A R Y N G E A L S PA C E
A L A R S PA C E
P R E V E R T E B R A L S PA C E
C AV I T Y O F P H A RY N X
P a s s a v a n t ’s r i d g e
ADENOIDS
 ENT - INICET MAY 2021 By
Dr Praneeth

Identify the condition shown in the image.

A. Adenoid facies

B. Goldenhar syndrome

C. Horse facies

D. Frog facies
 ENT - FMGE AUG 2020 By
Dr Praneeth

A 5-year-old girl is brought to you by her mother with complaints of mouth breathing. She has a flat,
expressionless long face with an open mouth. On examination, a high-arched palate and crowded
upper teeth are noted. The X-ray is given below. What is the most likely diagnosis?

A. Lingual tonsils

B. Quinsy

C. Tonsillar hypertrophy

D. Adenoid hypertrophy
 ENT - FMGE DEC 2021 By
Dr Praneeth

• A school-going child presents with a history of recurrent upper respiratory tract infections, mouth
breathing, and impaired hearing. On examination, a high arched palate is noted. What is the
management of this condition?

A. Tonsillectomy

B. Adenoidectomy

C. Adenoidectomy with grommet insertion

D. Myringotomy with grommet insertion

 ENT - FMGE JUN 2022 By
Dr Praneeth

• A 7-year-old child post-tonsillectomy comes to you with complaints of snoring, palpitations, mouth
breathing and a slight decrease in hearing. On examination, you notice a high arched palate. His
school performance has deteriorating as well. His mother is worried. What is the next line of
management for this child?

A. Adenoidectomy

B. Myringoplasty

C. Adenoidectomy with grommet insertion

D. Conservative management
 ENT - INICET MAY 2020 By
Dr Praneeth

A senior medical professional at the hospital is conducting the clinical examination depicted in the
provided image. Which of the subsequent anatomical structures will not be visible to him?

A. Adenoids

B. Arytenoids

C. Torus tubarius

D. Upper surface of soft palate

 ENT - INICET NOV 2022 By
Dr Praneeth

A 6-year-old boy presented with recurrent URTI, poor growth, high-arched palate, and impaired
hearing. Tympanogram is given as follows. What would be the most appropriate management?

A. Grommet insertion

B. Adenoidectomy with grommet insertion

C. Myringotomy with grommet insertion

D. Myringotomy
EAGLE SYNDROME
TONSILS
TONSILS
To n s i l l e c t o m y
 ENT - FMGE DEC 2020 By
Dr Praneeth

Which of the following conditions does not form a grey-white membrane over the tonsils?

A. Streptococcal tonsillitis ● Membranous tonsillitis

● Diphtheria
B. Diphtheria
● Infectious mononucleosis
C. Ludwig's angina ● Vincent's angina

D. Infectious mononucleosis ● Leukemia

● Candida
● Agranulocytosis
● Malignancy
● Aphthous ulcer
● Traumatic ulcer
 ENT - FMGE DEC 2020 By
Dr Praneeth

Which of the following is the main arterial supply of palatine tonsils?

• Tonsillar branch of the facial artery

• Descending palatine branch of maxillary artery

• Buccal branch of maxillary artery

• Ascending palatine branch of facial artery

 ENT - NEET 2021 By
Dr Praneeth

A patient post-tonsillectomy in the recovery room starts bleeding from the operative site. On
examination, blood clots are seen. What will be your immediate management?

A. Shift to OT, remove the clots, and cauterize/ligate the vessel

B. Shift to OT, start IV antibiotics, and pack the tonsillar fossa

C. Give anticoagulants, repeated gargling, and wait for 24 hours

D. Do blood transfusion and wait and watch

 ENT - FMGE DEC 2020 By
Dr Praneeth

Which of the following nerves is responsible for ear pain after a tonsillectomy surgery?

A. Glossopharyngeal nerve

B. Facial nerve

C. Trigeminal nerve

D. Vagus nerve
JNA
 ENT - FMGE JAN 2023 By
Dr Praneeth

A 16-year-old male is presented with recurrent epistaxis. What is the management of the patient?

A. FNAC

B. Biopsy

C. Radiotherapy

D. Surgical excision
 ENT - FMGE DEC 2021 By
Dr Praneeth

• A 14-year-old male presented with recurrent epistaxis. There is no history of trauma associated with
it. He also complained of nasal obstruction and rhinorrhea. On examination, there is a firm purplish
mass on the posterior nasopharynx. What is the most probable diagnosis?

A. Nasopharyngeal carcinoma

B. Rhabdomyosarcoma

C. Pyogenic granuloma

D. Juvenile nasopharyngeal angiofibroma

 ENT - FMGE AUG 2020 By
Dr Praneeth

A 14-year-old boy who is a football player comes to the casualty with complaints of epistaxis while
playing football on the ground. There is no history of trauma or fall. He also gives a history of recurrent
spontaneous nasal bleeding and also unilateral nasal obstruction and denasal speech. Contrast-
enhanced CT scan of the head is shown below. What is this sign known as?

A. Aquino sign

B. Holman Miller sign

C. Teardrop sign

D. Hanging drop sign

 ENT - NEET 2022 By
Dr Praneeth

A 20-year-old male patient presents with unilateral nasal obstruction and recurrent bleeding for the
past 1 year. Transnasal endoscopic results are shown below. A contrast-enhanced CT revealed a
mass extending from the posterior choana to the nasopharynx. What is the most likely diagnosis?

A. Nasopharyngeal angiofibroma

B. Antrochoanal polyp

C. Rhinoscleroma

D. Concha bullosa
 ENT - FMGE JAN 2023 By
Dr Praneeth

In a patient of nasopharyngeal angiofibroma, which one of the investigations you will do?

A. CT with contrast

B. Biopsy

C. FNAC

D. Chemoradiation
Nasopharyngeal carcinoma
 ENT - FMGE JUNE 2021 By
Dr Praneeth

• Identify the structure marked 2 in the endoscopic image of nasopharynx?

A. Sinus of Morgagni

B. Passavant's ridge

C. Fossa of Rosenmüller

D. Rathke's pouch
 ENT - FMGE JUN 2022 By
Dr Praneeth

• A 60-year-old male presents with painless cervical lymphadenopathy. On examination, the right ear
reveals conductive hearing loss with a dull tympanic membrane. Moreover, decreased mobility of
the soft palate was also noted. What is the probable diagnosis?

A. Nasopharyngeal carcinoma

B. Adenoid cystic cancer

C. Juvenile nasopharyngeal angiofibroma

D. Quinsy
 ENT - FMGE DEC 2021 By
Dr Praneeth

• Which of the following is part of trotter's triad, seen in nasopharyngeal carcinoma?

A. Conductive hearing loss, Ipsilateral temporoparietal neuralgia, Palatal paralysis

B. Sensorineural hearing loss, Contralateral temporoparietal neuralgia, Palatal paralysis

C. Sensorineural hearing loss, Ipsilateral temporoparietal neuralgia, Palatal paralysis

D. Conductive hearing loss, Contralateral temporoparietal neuralgia, Palatal paralysis

FORAMEN OVALE CONTENTS
O Otic ganglion
V V3
A Accessory meningeal artery
L Lesser petrosal nerve
E Emissary veins
 ENT - NEET 2020 By
Dr Praneeth

A 9-year-old boy comes with complaints of left ear pain, difficulty in opening the mouth, painful
swallowing, and fever. The oral cavity examination reveals the following. The external facial
examination is unremarkable. Which of the following is likely?
A. Pharyngitis

B. Parotid abscess

C. Bezold's Abscess

D. Quinsy
QUINSY
LUDWIG’S ANGINA
ORAL CAVITY
&
OROPHARYNX
A N AT O M Y
VINCENT INFECTION
ORAL THRUSH
A PHT HOUS ULCER S
A N K Y LO G LO S S I A
ORAL SUBMUCOUS FIBROSIS
RANULA
LEUKOPLAKIA
 ENT - FMGE DEC 2020 By
Dr Praneeth

The image given below is from a chronic smoker's oral examination. Identify the lesion given?

A. Erythroplakia

B. Leukoplakia

C. Fordyce's granules

D. Koplik's spots
ERYTHROPLAKIA
MUMPS
SIA LOLITHIASIS
PLEOMORPHIC ADENOMA
A D E N O LY M P H O M A / W A R T H I N
MUCOEPIDERMOID CARCINOMA
 ADENOID CYSTIC CARCINOMA

On high power, cribriform glandular

elements composed of a bland population
of basaloid cells with a “Swiss-cheese” or tumor infiltrating beyond the capsule into
sieve-like pattern are seen. the fat.
 ENT - NEET 2022 By
Dr Praneeth

A patient presents with a firm, tender, slow-growing mass below the ear as shown in the image below. What
could be the diagnosis?
A. Bezold abscess

B. Parotid abscess

C. Upper cervical lymphadenopathy

D. Osteoma of the mandible

 ENT - FMGE JUNE 2021 By
Dr Praneeth

• Which is the false statement among the following for the condition given in the picture?

A. Retention cyst of major salivary glands

B. Most common site is lower lip

C. Retention cyst of minor salivary glands

D. Treatment is surgical excision

 [email protected]

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