NEET-PG 2013 - ENT PYQs Practice Questions

Q: Fenestration operation is which type of tympanoplasty?

Type-5. ***Type-5*** - **Fenestration operation** is classified as **Type V tympanoplasty** in Wullstein's classification. - This procedure creates a **new fenestra (window) in the lateral semicircular canal** to bypass a fixed oval window/stapes in cases of **otosclerosis**. - Sound waves are directed to this new window, bypassing the immobile stapes footplate. - Historically important procedure before **stapedectomy** became the standard treatment for otosclerosis. *Type-2* - **Type II tympanoplasty** involves repair with a **partially eroded malleus** where the graft is placed onto the **incus or remaining malleus**. - Requires an intact and mobile stapes, unlike fenestration which bypasses a fixed stapes. - Used for tympanic membrane perforations with minor ossicular damage. *Type-3* - **Type III tympanoplasty** involves placing the graft directly onto the **stapes head** (columella effect). - Performed when malleus and incus are eroded but stapes is intact and mobile. - This is **myringostapediopexy**, not fenestration. *Type-4* - **Type IV tympanoplasty** involves creating a **small middle ear cavity** with the graft placed over the **round window**. - Used when the stapes arch is absent but the footplate is mobile. - Different from fenestration as it utilizes the round window, not a semicircular canal fenestra. [Practice more ENT PYQs on OnCourse]

Q: What are the potential causes of myringosclerosis?

Chronic inflammation from recurrent infections. ***Chronic inflammation from recurrent infections*** - **Myringosclerosis** is often a consequence of **chronic inflammation** and repair processes in the tympanic membrane (eardrum), commonly triggered by **recurrent otitis media** (middle ear infections). - The inflammatory exudates and subsequent healing lead to the deposition of **calcium and phosphate crystals** within the fibrous layer of the tympanic membrane, causing it to become stiff and opaque. *Genetic predisposition* - While genetics can play a role in some ear conditions, **myringosclerosis** is primarily an **acquired condition** rather than one solely determined by genetic factors. - No specific strong genetic link has been identified as a primary cause compared to environmental triggers. *Otosclerosis* - **Otosclerosis** is a condition affecting the **ossicles** (typically the stapes) in the middle ear, leading to conductive hearing loss due to abnormal bone growth, not directly affecting the tympanic membrane. - Myringosclerosis involves the eardrum itself, characterized by **calcification of the tympanic membrane**, which is distinct from the pathology of otosclerosis. *None of the options* - This option is incorrect because **chronic inflammation from recurrent infections** is a well-established cause of myringosclerosis. - The presence of a correct answer negates this choice. [Practice more ENT PYQs on OnCourse]

Q: Most commonly used tuning fork in ear examination?

512 Hz. ***512 Hz*** - The **512 Hz tuning fork** is the most commonly recommended and used for auditory tests like **Rinne** and **Weber** because its vibratory decay is slow enough to allow adequate testing, and it falls within the **speech frequency range**. - Its frequency is optimal for assessing both **bone conduction** and **air conduction** without introducing confusing overtones or being too low to be felt as a vibration rather than heard as a tone. *128 Hz* - A **128 Hz tuning fork** produces a strong vibratory sensation and is primarily used for **neurological examinations** to test **vibration sense**, not typically for ear examinations. - Its low frequency can be easily perceived as a **tactile vibration** through bone, making it less ideal for purely auditory assessment. *256 Hz* - While it falls within the audible range, a **256 Hz tuning fork** is less commonly used than 512 Hz for standard hearing tests. - Its vibratory tone may have a faster decay and might not provide as clear a distinction for **bone conduction** as the 512 Hz fork. *1024 Hz* - A **1024 Hz tuning fork** is a higher frequency tone, which may decay too quickly for accurate **Rinne and Weber tests**, especially when assessing subtle differences in hearing. - While audible, its higher pitch can be less representative of the critical **speech frequencies** typically evaluated in basic hearing screenings. [Practice more ENT PYQs on OnCourse]

Q: Which of the following can cause unilateral sensorineural hearing loss?

Acoustic neuroma. ***Acoustic neuroma*** - An **acoustic neuroma** (vestibular schwannoma) is a benign tumor that grows on the **vestibulocochlear nerve** (cranial nerve VIII), which can compress the nerve and cause progressive unilateral sensorineural hearing loss. - Other associated symptoms often include **tinnitus** and **balance disturbances** (vertigo or unsteadiness). *Coronavirus* - While some reports suggest a rare association between **COVID-19** and sudden sensorineural hearing loss due to viral inflammation or vascular compromise, it is not a common or definitive cause of progressive unilateral hearing loss. - Hearing loss directly due to coronavirus infection is typically acute and bilateral, rather than chronic and unilateral. *Pertussis* - **Pertussis** (whooping cough) is a bacterial respiratory infection that does not typically cause sensorineural hearing loss. - Complications are primarily pulmonary, neurological (e.g., seizures due to hypoxia), or nutritional, not otological. *Rotavirus* - **Rotavirus** causes severe gastroenteritis, particularly in infants and young children. - There is no established link between rotavirus infection and sensorineural hearing loss. [Practice more ENT PYQs on OnCourse]

Q: Bullous myringitis is caused by?

Mycoplasma pneumoniae. ***Mycoplasma pneumoniae*** - **Bullous myringitis** is characterized by the formation of **blisters** (bullae) on the **tympanic membrane**, which is a classic presentation associated with *Mycoplasma pneumoniae* infection. - While other bacteria can cause otitis media, *Mycoplasma pneumoniae* has a strong association with the development of **hemorrhagic bullae** on the eardrum. *Streptococcus pneumoniae* - This bacterium is the **most common cause** of **acute otitis media (AOM)**, but it typically presents with inflammation and bulging of the tympanic membrane **without** the characteristic bullae. - While it can cause severe ear infections, its typical presentation does not involve the **blister formation** seen in bullous myringitis. *Haemophilus influenzae* - This is another **common bacterial cause** of **acute otitis media**, especially in children, often leading to bulging and redness of the eardrum. - Similar to *Streptococcus pneumoniae*, it is not typically associated with the development of **bullae** on the tympanic membrane. *Candida* - **Candida** species are **fungi** and are a cause of **otitis externa** (ear canal infection) or, less commonly, **chronic otitis media**, particularly in immunocompromised individuals. - Fungal infections of the ear, including Candida, do **not** typically cause the characteristic **bullous myringitis** presentation. [Practice more ENT PYQs on OnCourse]

Question 1

Fenestration operation is which type of tympanoplasty?

Accepted Answer

Type-5

Answer

Type-3

Answer

Type-2

Answer

Type-4

Question 2

What are the potential causes of myringosclerosis?

Accepted Answer

Chronic inflammation from recurrent infections

Answer

Genetic predisposition

Answer

Otosclerosis

Answer

None of the options

Question 3

Most commonly used tuning fork in ear examination?

Accepted Answer

512 Hz

Answer

128 Hz

Answer

256 Hz

Answer

1024 Hz

Question 4

Which of the following can cause unilateral sensorineural hearing loss?

Accepted Answer

Acoustic neuroma

Answer

Coronavirus

Answer

Pertussis

Answer

Rotavirus

Question 5

Bullous myringitis is caused by?

Accepted Answer

Mycoplasma pneumoniae

Answer

Haemophilus influenzae

Answer

Candida

Answer

Streptococcus pneumoniae

Question 6

Cone of light focuses on which quadrant of tympanic membrane?

Accepted Answer

Anteroinferior

Answer

Posteroinferior

Answer

Anterosuperior

Answer

Posterosuperior

Question 7

Which of the following statements about conductive deafness is true?

Accepted Answer

Rinne's test is negative in conductive deafness.

Answer

Weber's test shows no lateralization in conductive deafness.

Answer

There is no decay in threshold tone in conductive deafness.

Answer

Air conduction is always completely absent in conductive deafness during Rinne's test

Question 8

Hearing loss of 65dB, what is the grade of deafness?

Accepted Answer

Moderately severe

Answer

Mild

Answer

Moderate

Answer

Severe

Question 9

Which of the following conditions is least likely to be associated with sensorineural hearing loss (SNHL)?

Accepted Answer

Distal renal tubular acidosis

Answer

Bartter syndrome

Answer

Alport syndrome

Answer

Nail-patella syndrome

Question 10

What is the most common fungal cause of otomycosis?

Accepted Answer

Aspergillus

Answer

Histoplasma

Answer

Rhinosporidium

Answer

Actinomyces

NEET-PG 2013 — ENT