MALLA REDDY MEDICAL COLLEGE FOR WOMEN
DEPT OF ENT & HEAD AND NECK SURGERY
1st INTERNAL EXAM FOR THIRD PROFESSIONAL MBBS – PART 1 (BATCH 2021)
DATE DAY TIME TOTAL MARKS
24-06-2024 MONDAY 10:00AM –01:00PM 100 MARKS
EASSY QUESTION ( 15*1 = 15m )
1. Meution the Complications of CSOM & write the management of lateral sinus thrombosis ?
WRITE SHORT NOTES ON THE FOLLOWING :- (3*6= 18m)
2. Etiology & management of Otosclerosis.
3. Describe theories of Cholesteatoma development & management of Cholesteatoma.
4. Management of Secretory Otitis Media.
WRITE BRIEF NOTES ON THE FOLLOWING :- (6*3 =18m)
5. Draw the diagram of left Tympanic membrane & label it.
6. Describe various types of mastoid Abscess.
7. Clinical features of menier’s disease.
8. Pre Anriculer Sinus.
9. Types of Ossiculoplasy.
10. Glomus tumors.
Multiple Choose Questions (MCQs) ( 49*1= 49m )
1. Which of the following statements are true for the stapes?
a. it is smallest bone of body
b. It weighs about 2.5 mg
c. Stapes footplate covers round window
d. Area of stapes footplate is 3.2 sq mm
2. During superficial parotidectomy which is said to be the most reliable landmark to identify main trunk
of facial nerve?
a. Tympanomastoid suture
B. Mastoid tip
c. Styloid process
d. Auricular cartilage
3. Which of the following is not the cause of fluctuating hearing loss?
a. Ear wax
b. Otitis media with effusion (serous otitis media)smorous
c. Meniere's disease
d. Perilymph fistula
e. Presbycusis
4. Which of the following is not a component of the External part of a Cochlear implant?
a. Microphone
b. Speech Processor
c. Elechode Array
d. Transmitter
5. Which of the following statements are true for endolymph?
a. It is present around the membranous labyrinth
b. It is produced by stria vascularis in scala media and dark cells of the vestibular labyrinth
c. It is absorbed by endolymphatic sac
d. It has more sodium than potassium
e. All of the above
6. Which of the following is not a common vestibular function test?
a. Head thrust test
b. Fistula test
c. Caloric test
d. Computerized rotary chair test
7. A 5-year-old boy was getting recurrent middle ear (ME) infections. He was operated for insertion of
grommet in the TM. After surgery, the child developed difficulty in tasting ice- cream. Which could be
the most likely cause?
a. Injury to the chorda tympani
b. Trauma to the CN VIII
c. Injury to Jacobson's nerve
d. Injury to Arnold's nerve
e. Effects of the endotracheal tube
8. Which of the following are the features of Bezold's abscess?
a. Torticollis
b. Tender swelling behind the angle of mandible
c. Fever
d. Chronic ear discharge with granulations in the ear canal
e. All of the above
9. A 4-year-young baby has been getting repeated episodes of otitis media for 1 year. Her parents are
concerned and want to know its cause. Why the children tend to get more ear infections than adults?
Which of the following structure favors these repeated infections with intact TM?
a. External ear canal
b. Internal auditory canal
c. Eustachian tube
d. ME ossicles
10. Which of the following is not true for eustachian tube?
a. Provides communication between middle ear and nasopharynx
b. 36 mm in length
c. Lateral one-third bony and medial two-thirds cartilaginous
d. Remains open at rest
11. Which of the following dimensions are false for the middle ear?
a. Vertical 15 mm
b Anteroposterior 15 mm
c. Transverse 6 min between the umbo and promontory
d. Transverse 6 min in epitympanum
e. Transverse 4 min in hypotympanum
12. Which of the following is not true for the Weber test?
a. External and middle ears are bypassed
b. Air and bone conduction interfere with each other on the normal side and make normal ear less
sensitive to bone conduction
c. Internal ear diseases lead to decreased bone conduction
d. Middle ear pathology causes Weber to lateralize towards normal side
13. The treatment of otomycosis does not include:
a. Salicylic acid
b. Gentian violet
c. Clotrimazole
d. Acyclovir
14. Which of the following is not true for malignant otitis externa?
a. Pseudomonas aeruginosa infection
b. Young adolescent patients
c. Diabetic or immunocompromised patients
d. Spread to skull base
e. Involves facial nerve at stylomastoid foramen
15. In which case, tympanic membrane will not appear blue (blue drum)?
a. Hemotympanum
b. Glue ear
c. Glomus tumor
d. Hemangioma of middle ear
e. Congenital cholesteatoma
16. Which of the following is not the common causative organism of acute otitis media?
a. Streptococcus pneumonia
b. Haemophilus influenzae
c. Moraxella catarrhalis
d. Staphylococcus aureus
17. Which of the following is not true for otitis media with effusion?
a. Conductive hearing loss is the presenting clinical feature
b. Tympanometry shows evidence of positive pressure and high compliance
c. Treatment of choice is myringotomy with grommet insertion
d. Rule out nasopharyngeal pathology in elderly patients
18. Which of the following statements are true for mastoid?
a. Mastoid tip is absent at the time of birth
b. Mastoid antrum is absent at the time of birth
c. Mastoid tip does not develop till 2 years
d. Post-aural incision for mastoid exploration in children similar to adults
19. Which of the following is not true for cholesteatoma?
a. Erodes bone
b. Attic perforation
c. Primary treatment of cholesteatoma is canal wall-down mastoidectomy, which may be combined with
tympanoplasty
d. It is middle ear tumor
20. Which of the following is not true for fistula test?
a. Performed by applying intermittent pressure on the tragus or by using Siegle's speculum
b. Positive in cases of labyrinthine fistula, hypermobile stapes footplate, following fenestration surgery
and erosion of the horizontal semicircular canal in cholesteatoma
C. Positive fistula indicates that labyrinth is still active and alive.
d. The test is negative when labyrinth is dead
e. It is noise induced vertigo
21. In patient with malignant Otitis externa the infection can potentially spread to which of he following
areas?
a. Paranaasal sinuses
b. Mastoid air cells
c. Temporomandibular joint
d. Skull base
22. A 4-year-young baby is having severe left ear pain due to an acute otitis media (AOM). Which of the
nerve carries the sensation of pain from the middle ear and tympanic membrane?
a. CN VII
b. CNIX
C. CNX
d. CN VIII
23. Which of the following is not the cause of hemorrhage into cochlea that can lead to sudden
sensorineural hearing loss?
a. Leukemia
b. Sickle-cell disease
c. Thalassemia
d. Hypertension
24. Which of the following is the most uncommon ototoxic drug?
a. Chloroquin
b. Cisplatin
c. Furosemide
d. Erythromycin
25. Which of the following statement is not true for ototoxicity?
a. The ototoxic effects of quinine, salicylates and furosemide are irreversible even if their administration
is stopped.
b. The principal site of damage in aminoglycoside ototoxicity is outer hair cells of basal turn of cochlea.
c. Semicircular ducts and saccule are very sensitive to strepto- mycin sulfate therapy.
d. Furosemide ototoxicity affects stria vascularis of scala media.
26. Patients with otosclerosis will not have :
a. Gradually progressive bilateral conductive hearing loss
b. Hearing loss increases during pregnancy
c. Normal tympanic membrane and eustachian tube
d. Rinne's test positive
27. Which of the following statements is not related with Schwartz sign?
a. Active otosclerosis
b. Not seen during pregnancy and in children
c. Pink reflex (reddish hue seen over the promontory
d. Seen through intact tympanic membrane in the area of oval window
28. Which of the following is not true for habenula perforata?
a. Openings through which branches of cochlear nerves enter the cochlea
b. Even if wide, they cannot lead to a perilymph gusher in stapes surgery
c. X-linked disease diagnosed on CT
d. It is associated with congenitally enlarged internal acoustic meatus and stapes fixation
29. Which of the following is not the treatment of otosclerosis:
a. Hearing aid
b. Stapedectomy is the treatment of choice for a young stapedial otosclerosis office going patient
c. Tympanoplasty
d. Sodium fluoride therapy used in the treatment of cochlear otosclerosis
30. Which of the following is not the extracranial complications of suppurative otitis media?
a. Facial nerve palsy
b. Labyrinthitis
c. None of the above
d. Hearing loss
e. Extradural abscess
31. What are the causes of ipsilateral (same direction) nystagmus?
a. Irrigation of ear with warm water
b. Serous labyrinthitis
c. Irrigation of ear with cold water
d. Purulent labyrinthitismos
32. Which of the following statement is not true for Ramsay-Hunt syndrome?
a. Herpes-zoster virus infection
b. Involves geniculate ganglion of facial nerve
c. Vesicular eruptions are seen in concha, posteromedial surface of pinna and soft palate
d. Upper motor neuron facial palsy
33. Which of the following is not the feature of Meniere's disease?
a. Raised endolymphatic pressure
b. Fluctuating hearing loss, episodic vertigo, roaring tinnitus and ear fullness
c. Idiopathic
d. Recruitment causes intolerance to loud sounds
e. Conductive hearing loss on audiogram
34. Which of the following is not the feature of Cogan's syndrome?
a. Episodic vertigo
b. Interstitial keratitis
c. Sensorineural heading loss
d. Syphilis
35. The treatment of the Meniere's disease patients, who have failed medical treatment but retain a
serviceable hearing, includes all, except:
a. Endolymphatic sac decompression
b. Intratympanic gentamicin
C. Vestibular nerve section
d. Labyrinthectomy
36. Which of the following is not the feature of lateral medullary syndrome?
a. Thrombosis of posterior inferior cerebellar artery
b. Vertigo, dysphagia, dysphonia, ataxia and tendency to fall on same side
c. Contralateral Horner's syndrome
d. Loss of pain and temperature sensation on ipsilateral face and contralateral limbs
37. Which of the following is not true regarding the nerve supply of middle ear?
a. Lateral surface of tympanic membrane is supplied by auriculotemporal nerve (CN V3) and auricular
branch of vagus nerve
b. Medial surface of tympanic membrane is supplied by glossopharyngeal nerve
c. Nerve supply of the middle ear-glossopharyngeal nerve
d. Jacobson's nerve is the branch of vagus nerve.
e. Jacobson's nerve supplies middle ear and mastoid air cells and supplies secretomotor fibers to parotid.
The section of this nerve relieves gustatory sweating
38. Which of the following is the shortest and most narrow segment of facial canal?
a. Labyrinthine segment
b. Tympanic segment
c. Mastoid segment
d. Meatalsegment
39. Which of the following statement is false for ear development?
a. The middle ear, malleus, incus, stapes, labyrinth and the cochlea are fully developed by birth
b. Hair cells in the vestibular and cochlear end organs are derived from ectoderm
c. Tympanic membrane develops only from mesoderm
d. Otic capsule ossifies from 14 centers. Ossification starts at 16th week of intrauterine life and ends by
20-21st week of gestation
40. Which of the following is not the cause of recurrent facial paralysis?
a. Facial nerve neuroma
b. Diabetes
c. Melkersson-Rosenthal syndrome
d. Sarcoidosis
e. None of the above
41. Which of the following is not true for Fitzgerald-Hallpike bithermal caloric test?
a. The posterior semicircular canal is tested
b. Cold water induces opposite side nystagmus while warm water results into the same side nystagmus
c. Patient's head is raised 30° forward if s/he is in supine position but in a sitting position the head is tilted
60° backward
d. Irrigation of cold (30°C) and warm (44°C) water in the EAC
42. Which of the following is not the function of Siegel's pneu- matic speculum?
a. Provides magnified view of tympanic membrane
b. Tests the mobility of the tympanic membrane
c. Performs fistula test
d. Introduction of topical medicine into middle ear if there is perforation in the tympanic membrane
e. Test hearing
43. Which of the syndrome? following is not the feature of Wallenberg
a. Ipsilateral sensorineural hearing loss, vertigo and horizontal nystagmus with fast component on
opposite side (vestibular and cochlear nuclei lesions)
b. Analgesia and thermal anesthesia of same side of body (spinothalamic tract lesion) and opposite side of
face (spinal nucleus of trigeminal nerve)
c. Dysphagia and drooping of palate (nucleus ambiguus lesion)
d. Ipsilateral Horner's syndrome (lesion of descending hypothalamic tract) dryness of face and
constriction of pupil
44. What is the primary function of the specch processor in a Cochlear implant ?
a. Captures sound from the environment
b. Sends the digital signal to the internal receiver
c. Converts the captured sounds into a digital signal
d. Directly stimulates the auditory nerve fibres
45. In Rinne’s test, a positive Rinne’s test ( AC > BC ) indicates :
a. Normal hearing on SNH
b. Couductive hearing loss
c. Mixed hearing loss
d. Central auditory processing disorder
46. Which of the following structures is most likely affected in a patient with a conductive hearing loss
and an intact tympanic membrane?
a. Cochlea
b. Auditory nerve
c. Ossicles
d. Semicircular canals
47. In which condition would you most likely observe a “cookie-bite” audiogram pattern?
a. Presbycusis
b. Noise in duced hearing loss
c. Meniere’s disease
d. Genetic sensory neural hearing loss
48. What is the main purpose of inserting grommets in the treatment of Otitis media with effusion?
a. To amplify sound entering the ear
b. To provide direct delivery of medications to the middle ear
c. To ventilale the middle ear and prevent fluid accumulation
d. To stimulate the E.T fuction
49.The most common presenting symptoms of malignant Otitis Externa in
a. Itching in the ear
b. Severe otalgia
c. Hearing loss
d. Tinnitus
