Last 5 Year PYQs in ENT for FMGE​

Q1. In a 2-year-old child with a sudden onset of noisy breathing, which type of stridor is most likely to be represented by the image below?​

1. Inspiratory
2. Expiratory
3. Biphasic
4. None of these

Ans. 1) Inspiratory

• In the context of a 2-year-old child with sudden onset noisy breathing and an omega-shaped epiglottis (which is a common presentation of laryngomalacia), inspiratory stridor is the most likely option.
• Laryngomalacia is a congenital condition characterized by the softening of the tissues of the larynx above the vocal cords. It is the most common cause of stridor in infants.
• The epiglottis in laryngomalacia often has an elongated, curled appearance, resembling the Greek letter omega (Ω), which can be observed during laryngoscopy.
• This condition typically presents with inspiratory stridor that worsens with feeding, crying, or lying supine, and usually improves by the age of 18 to 24 months as the cartilage stiffens and the airway grows.

Also read: Last 5 Year PYQs in Pediatrics for FMGE

Q2. Except in which of the following is laryngeal crepitus not present?

1. Post-cricoid malignancy
2. Hypopharyngeal abscess
3. Parapharyngeal abscess
4. Prevertebral abscess

Ans. 4) Prevertebral abscess

Laryngeal crepitus is a medical term that refers to a crackling or popping sound that can be felt or heard when there is air or gas trapped in the tissues of the neck or larynx. It is typically associated with subcutaneous emphysema, which occurs when air escapes from the respiratory or digestive tract and becomes trapped in the soft tissues of the neck.

Q3. An infant developed difficulty in breathing. His symptoms improve with crying. In which disease, symptoms get improved with crying?

1. Atrophic rhinitis
2. Acute rhinosinusitis
3. Allergic rhinitis
4. Choanal atresia

Ans. 4) Choanal atresia

• Choanal atresia is a congenital condition where there is a blockage or narrowing of the back of the nasal passage (choanae) that leads from the nasal cavity to the throat. This blockage can make it difficult for an infant to breathe through their nose. Interestingly, infants with choanal atresia often improve their breathing when they cry. When they cry, they open their mouths wider, allowing more air to flow into their lungs through their mouth, bypassing the blocked nasal passages. This temporary improvement in breathing during crying is a characteristic feature of choanal atresia.

Q4. What investigation is carried out immediately after a child is suspected of having inhaled a foreign body?

1. Rigid bronchoscopy
2. Chest X-ray
3. Direct laryngoscopy
4. Flexible endoscopy

Ans. 2) Chest X-ray

• After a child inhales or ingests a foreign body, a chest X-ray is often the initial investigation carried out. A chest X-ray can help identify the location and potential presence of a foreign body in the lungs or airways. It provides a quick and non-invasive way to assess the situation and determine the appropriate course of action.

Also read: Last 5 Year PYQs in Biochemistry for FMGE

Q5. What is the most common site of ranula?

1. Floor of the mouth
2. Tonsil
3. Uvula
4. Cingula

Ans. 1) Floor of the mouth

• A ranula is a type of mucocele that occurs in the floor of the mouth. It is a cystic swelling that develops due to the obstruction of the salivary gland duct, most commonly the sublingual gland duct. The sublingual gland is located beneath the tongue and its duct can become blocked, leading to the accumulation of saliva and the formation of a cystic swelling in the floor of the mouth. Ranulas can vary in size and may cause discomfort or interfere with speech and swallowing.

Q6. In nasopharyngeal carcinoma, which of the following is a component of trotter's triad?

1. Conductive hearing loss, ipsilateral temporoparietal neuralgia, Palatal paralysis
2. Sensorineural hearing loss, contralateral temporoparietal neuralgia, palatal paralysis
3. Sensorineural hearing loss, ipsilateral temporoparietal neuralgia, palatal paralysis
4. Conductive hearing loss, contralateral temporoparietal neuralgia, palatal paralysis

Ans. 1) Conductive hearing loss, ipsilateral temporoparietal neuralgia, Palatal paralysis

• Trotter’s triad comprises a complex of symptoms associated with malignant tumors invading the lateral wall of the nasopharynx.

Trotter's Triad

• Conductive deafness due to block of eustachian tube
• Ipsilateral temporo-parietal neuralgia due to 5th nerve involvement
• Palatal paralysis (10th nerve involvement)

Q7. Which nerve is responsible for the syncopal episode that occurred during the syringing procedure for ear wax removal in a patient?

1. Auriculotemporal nerve
2. Arnold’s nerve
3. Glossopharyngeal nerve
4. Jacobson’s nerve

Ans. 2) Arnold’s nerve

• Arnold's nerve, also called the auricular branch or mastoid branch, of the vagus nerve (CN X), is a small sensory nerve supplying the skin of the external acoustic meatus.
• Reflex syncope in the above case is due to stimulation of the auricular branch of the vagus nerve. This might occur due to a hyperactive vagal response which Targeted autonomic function tests can confirm.

Also read: FMGE Previous Year Question Papers

Q8. What is the most probable condition for a 6-year-old child who has not received immunization, presented to the Emergency Room by a concerned mother, experiencing symptoms such as fever, cough, and difficulty breathing? Physical examination reveals the presence of a pseudo membrane on the tonsils that bleeds upon attempted removal, as well as a swollen neck giving a bull-neck appearance.

1. Infectious mononucleosis
2. Tonsillitis
3. Diphtheria
4. Candidiasis

Ans. 3) Diphtheria

• Diphtheria is an acute respiratory infection mostly caused by toxigenic Corynebacterium diphtheriae strains.
• Depending on the anatomical site affected, diphtheria can be classified into
  • Respiratory -involving the anterior nasal, pharyngeal, and laryngeal cavities and the tonsils
  • Cutaneous (including the genital area)
  • Ocular
• The typical symptoms of acute diphtheria include the presence of a thick, grey layer- the pseudomembrane on the throat and/or tonsils and enlarged lymph nodes of the neck -Bull neck. In severe cases, myocarditis and inflammation of the nerves are seen due to the diphtheria toxin, which inhibits protein synthesis and causes cell death.

Q9. What is the recommended course of action for managing a 6-year-old boy who fell from a bed and now has swelling in his nose, along with breathing difficulties? During examination, it was observed that there are smooth, rounded swellings on both sides of the septum, visible through both nostrils. On palpation, the swellings were found to be soft and fluctuant.

1. Systemic antibiotics
2. Incision and drainage
3. High-resolution computerized tomography
4. Submucosal resection

Ans. 2) Incision and drainage

• The boy has likely developed Nasal Septal Hematoma.
• A septal hematoma usually occurs secondary to nasal trauma, and a newly formed hematoma is not always ecchymotic and can only be picked up by palpation.
• A hematoma feels soft and fluctuant on palpation, in contrast to the deviated nasal septum, which will be firm and concave on the opposite side.
• The key is to prevent abscess formation, which can eventually result in a saddle nose deformity or septal perforation, both of which are potentially permanent complications.. Thus incision and drainage of hematoma is the best option.

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Q10. A young lady presented to the ENT OPD with a history of sudden onset unilateral hearing loss, tinnitus, and dizziness following an episode of acute otitis media two weeks back. The Rinne test and fistula test were positive. She had refused treatment then and currently came with complaints of worsened hearing loss in the affected ear. On examination, the fistula test was negative. What would be the most likely finding on the Rinne test in this scenario?

1. True positive
2. True negative
3. False positive
4. False negative

Ans. 4) False negative

• The patient in this case has single sided deafness(dead ear). Therefore the fistula test is negative.
• But the rinne test is false negative as it is a case of severe sensorineural hearing loss due to suppurative labyrinthitis of the affected ear.
• Earlier fistula test was positive suggesting functioning labyrinth and positive rinne’s suggesting no hearing loss or sensorineural hearing loss.
• Later due to untreated suppurative labrynthitis leading to severe sensorineural hearing loss, fistula test is negative and rinne's test false negative.

Q11. The frontal sinus can be viewed by taking an X-ray at a specific angle, which is depicted in the image below. What is the name of the view depicted?​

1. Caldwell’s view
2. Towne’s view
3. Law’s view
4. Stenvers view​

Ans. 1) Caldwell's view

• The image depicts the head in a chin-down position, and the X-ray beam passing from behind the head at an angle of  15° to the radiographic plate. This description aligns with Caldwell's view, which is primarily used for assessing the frontal and ethmoidal sinuses as well as the nasal septum.​

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Q12. ​An elderly diabetic female patient presented with a black, foul-smelling discharge from the nose. On examination, a blackish necrotic mass has filled the nasal cavity and eroded the septum and hard palate. What is the most probable diagnosis?

1. Aspergillosis
2. Mucormycosis
3. Foreign body
4. Rhinosporidiosis

Ans. 2) Mucormycosis

• An elderly female diabetic patient with a black, foul-smelling nasal discharge, a black necrotic mass filling the nasal cavity, eroding the septum, and a hard palate is most likely suffering from mucormycosis.
• A class of molds known as mucormycetes is the source of mucormycosis.
• Mucormycosis is a rapid growing disease involving the arteries and causing endothelial damage and thrombosis.
• Immunocompromised people are more likely to develop mucormycosis, such as those with uncontrolled diabetes.

Q13. An elderly diabetic female patient presented with a black, foul-smelling discharge from the nose. On examination, a blackish necrotic mass has filled the nasal cavity and eroded the septum and hard palate. What is the most probable diagnosis?

1. Aspergillosis
2. Mucormycosis
3. Foreign body
4. Rhinosporidiosis

Ans. 2) Mucormycosis

• An elderly female diabetic patient with a black, foul-smelling nasal discharge, a black necrotic mass filling the nasal cavity, eroding the septum, and a hard palate is most likely suffering from mucormycosis.
• A class of molds known as mucormycetes is the source of mucormycosis.
• Mucormycosis is a rapid growing disease involving the arteries and causing endothelial damage and thrombosis.
• Immunocompromised people are more likely to develop mucormycosis, such as those with uncontrolled diabetes.

Q14. What could be the potential clinical diagnosis for a 35-year-old man who visited the clinic reporting intermittent dizziness, sensation of pressure and fullness in the ear, reduced hearing, and a low-frequency roaring sound in the ears?

1. Meniere’s disease
2. Benign paroxysmal positional vertigo
3. Labyrinthitis
4. Syncope​

 Ans. 1)  Meniere’s disease

• The patient is likely suffering from Meniere’s disease, It is characterized by:
  • Spontaneous attacks of vertigo,
  • Fluctuating sensorineural hearing loss, and
  • Tinnitus and Aural fullness
• Diuretics to lessen fluid buildup in the inner ear, medicines to decrease vertigo and nausea, and in extreme cases, surgery to alleviate pressure in the inner ear are all possible treatments for Meniere's disease.

Also read: FMGE Previous Year Questions For Radiology

Q15. What is the preferred treatment for a primipara who is experiencing hearing impairment that has worsened during her pregnancy? The Rinne's test yields negative results in both ears, while the Weber's test shows lateralization to the right side. The otoscopy reveals normal tympanic membranes, and audiometry indicates a dip in bone conduction at 2000 Hz.

1. Sodium fluoride​
2. Tympanoplasty
3. Stapedectomy
4. Stapedotomy

 Ans. 4) Stapedotomy

The patient appears to have conductive hearing loss in the right ear, according to the clinical findings. Bone conduction is preferable to air conduction, which is indicative of conductive hearing loss, according to the negative results of the Rinne test in both ears. 

Otosclerosis, a disorder in which there is abnormal bone growth in the middle ear that interferes with sound transmission, is the most likely reason for conductive hearing loss in a pregnant woman. The preferred method of treatment for otosclerosis is stapedotomy. A small hole is drilled or laser-cut into the footplate during stapedotomy to allow for the insertion of a prosthesis through the footplate.

Therefore, the correct treatment for the condition is stapedotomy.

Q16. A 30-year-old patient with chronic sinusitis and nasal congestion, which anatomical structure is the most likely drainage pathway for the bulla ethmoidalis?

1. Middle meatus
2. Superior meatus
3. Inferior meatus
4. Middle concha

Ans. 1) Middle meatus

• The middle meatus is the most likely drainage pathway for the bulla ethmoidalis. The bulla ethmoidalis is a rounded bony prominence in the ethmoidal labyrinth (a part of the ethmoid bone) located in the lateral wall of the nasal cavity. It is associated with the middle nasal concha. The middle meatus is a space located between the middle and inferior nasal conchae (turbinates), which are bony structures in the nasal cavity that help to create turbulence in the inspired air. The bulla ethmoidalis drains into the middle meatus through the ethmoid infundibulum, which is a narrow passage connecting the bulla to the middle meatus. This drainage pathway is important for proper ventilation and drainage of the frontal and anterior ethmoid sinuses.

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Q17. An infant developed difficulty in breathing. His symptoms improve with crying. In which disease, symptoms get improved with crying?

1. Atrophic rhinitis
2. Acute rhinosinusitis
3. Allergic rhinitis
4. Choanal atresia

Ans. 4) Choanal atresia

• Choanal atresia is a congenital condition where there is a blockage or narrowing of the back of the nasal passage (choanae) that leads from the nasal cavity to the throat. This blockage can make it difficult for an infant to breathe through their nose. Interestingly, infants with choanal atresia often improve their breathing when they cry. When they cry, they open their mouths wider, allowing more air to flow into their lungs through their mouth, bypassing the blocked nasal passages. This temporary improvement in breathing during crying is a characteristic feature of choanal atresia.

Q18. What investigation is carried out immediately after a child is suspected of having inhaled a foreign body?

1. Rigid bronchoscopy
2. Chest X-ray
3. Direct laryngoscopy
4. Flexible endoscopy

Ans. 2) Chest X-ray

• After a child inhales or ingests a foreign body, a chest X-ray is often the initial investigation carried out. A chest X-ray can help identify the location and potential presence of a foreign body in the lungs or airways. It provides a quick and non-invasive way to assess the situation and determine the appropriate course of action.

Q19. What is the most common site of ranula?

1. Floor of the mouth
2. Tonsil
3. Uvula
4. Cingula

Ans. 1) Floor of the mouth

• A ranula is a type of mucocele that occurs in the floor of the mouth. It is a cystic swelling that develops due to the obstruction of the salivary gland duct, most commonly the sublingual gland duct. The sublingual gland is located beneath the tongue and its duct can become blocked, leading to the accumulation of saliva and the formation of a cystic swelling in the floor of the mouth. Ranulas can vary in size and may cause discomfort or interfere with speech and swallowing.

Also read: Most IMP FMT PYQs for FMGE

Q20. A child with a mild cold who also has adenoid facies has been identified as having chronic adenoid hypertrophy. Which is the best surgical management for this condition?

1. Coblator
2. Microdebrider
3. Curettage
4. Breathing exercise and symptomatic treatment

Ans. 1) Coblator

• For a child with chronic adenoid hypertrophy and adenoid facies, the best surgical management option among the given choices is Option A: Coblator. This technique offers precise tissue removal with minimal damage, reduced postoperative pain, and faster recovery.

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