DFT(Daily Focus Test) ENT PART 1 DAY 2

A 6-year-old child presents with unilateral mucopurulent rhinorrhea for 2 weeks. What is the most common cause?

• Foreign body

• Adenoids blocking airways

• Deviated nasal septum

  
  

• Chronic frontal sinusitis

Answer explanation

Unilateral mucopurulent discharge in children is almost pathognomonic of foreign body, especially when foul-smelling.

Why Not B: Adenoid hypertrophy typically causes bilateral symptoms.

Why Not C: Septal deviation rarely causes unilateral purulent discharge.

Why Not D: Frontal sinusitis is rare in young children as sinuses aren't fully developed.

Regarding caloric testing, which statement is FALSE?

• Canal paresis makes the test inconclusive

• Cold water induces nystagmus to opposite side and warm water to same side

  
  

• It works by thermal stimulation of vestibular system

  
  

• None of the above

  
  

Answer explanation

Canal paresis actually provides valuable diagnostic information, showing reduced or absent response on affected side.

Why Not B: This is correct (COWS principle - Cold Opposite, Warm Same).

Why Not C: This is the basic principle of caloric testing.

Why Not D: A specific false statement exists among the options.

Which artery does NOT contribute to Little's area?

• Posterior ethmoidal artery

  
  

• Anterior ethmoidal artery

  
  

• Septal branch of facial artery

• Sphenopalatine artery

  
  

Answer explanation

Correct Answer Explanation (A):

Posterior ethmoidal artery does not contribute to Little's area, which is supplied by anterior ethmoidal, septal branch of facial, sphenopalatine, and greater palatine arteries.

Why Not B: Anterior ethmoidal artery is a major contributor to Little's area.

Why Not C: Septal branch of facial artery is a key contributor.

Why Not D: Sphenopalatine artery is an important contributor to Little's area.

Gelle's test is specifically used in the diagnosis of:

• Otosclerosis

• Serous otitis media

• Traumatic deafness

  
  

• Senile deafness

Answer explanation

Correct Answer Explanation (A):

Gelle's test evaluates ossicular chain mobility and is particularly useful in diagnosing otosclerosis, where stapes fixation leads to a negative test.

Why Not B: Serous otitis media primarily affects middle ear fluid, not ossicular fixation.

Why Not C: Traumatic deafness may have various mechanisms not specifically identified by Gelle's test.

Why Not D: Senile deafness is typically sensorineural, not related to ossicular chain mobility.

A 40-year-old male with sputum AFB positive presents with hoarseness and painful swallowing. On examination, vocal cords show mamillated appearance and hyperemia. Most likely diagnosis is:

• TB larynx

• Reinke's edema

• Epiglottitis

  
  

• Cancer of larynx

  
  

Answer explanation

Correct Answer Explanation (A):

Tuberculosis of larynx presents with hoarseness, odynophagia, and characteristic mamillated appearance of vocal cords in an AFB-positive patient.

Why Not B: Reinke's edema doesn't present with painful swallowing or mamillated appearance.

Why Not C: Epiglottitis typically presents with acute onset and doesn't show mamillated appearance.

Why Not D: Laryngeal cancer doesn't typically present with AFB positive sputum or mamillated appearance.

What is the primary stimulus that activates the semicircular canals?

• Rotation

  
  

• Gravity

•  Linear acceleration

  
  

• Sound

  
  

Answer explanation

Correct Answer Explanation (A):

Semicircular canals contain cristae which specifically sense angular or rotational acceleration, not other forms of movement.

Why Not B: Gravity is primarily sensed by otolith organs (utricle and saccule).

Why Not C: Linear acceleration is sensed by otolith organs, not semicircular canals.

Why Not D: Sound is detected by the cochlea, not semicircular canals.

From which branchial arch does the stapes develop?

• Second arch

•  First arch

• Third arch

  
  

• Fourth arch

Answer explanation

Correct Answer Explanation (A):

Stapes develops from second branchial arch, except its footplate and annular ligament which derive from the otic capsule.

Why Not B: First arch gives rise to malleus and incus.

Why Not C: Third arch doesn't contribute to middle ear ossicles.

Why Not D: Fourth arch has no role in ossicular development.

Among the following, which is NOT typically associated with epistaxis?

• Allergic rhinitis

  
  

• Foreign body

• Tumor

•  Hypertension

  
  

Answer explanation

Correct Answer Explanation (A):

Allergic rhinitis typically causes nasal congestion and rhinorrhea but is not a primary cause of epistaxis.

Why Not B: Foreign bodies commonly cause traumatic epistaxis.

Why Not C: Tumors, especially vascular ones, frequently present with epistaxis.

Why Not D: Hypertension is a well-documented cause of epistaxis.

A 50-year-old male presents with severe otalgia that worsens during swallowing. Examination reveals no pathology in the external auditory canal or tympanic membrane. Which nerve is most likely transmitting the pain?

• Jacobson’s nerve (IX)

• Arnold’s nerve (X)

• Auriculotemporal nerve (V3)

• Lesser occipital nerve (C2)

Answer explanation

Correct Option Explanation:

A. Jacobson’s nerve (IX): Jacobson’s nerve transmits referred otalgia from pharyngeal inflammation due to its sensory innervation to the middle ear and pharynx.

Wrong Options Explanation:

B. Arnold’s nerve (X): While Arnold’s nerve can transmit referred otalgia, it is primarily linked to laryngeal or vagal structures, not pharyngeal pathology.

C. Auriculotemporal nerve (V3): This nerve transmits pain from the temporomandibular joint or parotid, not pharynx-related issues.

D. Lesser occipital nerve (C2): This nerve provides sensory innervation to the scalp, unrelated to otalgia from pharyngeal sources.

The medial surface of the tympanic membrane receives sensory innervation from which nerve?

• Glossopharyngeal nerve (IX)

• Vagus nerve (X)

• Facial nerve (VII)

• Lesser occipital nerve (C2)

Answer explanation

Correct Option Explanation:

A. Glossopharyngeal nerve (IX): The medial side of the tympanic membrane is innervated by Jacobson’s nerve, a branch of the glossopharyngeal nerve, providing sensory input to the middle ear.

Wrong Options Explanation:

B. Vagus nerve (X): Arnold’s nerve (auricular branch of the vagus) innervates parts of the external ear and canal, not the medial tympanic membrane.

C. Facial nerve (VII): While the facial nerve is involved in motor innervation of the middle ear muscles, it does not supply sensory fibers to the medial TM.

D. Lesser occipital nerve (C2): This nerve supplies sensory innervation to the scalp, unrelated to the tympanic membrane.