A 25-year-old woman complains of bilateral hearing loss since 4 years which worsened during pregnancy. Type of tympanogram will be:

• As

• Ad

• C type

• B type

Answer explanation

Otosclerosis typically presents with low compliance (As) tympanogram due to stapes fixation, often worsening during pregnancy.

Clinical features of nasopharyngeal angiofibroma include:

• Adolescent male, epistaxis, nasal obstruction

• Third to fourth decades, epistaxis

  
  

• Female predominance, nasal obstruction

• Elderly male, epistaxis

  
  

Answer explanation

Nasopharyngeal angiofibroma typically occurs in adolescent males with epistaxis and nasal obstruction as cardinal symptoms.

Most common part of larynx involved in TB is:

• Posterior

  
  

• Anterior

•  Middle

• Anywhere

  
  

Answer explanation

TB predominantly affects posterior third of larynx, particularly the interarytenoid fold, due to pooling of infected sputum.

A female in the emergency department is found to have CSF rhinorrhea following a motor vehicle accident. What is the first line of treatment?

• Observation for 7-10 days with antibiotic therapy

  
  

• Immediate plugging of nose with petroleum gauze

• Craniotomy

• Forceful blowing of nose

  
  

Answer explanation

Early post-traumatic CSF rhinorrhea is managed conservatively with observation, semi-sitting position, and prophylactic antibiotics to prevent meningitis.

Osteomeatal complex connects:

• Nasal cavity with maxillary sinus

• Nasal cavity with sphenoid sinus

  
  

• The two nasal cavities

  
  

• Ethmoidal sinus with ethmoidal bulla

  
  

Answer explanation

Osteomeatal complex lies in middle meatus and is the final common drainage pathway for maxillary, frontal, and anterior ethmoid sinuses.

Stapedius muscle is supplied by:

• 5th nerve

  
  

• 6th nerve

• 7th nerve

•  8th nerve

Answer explanation

 Stapedius muscle is supplied by facial nerve (7th), which emerges from pyramid and inserts into neck of stapes.

The cough response caused while cleaning the ear canal is mediated by stimulation of:

• The X cranial nerve

• The V cranial nerve

• Innervation of external ear canal by C1 and C2

  
  

•  Branches of the VII cranial nerve

Answer explanation

Arnold's nerve (auricular branch of vagus nerve) when stimulated in external ear canal can reflexly cause cough or even cardiac inhibition.

Higher auditory centre determines:

• Sound localization

• Sound frequency

• Loudness

• Speech discrimination

Answer explanation

Sound localization is primarily determined by higher auditory centers through time lag and intensity differences between ears.

Most difficult site to remove cholesteatoma is related with:

• Posterior facial ridge

• Anterior facial ridge

•  Epitympanum

• Hypotympanum

Answer explanation

Sinus tympani (posterior facial ridge) is most difficult due to its location deep to promontory and facial nerve, above pyramid.

Which artery does not contribute to Little's area:

• Posterior ethmoidal artery

• Anterior ethmoidal artery

• Sphenopalatine artery

• Greater palatine artery

Answer explanation

 Explanation: Posterior ethmoidal artery does not contribute to Kiesselbach's plexus (Little's area).