QP Code: 21016

JSS Academy of Higher Education & Research, Mysuru

(Deemed to be University)
MBBS Phase-III-Part-I (RS 2) Examination – January 2023
Subject: Oto-Rhino-Laryngology
Note: All questions are compulsory
Draw neat labeled diagrams wherever necessary.
Your answer should be specific to the questions asked.
Time: 3 hours Max. Marks: 100

Part I Multiple Choice Questions 20 Marks To be answered in OMR sheet

Part II Long Essays 20 Marks To be answered in Answer
Short Essays 30 Marks Booklet
Short Answers 30 Marks

Part I
Multiple Choice Questions 20 x 1 = 20 Marks
1. Which of the following is NOT a feature of Meniere’s disease:
a) Episodic vertigo, roaring tinnitus with hearing loss
b) About 50% of patients have been reported to be allergic to inhalants / food items
c) Audiometry shows conductive hearing loss
d) Recruitment causes intolerance to loud sounds
2. Prolonged use of the following drug can cause rhinitis medicamentosa:
a) Steroid nasal spray
b) Nasal decongestant
c) Antihistamines
d) Leukotriene receptor antagonist
3. Carhart’s notch is seen in:
a) Meniere’s disease
b) Otosclerosis
c) CSOM
d) Noise induced hearing loss
4. The cough response caused while cleaning the ear canal is mediated by stimulation of:
a) 5th cranial nerve
b) 7th cranial nerve
c) 9th cranial nerve
d) 10th cranial nerve
5. Space involved in Ludwig’s angina is:
a) Submandibular
b) Retropharyngeal
c) Parapharyngeal
d) Danger space
6. Thyroid angle in males is:
a) 60
b) 90
c) 100
d) 120

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7. Pulsatile swelling in tonsillar fossa is due to:
a) Normal internal carotid artery
b) Carotid body tumor
c) Aneurysm of internal carotid artery
d) Peritonsillar abscess
8. Inferior turbinate is:
a) A separate bone
b) Part of ethmoid
c) Part of maxillary bone
d) Part of zygomatic bone
9. The shortest and narrowest segment of facial canal is:
a) Labyrinthine segment
b) Tympanic segment
c) Mastoid segment
d) Meatal segment
10. Epley’s manoeuvre is done for the treatment of:
a) Vestibular Neuronitis
b) Benign paroxysmal positional vertigo (BPPV)
c) Labyrinthitis
d) Acoustic neuroma
11. Irwin Moore sign is seen in:
a) Acute tonsillitis
b) Peritonsillar abscess
c) Chronic tonsillitis
d) Granular pharyngitis
12. Which of the following is NOT a feature of malignant otitis externa?
a) Mitotic figures are high
b) Caused by Pseudomonas aeruginosa
c) Patients are usually immune compromised
d) Presence of granulation tissue
13. A 15-year-old has unilateral nasal obstruction, mass in the cheek and recurrent epistaxis, the
diagnosis is:
a) Cancer of nasopharynx
b) Inverted papilloma nose
c) Maxillary sinusitis
d) Angiofibroma
14. All structures open in the middle meatus EXCEPT:
a) Sphenoid sinus
b) Maxillary sinus
c) The frontal sinus
d) The ethmoid sinus
15. Otoacoustic emissions are produced by:
a) Inner hair cells
b) Basilar membrane
c) Auditory nerve
d) Outer hair cells

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16. Eagles’ syndrome is:
a) Elongated styloid process
b) Nasopharyngeal tumour
c) Temporomandibular joint arthritis
d) Infection of lateral sinus
17. Fistula sign is seen in:
a) Acute mastoiditis
b) Erosion in basal turn of cochlea
c) Erosion of lateral semi-circular canal
d) Acute petrositis
18. Mikulicz cells are seen in:
a) Rhinosporidiosis
b) Rhinophyma
c) Rhinoscleroma
d) Lupus vulgaris
19. Which of the following is NOT correct about cholesteatoma:
a) Embryonic epidermal cell rests entrapped in the middle ear cleft or temporal bone may
cause ear discharge
b) Bone destruction due to cholesteatoma has been attributed to osteoclasts and
inflammatory cells
c) Treatment of choice is myringotomy with grommet insertion
d) Canal wall up or a canal wall down procedure can be planned to depend upon the extent
and site of cholesteatoma
20. Trotter’s triad is seen in:
a) Nasopharyngeal carcinoma
b) Hypopharyngeal carcinoma
c) Laryngeal carcinoma
d) Post-cricoid carcinoma
Part II
I. LONG ESSAYS 2x10=20 Marks
a. A 25-year-old female patient came to ENT OPD, her attendant complains of foul
1. (1+2+3+3+1)
smell from her nose which the patient is not able to smell. On examination, nasal
cavity shows crusting and purulent foul-smelling greenish discharge.
a) What is the diagnosis?
b) What are the investigations to be done for this patient?
c) What is the medical management?
d) What is the surgical management?
e) What is nasal myiasis?
e) A five-year-old child presented to the ENT OPD with complaints of snoring and
2. (1+3+2+2+2)
mouth breathing for one year. The mother also noticed that the child does not
respond immediately to call. She has also received complaints about
inattentiveness in the class from the teachers.
a) What is the probable diagnosis? Explain the etiopathogenesis.
b) Suggest relevant investigations to support your diagnosis.
c) Mention four causes of bilateral nasal obstruction in the paediatric age group.
d) Describe the management of the condition given in the clinical scenario.

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II. SHORT ESSAYS 6x5=30 Marks
3.
a) A 45-year-old male with history of tobacco chewing complains of difficulty in opening the
mouth and burning sensation in the mouth.
a) What is the probable diagnosis?
b) Write the etiopathogenesis of the above condition.
c) Briefly describe the management.
4. A 21-year-old male complains of sudden loss of hearing for two days. There is no history
of trauma, ear discharge.
a) Give the differential diagnosis of the above condition.
b) What is sudden sensorineural hearing loss (SNHL)?
c) Write the management of the above condition.
5. A 2-month-old baby presented with inspiratory stridor. The child is feeding well, stridor
improves on prone position.
a) What is the diagnosis?
b) Enumerate the causes of congenital stridor
c) How do you manage the child?
6. A patient complains of watery discharge from the right nasal cavity following a road traffic
accident (RTA). The discharge increases when the patient is in sitting position and bends
forward.
a) What is the most probable diagnosis?
b) Explain the investigations done.
c) Discuss the management.
7. A 10-year-old child presents with history of mouth breathing and snoring for three years.
a) Discuss the probable causes.
b) What is Waldeyer’s ring?
c) Discuss in brief management of the child.
8. A 25-year-old lady presents to the ENT OPD with decreased hearing in both ears in the last
3 years. She says that it increased after her pregnancy.
a) What is the diagnosis?
b) What investigations are required?
c) Discuss the treatment.

III. SHORT ANSWERS 10x3=30 Marks

9. Enumerate complications of CSOM.
10. Mac Ewen’s triangle.
11. Enumerate the complications of tonsillectomy.
12. Explain the structures seen in the lateral wall of the nose.
13. Rinne’s test.
14. Killian’s dehiscence.
15. Referred otalgia.
16. Rhinoscleroma.
17. Explain the bed of the tonsil with a diagram.
18. Puberphonia.
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