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​OTO-RHINO-LARYNGOLOGY​ (E.N.T)


OTO-RHINO-LARYNGOLOGY SYLLABUS

(These syllabus may change from time to time. Please check with the relevant Public Service Commission websites for any changes in the syllabus)​

Physiology – Mechanism of perception of smell and taste, mechanism of breathing and voice production, laerimation, deglutition and salivation. Functional tests of the nose and para nasal sinuses. Mechanism of cough and sneezing. 

Physics of sound, theories of hearing, mechanism of perception of sound and speech Production, Physiology of equilibrium & Cerebral function. Physiology of brain in connection with hearing, speech, smell and phonation. Audiologic tests like audiometry, impedance, evoked potentials, OAE, Speech audiometry Physiology of larynx, tracheobronchial tree & oesophagus – Histology of mucous membranes, internal ear and other associated organs and structures, nose, PNS NPx, Larynx, TB tree, Lymphoepithelial system. Mechanism of immune system/immunology and genetics.

Anatomy – Embryogenesis of ear, nose and throat including palate and the larynx, Oesophagus, trachea and lungs, tongue, salivary gland Head & Neck & skull base etc. Parapharyngeal spaces in the neck including connective tissue barriers of larynx.

Applied anatomy of the skull bones, accessory sinuses, external, middle and inner ears, nose, PNS, nasopharynx, meninges, brain, pharynx, larynx, trachea and bronchii, lungs, pleurae oesophagus and the mediastinums. Anatomy of all cranial nerves with their functions.

1 Clinical methodology as applied to ORL HN disease in adult & children and the accessory sinuses, diagnosis and surgical treatment of diseases of nose, throat and ear in adult and children. Prevention and treatment, infectious diseases of Otolaryngology and Head Neck region. Circulatory and nervous disturbances of the nose, throat and ear and their effects on other organs of the body. Deformities, injuries sinus infections, polyps and the tumours of the nose, and paranasal sinuses. Examination of the ear, deafness and allied diseases, complications of diseases of the ear. Injuries, tumours, nervous and circulatory neurological disturbances of the ear. Diagnosis and treatment of tinnitus and vertigo. Diagnosis and rehabilitation of the Hearing handicapped including, dispensing of hearing aid other vibrotatile aids.
2 Surgical pathology of Otolaryngology and Head Neck region.
3 Basic knowledge of the anaesthesia as related to E.N.T.
4 Examination of diseases of children (Pediactric ORL) in connection with throat and larynx. Neurological and vascular disturbances. Congenital and neonatal stridor.
5 Pathology of various diseases of the larynx and throat, tracheo bronchial tree and their causative organisms.
6 Indications and various techniques of direct laryngoscopy, nasal endoscopy, bronchoscopy and oesophagoscopy, including microlaryngoscopic procedures.
7 Reading of radiograms, scans, audiograms, nystagmograms and tympanograms in connection with E.N.T. diseases/disorders.
8 Special apparatus for the diagnosis and treatment of the diseases of ear, nose and throat including audiometer, BERA, ENG, Speech analyser etc.
9 The recent developments in the diagnosis pathogenesis treatments of the E.N.T. diseases.
10 The knowledge of the frontiers of the oto-laryngology and lateral skull base surgery.
11 Rhinoplasties, endoscopic sinus surgery and anterior cranial fossa surgery.
12 Knowledge of LASERS and fibre optics.
13 Other methods of managing Hearing loss.
14 Implantable hearing aids, cochlear implants.
15 Phonosurgery.
16 Etiology and Managements of sleep apnoea/snoring.
17 Hypophysectomies and optic nerve decompressions.
18 Immunotherapy and modalities of the gene therapy.
19 Newer techniques for Radiotherapy including, use of gamma knife for treatment of intracranial tumours and other malignancy.
20 Chemotherapy of cancer.
21 General surgery, Head & Neck oncology and Medicine as applicable to the ENT disorders/diseases. Surgery of congentital deformities of nose, ear (Pinna) & trachea/oesophagus etc.
22 Radiology, Imaging – computed tomography and magnetic resonance imaging, (MRI) and interventional radiology and angiography as related to E.N.T.
​23 General pathologic aspects such as wound healing and also Pathology and Pathogenesis of E.N.T. diseases, Pharmacology, molecular biology, genetics, cytology, haematology and immunology as applicable to otolaryngology.
24 General principles of faciomaxillary traumatology and also neck injury, Plastic surgery as applicable to Otolaryngology.
25 Basic computers, computer averaging of the biological signals and its applications in Otolaryngology & Otolaryngologic equipments.
26 Audiologic and speech disorders and their management strategies.
27 Principles of Jurisprudence and ethical issues as applicable to E.N.T. surgeons.
28 Fascial spaces of Neck.
29 Lymph nodes & Lymphatic's of Head & Neck region.
30 Anatomy of thyroid gland. Benign and Malignant thyroid neoplasm.
31 Principals of Nuclear Medicine,role of Nuclear Medicine in Oto-Rhino-Laryngology.
32 Role of robotic surgery in Oto-Rhino-Laryngology.
33 Medical education & newer teaching tools: OSCE, OSPE, etc.
34 Research Methodology: Sampling, study bias, clinical research design, clinical trials, p-values.
35 Lymphomas of head & neck region.

Oto-Rhino-Laryngology Answer Keys

1. Stapedial reflex is mediated by
1) V and VII nerve 2) V and VIII nerve 3) VII and VI nerve 4) VII and VIII nerve

 Ans: D 

2. Hyperacusis in Bell’s palsy is due to paralysis of following muscle
1) Tensor tympani 2) Levator palati 3) Tensor veli palatini 4) Stapedius

 Ans: D 
 
3. Brown's sign is seen in
1) Glomus tumor 2) Meniere’s disease 3) Acoustic neuroma 4) Otosclerosis

 Ans: A 
 
4. Bezold's abscess is a collection of pus :
1) above and in front of the auricle 2) behind the auricle
3) in the upper part of the neck deep to the sternomastoid 4) in the peritonsillar space

 Ans: C 
 
5. During ear examination, the reservoir sign is diagnostic of:
1) Acute Otitis Media 2) Mastoiditis 3) Petrositis 4) Cholesteatoma

 Ans: B 
 
6. Uncontrolled diabetes in elderly patient may predispose to
1) Cholesteatoma 2) Malignant otitis externa 3) Presbyacusis 4) Vestibular neuronitis

 Ans: B 
 
7. Suprapyramidal recess is another name for
1) superior incudal space 2) facial recess 3) Prusssak’s space 4) cochlear space

 Ans: B
 
8. MacEwen's Triangle is surface marking for
1) Mastoid antrum 2) Cochlea 3) Lateral Semicircular canal 4) Endolymphatic Sac

 Ans: A
 
9. Prussak's space lies between
1) Lateral and superior semicircular canal 2) Neck of Malleus and pars flaccida
3) Stapes and stapedial tendon 4) Malleus and Incus

 Ans: B
  
10. Jahrsdoerfer's criteria is used to
1) Select patients with malignant otitis externa who could benefit from surgery
2) Grade patients with hyperostosis of external canal
3) Grade patients with malignant otitis externa
4) Select patients with meatal atresia who would benefit from surgery

 Ans: D 
 
11. Multiple exostosis of external auditory canal commonly occurs in
1) Inner third of the bony canal 2) Outer third of the bony canal
3) Cartilagenous portion of the auditory canal 4) Mastoid tip

 Ans: A 
 
12. In patients with Otosclerosis, tympanometry produces
1) A type curve 2) As type curve 3) Ad type curve 4) B type curve

 Ans: B 
 
13. Most common fungus causing Otomycosis is
1) Aspergillus Fumigatus 2) Candida 3) Mucor 4) Penicillin

 Ans: A 
 
14. Cart Wheel sign is seen in
1) ASOM 2) Adhesive OM 3) OME
4) CSOM
 Ans: A
 
15. A 7 year child presented with acute otitis media does not respond to ampicillin. Examination reveals full and bulging TM, the treatment of choice is
1) Systemic steroid 2) Ciprofloxacin 3) Myringotomy 4) Cortical mastoidectomy

 Ans: C 
 
16. Light- House Sign characterizes
1) ASOM 2) CSOM 3) Menieres disease 4) Cholesteatoma

 Ans: A 
 
17. A 6 year old child with recurrent URTI with mouth breathing, failure to grow, high arched palate and impaired hearing - Rx
1) Tonsillectomy 2) Grommet insertion 3) Myringotomy 4) Adenoidectomy with grommet insertion

 Ans: D 
 
18. Most accepted theory for formation of cholesteatoma
1) Congenital 2) Squamous metaplasia 3) Ingrowth of squamous epithelium 4) Retraction pocket

 Ans: D 
 
19. The treatment of choice for Attico antral variety of CSOM
1) Mastoidectomy 2) Medical management 3) Myringoplasty 4) Insertion of ventilation tube

 Ans: A 
 
20. All of the following are the features of cholesteatoma except
1) Keratinized stratified squamous cell epithelium 2) Deafness 3) Erodes bones 4) Lymphatic permeation

 Ans: D 
 
21. Essential radiological feature of acute mastoiditis is
1) Temporal bone pneumatization 2) Clouding of mastoid air cells 3) Rarefaction of petrous bone 4) Thickening of temporal bone

 Ans: B 
 
22. Treatment of choice for CSOM with vertigo and facial nerve palsy is
1) Antibiotics and antihistaminics 2) Myringoplasty 3) Immediate mastoid exploration 4) Labyrinthectomy

Ans: 3 
 
23. Which one of the following is not a typical feature of Menieres disease
1) SNHL 2) Pulsatile tinnitus 3) Vertigo 4) Fluctuating deafness

 Ans: B
  
24. Recruitment phenomenon is seen in
1) Otosclerosis 2) Menieres disease 3) Acoustic Schwannoma 4) Otitis media with effusion

 Ans: B 
 
25. Schwartz sign is seen in
1) Glomus jugulare 2) Otosclerosis 3) Menieres disease 4) Acoustic neuroma
 Ans: B 
 
26. Most common cause of facial palsy
1) Post operative 2) Trauma 3) Bell's palsy 4) Ramsay Hunt Syndrome

 Ans: C 
 
27. A man presents with vesicles over external acoustic meatus with ipsilateral LMN facial palsy
1) Herpes Zoster 2) HSV 1 3) Varicella 4) None

 Ans: A 
 
28. Most common CP angle tumor is
1) Acoustic neuroma 2) Cholesteatoma 3) Meningioma 4) All

 Ans: A 
 
29. Surgical emphysema after tracheostomy is corrected by:
1) taking more stitches on the wound 2) cold compresses
3) widening of the wound by removal of some stitches 4) antihistaminic intake

 Ans: C 
 
30. Commonest cause of septal perforation is:
1) trauma 2) syphilis

3) lupus 4) blood disease
 Ans: A
 
31. Saddle nose may be due to the following except:
1) overresection of septal cartilage 2) nasal trauma 3) septal abcess 4) Rhinoscleroma

 Ans: D 
 
32. Referred otalgia may be due to the following except:
1) acute suppurative otitis media 2) quinsy 3) dental infection 4) maxillary sinusitis

 Ans: A 
 
33. Proptosis may be due to the following except:
1) frontoethmoid mucocele 2) osteomats of the frontoethmoid
3) antrochoanal polyp 4) nasopharyngeal fibroma

 Ans: C
 
34. Otoscopic manifestation of chronic secretory otitis media may include the following except:
1) perforation at pars flaccida 2) transverse handle of malleous
3) absent cone of light 4) air bubbles behind the tympanic membrane

 Ans: A 
 
35. A newly born infant with respiratory distress & difficult feeding is more likely to be due to:
1) laryngeal web at the anterior half of vocal cords 2) bilateral posterior choanal atresia
3) congenital subglottic stenosis 4) congenital meatal atresia

 Ans: B 
 
36. Unilateral offensive blood tinged purulent rhinorrhea in a 3 years old is more likely due to:
1) Rhinoscleroma 2) lupus 3) foreign body 4) Adenoids

 Ans: C 
 
37. Conservative septoplasty is:
1) surgical correction of deviated septum above 17 years
2) surgical correction of deviated septum below 17 years
3) closed reduction of fractured septum by Ash's forceps
4) Submucous Resection

 Ans: B
 
38. A 20 years old man c/o fever & increasing sore throat with dribbling of saliva & trismus for only 2 days, on examination (the right tonsil pushed medially & forward) no response to antibiotics. Rapid relief can be obtained by :
1) short course of radiotherapy 2) assurance & rest 3) antidiphtheritic serum 4) incision & drainage

 Ans: D 
 
39. The most common cause of conductive deafness is:
1) otosclerosis 2) secretory otitis media 3) congenital ossicular fixation 4) collection of wax

 Ans: D
 
40. Posterior nasal pack may be used in :
1) antrochoanal polyp 2) epistaxis from Little's area 3) CSF rhinorrhoea 4) post-adenoidectomy bleeding

 Ans: D 
 
41. Investigation of choice for nasopharyngeal angiofibroma is
1) CT 2) MRI 3) Angiography 4) Plain X-ray

 Ans: A 
 
42. Otosclerosis means:
1) congenital fixation of incus 2) congenital fixation of stapes 3) ossicular disruption 4) none of the above

 Ans: D 
 
43. Unilateral clear watery nasal discharge reducing Fehling's solution is suggestive of:
1) CSF rhinorrhoea 2) allergic rhinitis 3) viral rhinitis 4) nasal diphtheria

 Ans: A 
 
44. The most common cause of oroantral fistula is:
1) acute sinusitis 2) car accident 3) dental extraction of upper second premolar tooth 4) radical antrum operation

 Ans: C 
 
45. Post-tonsillectomy otalgia is mediated through:
1) Vagus nerve 2) Glossopharyngeal nerve 3) Trigeminal nerve 4) Second & third cervical nerve

 Ans: B 
 
46. Which of the following structures are preserved in radical neck dissection?
1) Vagus nerve 2) Accessory Nerve 3) Internal jugular vein 4) Sternocleidomastoid muscle
 Ans: A
 
47. Which is not a part of hypopharynx
1) Posterior cricoid region 2) Ary epiglottic fold 3) Posterior pharyngeal wall 4) Pyriform fossa

 Ans: B
 
48. Laryngocele arises from
1) True cord 2) Subglottis 3) Saccule of the ventricle 4) Anterior commissure

 Ans: C 
 
49. Hitselberger's sign is associated with
1) Glomus jugulare 2) Acoustic neuroma 3) Otosclerosis 4) carcinoma of the middle ear

 Ans: B
 
50. Phelp's sign is seen in
1) Malignancy of the Maxillay sinus 2) Fracture of temporal bone 3) facial nerve palsy 4) Glomus jugulare

 Ans: D
51. The thinnest part of Facial nerve in fallopian canal is
1) Tympanic
2) Mastoid
3) Labyrinthine

4) none of the above
 Ans: C 
 
52. McNaught Keel may be used during the surgery of
1) Subglottic stenosis 2) Cleft Larynx 3) Laryngeal Web 4) none of the above

Ans: 3 
 
53. Chevallet Fracture is
1) Vertical fracture of nasal septum 2) Horizontal fracture of nasal septum
3) C' shaped fracture of nasal septum 4) none of the above

 Ans: A 
 
54. Gray's struts used to diagnose
1) Deviated nasal septum in adults 2) Deviated nasal septum in newborns 3) sleep apnoea syndrome 4) nasal polyposis

 Ans: B 
 
55. Hard elongated swelling in the tonsillar fossa after tonsillectomy is
1) Thrombosed vein 2) Tonsillolith 3) elongated styloid process 4) Calcified esophagus

 Ans: C 
 
56. The Eustachian tube opens into the nasopharnyx approximately 1 cm behind the
1) Tonsil 2) Posterior end of the superior turbinate
3) Posterior end of the middle turbinate 4) Posterior end of the inferior turbinate

Ans: 4
 
57. Structures passing between the upper border of the superior constrictor muscle and the base of the skull are
1) Styloid ligament and Eustachian tube 2) Superior laryngeal nerves and vessels
3) Styloid ligament and superior laryngeal nerve 4) Levator palati muscle and the cartilaginous Eustachian tube

 Ans: D
 
58. Dysphagia lusoria is because of
1) Esophageal webs 2) Achalasia 3) Esophageal structure 4) Vascular anamolies

 Ans: D
 
59. Polyp which has a mulberry like appearance and bleeds on touch is due to
1) Malignancy 2) Rhinosporidiosis 3) antrochoanal polyp 4) nasopharyngeal fibroma

 Ans: B 
 
60. Ramsay hunt syndrome is characterized by
1) Herpes Zoster of geniculate ganglion 2) Abduscens nerve palsy
3) facial nerve palsy (upper motor neuron) 4) Caused by bacterial infection

Ans: 1 
 
61. Nerve of the pterygoid canal is also known as
1) Arnolds nerve 2) Vidian nerve 3) Nerve of Kuntz 4) Criminal nerve of Grassi

 Ans: B
 
62. Pendred syndrome is goitre associated with
1) Sensorineural deafness 2) Conductive deafness 3) No hearing loss 4) Dysphagia

 Ans: A 
 
63. Arnold's nerve is a branch of --------- nerve
1) vagus 2) Glossopharyngeal 3) Auditory 4) Facial

 Ans: A 
 
64. LeFort's fracture does not involve 
1) Zygoma 2) Maxilla 3) nasal bones 4) Mandible

 Ans: D 
 
65. Recurrent laryngeal nerve is closely related to
1) superior layngeal artery 2) inferior thyroid artery 3) middle thyroid vein 4) superior thyroid artery

 Ans: B 
 
66. Least chance of nodal metastasis is in -------- carcinoma
1) Pyriform fossa 2) Glottic 3) Supraglottic 4) Transglottic

 Ans: B 
 
67. Ceruminous glands present in the ear are
1) Modified Eccrine glands 2) Modified Sweat glands

3) Mucous glands 4) Modified Holocrine glands
 Ans: B 
 
68. Lore's triangle is bounded by all except
1) Trachea 2) Medial edge of retracted strap muscles 3) Thyroid 4) Subclavian Artery

 Ans: D 
 
69. Horizontal crest at the internal auditory canal dividing into superior and inferior halves is :
1) Bill's bar 2) Ponticulus 3) Cog 4) Falciform crest

 Ans: D 
 
70. The Bjork flap is made during which procedure
1) Tracheostomy 2) Modified Radical mastoidectomy 3) Hemithyroidectomy 4) none of the above

 Ans: A 
 
71. Mc Govern's technique used in treatment of
1) Laryngomalacia 2) Choanal atresia 3) Adenoids 4) Wegener's granulomatosis

 Ans: B 
 
72. Tripod fracture is seen
1) Mandible 2) Zygoma 3) Nasal bone   4) Maxilla
 Ans: B 
 
73. Best approach for Glossopharyngeal Neurectomy is
1) Tonsillectomy approach 2) Transpalatal approach 3) Transmandibular approach 4) Transpharyngeal approach

 Ans: A 
 
74. The Bent and Kuhn criteria (major criteria) for allergic fungal rhino sinusitis include all except
1) history of type I hypersensitivity 2) nasal polyposis
3) characteristic computed tomography (CT) scan findings 4) negative fungal stain of sinus contents

 Ans: D 
 
75. Donaldson's line bisects the
1) Horizontal semi-circular canal 2) Posterior semi-circular canal 3) Superior semi-circular canal 4) Facial canal

 Ans: B 
 
76. Microlaryngoscopy was started by
1) Bruce Benzamin 2) Kleinsasser 3) Chevalier jackson 4) None
 Ans: B 
 
77. Endolymph is produced by cells of
1) Stria vascularis 2) Scala vestibuli 3) Scala tympani 4) Heller's cells

 Ans: A 
 
78. Carhart's notch in otosclerosis is seen at
1) 2 KHz 2) 1 KHz 3) 3 KHz 4) 4 KHz

Ans: 1 
 
79. Intrinsic membrane of larynx
1) Thyrohyoid 2) Cricothyroid 3) Cricotracheal 4) Cricovocal

 Ans: D 
 
80. Surgical landmark of facial nerve except
1) Processus cochleariformis 2) Oval Window 3) Short process of incus 4) Trautman's triangle

 Ans: D 
 
81. Branches of facial nerve except
1) Greater superior petrosal N 2) Nerve to stapedius
3) Chorda tympani 4) Greater auricular nerve

 Ans: D 
 
82. Concha Bullosa is pneumatization of
1) Inferior turbinate 2) Middle turbinate 3) Superior turbinate 4) Septum

 Ans: B 
 
83. Kartagener's syndrome includes all except
1) chronic rhinosinusitis 2) Bronchiectasis

3) Situs inversus 4) Coloboma
 Ans: D 
 
84. Bony septal perforation occurs in
1) TB 2) Leprosy 3) Syphilis 4) Sarcoidosis
Ans: C 
 
85. Ozeana' is a feature of
1) Hypertrophic rhinitis 2) Atrophic rhinitis 3) Rhinitis caseosa 4) Rhinitis sicca

 Ans: B 
 
86. Quinsy is
1) Acute Tonsillitis 2) Peritonsillar abscess 3) Membranous Tonsillitis 4) Diphtheritic Tonsillitis

 Ans: B 
 
87. Schirmer's test is used to test
1) greater superficial petrosal nerve 2) Nerve to stapedius 3) Chorda tympani 4) Peripheral branches

 Ans: A 
 
88. Most common thyroid malignancy is
1) Follicular 2) Papillary 3) Medullary 4) Anaplastic

 Ans: B 
 
89. All are well differentiated thyroid cancers except
1) Follicular 2) Papillary 3) Medullary 4) Anaplastic

 Ans: D 
 
90. Tone decay test is positive in
1) conductive deafness 2) cochlear deafness 3) Retrocochlear deafness 4) all of the above

 Ans: C 
 
91. Bleeding polypus of septum is
1) capillary haemangioma 2) cavernous haemangioma 3) A-V malformation 4) none of the above

 Ans: A
 
92. Apple jelly nodule on septum are seen in
1) Syphilis 2) Rhino scleroma 3) Lupus vulgaris 4) Leprosy

Ans: 3
 
93. Best view of Frontal sinus is
1) Caldwell's view 2) Towne's view 3) Water's view 4) Lateral view

 Ans: A
 
94. If posterior epistaxis cannot be controlled , which artery is ligated
1) Posterior ethmodial artery 2) Maxillary artery 3) sphenopalatine artery 4) external carotid artery
 Ans: C
 
95. Third window effect is seen
1) Perforated TM 2) Dehiscent superior semi circular canal 3) Round window 4) Oval window

 Ans: B
 
96. "Bernoulli's theorem" explains
1) Nasal polyp 2) Thryoglossal cyst 3) Zenker's diverticulum 4) Laryngomalacia

 Ans: A ​
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