INI-CET High Yield Questions for ENT

Mastering the INI-CET demands a strategic approach to preparation, with an emphasis on high-yield topics proving to be a successful tactic. This blog zeroes in on exactly that – a curated list of high-yield questions in ENT that are highly likely to appear on the INI-CET. By acquainting yourself with these questions and their detailed explanations, you'll deepen your understanding of ENT concepts, enhancing your confidence and readiness for exam day.

Q.1. What is the characteristic nature of stridor seen in the condition depicted in the image of laryngoscopy given below?

A. Stridor in prone position

B. Stridor during expiration

C. Stridor diminishes while crying

D. Stridor in supine position

Correct Option D- Stridor in supine position:

• The given image shows omega-shaped epiglottis, which is a feature of laryngomalacia. In laryngomalacia, the characteristic nature of stridor is that it worsens when the infant is in the supine position. This exacerbation occurs because when the child is lying on their back, the epiglottis falls backward and covers the laryngeal inlet, leading to increased airway obstruction and thus worsening of the stridor.

Incorrect Options:

Option A- Stridor in prone position: Laryngomalacia typically presents with stridor worsening in the supine position, not in the prone position.

Option B- Stridor during expiration: Laryngomalacia typically manifests with inspiratory stridor, not expiratory stridor.

Option C- Stridor diminishes while crying: Crying exacerbates the stridor in laryngomalacia due to the negative intrathoracic pressure created during crying, which pulls the epiglottis further inward, causing increased airway obstruction and worsening of the stridor.

2. Which of the following is not caused by the condition depicted in the image below?

A. Epistaxis

B. Middle ear infections

C. Sinusitis

D. Septal hematoma

Correct Option D - Septal hematoma:

• The given image shows a deviated nasal septum. A septal hematoma is not caused by Deviated Nasal Septum (DNS). Instead, it is typically the result of trauma to the nose.

Incorrect Options:

Option A - Epistaxis: When there is a sharp bony projection from the septum, the mucosa overlying this projection may get thinned out and because of the small trivial traumas like picking the nose, sneezing, or blowing the nose will cause mucosal tears and lead to bleeding.

Option B - Middle ear infections: The air goes from the nose to the nasopharynx and via the nasopharynx reaches the middle ear. If the ventilation to the Eustachian tube is decreased, it can result in middle ear infection.

Option C - Sinusitis: The ventilation to the sinus gets affected when the air does not go through the nose adequately. The negative pressure gets build up in the sinus and causes sinus headache as well as sinusitis.

3. A 28-year-old male military personnel presents to the emergency with pain and difficulty opening his mouth following a traumatic event during a parade drill. On radiological evaluation, the following is seen:

What is the ideal management for this patient?

1. Closed reduction
2. Open reduction
3. Conservative management
4. Observation

Correct Option B- Open reduction:

• The given findings are suggestive of Parade ground fracture. The ideal management involves open reduction with titanium wiring to prevent temporomandibular joint (TMJ) ankylosis.

Incorrect Options:

Option A- Closed reduction: Closed reduction is avoided as it can result in TMJ ankylosis.

Option C- Conservative management: Conservative management is not sufficient to manage Parade ground fracture.

Option D- Observation: Observing the patient without any intervention is not the ideal management of Parade ground fracture.

4. A 45-year-old patient presents to the clinic with a sudden onset of vertigo, nausea, and vomiting. There is no associated hearing loss or tinnitus. The caloric test reveals canal paresis and directional preponderance. What is the most appropriate initial treatment for this condition?

1. Epley’s maneuver
2. Corticosteroids
3. Bed rest and labyrinthine sedatives
4. Surgical intervention

Correct Option C - Bed rest and labyrinthine sedatives:

• The given clinical findings point towards the diagnosis of Vestibular neuronitis. The most appropriate initial treatment for vestibular neuronitis is supportive care, which includes bed rest and labyrinthine sedatives. This approach helps manage symptoms and allows the body to recover from the inflammatory process affecting the vestibular nerve.

Incorrect Options:

Option A - Epley’s maneuver: Epley's maneuver is a specific technique used to treat benign paroxysmal positional vertigo (BPPV). It is not the primary treatment for vestibular neuronitis.

Option B - Corticosteroids: Corticosteroids are not the initial treatment. Supportive care is generally recommended first.

Option D - Surgical intervention: Surgical intervention is not the initial or primary treatment for vestibular neuronitis. Conservative measures such as bed rest and medication are typically employed initially.

5. Which age group has a high tendency to develop the following condition?

A. 30- 40 years of age

B. 60-70 years of age

C. 40-60 years of age

D. 20-40 years of age

Correct Option C - 40-60 years of age:

• The given image shows acoustic neuroma, also known as vestibular schwannoma, which is most commonly seen in individuals between the ages of 40 and 60 years.

Incorrect Options:

Option A - 30-40 years of age: Acoustic neuroma is less common in individuals aged 30-40 years.

Option B - 60-70 years of age: The peak incidence is typically observed in the 40-60 age group, not 60-70.

Option D - 20-40 years of age: Acoustic neuroma is less common in individuals aged 20-40 years.

Also Read: INI-CET Previous Year Question Papers

6. Which of the following marked structures corresponds to Luschka’s tonsils and Gerlach’s tonsils?

A. A, B

B. B, C

C. C, B

D. B, D

Correct Option A - A, B: 

• The structure marked as ‘A’ corresponds to Luschka’s tonsils, also known as pharyngeal tonsils, and the structure marked as ‘B’ corresponds to Gerlach’s tonsils, also known as Tubal tonsils.

Incorrect Options:

Option B - B, C: The structure marked as ‘B’ corresponds to Gerlach’s tonsils, not Luschka’s tonsils and the structure marked as ‘C’ corresponds to palatine tonsils(not Geralch’s tonsils).

Option C - C, B: The structure marked as ‘C’ corresponds to palatine tonsils and the structure marked as ‘B’ corresponds to Gerlach’s tonsils.

Option D - B, D: The structure marked as ‘B’ corresponds to Gerlach’s tonsils, not Luschka’s tonsils and the structure marked as ‘D’ corresponds to lingual tonsils.

7. A 3-year-old girl is brought to the ENT clinic by her parents with complaints of barking seal like cough, difficulty breathing, and a low-grade fever since yesterday. On examination, the child is sitting upright and has biphasic stridor. What is the most likely diagnosis for this child?

1. Acute epiglottitis
2. Acute laryngotracheobronchitis
3. Pachyderma laryngitis
4. Tuberculosis of the larynx

Correct Option B - Acute laryngotracheobronchitis:

• This clinical presentation, characterized by a barking seal like cough, difficulty breathing, low-grade fever, and biphasic stridor, along with the child sitting upright, is classic for acute laryngotracheobronchitis, also known as croup.

Incorrect Options:

Option A - Acute epiglottitis: Acute epiglottitis typically presents with sudden onset of high fever, severe sore throat, difficulty swallowing, drooling, and inspiratory stridor. The child often assumes a tripod position.

Option C - Pachyderma laryngitis: Pachyderma laryngitis is characterized by thickening of the vocal cords due to chronic irritation, often seen in individuals with excessive voice use or reflux. It does not typically present with a barking cough or inspiratory stridor.

Option D - Tuberculosis of the larynx: Tuberculosis of the larynx usually presents with symptoms such as odynophagia (painful swallowing), change in voice, and is less common in children, especially in the age range of 3 years old.

8. A 45-year-old patient complains of persistent nasal symptoms, including paroxysmal sneezing, excessive rhinorrhea, and postnasal drip. Upon investigation, the serum IgE level is within the normal range. What condition is most likely responsible for the patient's presentation?

A. Rhinitis caseosa

B. Vasomotor rhinitis

C. Rhinitis sicca

D. Atrophic rhinitis

Correct Option B - Vasomotor rhinitis:

• Vasomotor rhinitis is characterized by symptoms similar to allergic rhinitis, but individuals with vasomotor rhinitis have normal serum IgE levels and eosinophil counts. The condition is associated with an imbalance of the sympathetic and parasympathetic nervous systems, leading to alternations in nasal mucosal blood flow and glandular activity. The symptoms often occur without a clear allergic trigger.

Incorrect Options:

Option A - Rhinitis caseosa: Rhinitis caseosa causes chronic retention of a secretion at the sinuses, which forms a waxy, sebaceous, sticky mass inside the nose called rhinitis caseosa.

Option C - Rhinitis sicca: Rhinitis sicca occurs in those people who expose to hot-dry climates, typically seen in people who work in bakeries.

Option D - Atrophic rhinitis: Atrophic rhinitis consists of a history of merciful anosmia and nasal obstruction.

9. Which of the following marked structures represents the main artery supplying the tonsils?

1. A
2. B
3. C
4. D

Correct Option C - C:

• The structure marked as ‘C’ represents the tonsillar branch of the facial artery. It contributes to the main arterial supply of the tonsils.

Incorrect Options:

Option A - A: The structure marked as ‘A’ is the descending palatine artery and is not the major arterial supply of the tonsils.

Option B - B: The structure marked as ‘B’ is the ascending pharyngeal artery and is not the major arterial supply of the tonsils.

Option D - D: The structure marked as ‘D’ is the dorsal lingual artery and is not the major arterial supply of the tonsils.

10. Which of the following marked structures represents the greater palatine artery?

A. A

B. B

C. C

D. D

The given image represents the blood supply of the medial wall of the nose, and the structure marked as “D” represents the greater palatine artery.

Incorrect Options:

Option A - “A”: Represents the anterior ethmoidal artery, not the greater palatine artery.

Option B - “B”: Represents the septal branch of the superior labial artery, not the greater palatine artery.

Option C - “C”: Represents the posterior ethmoidal artery, not the greater palatine artery.

Option E - “E”: Represents the branches of the sphenopalatine artery, not the greater palatine artery.