Nose: primary ciliary dyskinesia screening: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose: primary ciliary dyskinesia screening

Sample item

A 9-year-old has daily wet cough, chronic rhinosinusitis, recurrent otitis media with effusion and dextrocardia on chest film. Which screening test is most appropriate before confirmatory ciliary studies?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Nasal nitric oxide measurement, which is characteristically very low

The picture with situs inversus suggests Kartagener syndrome, a form of primary ciliary dyskinesia. Nasal nitric oxide is markedly reduced and is a useful screening test, followed by ciliary beat analysis, electron microscopy or genetics. Cystic fibrosis is a differential and sweat testing is done in addition, not instead.

Option by option

  • A. Skin prick testing

    Allergy testing does not explain situs inversus.

  • B. Serum IgE level

    A high IgE suggests allergic disease, not ciliary dysfunction.

  • C. Nasal nitric oxide measurement, which is characteristically very low (correct)

    Correct. Very low nasal nitric oxide is typical of ciliary dyskinesia.

  • D. Sweat chloride only, to the exclusion of other tests

    Sweat chloride tests for cystic fibrosis and would not exclude ciliary disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Nasal nitric oxide measurement, which is characteristically very low. The picture with situs inversus suggests Kartagener syndrome, a form of primary ciliary dyskinesia.

Why is "Skin prick testing" not the answer?

Allergy testing does not explain situs inversus.

Why is "Serum IgE level" not the answer?

A high IgE suggests allergic disease, not ciliary dysfunction.

Why is "Sweat chloride only, to the exclusion of other tests" not the answer?

Sweat chloride tests for cystic fibrosis and would not exclude ciliary disease.

What concept does this question test?

It tests Nose: primary ciliary dyskinesia screening in ENT. Nasal nitric oxide is markedly reduced and is a useful screening test, followed by ciliary beat analysis, electron microscopy or genetics. Cystic fibrosis is a differential and sweat testing is done in addition, not instead.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose: primary ciliary dyskinesia screening?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.