Facial nerve disorders: 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 · Facial nerve disorders

Sample item

A 48-year-old woman has severe ear pain, a cluster of vesicles in the concha and external canal, and a lower motor neuron facial palsy on the same side. What is the most likely diagnosis?

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

The answer and the reasoning

D. Ramsay Hunt syndrome

Reactivation of varicella zoster virus in the geniculate ganglion produces zoster oticus: otalgia, vesicles in the ear, and facial palsy, sometimes with sensorineural hearing loss and vertigo. The vesicles separate it from idiopathic Bell's palsy. Antivirals and steroids are given early.

Option by option

  • A. Acute suppurative otitis media with facial palsy

    Acute suppurative otitis media shows a bulging or perforated eardrum with discharge, and no vesicles on the concha.

  • B. Bell's palsy

    Bell's palsy is idiopathic and does not produce vesicles or marked ear pain.

  • C. Malignant otitis externa

    Malignant otitis externa occurs in elderly diabetic or immunocompromised patients with granulation tissue in the canal, not vesicles.

  • D. Ramsay Hunt syndrome (correct)

    Correct. Vesicles with painful ear and facial palsy define this herpes zoster syndrome.

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.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Ramsay Hunt syndrome. Reactivation of varicella zoster virus in the geniculate ganglion produces zoster oticus: otalgia, vesicles in the ear, and facial palsy, sometimes with sensorineural hearing loss and vertigo.

Why is "Acute suppurative otitis media with facial palsy" not the answer?

Acute suppurative otitis media shows a bulging or perforated eardrum with discharge, and no vesicles on the concha.

Why is "Bell's palsy" not the answer?

Bell's palsy is idiopathic and does not produce vesicles or marked ear pain.

Why is "Malignant otitis externa" not the answer?

Malignant otitis externa occurs in elderly diabetic or immunocompromised patients with granulation tissue in the canal, not vesicles.

What concept does this question test?

It tests Facial nerve disorders in ENT. The vesicles separate it from idiopathic Bell's palsy. Antivirals and steroids are given early.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Facial nerve disorders?

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.