Deep neck infections: 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 · Deep neck infections

Sample item

A diabetic man with an infected lower molar has woody bilateral swelling of the submandibular region, a raised tongue, trismus and drooling. What is the most important immediate priority?

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

The answer and the reasoning

B. Secure the airway while starting intravenous antibiotics

This is Ludwig's angina, a rapidly spreading cellulitis of the submandibular, sublingual and submental spaces usually of dental origin. Elevation of the tongue and floor of mouth threatens the airway, so airway protection comes first, with intravenous antibiotics and drainage if collections form. Diabetes increases the risk.

Option by option

  • A. Needle aspiration of the submandibular gland

    The gland is not the source; the infection is a diffuse cellulitis of floor-of-mouth spaces.

  • B. Secure the airway while starting intravenous antibiotics (correct)

    Correct. Airway compromise is the main cause of death in this condition.

  • C. Lie the patient flat for a CT scan before any other intervention

    Lying flat for imaging can precipitate obstruction, so it must not precede airway control.

  • D. Oral antibiotics and review after 48 hours

    Oral antibiotics with delayed review underestimates a rapidly progressive airway threat.

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 B, Secure the airway while starting intravenous antibiotics. This is Ludwig's angina, a rapidly spreading cellulitis of the submandibular, sublingual and submental spaces usually of dental origin.

Why is "Needle aspiration of the submandibular gland" not the answer?

The gland is not the source; the infection is a diffuse cellulitis of floor-of-mouth spaces.

Why is "Lie the patient flat for a CT scan before any other intervention" not the answer?

Lying flat for imaging can precipitate obstruction, so it must not precede airway control.

Why is "Oral antibiotics and review after 48 hours" not the answer?

Oral antibiotics with delayed review underestimates a rapidly progressive airway threat.

What concept does this question test?

It tests Deep neck infections in ENT. Elevation of the tongue and floor of mouth threatens the airway, so airway protection comes first, with intravenous antibiotics and drainage if collections form. Diabetes increases the risk.

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 Deep neck infections?

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.