External ear: 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 · External ear

Sample item

An elderly diabetic patient has severe night-time ear pain, persistent discharge and granulation tissue at the junction of the bony and cartilaginous canal that has not responded to topical drops. Which organism is most often responsible?

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

The answer and the reasoning

D. Pseudomonas aeruginosa

Necrotising (malignant) otitis externa is an invasive infection of the skull base spreading from the external canal, caused by Pseudomonas aeruginosa in the great majority. It can lead to cranial nerve palsies, especially the facial nerve. Prolonged anti-pseudomonal antibiotics with glycaemic control are required.

Option by option

  • A. Staphylococcus aureus

    Staphylococcus aureus causes localised furuncles of the canal, not skull base osteomyelitis.

  • B. Streptococcus pneumoniae

    Pneumococcus is a common cause of acute otitis media, not of this canal infection.

  • C. Aspergillus niger

    Aspergillus causes superficial fungal otitis externa with debris and is not the usual cause here.

  • D. Pseudomonas aeruginosa (correct)

    Correct. Pseudomonas is the typical pathogen of this condition.

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, Pseudomonas aeruginosa. Necrotising (malignant) otitis externa is an invasive infection of the skull base spreading from the external canal, caused by Pseudomonas aeruginosa in the great majority.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus aureus causes localised furuncles of the canal, not skull base osteomyelitis.

Why is "Streptococcus pneumoniae" not the answer?

Pneumococcus is a common cause of acute otitis media, not of this canal infection.

Why is "Aspergillus niger" not the answer?

Aspergillus causes superficial fungal otitis externa with debris and is not the usual cause here.

What concept does this question test?

It tests External ear in ENT. It can lead to cranial nerve palsies, especially the facial nerve. Prolonged anti-pseudomonal antibiotics with glycaemic control are required.

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 External ear?

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.