Nasal trauma: 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 · Nasal trauma

Sample item

An 8-year-old boy falls on his nose while playing. Two days later he has bilateral nasal obstruction, and the nasal septum shows a soft, bluish, boggy swelling on both sides. What is the most appropriate management?

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

The answer and the reasoning

D. Prompt incision and drainage of the clot with anterior nasal packing and antibiotics

A septal haematoma lifts the perichondrium off the cartilage and cuts off its blood supply. Untreated, it leads to cartilage necrosis, a saddle nose deformity or a septal abscess, so it must be drained early.

Option by option

  • A. Nasal decongestant drops and review in a week

    Decongestants do not clear a clot, and waiting allows pressure necrosis of the septal cartilage.

  • B. A CT scan of the paranasal sinuses before any intervention

    Imaging is unnecessary for a clinical diagnosis and delays definitive drainage.

  • C. Delayed closed reduction of the nasal bones after the swelling subsides

    Reducing a nasal bone fracture does not treat the haematoma, which is the urgent problem.

  • D. Prompt incision and drainage of the clot with anterior nasal packing and antibiotics (correct)

    Draining the collection and packing to prevent re-accumulation restores the cartilage blood supply and prevents necrosis.

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, Prompt incision and drainage of the clot with anterior nasal packing and antibiotics. A septal haematoma lifts the perichondrium off the cartilage and cuts off its blood supply.

Why is "Nasal decongestant drops and review in a week" not the answer?

Decongestants do not clear a clot, and waiting allows pressure necrosis of the septal cartilage.

Why is "A CT scan of the paranasal sinuses before any intervention" not the answer?

Imaging is unnecessary for a clinical diagnosis and delays definitive drainage.

Why is "Delayed closed reduction of the nasal bones after the swelling subsid…" not the answer?

Reducing a nasal bone fracture does not treat the haematoma, which is the urgent problem.

What concept does this question test?

It tests Nasal trauma in ENT. Untreated, it leads to cartilage necrosis, a saddle nose deformity or a septal abscess, so it must be drained 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 Nasal trauma?

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.