Vertigo: 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 · Vertigo

Sample item

A man with long-standing foul-smelling attic discharge and cholesteatoma develops vertigo and nystagmus when pressure is applied to the tragus to compress the air in the external canal. Which structure has most likely been eroded?

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

The answer and the reasoning

A. Lateral semicircular canal

A positive fistula test means pressure changes are transmitted through a bony defect to the labyrinth, producing vertigo and nystagmus. The lateral semicircular canal is the commonest site of erosion by cholesteatoma because it projects into the aditus region.

Option by option

  • A. Lateral semicircular canal (correct)

    The lateral canal is the usual site of labyrinthine fistula in cholesteatoma and gives a positive fistula test.

  • B. Tegmen tympani

    Erosion of the tegmen causes meningitis or temporal lobe abscess, not pressure-induced vertigo.

  • C. Fallopian canal (facial nerve canal)

    Erosion of the facial canal causes a lower motor neuron facial palsy rather than vertigo.

  • D. Basal turn of the cochlea

    Erosion of the cochlea would mainly cause sensorineural hearing loss rather than pressure-induced vertigo.

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 A, Lateral semicircular canal. A positive fistula test means pressure changes are transmitted through a bony defect to the labyrinth, producing vertigo and nystagmus.

Why is "Tegmen tympani" not the answer?

Erosion of the tegmen causes meningitis or temporal lobe abscess, not pressure-induced vertigo.

Why is "Fallopian canal (facial nerve canal)" not the answer?

Erosion of the facial canal causes a lower motor neuron facial palsy rather than vertigo.

Why is "Basal turn of the cochlea" not the answer?

Erosion of the cochlea would mainly cause sensorineural hearing loss rather than pressure-induced vertigo.

What concept does this question test?

It tests Vertigo in ENT. The lateral semicircular canal is the commonest site of erosion by cholesteatoma because it projects into the aditus region.

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 Vertigo?

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.