Ear and audiology: cholesterol granuloma: 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 · Ear and audiology: cholesterol granuloma

Sample item

A 40-year-old man has mild conductive hearing loss and a dark blue bulging tympanic membrane, with no history of trauma. MRI of the temporal bone shows a middle ear lesion that is bright on both T1 and T2 sequences. What is the diagnosis?

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

The answer and the reasoning

D. Cholesterol granuloma

A cholesterol granuloma contains blood breakdown products and cholesterol crystals, giving a blue drum and high signal on both T1 and T2. A cholesteatoma is dull on T1 with restricted diffusion. A glomus tumour is a red vascular mass that enhances.

Option by option

  • A. Tympanosclerosis

    Tympanosclerosis gives white chalky plaques in the drum, not a blue bulging membrane.

  • B. Cholesteatoma

    A cholesteatoma is intermediate to low on T1 and shows restricted diffusion, and the drum is white or retracted.

  • C. Glomus tympanicum

    A glomus tympanicum is a red, pulsatile mass with intense enhancement and pulsatile tinnitus.

  • D. Cholesterol granuloma (correct)

    Correct. A blue drum with high T1 and high T2 signal is typical of a cholesterol granuloma.

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, Cholesterol granuloma. A cholesterol granuloma contains blood breakdown products and cholesterol crystals, giving a blue drum and high signal on both T1 and T2.

Why is "Tympanosclerosis" not the answer?

Tympanosclerosis gives white chalky plaques in the drum, not a blue bulging membrane.

Why is "Cholesteatoma" not the answer?

A cholesteatoma is intermediate to low on T1 and shows restricted diffusion, and the drum is white or retracted.

Why is "Glomus tympanicum" not the answer?

A glomus tympanicum is a red, pulsatile mass with intense enhancement and pulsatile tinnitus.

What concept does this question test?

It tests Ear and audiology: cholesterol granuloma in ENT. A cholesteatoma is dull on T1 with restricted diffusion. A glomus tumour is a red vascular mass that enhances.

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 Ear and audiology: cholesterol granuloma?

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.