Ear and audiology: unilateral effusion in an adult: 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: unilateral effusion in an adult

Sample item

A 52-year-old man has had blocked hearing in the right ear for two months with no cold or allergy. The right drum is dull with an air-fluid level and tympanometry is flat. Which next step is most important?

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

The answer and the reasoning

C. Nasopharyngeal endoscopy with biopsy of any lesion

Persistent unilateral middle ear effusion in an adult may be the first sign of a nasopharyngeal carcinoma obstructing the eustachian tube. The nasopharynx must be examined and biopsied if abnormal. Treating the ear alone delays diagnosis.

Option by option

  • A. Repeated Valsalva autoinflation exercises

    Autoinflation will not clear an effusion caused by a mass at the tubal opening.

  • B. A 10-day course of oral amoxicillin

    Antibiotics treat acute infection and no infective features are described.

  • C. Nasopharyngeal endoscopy with biopsy of any lesion (correct)

    Correct. Unilateral adult effusion needs the postnasal space examined to exclude nasopharyngeal carcinoma.

  • D. Insertion of a ventilation tube alone

    A ventilation tube drains the fluid but leaves the cause unexamined and the diagnosis delayed.

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 C, Nasopharyngeal endoscopy with biopsy of any lesion. Persistent unilateral middle ear effusion in an adult may be the first sign of a nasopharyngeal carcinoma obstructing the eustachian tube.

Why is "Repeated Valsalva autoinflation exercises" not the answer?

Autoinflation will not clear an effusion caused by a mass at the tubal opening.

Why is "A 10-day course of oral amoxicillin" not the answer?

Antibiotics treat acute infection and no infective features are described.

Why is "Insertion of a ventilation tube alone" not the answer?

A ventilation tube drains the fluid but leaves the cause unexamined and the diagnosis delayed.

What concept does this question test?

It tests Ear and audiology: unilateral effusion in an adult in ENT. The nasopharynx must be examined and biopsied if abnormal. Treating the ear alone delays diagnosis.

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: unilateral effusion in an adult?

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.