Ear and audiology: signs of coalescent mastoiditis: 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: signs of coalescent mastoiditis

Sample item

A 4-year-old has fever, a tender postauricular swelling pushing the pinna forwards, and otoscopy shows drooping of the posterosuperior part of the bony canal wall. What is the diagnosis?

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

The answer and the reasoning

B. Coalescent acute mastoiditis with a subperiosteal collection

Sagging of the posterosuperior canal wall with a postauricular swelling is pathognomonic of mastoid coalescence with a subperiosteal abscess. Treatment is intravenous antibiotics with drainage and often mastoidectomy. Otitis externa shows pain on moving the pinna but no sagging.

Option by option

  • A. Perichondritis of the pinna

    Perichondritis involves the cartilage of the pinna, which is red and swollen with no canal wall sagging.

  • B. Coalescent acute mastoiditis with a subperiosteal collection (correct)

    Correct. Canal wall sagging with a postauricular swelling shows a coalescent mastoid collection.

  • C. Furuncle of the canal

    A furuncle is a localised painful swelling in the outer canal without sagging of the deep wall.

  • D. Acute diffuse otitis externa

    Diffuse otitis externa causes pain on pinna traction and canal oedema but no postauricular collection.

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 B, Coalescent acute mastoiditis with a subperiosteal collection. Sagging of the posterosuperior canal wall with a postauricular swelling is pathognomonic of mastoid coalescence with a subperiosteal abscess.

Why is "Perichondritis of the pinna" not the answer?

Perichondritis involves the cartilage of the pinna, which is red and swollen with no canal wall sagging.

Why is "Furuncle of the canal" not the answer?

A furuncle is a localised painful swelling in the outer canal without sagging of the deep wall.

Why is "Acute diffuse otitis externa" not the answer?

Diffuse otitis externa causes pain on pinna traction and canal oedema but no postauricular collection.

What concept does this question test?

It tests Ear and audiology: signs of coalescent mastoiditis in ENT. Treatment is intravenous antibiotics with drainage and often mastoidectomy. Otitis externa shows pain on moving the pinna but no sagging.

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 Ear and audiology: signs of coalescent mastoiditis?

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.