Kathmandu University
BIRAT MEDICAL COLLEGE
Budhiganga-02, Tankisinuwari, Morang
Level: III MBBS (Batch: 2022)
Semester: 7th
Examination: Pre-University
Subject: Otorhinolaryngology
Time: 2 hrs. 30 mins.
Date: March 10, 2026
Marks: 50
#INSTRUCTION TO THE CANDIDATE
Answer each section in a separate answer book.
Write brief, relevant and legible answers.
Illustrate your answer with well labeled diagrams where required.
All questions are compulsory.
#SECTION ‘B’
Short Answer Questions (6Q × 5 = 30 marks)
#1.
Describe the anatomical divisions of the middle ear and include a properly labeled diagram.
Describe the classification of hearing loss. Discuss in detail the aetiology and management strategies for conductive hearing loss.
[2+1+2 = 5]
#2.
Describe the Osteomeatal Complex (OMC). List the structures that drain into the middle meatus. Explain the principle and complications of Functional Endoscopic Sinus Surgery (FESS).
[2+1+2 = 5]
#3.
Define stridor. Provide a differential diagnosis for acute-onset stridor in a pediatric patient. List the indications and complications of tracheostomy.
[1+1+3 = 5]
#4.
Define Quinsy. Enumerate its clinical features. Identify the specific site for incision and drainage.
[1+3+1 = 5]
#5.
List the various segments of the intratemporal portion of the facial nerve. Describe the clinical features of Bell’s palsy and differentiate it from a supranuclear (Upper Motor Neuron) facial lesion.
[1+2+2 = 5]
#6.
Describe the clinical approach to a neck swelling, including history, examination, and investigations. List four differential diagnosis of lateral neck swelling.
[3+2 = 5]
#SECTION ‘C’
Problem Based Questions / Modified Essay Questions (2Q × 10 = 20 marks)
#Problem I
A 55-year-old chronic smoker presents with progressive hoarseness for 3 months.
a. Discuss the differential diagnosis of persistent hoarseness. [2]
b. Mention the subsites of the larynx. [2]
c. Explain the TNM staging of supraglottic carcinoma. [3]
d. Outline evidence-based management strategies based on stage. [3]
#Problem II
A 40-year-old female presents with episodic vertigo lasting 2–4 hours, fluctuating sensorineural hearing loss, and a “roaring” tinnitus in the left ear.
a. What is the most likely diagnosis? [1]
b. Discuss pathophysiology and medical management. [5+4 = 9]