Nose and paranasal sinuses: toxic shock syndrome after nasal packing: 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 · Nose and paranasal sinuses: toxic shock syndrome after nasal packing

Sample item

A woman develops fever of 39 degrees C, hypotension, a diffuse erythematous rash and vomiting 36 hours after nasal packing for epistaxis. Which organism toxin is responsible?

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

The answer and the reasoning

C. Toxic shock syndrome toxin of Staphylococcus aureus

Toxic shock syndrome toxin-1 from Staphylococcus aureus acts as a superantigen that triggers massive cytokine release. It is a recognised complication of nasal packing and nasal surgery. Treatment is removal of the pack, fluids, and antistaphylococcal antibiotics.

Option by option

  • A. Streptococcal M protein only

    M protein is an antiphagocytic virulence factor of group A Streptococcus, not the toxin of nasal pack toxic shock.

  • B. Pseudomonas exotoxin A

    Exotoxin A is associated with Pseudomonas infection of wounds and burns.

  • C. Toxic shock syndrome toxin of Staphylococcus aureus (correct)

    Correct. TSST-1 acts as a superantigen.

  • D. Diphtheria toxin

    Diphtheria toxin causes membranous pharyngitis and myocarditis.

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.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Toxic shock syndrome toxin of Staphylococcus aureus. Toxic shock syndrome toxin-1 from Staphylococcus aureus acts as a superantigen that triggers massive cytokine release.

Why is "Streptococcal M protein only" not the answer?

M protein is an antiphagocytic virulence factor of group A Streptococcus, not the toxin of nasal pack toxic shock.

Why is "Pseudomonas exotoxin A" not the answer?

Exotoxin A is associated with Pseudomonas infection of wounds and burns.

Why is "Diphtheria toxin" not the answer?

Diphtheria toxin causes membranous pharyngitis and myocarditis.

What concept does this question test?

It tests Nose and paranasal sinuses: toxic shock syndrome after nasal packing in ENT. It is a recognised complication of nasal packing and nasal surgery. Treatment is removal of the pack, fluids, and antistaphylococcal antibiotics.

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 Nose and paranasal sinuses: toxic shock syndrome after nasal packing?

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.