Vestibular disorders: caloric direction of nystagmus: 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 · Vestibular disorders: caloric direction of nystagmus

Sample item

In a normal subject, cold water is irrigated into the left ear during caloric testing. In which direction does the fast component of nystagmus beat?

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

The answer and the reasoning

D. Towards the right ear

The mnemonic COWS states cold opposite, warm same, which refers to the direction of the fast phase. Cold water reduces activity of the left labyrinth, so the slow phase is to the left and the corrective fast phase is to the right.

Option by option

  • A. Towards the left ear

    Fast phase towards the same ear follows warm irrigation.

  • B. Vertically upward

    Vertical nystagmus is not elicited by lateral canal stimulation.

  • C. There is no nystagmus

    A normal labyrinth responds with nystagmus.

  • D. Towards the right ear (correct)

    Correct. Cold irrigation gives a fast phase to the opposite ear.

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 D, Towards the right ear. The mnemonic COWS states cold opposite, warm same, which refers to the direction of the fast phase.

Why is "Towards the left ear" not the answer?

Fast phase towards the same ear follows warm irrigation.

Why is "Vertically upward" not the answer?

Vertical nystagmus is not elicited by lateral canal stimulation.

Why is "There is no nystagmus" not the answer?

A normal labyrinth responds with nystagmus.

What concept does this question test?

It tests Vestibular disorders: caloric direction of nystagmus in ENT. Cold water reduces activity of the left labyrinth, so the slow phase is to the left and the corrective fast phase is to the right.

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 Vestibular disorders: caloric direction of nystagmus?

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.