Ear and audiology: pulsatile tinnitus with normal ear: 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.

Try it

ENT · Ear and audiology: pulsatile tinnitus with normal ear

Sample item

A 26-year-old obese woman has had a whooshing pulsatile tinnitus in the right ear for two months with daily headaches and brief visual blurring on standing. Otoscopy and tympanometry are normal and the sound stops on gentle pressure over the neck. What is the most appropriate next step?

AExploratory tympanotomy for a glomus tumourBTinnitus masker therapy aloneCInsertion of a ventilation tubeDFundus examination for papilloedema

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

The answer and the reasoning

D. Fundus examination for papilloedema

Pulsatile tinnitus abolished by jugular compression with a normal ear in an obese young woman and headache suggests venous causes, notably raised intracranial pressure from idiopathic intracranial hypertension. Papilloedema must be looked for urgently because vision is at risk, followed by imaging and lumbar puncture pressure measurement.

Option by option

A. Exploratory tympanotomy for a glomus tumour
A glomus tumour produces a visible red retrotympanic mass, which is absent here.
B. Tinnitus masker therapy alone
Masking alone would leave a possible sight-threatening cause untreated.
C. Insertion of a ventilation tube
A ventilation tube treats effusion, which is not present with a normal tympanogram.
D. Fundus examination for papilloedema (correct)
Correct. Papilloedema should be sought first because untreated raised pressure threatens vision.

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.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Fundus examination for papilloedema. Pulsatile tinnitus abolished by jugular compression with a normal ear in an obese young woman and headache suggests venous causes, notably raised intracranial pressure from idiopathic intracranial hypertension.

Why is "Exploratory tympanotomy for a glomus tumour" not the answer?

A glomus tumour produces a visible red retrotympanic mass, which is absent here.

Why is "Tinnitus masker therapy alone" not the answer?

Masking alone would leave a possible sight-threatening cause untreated.

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

A ventilation tube treats effusion, which is not present with a normal tympanogram.

What concept does this question test?

It tests Ear and audiology: pulsatile tinnitus with normal ear in ENT. Papilloedema must be looked for urgently because vision is at risk, followed by imaging and lumbar puncture pressure measurement.

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: pulsatile tinnitus with normal ear?

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.