Nose and paranasal sinuses: nasopulmonary reflex after posterior 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: nasopulmonary reflex after posterior packing

Sample item

An elderly man with a posterior nasal pack for severe epistaxis becomes drowsy overnight, with falling oxygen saturation and rising carbon dioxide, although the airway is clear. Which mechanism is responsible?

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

The answer and the reasoning

A. Nasopulmonary reflex causing hypoventilation

Posterior packing can cause hypoxaemia and hypercapnia through a nasopulmonary reflex and by obstructing nasal airflow in a patient who may already have lung disease. Patients are therefore admitted with oxygen saturation monitoring and supplemental oxygen when required.

Option by option

  • A. Nasopulmonary reflex causing hypoventilation (correct)

    Correct. The nasopulmonary reflex reduces ventilation and causes hypoxaemia and hypercapnia.

  • B. Eustachian tube obstruction

    Eustachian tube obstruction causes ear fullness and does not affect gas exchange.

  • C. Aspiration of the pack

    The stem excludes airway obstruction, so aspiration of the pack does not explain the picture.

  • D. Toxic shock syndrome

    Toxic shock presents with fever, rash and hypotension, usually days later.

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 A, Nasopulmonary reflex causing hypoventilation. Posterior packing can cause hypoxaemia and hypercapnia through a nasopulmonary reflex and by obstructing nasal airflow in a patient who may already have lung disease.

Why is "Eustachian tube obstruction" not the answer?

Eustachian tube obstruction causes ear fullness and does not affect gas exchange.

Why is "Aspiration of the pack" not the answer?

The stem excludes airway obstruction, so aspiration of the pack does not explain the picture.

Why is "Toxic shock syndrome" not the answer?

Toxic shock presents with fever, rash and hypotension, usually days later.

What concept does this question test?

It tests Nose and paranasal sinuses: nasopulmonary reflex after posterior packing in ENT. Patients are therefore admitted with oxygen saturation monitoring and supplemental oxygen when required.

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 Nose and paranasal sinuses: nasopulmonary reflex after posterior 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.