Pharynx and tonsils: tonsillar chancre: 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 · Pharynx and tonsils: tonsillar chancre

Sample item

A 24-year-old man has a painless, shallow ulcer with an indurated base on one tonsil and firm, painless, ipsilateral neck nodes three weeks after unprotected oral sex. Which diagnosis fits best?

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

The answer and the reasoning

B. Primary syphilis

A painless indurated ulcer with painless regional adenopathy after the usual incubation period is a primary chancre, which may occur on the tonsil after oral exposure. Diagnosis rests on dark-ground microscopy or serology, and treatment is benzathine penicillin.

Option by option

  • A. Peritonsillar abscess

    Peritonsillar abscess is painful with trismus, fever and a bulging soft palate.

  • B. Primary syphilis (correct)

    Correct. An extragenital chancre on the tonsil is painless, indurated and has firm painless nodes.

  • C. Vincent's angina

    Vincent's angina gives painful necrotic ulcers with foul breath and bleeding gums.

  • D. Tonsillar lymphoma

    Lymphoma enlarges the tonsil without a discrete short-history ulcer and is not tied to an exposure.

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 B, Primary syphilis. A painless indurated ulcer with painless regional adenopathy after the usual incubation period is a primary chancre, which may occur on the tonsil after oral exposure.

Why is "Peritonsillar abscess" not the answer?

Peritonsillar abscess is painful with trismus, fever and a bulging soft palate.

Why is "Vincent's angina" not the answer?

Vincent's angina gives painful necrotic ulcers with foul breath and bleeding gums.

Why is "Tonsillar lymphoma" not the answer?

Lymphoma enlarges the tonsil without a discrete short-history ulcer and is not tied to an exposure.

What concept does this question test?

It tests Pharynx and tonsils: tonsillar chancre in ENT. Diagnosis rests on dark-ground microscopy or serology, and treatment is benzathine penicillin.

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 Pharynx and tonsils: tonsillar chancre?

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.