Pharynx and tonsils: pyriform fossa foreign body: 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: pyriform fossa foreign body

Sample item

A man who swallowed a sharp fragment of bone has pain on swallowing localised to the throat, pooling of saliva, and on indirect laryngoscopy saliva pooled in the right pyriform fossa. What is the best next step?

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

The answer and the reasoning

D. Direct laryngoscopy and removal under anaesthesia

Persistent pain and pooled saliva after a sharp foreign body indicate a probable impacted fragment, and removal under direct vision is needed. Thick barium coats the fragment and impairs endoscopy, and vomiting risks perforation.

Option by option

  • A. Barium swallow with thick barium paste

    Thick barium obscures the field and increases aspiration risk.

  • B. Reassurance and observation at home

    Observation risks deep neck infection or perforation if the fragment is impacted.

  • C. Induce vomiting

    Induced vomiting can drive a sharp fragment through the wall.

  • D. Direct laryngoscopy and removal under anaesthesia (correct)

    Correct. A sharp impacted object with pooling should be removed endoscopically under anaesthesia.

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, Direct laryngoscopy and removal under anaesthesia. Persistent pain and pooled saliva after a sharp foreign body indicate a probable impacted fragment, and removal under direct vision is needed.

Why is "Barium swallow with thick barium paste" not the answer?

Thick barium obscures the field and increases aspiration risk.

Why is "Reassurance and observation at home" not the answer?

Observation risks deep neck infection or perforation if the fragment is impacted.

Why is "Induce vomiting" not the answer?

Induced vomiting can drive a sharp fragment through the wall.

What concept does this question test?

It tests Pharynx and tonsils: pyriform fossa foreign body in ENT. Thick barium coats the fragment and impairs endoscopy, and vomiting risks perforation.

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 Pharynx and tonsils: pyriform fossa foreign body?

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.