Nose: septal perforation: 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: septal perforation

Sample item

A man who snorts cocaine presents with crusting and whistling on breathing. A perforation of the cartilaginous nasal septum is seen. Why does this occur?

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

The answer and the reasoning

D. Vasoconstriction causing ischaemic necrosis of the septum

Cocaine causes intense vasoconstriction leading to ischaemia and perforation of the anterior cartilaginous septum. Tertiary syphilis tends to perforate the bony septum. Nasal crusting and whistling are typical symptoms.

Option by option

  • A. Chronic fungal invasion

    Fungal invasion occurs in immunocompromised patients and causes necrosis.

  • B. Allergic inflammation of the septum

    Allergy does not perforate the septum.

  • C. Direct tumour infiltration

    Tumour infiltration is not the typical cause here.

  • D. Vasoconstriction causing ischaemic necrosis of the septum (correct)

    Correct. Ischaemic necrosis from vasoconstriction is the mechanism.

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, Vasoconstriction causing ischaemic necrosis of the septum. Cocaine causes intense vasoconstriction leading to ischaemia and perforation of the anterior cartilaginous septum.

Why is "Chronic fungal invasion" not the answer?

Fungal invasion occurs in immunocompromised patients and causes necrosis.

Why is "Allergic inflammation of the septum" not the answer?

Allergy does not perforate the septum.

Why is "Direct tumour infiltration" not the answer?

Tumour infiltration is not the typical cause here.

What concept does this question test?

It tests Nose: septal perforation in ENT. Tertiary syphilis tends to perforate the bony septum. Nasal crusting and whistling are typical symptoms.

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: septal perforation?

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.