Nose and paranasal sinuses: lupus vulgaris of the nose: 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: lupus vulgaris of the nose

Sample item

A young woman has a slowly enlarging reddish-brown nodule on the skin of the nasal vestibule. On pressing with a glass slide, the lesion turns an apple-jelly colour. Which organism causes this?

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

The answer and the reasoning

C. Mycobacterium tuberculosis

Lupus vulgaris is cutaneous tuberculosis, and the nose is a favourite site. Diascopy shows the apple-jelly nodules, and untreated lesions destroy cartilage. Antitubercular therapy cures it.

Option by option

  • A. Rhinosporidium seeberi

    Rhinosporidium seeberi forms a bleeding strawberry-like polyp with white spores, not a skin nodule.

  • B. Klebsiella rhinoscleromatis

    Klebsiella rhinoscleromatis causes a hard, painless granulomatous nasal mass with Mikulicz cells.

  • C. Mycobacterium tuberculosis (correct)

    Correct. Lupus vulgaris is skin tuberculosis with an apple-jelly appearance on diascopy.

  • D. Mycobacterium leprae

    Mycobacterium leprae causes lepromatous nasal crusting and collapse with anaesthetic skin patches.

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.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Mycobacterium tuberculosis. Lupus vulgaris is cutaneous tuberculosis, and the nose is a favourite site.

Why is "Rhinosporidium seeberi" not the answer?

Rhinosporidium seeberi forms a bleeding strawberry-like polyp with white spores, not a skin nodule.

Why is "Klebsiella rhinoscleromatis" not the answer?

Klebsiella rhinoscleromatis causes a hard, painless granulomatous nasal mass with Mikulicz cells.

Why is "Mycobacterium leprae" not the answer?

Mycobacterium leprae causes lepromatous nasal crusting and collapse with anaesthetic skin patches.

What concept does this question test?

It tests Nose and paranasal sinuses: lupus vulgaris of the nose in ENT. Diascopy shows the apple-jelly nodules, and untreated lesions destroy cartilage. Antitubercular therapy cures it.

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: lupus vulgaris of the nose?

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.