Nose and paranasal sinuses: nasal diphtheria: 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: nasal diphtheria

Sample item

An unimmunised 4-year-old has unilateral blood-stained foul nasal discharge. A greyish membrane is seen in the nasal cavity and the child is toxic. Which organism is responsible?

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

The answer and the reasoning

C. Corynebacterium diphtheriae

Nasal diphtheria gives a unilateral serosanguinous discharge with a grey adherent membrane in an unimmunised child. Antitoxin and antibiotics are given early on clinical suspicion and the child is isolated. Retained foreign body is the commoner cause of unilateral discharge but has no membrane or toxicity.

Option by option

  • A. Staphylococcus aureus

    Staphylococcus causes vestibulitis and furuncles, with no toxic membrane.

  • B. Klebsiella ozaenae

    Klebsiella ozaenae causes atrophic rhinitis with crusting and foul smell, typically in young adults.

  • C. Corynebacterium diphtheriae (correct)

    Correct. A grey nasal membrane with unilateral bloody discharge in an unimmunised child indicates diphtheria.

  • D. Rhinosporidium seeberi

    Rhinosporidium forms a red friable polyp with white spots and is not membranous.

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, Corynebacterium diphtheriae. Nasal diphtheria gives a unilateral serosanguinous discharge with a grey adherent membrane in an unimmunised child.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus causes vestibulitis and furuncles, with no toxic membrane.

Why is "Klebsiella ozaenae" not the answer?

Klebsiella ozaenae causes atrophic rhinitis with crusting and foul smell, typically in young adults.

Why is "Rhinosporidium seeberi" not the answer?

Rhinosporidium forms a red friable polyp with white spots and is not membranous.

What concept does this question test?

It tests Nose and paranasal sinuses: nasal diphtheria in ENT. Antitoxin and antibiotics are given early on clinical suspicion and the child is isolated. Retained foreign body is the commoner cause of unilateral discharge but has no membrane or toxicity.

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: nasal diphtheria?

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.