Tonsillitis and peritonsillar infection: 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 · Tonsillitis and peritonsillar infection

Sample item

A patient with fever, trismus and a unilateral swelling above the tonsil speaks in a thick 'hot potato' voice. What is the main reason for this change in voice?

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

The answer and the reasoning

C. Impaired movement of the soft palate due to inflammation and spasm of adjacent muscles

In a peritonsillar abscess the inflamed palatal muscles and tissue cannot move normally, so resonance is altered and speech sounds muffled. The vocal folds themselves are usually unaffected. Trismus further limits articulation.

Option by option

  • A. Paralysis of the recurrent laryngeal nerve

    Recurrent laryngeal palsy causes a breathy, weak voice and is not due to local infection.

  • B. Nasal obstruction causing hyponasal speech

    Hyponasality arises from nasal blockage and is not the mechanism here.

  • C. Impaired movement of the soft palate due to inflammation and spasm of adjacent muscles (correct)

    Correct. Reduced palatal mobility changes oral resonance.

  • D. Oedema of the vocal folds

    Vocal fold oedema produces hoarseness rather than muffled speech.

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 C, Impaired movement of the soft palate due to inflammation and spasm of adjacent muscles. In a peritonsillar abscess the inflamed palatal muscles and tissue cannot move normally, so resonance is altered and speech sounds muffled.

Why is "Paralysis of the recurrent laryngeal nerve" not the answer?

Recurrent laryngeal palsy causes a breathy, weak voice and is not due to local infection.

Why is "Nasal obstruction causing hyponasal speech" not the answer?

Hyponasality arises from nasal blockage and is not the mechanism here.

Why is "Oedema of the vocal folds" not the answer?

Vocal fold oedema produces hoarseness rather than muffled speech.

What concept does this question test?

It tests Tonsillitis and peritonsillar infection in ENT. The vocal folds themselves are usually unaffected. Trismus further limits articulation.

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 Tonsillitis and peritonsillar infection?

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.