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MSRA ENT High-Yield Quiz: Nasal Foreign Bodies, Polyps & Red Flags

Updated: Jul 9

Question 1.

A 3-year-old boy is brought to the GP with a sudden onset of unilateral nasal discharge that is thick, green, and foul-smelling. There is no fever. What is the most likely cause?

Choose the correct answer

  • A) Viral rhinitis

  • B) Bacterial sinusitis

  • C) Allergic rhinitis

  • D) Nasal foreign body

✔️ Answer: D) Nasal foreign body



Question 2. 

Which immediate management technique can be attempted in primary care for a visible anterior nasal foreign body in a cooperative child before ENT referral?

Choose the correct answer

  • A) Nasal irrigation

  • B) Parent’s kiss technique

  • C) Intranasal corticosteroids

  • D) Oral antibiotics

✔️ Answer: B) Parent’s kiss technique



Question 3. 

Which type of nasal foreign body requires urgent ENT referral for removal within 2 hours due to risk of septal perforation and tissue necrosis?

Choose the correct answer

  • A) Bead

  • B) Button battery

  • C) Pebble

  • D) Small toy part

✔️ Answer: B) Button battery



Question 4. 

A 35-year-old man with a history of asthma and aspirin sensitivity presents with bilateral nasal obstruction, clear rhinorrhoea, and anosmia. What is the most likely diagnosis?

Choose the correct answer

  • A) Deviated nasal septum

  • B) Allergic rhinitis

  • C) Nasal polyposis

  • D) Chronic sinusitis

✔️ Answer: C) Nasal polyposis



Question 5.

 Which of the following is NOT part of Samter’s triad (Aspirin Exacerbated Respiratory Disease)?

Choose the correct answer

  • A) Asthma

  • B) Aspirin/NSAID sensitivity

  • C) Nasal polyps

  • D) Eosinophilic granulomatosis with polyangiitis

✔️ Answer: D) Eosinophilic granulomatosis with polyangiitis

 (Not part of Samter’s triad, though it causes similar features)



Question 6.

 Which of the following statements about unilateral nasal polyps is TRUE?

Choose the correct answer

  • A) Usually benign in adults; no further assessment needed

  • B) Common in asthmatic patients with polyposis

  • C) Always need ENT referral ± biopsy to rule out cancer

  • D) They are usually caused by allergic rhinitis.

✔️ Answer: C) They always require ENT referral for assessment and possible biopsy to rule out malignancy.



Question 7.

 An adult patient is found to have a unilateral nasal polyp with epistaxis and facial swelling. Which condition must be ruled out?

Choose the correct answer

  • A) Antrochoanal polyp

  • B) Inverted papilloma

  • C) Nasal foreign body

  • D) Allergic fungal sinusitis

✔️ Answer: B) Inverted papilloma (due to malignancy risk and local invasion)



Question 8.

 Which of the following best describes the choana?

Choose the correct answer

  • A) The anterior opening of the nasal cavity

  • B) The space between the nasal septum and inferior turbinate

  • C) The posterior opening between the nasal cavity and nasoph

  • D) The opening of the maxillary sinus into the nasal cavity

✔️ Answer: C) The posterior opening between the nasal cavity and nasopharynx



Question 9.

A 4-year-old girl presents with unilateral nasal obstruction and persistent foul-smelling discharge. On examination, there is visible congestion on the affected side but she is otherwise well. What is the most appropriate next step?

Choose the correct answer

  • A) Prescribe intranasal corticosteroids

  • B) Prescribe oral antibiotics

  • C) Attempt removal with forceps or parent’s kiss

  • D) Arrange urgent ENT referral within 2 weeks

✔️ Answer: C) Attempt removal with forceps or parent’s kiss



Question 10. 

Which of the following foreign bodies should NOT be removed using irrigation techniques?

Choose the correct answer

  • A) Bead

  • B) Paper

  • C) Button battery

  • D) Small stone

✔️ Answer: C) Button battery (due to risk of leakage and tissue damage)



Question 11. 

A 30-year-old man with asthma complains of gradually worsening bilateral nasal obstruction and loss of smell. He has no fever. Which is the first-line treatment?

Choose the correct answer

  • A) Oral corticosteroids for 4 weeks

  • B) Intranasal corticosteroid spray

  • C) Nasal saline irrigation alone

  • D) Oral antihistamines

✔️ Answer: B) Intranasal corticosteroid spray



Question 12. 

Which feature differentiates nasal polyps from nasal foreign bodies on examination?

Choose the correct answer

  • A) Bilateral presentation

  • B) Foul-smelling discharge

  • C) Acute onset

  • D) Visible grape-like mass

✔️ Answer: D) Visible grape-like mass (polyps are smooth, pale, grape-like; foreign bodies are irregular objects)



Question 13. 

What is the most common cause of a unilateral nasal polyp in children?

Choose the correct answer

  • A) Inverted papilloma

  • B) Antrochoanal polyp

  • C) Nasal carcinoma

  • D) Fungal sinusitis

✔️ Answer: B) Antrochoanal polyp



Question 14. 

Which of the following is TRUE regarding inverted papilloma?

Choose the correct answer

  • A) It commonly presents bilaterally

  • B) It is not associated with HPV

  • C) It carries a risk of malignant transformation

  • D) It can be treated with intranasal corticosteroids alone

✔️ Answer: C) It carries a risk of malignant transformation (5–15% to SCC)



Question 15. 

A 55-year-old man presents with unilateral nasal obstruction, epistaxis, and facial pain. What is the most appropriate next step?

Choose the correct answer

  • A) Start intranasal steroids and review in 4 weeks

  • B) Start oral antibiotics for sinusitis

  • C) Refer to ENT urgently for assessment and biopsy

  • D) Advise saline irrigation and monitor

✔️ Answer: C) Refer to ENT urgently for assessment and biopsy



🔑 Key Rapid Recall Points

✔️ Unilateral + foul-smelling + child → foreign body 

✔️ Button battery → urgent ENT (<2h) 

✔️ Samter’s triad: asthma + nasal polyps + aspirin sensitivity 

✔️ Unilateral polyp in adult → RED FLAG for malignancy or inverted papilloma

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