Q.1 Which of the following is the most common cause of obstructive sleep apnea (OSA) in adults?
Adenoid hypertrophy
Obesity
Nasal polyps
Deviated nasal septum
Explanation - Obesity leads to fat deposition in the upper airway, increasing collapsibility and making it the most common cause of OSA in adults.
Correct answer is: Obesity
Q.2 Which craniofacial abnormality is commonly associated with pediatric obstructive sleep apnea?
Micrognathia
Macroglossia
Retrognathia
All of the above
Explanation - Micrognathia, retrognathia, and macroglossia can all contribute to airway obstruction in children, leading to OSA.
Correct answer is: All of the above
Q.3 Which diagnostic test is considered the gold standard for confirming obstructive sleep apnea?
Polysomnography
CT scan of the head
Epworth Sleepiness Scale
Overnight pulse oximetry
Explanation - Polysomnography is the gold standard for diagnosing OSA as it monitors multiple physiological parameters during sleep.
Correct answer is: Polysomnography
Q.4 Which ENT surgical procedure is most commonly performed for pediatric OSA due to enlarged tonsils and adenoids?
Uvulopalatopharyngoplasty
Tonsillectomy and adenoidectomy
Septoplasty
Tracheostomy
Explanation - Enlarged tonsils and adenoids are a common cause of OSA in children, and removal usually resolves symptoms.
Correct answer is: Tonsillectomy and adenoidectomy
Q.5 Which symptom is least likely to be a manifestation of sleep-disordered breathing in adults?
Morning headaches
Excessive daytime sleepiness
Nocturnal choking
Persistent ear infection
Explanation - While morning headaches, daytime sleepiness, and nocturnal choking are typical OSA symptoms, persistent ear infection is not commonly associated.
Correct answer is: Persistent ear infection
Q.6 Continuous positive airway pressure (CPAP) therapy primarily works by:
Reducing nasal congestion
Splinting the upper airway open during sleep
Increasing REM sleep
Decreasing tonsil size
Explanation - CPAP delivers pressurized air to prevent airway collapse during sleep, which is the main pathology in OSA.
Correct answer is: Splinting the upper airway open during sleep
Q.7 Which of the following is a common risk factor for obstructive sleep apnea in adults?
Male gender
Postmenopausal status
Obesity
All of the above
Explanation - Male gender, postmenopausal status, and obesity are all recognized risk factors for OSA.
Correct answer is: All of the above
Q.8 The Mallampati score is used to assess:
Nasal obstruction
Tongue size and airway visibility
Snoring frequency
Sleep stage distribution
Explanation - The Mallampati score evaluates airway visibility, helping predict risk of OSA or difficulty with intubation.
Correct answer is: Tongue size and airway visibility
Q.9 Nocturnal stridor is most commonly associated with which ENT disorder?
Laryngomalacia
Obstructive sleep apnea
Chronic sinusitis
Epistaxis
Explanation - Laryngomalacia causes supraglottic collapse during inspiration, often producing stridor in infants at night.
Correct answer is: Laryngomalacia
Q.10 Which of the following medications can worsen obstructive sleep apnea?
Corticosteroids
Benzodiazepines
Antibiotics
Antihistamines
Explanation - Benzodiazepines relax upper airway muscles, potentially exacerbating OSA severity.
Correct answer is: Benzodiazepines
Q.11 Which anatomical site is most frequently responsible for obstruction in adult OSA?
Nasal cavity
Oropharynx
Larynx
Trachea
Explanation - The oropharyngeal region, including soft palate and tonsils, is the most common site of airway collapse in adult OSA.
Correct answer is: Oropharynx
Q.12 Which daytime symptom is most predictive of sleep apnea severity?
Snoring
Excessive daytime sleepiness
Morning dry mouth
Insomnia
Explanation - Daytime sleepiness correlates strongly with OSA severity and is a major clinical indicator.
Correct answer is: Excessive daytime sleepiness
Q.13 In children, OSA is most commonly caused by:
Obesity
Enlarged tonsils/adenoids
Craniofacial anomalies
Neuromuscular disorders
Explanation - Enlarged tonsils and adenoids are the leading cause of pediatric obstructive sleep apnea.
Correct answer is: Enlarged tonsils/adenoids
Q.14 Which of the following is NOT a typical complication of untreated OSA?
Hypertension
Cardiovascular disease
Stroke
Otitis media
Explanation - While OSA can cause cardiovascular complications, otitis media is not a recognized direct complication.
Correct answer is: Otitis media
Q.15 Positional therapy for OSA is particularly effective in patients who:
Have central sleep apnea
Have apneas predominantly in supine position
Have severe obesity
Are children with adenotonsillar hypertrophy
Explanation - Positional therapy involves preventing supine sleep, which is effective in patients whose OSA worsens when lying on their back.
Correct answer is: Have apneas predominantly in supine position
Q.16 Which of the following is a first-line treatment for mild adult OSA?
Uvulopalatopharyngoplasty
Lifestyle modifications and CPAP
Tracheostomy
Mandibular distraction osteogenesis
Explanation - For mild OSA, weight loss, positional therapy, and CPAP are first-line treatments before surgery is considered.
Correct answer is: Lifestyle modifications and CPAP
Q.17 Which diagnostic questionnaire is commonly used to assess daytime sleepiness in suspected OSA patients?
Berlin Questionnaire
STOP-Bang
Epworth Sleepiness Scale
Pittsburgh Sleep Quality Index
Explanation - The Epworth Sleepiness Scale quantifies daytime sleepiness and helps screen for sleep disorders including OSA.
Correct answer is: Epworth Sleepiness Scale
Q.18 Which syndrome is associated with severe OSA due to craniofacial abnormalities?
Down syndrome
Marfan syndrome
Turner syndrome
Klinefelter syndrome
Explanation - Children with Down syndrome have midface hypoplasia and hypotonia, increasing risk of severe OSA.
Correct answer is: Down syndrome
Q.19 Which of the following is a hallmark finding of OSA on polysomnography?
Periodic limb movements
Apnea-hypopnea index >5 per hour
REM sleep without atonia
Frequent arousals due to seizures
Explanation - An AHI >5 per hour with symptoms is diagnostic for OSA, representing repeated airway obstruction events.
Correct answer is: Apnea-hypopnea index >5 per hour
Q.20 Which pediatric sleep-related breathing disorder is characterized by noisy breathing and feeding difficulties in infants?
Obstructive sleep apnea
Laryngomalacia
Central sleep apnea
Choanal atresia
Explanation - Laryngomalacia causes inspiratory stridor and may present with feeding difficulties in infants.
Correct answer is: Laryngomalacia
Q.21 Which structural nasal abnormality can contribute to sleep-disordered breathing?
Deviated nasal septum
Nasal polyps
Turbinate hypertrophy
All of the above
Explanation - Any condition causing nasal obstruction can worsen airflow and contribute to sleep-disordered breathing.
Correct answer is: All of the above
Q.22 Uvulopalatopharyngoplasty (UPPP) is primarily indicated for:
Severe nasal polyps
Obstructive sleep apnea due to soft palate obstruction
Chronic otitis media
Laryngeal cancer
Explanation - UPPP removes excess tissue in the oropharynx to enlarge the airway in patients with OSA.
Correct answer is: Obstructive sleep apnea due to soft palate obstruction
Q.23 Which of the following is a contraindication to CPAP therapy?
Severe nasal obstruction
Obesity
Mild OSA
Age < 18 years
Explanation - Severe nasal obstruction can prevent effective CPAP use; in such cases, surgery or alternative therapy may be needed.
Correct answer is: Severe nasal obstruction
Q.24 Which of the following is a common cardiovascular complication of untreated OSA?
Atrial fibrillation
Hypertension
Pulmonary hypertension
All of the above
Explanation - OSA causes intermittent hypoxia and sympathetic activation, leading to arrhythmias, systemic and pulmonary hypertension.
Correct answer is: All of the above
Q.25 Which lifestyle modification can improve mild sleep-disordered breathing?
Weight loss
Avoiding alcohol before bedtime
Sleeping on the side
All of the above
Explanation - Weight reduction, positional therapy, and avoiding sedatives or alcohol at night can reduce airway obstruction and improve symptoms.
Correct answer is: All of the above