Differential of Maxillary Swelling/Nasal Mass MCQ Quiz | Nose & Paranasal Sinuses

Quiz Introduction

Welcome, MBBS students! This quiz is designed to test your knowledge on the differential diagnosis of maxillary swellings and nasal masses, a critical topic in Otolaryngology. You will face 25 multiple-choice questions covering a range of pathologies from common inflammatory conditions to rare malignancies. This exercise will help you consolidate your understanding of clinical presentations, radiological findings, and key differentiating features essential for your examinations and future practice. Carefully read each question and select the most appropriate answer. After submitting, you can review your score and see the correct answers highlighted. You can also download a PDF copy of all questions and their correct answers for your revision. Good luck!

1. A 15-year-old male presents with recurrent, profuse unilateral epistaxis and nasal obstruction. On examination, a reddish-purple mass is seen in the nasopharynx. What is the most likely diagnosis?

2. A 55-year-old male presents with unilateral nasal obstruction. Endoscopy reveals a “cauliflower-like” growth originating from the lateral nasal wall. Biopsy is taken. This lesion has a known potential for malignant transformation into which of the following?

3. A 65-year-old smoker presents with facial pain, proptosis, and loosening of the upper teeth. A mass is suspected in the maxillary sinus. What is the most common malignancy found in this location?

4. A CT scan of a young patient with facial asymmetry shows a well-defined, expansile lesion in the maxilla with a characteristic “ground-glass” appearance. What is the most probable diagnosis?

5. A patient with a history of asthma and aspirin sensitivity presents with bilateral, grape-like masses filling the nasal cavities. This condition is known as:

6. A painless, slow-growing swelling of the hard palate is associated with a non-vital maxillary incisor on radiographic examination. This is most likely a:

7. An immunocompromised patient with diabetic ketoacidosis presents with fever, facial pain, and a black eschar in the nasal cavity. This is highly suggestive of:

8. A patient known to have Granulomatosis with Polyangiitis (GPA) is most likely to present with which nasal deformity?

9. A CT scan reveals a smooth, homogenous, non-enhancing, expansile lesion causing thinning of the bony walls of the frontal sinus. This description is classic for a:

10. A mass arising from the superior nasal cavity, showing a “dumbbell” shape as it extends through the cribriform plate into the anterior cranial fossa, is characteristic of:

11. An orthopantomogram (OPG) taken for dental reasons reveals a unilocular radiolucency surrounding the crown of an unerupted mandibular third molar. This finding is most consistent with:

12. The most common benign tumor of the paranasal sinuses, often found incidentally on imaging and typically located in the fronto-ethmoidal region, is:

13. Which histological feature is characteristic of an inverted papilloma?

14. Occupational exposure to wood dust is a well-established risk factor for which type of sinonasal malignancy?

15. Which imaging modality is superior for evaluating soft tissue detail, perineural spread, and intracranial extension of a nasal mass?

16. A newborn presents with a bluish, compressible mass at the root of the nose that enlarges when the baby cries or strains (positive Furstenberg’s test). This is most likely a(n):

17. The “double-density” sign on a non-contrast CT scan, representing hyperdense inspissated mucus surrounded by hypodense mucosal edema, is characteristic of:

18. What is the standard initial management step for a large, actively bleeding Juvenile Nasopharyngeal Angiofibroma (JNA) before surgical excision?

19. A patient presents with foul-smelling, cheesy, unilateral nasal discharge. A CT scan reveals a calcified mass within the nasal cavity. The most likely diagnosis is:

20. In Asian populations, a destructive midline nasal mass associated with Epstein-Barr virus (EBV) is most likely to be:

21. The most common site of origin for squamous cell carcinoma within the paranasal sinuses is the:

22. A rapidly growing maxillary swelling in an adolescent, with a “sun-ray” or “sunburst” appearance on an occlusal radiograph, is highly suspicious for:

23. The appearance of “strawberry-like” lesions on the nasal mucosa, which are friable and bleed easily, is a classic finding in:

24. A firm, rubbery, painless swelling in the canine fossa that does not transilluminate and is not associated with any dental pathology is likely a:

25. Holman-Miller sign (antral bowing of posterior maxillary wall) is a characteristic radiological finding in: