This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Larynx, Subject name: ENT
The earliest sign of tuberculosis of vocal cords is 
Select and explain. 
A. Mouse nibbled appearance, B. Hyperemia of the free margin, C. Turban epiglotitis, D. Ulceration of vocal cord
B: Hyperemia of the free margin
Answer: B: Hyperemia of the free margin 
Explanation: The weakness of voice is the earliest symptom followed by hoarseness of voice. Ulceration of larynx produces severe pain, which may radiate to ears. Pain during swallowing is seen in later stages. On examination, hyperemia of the vocal cord in its whole extent or confined to posterior pa with impairment of adduction is the first sign. Note the hyperaemia Ref : www.ncbi.nlm.gov