Vestibular disorders: electrocochleography in Meniere disease: 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 · Vestibular disorders: electrocochleography in Meniere disease

Sample item

A 44-year-old man with episodic vertigo and fluctuating hearing loss undergoes electrocochleography. Which finding supports endolymphatic hydrops?

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

The answer and the reasoning

C. Summating potential to action potential ratio above about 0.4

In hydrops, the summating potential is enlarged relative to the action potential, giving an SP/AP ratio over 0.4 on electrocochleography. The test is a supportive rather than a diagnostic investigation. ABR is used for retrocochlear lesions.

Option by option

  • A. Flat tympanogram

    A flat tympanogram suggests effusion or perforation.

  • B. Absent otoacoustic emissions with normal ABR

    Absent otoacoustic emissions with a normal ABR is not a feature of hydrops; auditory neuropathy shows the opposite pattern, with present emissions and an abnormal ABR.

  • C. Summating potential to action potential ratio above about 0.4 (correct)

    Correct. A raised SP/AP ratio indicates hydrops.

  • D. Absent wave V on ABR

    An absent wave V suggests retrocochlear or severe loss.

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, Summating potential to action potential ratio above about 0.4. In hydrops, the summating potential is enlarged relative to the action potential, giving an SP/AP ratio over 0.

Why is "Flat tympanogram" not the answer?

A flat tympanogram suggests effusion or perforation.

Why is "Absent otoacoustic emissions with normal ABR" not the answer?

Absent otoacoustic emissions with a normal ABR is not a feature of hydrops; auditory neuropathy shows the opposite pattern, with present emissions and an abnormal ABR.

Why is "Absent wave V on ABR" not the answer?

An absent wave V suggests retrocochlear or severe loss.

What concept does this question test?

It tests Vestibular disorders: electrocochleography in Meniere disease in ENT. 4 on electrocochleography. The test is a supportive rather than a diagnostic investigation. ABR is used for retrocochlear lesions.

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 Vestibular disorders: electrocochleography in Meniere disease?

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.