Try it
ENT · Otology: hearing disorders
Sample itemA 68-year-old man has noticed difficulty understanding speech in noisy places and a gradual loss of high-pitched sounds in both ears, with an audiogram showing symmetrical high-frequency sensorineural loss and no other symptoms. What is the most likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Presbycusis
Presbycusis is age-related sensorineural hearing loss, symmetrical and affecting high frequencies first because of degeneration of hair cells at the basal turn of the cochlea. Speech discrimination in noise is poor. Management is hearing aids and counselling. Otosclerosis causes conductive loss, Meniere's disease causes fluctuating low-frequency loss with vertigo, and acoustic neuroma causes asymmetric loss.
Option by option
A. Meniere's disease
Meniere's disease has episodic vertigo, tinnitus, fullness and fluctuating low-frequency loss.
B. Otosclerosis
Otosclerosis causes conductive hearing loss with a Carhart notch.
C. Acoustic neuroma
Acoustic neuroma causes unilateral or asymmetric loss.
D. Presbycusis (correct)
Correct. Symmetrical, gradual, high-frequency loss is typical of age-related change.
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.
More ENT questions
- AudiologyIn a tuning fork test, Rinne is negative (bone conduction louder than air conduction) in…
- EarWhich type of chronic suppurative otitis media is considered 'unsafe'?
- LarynxIn singers, vocal nodules typically occur at:
- Vestibular disordersA patient has recurrent attacks of vertigo lasting hours, with fluctuating low-frequency…