Ear and audiology: loop diuretic ototoxicity site: 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 · Ear and audiology: loop diuretic ototoxicity site

Sample item

A patient with renal failure given rapid intravenous high-dose furosemide develops tinnitus and bilateral sensorineural hearing loss that recovers over several days after the drug is stopped. Which cochlear structure is mainly affected?

AStria vascularisBTectorial membraneCSpiral ganglion neuronesDOuter hair cells of the basal turn

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

The answer and the reasoning

A. Stria vascularis

Loop diuretics inhibit the Na-K-2Cl cotransporter in the stria vascularis, disturbing the endolymph ionic composition and the endocochlear potential. The effect is usually reversible and is more likely with rapid injection, renal failure or concurrent aminoglycosides. Aminoglycosides and cisplatin cause permanent outer hair cell damage instead.

Option by option

A. Stria vascularis (correct)
Correct. Strial transport is disrupted, which explains the dose-related and usually reversible loss.
B. Tectorial membrane
The tectorial membrane is not the target of loop diuretics.
C. Spiral ganglion neurones
Spiral ganglion injury is not the mechanism of loop diuretic toxicity.
D. Outer hair cells of the basal turn
Basal outer hair cell loss is the lesion of aminoglycosides and cisplatin and is permanent.

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.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Stria vascularis. Loop diuretics inhibit the Na-K-2Cl cotransporter in the stria vascularis, disturbing the endolymph ionic composition and the endocochlear potential.

Why is "Tectorial membrane" not the answer?

The tectorial membrane is not the target of loop diuretics.

Why is "Spiral ganglion neurones" not the answer?

Spiral ganglion injury is not the mechanism of loop diuretic toxicity.

Why is "Outer hair cells of the basal turn" not the answer?

Basal outer hair cell loss is the lesion of aminoglycosides and cisplatin and is permanent.

What concept does this question test?

It tests Ear and audiology: loop diuretic ototoxicity site in ENT. The effect is usually reversible and is more likely with rapid injection, renal failure or concurrent aminoglycosides. Aminoglycosides and cisplatin cause permanent outer hair cell damage instead.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Ear and audiology: loop diuretic ototoxicity site?

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.