Ear and audiology: first site of aminoglycoside cochlear damage: 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: first site of aminoglycoside cochlear damage

Sample item

A patient on an injectable aminoglycoside for multidrug-resistant tuberculosis develops bilateral high-pitched tinnitus. Which is the earliest site of histological damage in the cochlea?

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

The answer and the reasoning

D. Outer hair cells of the basal turn

Aminoglycosides accumulate in perilymph and hair cells and destroy outer hair cells first, beginning in the basal turn, which explains the early loss of high frequencies and high-pitched tinnitus. Loss is permanent and may continue after the drug is stopped, so audiometry is done during treatment.

Option by option

  • A. Reissner membrane

    Reissner membrane is a thin partition that is not the main target.

  • B. Inner hair cells of the apical turn

    Inner hair cells are damaged later, and the apex is affected last.

  • C. Stria vascularis of the apical turn

    The stria is the target of loop diuretics, not aminoglycosides.

  • D. Outer hair cells of the basal turn (correct)

    Correct. Damage starts in the outer hair cells of the basal turn and spreads towards the apex.

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 D, Outer hair cells of the basal turn. Aminoglycosides accumulate in perilymph and hair cells and destroy outer hair cells first, beginning in the basal turn, which explains the early loss of high frequencies and high-pitched tinnitus.

Why is "Reissner membrane" not the answer?

Reissner membrane is a thin partition that is not the main target.

Why is "Inner hair cells of the apical turn" not the answer?

Inner hair cells are damaged later, and the apex is affected last.

Why is "Stria vascularis of the apical turn" not the answer?

The stria is the target of loop diuretics, not aminoglycosides.

What concept does this question test?

It tests Ear and audiology: first site of aminoglycoside cochlear damage in ENT. Loss is permanent and may continue after the drug is stopped, so audiometry is done during treatment.

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: first site of aminoglycoside cochlear damage?

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.