Ear and audiology: ototoxicity of iron chelation: 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: ototoxicity of iron chelation

Sample item

A 12-year-old with transfusion-dependent thalassaemia receiving long-term subcutaneous infusions to remove iron develops bilateral high-frequency sensorineural loss and tinnitus. Which drug is the likely cause?

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

The answer and the reasoning

B. Desferrioxamine

Desferrioxamine can cause high-frequency sensorineural hearing loss, as well as retinal toxicity, especially at high doses with low iron load. Audiometry is advised in patients on it, and dose reduction usually allows recovery.

Option by option

  • A. Hydroxyurea

    Hydroxyurea causes marrow suppression and is not a cause of hearing loss.

  • B. Desferrioxamine (correct)

    Correct. Desferrioxamine is the chelator associated with high-frequency sensorineural loss and retinal toxicity.

  • C. Deferiprone

    Deferiprone is oral and its main risks are agranulocytosis and arthropathy.

  • D. Folic acid

    Folic acid is a vitamin supplement with no ototoxic effect.

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 B, Desferrioxamine. Desferrioxamine can cause high-frequency sensorineural hearing loss, as well as retinal toxicity, especially at high doses with low iron load.

Why is "Hydroxyurea" not the answer?

Hydroxyurea causes marrow suppression and is not a cause of hearing loss.

Why is "Deferiprone" not the answer?

Deferiprone is oral and its main risks are agranulocytosis and arthropathy.

Why is "Folic acid" not the answer?

Folic acid is a vitamin supplement with no ototoxic effect.

What concept does this question test?

It tests Ear and audiology: ototoxicity of iron chelation in ENT. Audiometry is advised in patients on it, and dose reduction usually allows recovery.

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: ototoxicity of iron chelation?

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.