Ear and audiology: neural presbycusis: 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: neural presbycusis

Sample item

A 78-year-old says he hears people speaking but cannot understand them. Pure tone audiometry shows only a mild sloping high-frequency loss, but speech discrimination is far worse than expected. Which type of presbycusis is this?

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

The answer and the reasoning

A. Neural presbycusis

Neural presbycusis results from loss of spiral ganglion neurons and auditory pathway cells, so discrimination is out of proportion to the pure tone loss. Strial presbycusis gives a flat audiogram with good discrimination. Sensory presbycusis gives a steep high-frequency drop with preserved discrimination.

Option by option

  • A. Neural presbycusis (correct)

    Correct. Discrimination far worse than the pure tone loss indicates neural presbycusis.

  • B. Cochlear conductive presbycusis

    Cochlear conductive presbycusis is a stiff basilar membrane with a straight descending audiogram and fair discrimination.

  • C. Sensory presbycusis

    Sensory presbycusis gives an abrupt high-frequency fall with discrimination preserved until late.

  • D. Strial presbycusis

    Strial atrophy gives a flat audiogram with good speech discrimination.

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

Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Neural presbycusis. Neural presbycusis results from loss of spiral ganglion neurons and auditory pathway cells, so discrimination is out of proportion to the pure tone loss.

Why is "Cochlear conductive presbycusis" not the answer?

Cochlear conductive presbycusis is a stiff basilar membrane with a straight descending audiogram and fair discrimination.

Why is "Sensory presbycusis" not the answer?

Sensory presbycusis gives an abrupt high-frequency fall with discrimination preserved until late.

Why is "Strial presbycusis" not the answer?

Strial atrophy gives a flat audiogram with good speech discrimination.

What concept does this question test?

It tests Ear and audiology: neural presbycusis in ENT. Strial presbycusis gives a flat audiogram with good discrimination. Sensory presbycusis gives a steep high-frequency drop with preserved discrimination.

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 Ear and audiology: neural presbycusis?

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.