October 17, 2010

PLAB Question 12

An 80 year old develops bilaterally symmetric hearing loss which is gradual in onset. On examination he is found to have a predominantly high frequency loss.

A likely diagnosis is:

a) Meniere's disease
b) Presbycusis
c) Multiple sclerosis
d) Aminoglycosides
e) Acoustic neuroma
f) Chronic otitis media
g) Lyme disease
h) Alport's syndrome
i) Usher's syndrome
j) bacterial labyrinthitis

The correct answer is B

Presbycusis is hearing loss associated with aging and is the most common cause of diminished hearing in the elderly.

There are four types of presbycusis, distinguished according to the correlated pathologic changes in the cochlea. Hair cell loss and cochlear neuron degeneration are the most widely recognized changes.

The hearing loss is bilaterally symmetric and gradual in onset. The majority of cases begin with a loss of the high frequencies with slow progression. Eventually, middle- and low-frequency sounds also become difficult to perceive

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