Presbycusis/Hearing Loss Causes

Question 1

Presbycusis is a common age-related hearing loss that affects individuals over the age of 65. How common is this?

1 - 1 cases per 100,000
2 - 10 cases per 100,000
3 - 100 cases per 100,000
4 - 1000 cases per 100,000

Answer 1

4 - 1000 cases per 100,000

Slightly more common in men and women

Question 2

Presbycusis is a common age-related hearing loss that affects individuals over the age of 65. Is this a conductive or sensorineural loss of hearing?

Answer 2

• sensorineural

Question 3

Presbycusis is a common age-related hearing loss that affects individuals over the age of 65. This causes sensorineural loss. is this gradual or rapid onset?

Answer 3

• gradual decline

Question 4

In the audiogram below, what type of hearing loss is this?

1 - sensorineural
2 - conductive
3 - normal
4 - mixed

Answer 4

1 - sensorineural

Question 5

Presbycusis is a common age-related hearing loss that affects individuals over the age of 65. This causes sensorineural loss. Does this affect high or low frequencies more?

Answer 5

• High frequencies

Question 6

Although the exact cause of Presbycusis is likely to be multifactorial, what it the most likely cause?

1 - reduce perilymph
2 - loss of hairs and spiral ganglion cells
3 - demyelination of CN 8
4 - genetics

Answer 6

2 - loss of hairs and spiral ganglion cells

Question 7

In conductive hearing loss, can vibration from a Webers test be heard better in the effected or unaffected ear?

Answer 7

• affected ear

Question 8

In sensorineural hearing loss, can vibration from a Webers test be heard better in the effected or unaffected ear?

Answer 8

• unaffected ear

Question 9

Presbycusis is a common age-related hearing loss that affects individuals over the age of 65. This causes sensorineural loss. Is the hearing loss typically unilateral or bilateral?

Answer 9

• bilateral

Patients may struggle hearing in loud environments

Tinnitus can occur and is serious, but is not common

Question 10

Which 2 can be used to treat patients with Presbycusis?

1 - hearing rehabilitation (hearing aids)
2 - surgery
3 - antibiotics and grommet
4 - counselling and advice (reduce further loud noises)

Answer 10

1 - hearing rehabilitation (hearing aids)
4 - counselling and advice (reduce further loud noises)

Question 11

Noise induced hearing loss affects the outer hair cells, inner hair cells and spiral ganglion. The hearing loss is associated with the amplitude and duration of exposure. Is this conductive or sensorineural hearing loss?

Answer 11

• sensorineural

The damage is typically due to sounds of high frequencies

Question 12

Noise induced hearing loss affects the outer hair cells, inner hair cells and spiral ganglion. The hearing loss is associated with the amplitude and duration of exposure. Is this typically unilateral or bilateral hearing loss?

Answer 12

• bilateral

Question 13

Noise induced hearing loss affects the outer hair cells, inner hair cells and spiral ganglion. The hearing loss is associated with the amplitude and duration of exposure. Why is the hearing loss typically higher frequencies?

1 - high frequencies have more damage
2 - acoustic reflex is greater at higher frequencies
3 - acoustic reflex is only affective at frequencies < 2kHz
4 - hair cells are damaged at higher frequencies only

Answer 13

3 - acoustic reflex is only affective at frequencies < 2kHz

Acoustic/stapedial reflex – contraction of stapedius when exposed to loud sound - protective

Question 14

Which 2 can be used to treat patients with Noise induced hearing loss?

1 - hearing rehabilitation (hearing aids)
2 - surgery
3 - antibiotics and grommet
4 - counselling and advice (reduce further loud noises)

Answer 14

1 - hearing rehabilitation (hearing aids)

4 - counselling and advice (reduce further loud noises)

Question 15

Unilateral sudden sensorineural hearing loss (SNHL) occurs over a 3 day period and audiograms confirming ≥ 30dB SNHL in ≥ 3 contiguous frequencies. This is suggested to be due to inflammation of the cochlear nerve. All of the following are likely differentials, but which of the following is suspected to cause 85-90% of cases?

1 - Idiopathic
2 - Infective: Viral, labyrinthitis, meningitis, Lyme disease, syphilis
3 - Vascular: Cerebrovascular accident
4 - Autoimmune disorders: Autoimmune inner ear disease, RA, GPA, Cogan’s syndrome,
5 - Neurological: Multiple sclerosis
6 - Neoplastic: Acoustic neuroma
Iatrogenic: Ototoxic medications

Answer 15

1 - Idiopathic

Question 16

Unilateral sudden sensorineural hearing loss (SNHL) occurs over a 3 day period and audiograms confirming ≥ 30dB SNHL in ≥ 3 contiguous frequencies. This is suggested to be due to inflammation of the cochlear nerve. Auditory tests are completed, and which of the following blood tests?

1 - FBC
2 - U&Es
3 - ESR
4 - Autoimmune screen (ANCA, ACE-i (sarcoidosis), Anticardiolipin, ANA), Syphilis serology, Lyme disease
5 - all of the above

Answer 16

5 - all of the above

Question 17

Unilateral sudden sensorineural hearing loss (SNHL) occurs over a 3 day period and audiograms confirming ≥ 30dB SNHL in ≥ 3 contiguous frequencies. This is suggested to be due to inflammation of the cochlear nerve. Which of the following can patients with Unilateral sudden sensorineural hearing loss be treated with?

1 - grommets
2 - hearing rehabilitation (hearing aids)
3 - steroids (prednisolone)
4 - douching

Answer 17

3 - steroids (prednisolone)

Started as soon as possible

1mg/kg/day for 7 days, tapered over the next 7 days

If the steroids dont work, we can try Intratympanic steroid injection

Question 18

Is sudden unilateral or bilateral sensorineural hearing loss a red flag?

Answer 18

• unilateral

Should be referred to ENT urgently

Question 19

Which of the following is an indication for an MRI of the internal ear?

1 - not responsive to antibiotics
2 - <5 years old
3 - asymmetry on audiometry of ≥ 15dB at any 2adjacent test frequencies
4 - >4 infections in last 12 months

Answer 19

3 - asymmetry on audiometry of ≥ 15dB at any 2adjacent test frequencies

Question 20

What % of paediatric children are born death?

1 - 1/1000
2 - 10/1000
3 - 100/1000
4 - 150/1000

Answer 20

1 - 1/1000

And 1/1000 children become death during childhood

Question 21

50% of children who become death during their childhood is non-genetic. Which of the following can lead to deafness in paediatrics?

1 - Perinatal infections: TORCH
2 - Birth complications
3 - Prematurity, SCBU/NICU
4 - Hyperbilirubinaemia
5 - Ototoxic medications
6 - all of the above

Answer 21

6 - all of the above