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NBME 23 Answers

nbme23/Block 3/Question#33

A 78-year-old man has had progressive loss of ...

Otosclerosis

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submitted by mousie(127),

My understanding if BC>AC this is abnormal = conductive hearing loss = otosclerosis VS Sensoryneural hearing loss will have normal AC>BC = loss of hair cells

dentist  VS: progressive unilateral hearing loss, doesn't affect Rinne Test, associated with NF2 and actor Mark Ruffalo Otoslcerosis is (usually....) progressive bilateral hearing loss, BC > AC. source +  
tallerthanmymom  If BC > AC in BOTH ears, why does he have hearing loss in only one ear? My logic was that he probably had otosclerosis in both ears and then something extra going on in his right ear that would make it worse than the left. I still don't understand why otosclerosis is the best answer here. +  




 +1  upvote downvote
submitted by hello(145),

can someone please explain this?

thomasburton  My reasoning was BC>AC so this must be a conductive problem (which to me means something middle ear or out) so usually I think something blocking air flow or impeding the ossicles. You can rule out all other answers as they are all causes of sensorineural (AC>BC). +2  
madojo  Meniere's disease is sensorineural hearing loss with peripheral vertigo due to increased endolymph within the ear. +  




 +0  upvote downvote
submitted by ergogenic22(127),

1) know that BC>AC = conductive hearing loss 2) conductive hearing loss means issue with structure before the inner ear 3) everything else occurs in the inner ear or in the brain