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Patient case: Vertigo

Patient case: Vertigo

Discussion

A 42-year-old male presents to the clinic with a complaint of a persistent ringing sound in his ears for the past three weeks. The patient describes the sensation as a constant "high-pitched" noise that is more noticeable when in a quiet environment, especially at night. He reports no hearing loss, dizziness, or pain. The patient has a history of prolonged exposure to loud music during his years as a musician but denies recent trauma or infections. He is otherwise healthy, with no significant medical history or medication use. On physical examination, the ear canal and tympanic membranes appear normal. Audiometry testing reveals no significant hearing loss. The patient is diagnosed with tinnitus, likely due to noise-induced damage to the cochlear hair cells. Counseling on management options, including sound therapy and cognitive behavioral therapy, is provided. The patient is advised to avoid loud noises and to follow up in six weeks.

 

Questions
1. Which of the following is the most likely cause of the patient's tinnitus?

A) Acute otitis media

B) Noise-induced hearing loss

C) Meniere's disease

D) Otosclerosis

2. What is the most appropriate first step in managing this patient with tinnitus?

A) Surgical intervention

B) Prescribing antibiotics

C) Audiometry testing and counseling

D) Referral for hearing aids

3. Which of the following is a common risk factor for tinnitus, as seen in this patient?

A) Prolonged exposure to loud music

B) Upper respiratory infections

C) Family history of hearing loss

D) Use of oral contraceptives

4. Which of the following treatments is NOT typically used for managing tinnitus?

A) Cognitive behavioral therapy

B) Sound therapy

C) Antibiotics

D) Hearing aids (if hearing loss is present)

Reveal answers

Answers

1. B) Noise-induced hearing loss

2. C) Audiometry testing and counseling

3. A) Prolonged exposure to loud music

4. C) Antibiotics