WBR0265
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| Author | Vendhan Ramanujam |
|---|---|
| Exam Type | USMLE Step 2 CK |
| Main Category | Internal medicine |
| Sub Category | Head and Neck |
| Prompt | Following a large explosion at a construction site during excavation, its workers are brought to the ER. While examining them none appear to be injured. But some were diagnosed with hearing loss following the explosion. They were exposed to sound pressure levels of 190 dB. Which of the following is the most likely type of hearing loss |
| Answer A | Permanent conductive hearing loss |
| Answer A Explanation | Incorrect-Since spontaneous and surgical repair of ruptured tympanic membrane is possible, permanent conductive hearing loss usually does not occur. |
| Answer B | Temporary conductive hearing loss |
| Answer B Explanation | Correct-Acute exposures to sound pressure levels above 180 dB result in traumatic rupture of the tympanic membrane and conductive hearing loss. The rupture should repair spontaneously unless infection occurs. If the loss persists for more than 3 months, surgical repair is possible. |
| Answer C | Temporary sensorineural hearing loss |
| Answer C Explanation | Incorrect-Sensorineural hearing loss is generally due to fractures or trauma to the inner ear. |
| Answer D | Permanent sensorineural hearing loss |
| Answer D Explanation | Incorrect-Sensorineural hearing loss is generally due to fractures or trauma to the inner ear. |
| Answer E | Mixed conductive and sensorineural hearing loss |
| Answer E Explanation | Incorrect-Mixed hearing loss can occur secondary to fractures of the temporal bone when both the middle and the inner ear are traumatized. |
| Right Answer | B |
| Explanation | Acute exposures to sound pressure levels above 180 dB result in traumatic rupture of the tympanic membrane and conductive hearing loss. The rupture should repair spontaneously unless infection occurs. If the loss persists for more than 3 months, surgical repair is possible.
Educational Objective:
Acute exposures to sound pressure levels above 180 dB result in traumatic rupture of the tympanic membrane and a temporary conductive hearing loss, which reverses either spontaneously or by surgical repair. |
| Approved | Yes |
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