Ototoxicity: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Ototoxicity

Sample item

A patient with tuberculosis on a streptomycin-containing regimen develops unsteadiness in the dark, oscillopsia on walking and a positive Romberg test, with only mild hearing loss. Which statement about this drug is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. It is predominantly vestibulotoxic and destroys hair cells of the vestibular sensory epithelium

Streptomycin and gentamicin are mainly vestibulotoxic, whereas neomycin, kanamycin and amikacin are mainly cochleotoxic. The damage is to hair cells and is generally irreversible, though central compensation may improve symptoms.

Option by option

  • A. It is predominantly cochleotoxic and damages the stria vascularis only

    Loop diuretics damage the stria vascularis, and streptomycin does not mainly act there.

  • B. Toxicity is limited to the central vestibular nuclei in the brainstem

    The peripheral sensory epithelium is injured, not the brainstem nuclei.

  • C. Toxicity is reversible and reflects a transient conduction block

    Aminoglycoside hair-cell damage is permanent, not a transient block.

  • D. It is predominantly vestibulotoxic and destroys hair cells of the vestibular sensory epithelium (correct)

    Correct. Hair cells of the vestibular end organs are the principal target.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, It is predominantly vestibulotoxic and destroys hair cells of the vestibular sensory epithelium. Streptomycin and gentamicin are mainly vestibulotoxic, whereas neomycin, kanamycin and amikacin are mainly cochleotoxic.

Why is "It is predominantly cochleotoxic and damages the stria vascularis only" not the answer?

Loop diuretics damage the stria vascularis, and streptomycin does not mainly act there.

Why is "Toxicity is limited to the central vestibular nuclei in the brainstem" not the answer?

The peripheral sensory epithelium is injured, not the brainstem nuclei.

Why is "Toxicity is reversible and reflects a transient conduction block" not the answer?

Aminoglycoside hair-cell damage is permanent, not a transient block.

What concept does this question test?

It tests Ototoxicity in ENT. The damage is to hair cells and is generally irreversible, though central compensation may improve symptoms.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Ototoxicity?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.