DrVirgo
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A 48 year old man presents to the physician's office with progressive hearing loss in his right ear for the past several months. He describes a ringing and hissing sound in his right ear, and he feels unsteady on his feet, as if he is losing his sense of balance. His past medical history includes syphilis, which was treated at age 20, and bronchial asthma, which is controlled with medications. On physical examination, right-sided facial numbness is noted and a Rinne test shows air conduction that is greater than bone conduction. Routine lab profile is normal, and rapid plasma reagin is negative. Which of the following is the most likely diagnosis?
A. Acoustic Neuroma
B. Benign positional vertigo
C. Lyme disease
D. Meniere disease
E. Tertiary syphilis
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| prathapdoctor
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? Acoustic neuroma.
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| DrVirgo
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Yes A
WHY NOT D??? What differentiates it as acoustic neuroma instead of meniere's disease??
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| Justice
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A. Acoustic Neuroma
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| DrVirgo
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Yes, but why Acoustic Neuroma over Meniere's disease?
Because of right-sided facial numbness?
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| Justice
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DrVirgo wrote:
Yes, but why Acoustic Neuroma over Meniere's disease?
Because of right-sided facial numbness?
No constant noise in the ear... And CN V palsy is associated with the mass effect of the neuroma...
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| pradsdoc
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Also, Meniers presents with bilateral symptoms while Acoustic neuroma with unilateral symptoms 
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| arlete
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Meniere is an acute process, symptoms wax and wane.
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| sailing boat
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i think menieres disease attack lasta 8 hrs approx, and then no symptomes whereas, in acoustic neuroma, sx pst all the time, and also the 5th nerve involvement is also seen in acoustic neuroma..
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| dr in trouble
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its A, Aucostic neuroma
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