1.

A 34-year-old investment banker complains of intermittent episodes of vertigo associated

with a feeling of fullness in his right ear. These last for several hours. He has had
progressive hearing loss in the right ear. There are no other symptoms. He takes no
medications and has no history of head trauma.
a. Mnires disease
b. Cholesteatoma
c. Vestibular schwannoma
d. Benign positional vertigo (BPV)
e. Aminoglycoside toxicity
2. Early in the evolution of Mnires disease, hearing is lost
a. Over all frequencies
b. Primarily over high frequencies
c. Primarily over middle frequencies
d. Primarily over low frequencies
e. In virtually no patients
3. A 62-year-old man has started getting a haircut every week. Whenever he lays his head
back to have his hair washed, he has the sensation of spinning. With vertigo that develops
on extreme extension or rotation of the head, the patient probably has insufficiency in
the
a. Left subclavian artery
b. Internal carotid arteries bilaterally
c. Vertebrobasilar system
d. Internal maxillary artery
e. Innominate artery

4. A 60-year-old woman complains of feeling dizzy intermittently during to the point that
she tends to keep her head stiff, looking forward. She becomes particularly dizzy when
she lies down in bed at night or turns onto her left side. She occasionally wakes up in the
middle of the night feeling dizzy. She had a similar experience 2 years ago, which lasted
for 2 weeks and then spontaneously resolved. She has otherwise felt well, and her hearing

is normal. On examination, putting her head back and the left ear down elicits a feeling of
dizziness and nausea associated with rotator nystagmus, which lasts for 15 s and then
resolves. What is your diagnosis?
a. Mnires disease
b. Cholesteatoma
c. Vestibular schwannoma
d. Benign positional vertigo (BPV)
e. Aminoglycoside toxicity