Ear, nose & throat · UKMLA & AKT
Ménière's disease
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise ménière's disease — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Ménière's disease presents with a characteristic tetrad of symptoms, typically unilateral, following a relapsing-remitting course.
- Episodic vertigo - true rotational vertigo lasting 20 minutes to 12 hours (typically 2-3 hours); spontaneous, no positional trigger
- Fluctuating sensorineural hearing loss - low-to-medium frequency; worsens during attacks, becomes progressive over time
- Tinnitus - low-pitched, roaring or buzzing quality in the affected ear
- Aural fullness - sensation of pressure or blockage; often prodromal
- Nausea and vomiting - accompany acute attacks
- Weber's test lateralises to the unaffected (better-hearing) ear; Rinne's test positive bilaterally - consistent with unilateral sensorineural hearing loss
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