MRCP revision battle 32.1: Deafness: Rinnes and Webers
MRCP revision battle 32.2: Tinnitus
MRCP revision battle 32.3: TIA
MRCP revision battle 32.4: Epilepsy
MRCP revision battle 32.5: Macular degeneration
MRCP revision battle 32.6: Glaucoma
MRCP revision battle 32.7: Autonomic neuropathy
MRCP revision battle 32.1: Deafness: Rinnes and Webers
Hearing loss and Rinne and Weber's tests are MRCP favourites.
Remember there are 2 types of deafness:
- conductive deafness
- ear wax
- otosclerosis
- otitis media
- glue ear
- sensorineural deafness
- acoustic neuroma
- Pagets
- MS
- CVA
- Menieres
- head trauma
- noise exposure
- drugs
- aminoglycosides (gentamycin)
- furosemide
- lead
Tests are done with a 256- 512 Hz tuning fork
Rinne's test:
- hold vibrating tuning fork next to ear meatus, then place on mastoid
- ask which is louder
- air conduction (AC) > bone conduction (BC) = normal, or, if hearing is decreased, suggests sensorineural loss
- BC>AC = conductive deafness = Rinne negative
- Remember as: ALS (like the course) - air loudest: sensorineural.
Weber's test:
- hold vibrating tuning fork on forehead
- ask which side it is heard loudest in
- in sensorineural loss it laterals to the unaffected side
- in conductive loss it laterals to the affected side
- midline if normal, or bilateral sensorineural loss
- Remember as: SUCA - sensorineural unaffected, conductive affected.
Next up - a spot of tinnitus...
