How to Answer Your Patient Tinnitus Questions (Complete Guide)
This type of question evaluates analytical and critical thinking skills.
What This Question Is About
This question relates to your patient tinnitus and requires a structured academic response.
How to Approach This Question
Use appropriate theories and support your answer with clear reasoning.
Key Explanation
This topic involves your patient tinnitus. A strong answer should include explanation, application, and examples.
Original Question
Your 70 yo patient has tinnitus and cannot fall asleep due to the sound of ringing in his ears, worse when it is quiet. An audiology evaluation is negative for hearing loss. There is no dizziness. So far, nothing the patient has done nonpharmacologically has worked to reduce the tinnitus symptoms. You were concerned over the severity of the symptoms, and referred the patient to your neurology consultant for evaluation. The neurologist has completed the evaluation (workup) and states there is no medical/surgical reason for the tinnitus, but that this may represent an early symptom of Meniere’s disease before hearing loss has occurred. He recommends using a low-dose benzodiazepine at bedtime as an off-label method of tinnitus symptom control, and asks that you provide the prescription and refills for ongoing care since further specialty care is not needed. The neurologist suggests using diazepam (Valium) at bedtime for this purpose; he is discharged from neurology service and returns to your care. You decide to follow the neurologist’s recommendation for a benzodiazepine trial. Which of the following might be a clinical consideration? a) alprazolam might be a better choice since it is shorter-acting than diazepam O b) you explain that benzodiazepines are a concern in the elderly (due to potential for tolerance, dependence, and adverse effects) O c) the Beers Criteria generally recommends against benzodiazepines in the older adult (elderly) O d) all of the given answer choices are correct
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