American Board of Internal Medicine (ABIM) Certification Practice Exam

Which triad is characteristic of Meniere disease?

1. Tinnitus, otorrhea, and vertigo

2. Sensorineural hearing loss, tinnitus, and vertigo

3. Tinnitus, vertigo, and headache

4. Hearing loss, aural fullness, and vertigo

The correct answer is: Sensorineural hearing loss, tinnitus, and vertigo

The characteristic triad of Meniere disease includes sensorineural hearing loss, tinnitus, and vertigo. Meniere disease is a disorder of the inner ear that affects balance and hearing. The presence of sensorineural hearing loss denotes the auditory component of the disorder, where patients experience a fluctuating loss of hearing that can worsen during episodes. Tinnitus, often described as a ringing or buzzing in the ear, frequently accompanies the condition and reflects changes in the inner ear's fluid dynamics. Vertigo is another defining symptom, indicating episodes of spinning or dizziness that arise due to disturbances in the vestibular system. Understanding these elements helps clarify why the other options do not fully capture the essence of Meniere disease. For instance, the inclusion of otorrhea (ear discharge) suggests an infectious process rather than the fluid imbalance seen in Meniere disease. Headaches are not a core symptom associated with this condition, and aural fullness, while relevant to the experience of pressure in the ear, is not part of the traditional triad but rather an accompanying symptom. Therefore, the triad outlined in the correct answer accurately represents the hallmark features clinicians look for when diagnosing Meniere disease.