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Medical Professionals: Articles: Case Reports:

COGAN'S SYNDROME

Elisabetta Miserocchi, M.D.

1. Which type of corneal findings are present in patient's with Cogan's syndrome?

1. Peripheral corneal thinning.
2. Endothelial keratic precipitates.
3. Patchy stromal infiltrates.
4. Descemet's folds.

2. Which manifestations are present in atypical cases of Cogan's syndrome?

1. Chorioretinal folds.
2. Retinal hemorrages.
3. Posterior scleritis.
4. Corneal neovascularization.

3. Choose the correct statement.

1. Cogan's syndrome typically affects children.
2. The audiovestibular symptoms can precede or follow the ocular manifestations.
3. Half percent of patients with Cogan's syndrome can have isolated ocular manifestations.
4. Interstitial keratitis is present in 30% of the cases.

4. The audiovestibular findings in Cogan's syndrome include all the following except.

1. Sensorineural deafness.
2. Nausea, vomiting, tinnitus.
3. The audiogram indicating cochlear pathology.
4. Hearing loss more pronounced at the mid frequency.

5. The most common site of systemic vasculitis in patients with Cogan's syndrome is:

1. Cardiovascular system.
2. Spleen and liver.
3. Renal artery.
4. Central nervous system.

6. All the following systemic symptoms can be present in Cogan's syndrome except :

1. Meningismus and encephalitis.
2. Abdominal pain
3. Granulomas of the skin.
4. Pneumonia.

7. The diagnosis of Cogan's syndrome is made when:

1. The audiogram is abnormal at the high frequencies.
2. Antibodies against the inner ear and the cornea are present.
3. Systemic vasculitis of large-medium vessels and sensorineural deafness are present.
4. Ocular typical or atypical findings are associated with vestibuloauditory symptoms.

8. In the differential diagnosis of Cogan's syndrome one must consider all the following diseases except:

1. Syphilis.
2. Lyme.
3. Systemic lupus erythematosus.
4. Wegener's granulomatosis.

9. The pathogenesis of deafness in patients with Cogan's syndrome is believed to be related to:

1. Atrophy of the organ of Corti.
2. Lymphocytic infiltration of the spiral ligament.
3. Plasma cell infiltration of the temporal bone.
4. Demyelinization of the eight cranial nerve.

10. Which of the following statements regarding treatment management in case of Cogan's syndrome are correct:

1. Interstitial keratitis is responsive to topical corticosteroids.
2. When the ear is involved high doses of systemic corticosteroids are mandatory.
3. When corticosteroids are administrated promptly, patients do not progress to further deafness.
4. Cyclosporin is the drug of choice when systemic vasculitis is present.

Correct answers:

1. b), c)
2. b), c)
3. b), c)
4. d)
5. a)
6. c), d)
7. d)
8. c)
9. a), b), d)
10. a), b)

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