**Question:** Audiogram in early Meniere's disease shows:

A. A flattened curve
B. A high-frequency hearing loss
C. A low-frequency hearing loss
D. A mixed hearing loss

**Core Concept:** Meniere's disease is a disorder of the inner ear affecting the vestibular system, causing episodes of vertigo, hearing loss, tinnitus, and hearing fluctuation. The audiogram is a test that measures hearing sensitivity by plotting the threshold of hearing for different frequencies.

**Why the Correct Answer is Right:**

In early Meniere's disease, the audiogram typically shows a **mixed hearing loss** (Correct Answer D). This occurs due to the involvement of multiple frequencies, which is in contrast to a specific frequency pattern seen in other disorders or conditions. The mixed hearing loss is caused by the disruption of both the cochlear and vestibular systems. The cochlear involvement results in high-frequency hearing loss, while the vestibular involvement leads to low-frequency hearing loss.

**Why Each Wrong Option is Incorrect:**

A. A flattened curve (Option A) is not a typical result for Meniere's disease. In Meniere's disease, the hearing loss is not constant across all frequencies but rather involves multiple frequencies.

B. A high-frequency hearing loss (Option B) is not representative of early Meniere's disease. In early Meniere's disease, both high- and low-frequency hearing loss are present, not a high-frequency loss.

C. A low-frequency hearing loss (Option C) is not consistent with Meniere's disease. Meniere's disease typically causes mixed hearing loss, including both high- and low-frequency impairments.

**Clinical Pearl:**

In clinical practice, understanding the characteristic audiogram findings of Meniere's disease is essential, as it aids in differentiating it from other conditions with similar symptoms such as sensorineural hearing loss and presbycusis. This knowledge helps in making an accurate diagnosis and initiating appropriate management strategies.

**Correct Answer:** D. Mixed hearing loss

**Why Each Wrong Option is Incorrect:**

A. Flattened curve: Mixed hearing loss
B. High-frequency hearing loss: Involves multiple frequencies, not just high-frequency
C. Low-frequency hearing loss: Involves multiple frequencies, not just low-frequency