Audiology and Speech Disorders Practice Questions

Q: Which of the following is true about the image provided?

It needs sound proof room. ***It needs sound proof room*** - The image shows a subject undergoing an **audiometry test**, indicated by the headphones and the setup appearing to be for hearing evaluation. - **Audiometry** requires a **sound-attenuating (sound-proof) environment** to ensure accurate measurement of hearing thresholds, free from ambient noise interference. *Caloric stimulation test* - A **caloric stimulation test** evaluates the vestibular system and involves injecting warm or cold water/air into the ear canal, which is not depicted here. - The image clearly shows a setup for **hearing assessment**, not vestibular function testing. *It is an objective invasive test* - **Audiometry** (as depicted) is generally a **subjective test** because it relies on the patient's vocal response or behavioral feedback (e.g., raising a hand) to indicate perceived sounds. - While some audiological tests can be objective (e.g., **otoacoustic emissions**, **auditory brainstem response**), invasive tests involve penetrating the body, which is not the case for conventional audiometry. *Frequency detection of 12,000 to 20,000 Hz is done conventionally* - Conventional **pure-tone audiometry** typically tests frequencies between **250 Hz and 8000 Hz**, which are most crucial for speech understanding. - Testing frequencies up to **12,000-20,000 Hz** is considered **high-frequency audiometry** and is not part of the standard conventional battery of tests.

Q: All of the following are early complications of cochlear implant surgery shown except:

Device extrusion. ***Device extrusion*** - **Device extrusion** is a late complication typically resulting from chronic infection, trauma, or insufficient soft tissue coverage over time. - While it can occur, it is generally not considered an **early complication** that arises immediately or shortly after cochlear implant surgery. *Facial palsy* - The **facial nerve (CN VII)** runs in close proximity to the surgical field for cochlear implantation. - Injury to the facial nerve during drilling or electrode insertion can lead to **facial palsy**, making it an early complication. *Taste disturbances* - The **chorda tympani nerve**, which carries taste sensation, passes through the middle ear and can be inadvertently damaged during cochlear implant surgery. - Damage to this nerve causes **taste disturbances** (dysgeusia), which can manifest soon after the procedure. *CSF leakage* - Cochlear implant surgery involves breaching the inner ear structures, which are continuous with the **subarachnoid space**. - This can create a pathway for **cerebrospinal fluid (CSF) leakage**, an immediate and serious early complication.

Q: Which of the following hearing aid or implant is shown below?

Cochlear implant. ***Cochlear implant*** - The image clearly shows an **electrode array** inserted into the **cochlea**, bypassing damaged hair cells and directly stimulating the auditory nerve. - This is characteristic of a **cochlear implant**, which is used for individuals with severe to profound sensorineural hearing loss. *Brainstem auditory implant* - A **brainstem auditory implant** (BAI) electrode is placed on the **cochlear nucleus** in the brainstem, not the cochlea itself. - BAIs are typically used for conditions where the auditory nerve is damaged or absent, such as in cases of **neurofibromatosis type 2** with bilateral acoustic neuromas. *Bone anchored hearing aid* - A **bone-anchored hearing aid** (BAHA) works by transmitting sound vibrations directly to the cochlea via bone conduction, typically through a surgically implanted post or magnet in the **skull bone**. - The image does not depict an external processor or bone conduction mechanism, but rather an internal electrode within the inner ear. *In the canal hearing aid* - An **in-the-canal (ITC) hearing aid** is an external device that sits within the ear canal and amplifies sound acoustically. - The image shows an **invasive internal device** implanted into the cochlea, which is distinct from a non-invasive, external ITC hearing aid.

Q: The electrode of the hearing implant shown below is placed in:

Scala tympani. ***Scala tympani*** - The electrode array of a cochlear implant is typically inserted into the **scala tympani** to deliver electrical stimulation directly to the auditory nerve fibers. - This placement avoids damage to the delicate **organ of Corti** located in the scala media. *Scala vestibuli* - The scala vestibuli is separated from the scala media by **Reissner's membrane** and contains perilymph. - Inserting the electrode here is not the standard approach and could potentially damage the **cochlear duct**. *Scala media* - The scala media (cochlear duct) contains the **organ of Corti** and endolymph, which is crucial for natural hearing. - Placing an electrode here would likely **destroy the hair cells** and organ of Corti, preventing any residual natural hearing. *Tectorial membrane* - The tectorial membrane lies above the hair cells within the **scala media** and is essential for converting mechanical vibrations into electrical signals in natural hearing. - This membrane is not a fluid-filled space and is too delicate and structurally integral for electrode insertion.

Q: All of the following are true about the hearing aid shown in the figure except:

Indicated in patients with unilateral profound hearing loss. ***Indicated in patients with unilateral profound hearing loss*** - While **bone conduction hearing implants** can be used for **unilateral hearing loss**, they are typically indicated for **single-sided deafness with normal hearing in the contralateral ear** to provide sound awareness to the deaf side. However, in cases of **profound unilateral hearing loss, cochlear implantation** is often the preferred and more effective intervention for direct sound perception. *Bypasses the external and middle ear* - This statement is true; the device shown is a **bone conduction hearing system** (like BAHA), which transmits sound vibrations directly to the inner ear via the bone, thus **bypassing problems in the external auditory canal and middle ear**. - It is effective for **conductive or mixed hearing loss** where the inner ear function is relatively preserved. *Osseointegration of titanium fixture takes 2-6 months* - This statement is true; **osseointegration** is the biological process where the titanium implant fuses with the bone, which typically takes **2 to 6 months** before the external sound processor can be safely attached. - This fusion is crucial for stable and effective **bone sound conduction**. *Disadvantage of multi-stage surgery* - This statement is true; traditional bone conduction implants often require a **two-stage surgical procedure**: one for implanting the fixture and another for attaching the abutment after successful osseointegration. - This involves **multiple clinic visits, recovery periods**, and potential complications associated with two separate surgeries.

Q: Which type of hearing aid is shown below?

Body-worn. ***Body-worn*** - This image displays a **body-worn hearing aid**, which is characterized by a separate unit worn on the body (e.g., in a pocket or clipped to clothing) connected by a wire to an ear mold. - They are typically used for **severe to profound hearing loss** and are less common today due to advancements in smaller, more discreet models. *In-the-ear* - **In-the-ear (ITE) hearing aids** fit entirely within the outer ear bowl and are custom-made for the individual. - They are larger than canal models but still fit within the ear, unlike the device shown. *In-the-canal* - **In-the-canal (ITC) hearing aids** are smaller than ITE models and fit partially into the ear canal, with a small portion visible in the outer ear. - They are more discreet than ITEs but still housed within the ear, which does not match the pictured device. *Completely in canal* - **Completely-in-canal (CIC) hearing aids** are the smallest and fit almost entirely inside the ear canal, making them nearly invisible. - The pictured device is clearly a larger, external unit, not designed to fit invisibly within the canal.

Q: The following test is useful for diagnosis of all except:

Postmeningitis deafness. ***Postmeningitis deafness*** - The image illustrates a **tympanometer**, which primarily assesses the function of the **middle ear** and **eardrum mobility** within the context of air pressure changes. - **Postmeningitis deafness** typically results from **sensorineural hearing loss** due to damage to the **cochlea** or **auditory nerve**, which is a condition of the inner ear and cannot be directly diagnosed by tympanometry. *Ossicular discontinuity* - This condition involves a break or separation in the **ossicular chain**, leading to excessive mobility of the tympanic membrane. - Tympanometry in **ossicular discontinuity** typically shows a **Type Ad tympanogram**, characterized by abnormally high compliance due to the lack of resistance from the damaged ossicles. *Otosclerosis* - **Otosclerosis** involves abnormal bone growth around the **stapes** footplate, leading to its fixation and reduced mobility. - Tympanometry in otosclerosis typically yields a **Type As tympanogram**, indicating abnormally low compliance or a shallow peak. *Serous otitis media* - Also known as **otitis media with effusion**, this condition involves the accumulation of fluid in the middle ear without signs of acute infection. - Tympanometry in **serous otitis media** typically presents with a **Type B tympanogram**, characterized by a flat curve due to reduced or absent eardrum mobility caused by the fluid.

Q: A 1-year-old child has spastic cerebral palsy. Which of the following tests is being performed on the child?

Brainstem evoked auditory response. ***Brainstem evoked auditory response*** - The image shows a child with electrodes placed on the head and an earphone in the ear, along with a waveform graph labeled "Neonate" and showing peaks I, III, and V, which are characteristic of **Brainstem Evoked Auditory Response (BAER)**, also known as ABR. - BAER is an objective and reliable test for assessing **auditory nerve and brainstem pathways** in infants and uncooperative individuals, making it suitable for a 1-year-old with spastic cerebral palsy to screen for hearing loss. *Otoacoustic emission* - This test measures sounds produced by the **cochlea's outer hair cells** and is primarily used for **newborn hearing screening**. - While also objective, it does not assess the **auditory nerve or brainstem function**, which is often crucial in children with neurological conditions like cerebral palsy. *Pure tone audiometry* - This is a **subjective test** that requires the patient to respond to different tones, which is not feasible for a 1-year-old child, especially one with spastic cerebral palsy. - It measures the **thresholds of hearing across different frequencies** but cannot be performed reliably in uncooperative patients. *Caloric electronystagmogram* - This test assesses the function of the **vestibular system** by introducing warm or cold water into the ear canal to induce nystagmus. - It is used to evaluate **balance disorders** and vertigo, not for assessing primary hearing loss, and is generally performed in older children or adults.

Q: The audiogram shown below denotes:

High frequency sensorineural hearing loss. ***High frequency sensorineural hearing loss*** - The audiogram shows a significant drop in hearing thresholds (increased hearing loss in dB) at **higher frequencies (2000 Hz and above)** for both air and bone conduction. - The **air and bone conduction thresholds are closely matched (within 10-15 dB)**, indicating a sensorineural hearing loss, as there is no significant air-bone gap. *Low frequency sensorineural hearing loss* - This audiogram demonstrates relatively normal hearing thresholds at **lower frequencies (below 1000 Hz)**, contradicting a low-frequency hearing loss. - While it is a sensorineural loss, the pattern is clearly affecting the higher frequencies, not the lower ones. *High frequency conductive hearing loss* - A conductive hearing loss would present with an **air-bone gap**, where air conduction thresholds are significantly worse than bone conduction thresholds. - In this audiogram, the air and bone conduction thresholds are very similar, ruling out a conductive component. *Low frequency conductive hearing loss* - The audiogram shows **no air-bone gap** at any frequency, including the lower frequencies, ruling out conductive hearing loss. - Additionally, the hearing thresholds at **low frequencies (125-1000 Hz) are normal or near-normal**, so there is no low-frequency hearing loss of any type.

Question 1

Which of the following is true about the image provided?

Accepted Answer

It needs sound proof room

Answer

Caloric stimulation test

Answer

It is an objective invasive test

Answer

Frequency detection of 12,000 to 20,000 Hz is done conventionally

Question 2

Which of the following best describes the principle of the test being performed?

Accepted Answer

Placing the device on the forehead and asking her to report in which ear she hears it better.

Answer

Placing the device on the forehead comparing the bone conduction of the patient with that of the examiner.

Answer

Placing the device on the vertex of the skull and determining the effect of gently occluding the auditory canal on the threshold of low frequencies.

Answer

Placing the device on the mastoid process and comparing the air conduction in patient.

Question 3

All of the following are early complications of cochlear implant surgery shown except:

Accepted Answer

Device extrusion

Answer

Facial palsy

Answer

Taste disturbances

Answer

CSF leakage

Question 4

Which of the following hearing aid or implant is shown below?

Accepted Answer

Cochlear implant

Answer

Brainstem auditory implant

Answer

Bone anchored hearing aid

Answer

In the canal hearing aid

Question 5

The electrode of the hearing implant shown below is placed in:

Accepted Answer

Scala tympani

Answer

Scala vestibuli

Answer

Scala media

Answer

Tectorial membrane

Question 6

All of the following are true about the hearing aid shown in the figure except:

Accepted Answer

Indicated in patients with unilateral profound hearing loss

Answer

Bypasses the external and middle ear

Answer

Osseointegration of titanium fixture takes 2-6 months

Answer

Disadvantage of multi-stage surgery

Question 7

Which type of hearing aid is shown below?

Accepted Answer

Body-worn

Answer

In-the-ear

Answer

In-the-canal

Answer

Completely-in-canal

Question 8

The following test is useful for diagnosis of all except:

Accepted Answer

Postmeningitis deafness

Answer

Ossicular discontinuity

Answer

Otosclerosis

Answer

Serous otitis media

Question 9

A 1-year-old child has spastic cerebral palsy. Which of the following tests is being performed on the child?

Accepted Answer

Brainstem evoked auditory response

Answer

Otoacoustic emission

Answer

Pure tone audiometry

Answer

Caloric electronystagmogram

Question 10

The audiogram shown below denotes:

Accepted Answer

High frequency sensorineural hearing loss

Answer

Low frequency sensorineural hearing loss

Answer

High frequency conductive hearing loss

Answer

Low frequency sensorineural hearing loss

Answer

Low frequency conductive hearing loss

Audiology and Speech Disorders — MCQs

Audiology and Speech Disorders — MCQs

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