Audiology and Speech Disorders Practice Questions

Q: Which is correct about the pure tone audiometry tracing given below?

A= Conductive hearing loss, B= Sensorineural hearing loss. ***A= Conductive hearing loss, B= Sensorineural hearing loss*** - Graph A demonstrates a significant **air-bone gap** (air conduction thresholds worse than bone conduction by >10 dB), which is the hallmark of **conductive hearing loss** - Graph B shows **overlapping air and bone conduction thresholds** at elevated levels with no significant air-bone gap, characteristic of **sensorineural hearing loss** *A= Sensorineural hearing loss, B= Conductive hearing loss* - Incorrect: Graph A shows clear **air-bone gap** (conductive pattern), not overlapping thresholds - Incorrect: Graph B shows **overlapping elevated thresholds** (sensorineural pattern), not air-bone gap *A= Normal, B= Conductive hearing loss* - Incorrect: Graph A shows significant hearing loss with **air-bone gap**, not normal hearing (0-25 dB) - Incorrect: Graph B shows **overlapping elevated thresholds** indicating sensorineural hearing loss, not conductive *A= Sensorineural hearing loss, B= Normal* - Incorrect: Graph A displays **air-bone gap** characteristic of conductive hearing loss, not sensorineural - Incorrect: Graph B shows elevated thresholds indicating **hearing loss is present**, not normal hearing

Q: All are true about the recording shown in the image except:

Wave I originates from proximal part of Cranial nerve VIII. ***Wave I originates from proximal part of Cranial nerve VIII*** - **Wave I** of the ABR actually originates from the **distal portion of cranial nerve VIII**, specifically near the cochlea. - The more proximal parts of the auditory nerve and brainstem generate subsequent waves (II-VII). *Noninvasive* - Auditory brainstem response (**ABR**) testing is indeed a **noninvasive** procedure. - It involves placing electrodes on the scalp to record electrical activity in response to auditory stimuli. *Test integrity of central auditory pathways* - ABR measures electrical activity as sound travels from the cochlea through the **auditory nerve** and into the **brainstem**. - This makes it an excellent tool for assessing the **integrity of the central auditory pathways**, identifying neurological issues. *Measures hearing in range of 1000-4000 Hz* - ABR testing primarily evaluates hearing sensitivity in the **higher frequency range**, typically 1000-4000 Hz. - This range is crucial for speech understanding and is often the first to be affected in certain types of hearing loss.

Q: The tympanogram shown below is seen in which of the following conditions?

X= Ossicular discontinuity, Y= Middle ear effusion. ***X= Ossicular discontinuity, Y= Middle ear effusion*** - Curve **X** shows a **hypermobile tympanogram** with extremely high peak compliance, characteristic of **ossicular discontinuity** where the broken ossicular chain allows excessive tympanic membrane movement. - Curve **Y** demonstrates a **flat Type B tympanogram** with no identifiable peak, indicating **middle ear effusion** where fluid prevents normal tympanic membrane mobility. *X= Retracted tympanic membrane, Y= Middle ear effusion* - A **retracted tympanic membrane** produces a **Type C tympanogram** with the peak shifted to negative pressure, not the hypermobile pattern seen in curve X. - While curve Y correctly represents middle ear effusion, curve X is inconsistent with tympanic membrane retraction. *X= Thin lax tympanic membrane, Y= Otosclerosis* - Although a **thin lax tympanic membrane** can cause hypermobility, **ossicular discontinuity** better explains the extreme hypercompliance shown in curve X. - **Otosclerosis** typically produces a **Type As tympanogram** with reduced compliance and a shallow peak, not the flat pattern of curve Y. *X= Malleus fixation, Y= Thin lax tympanic membrane* - **Malleus fixation** (as in otosclerosis) results in **reduced compliance** and a Type As pattern, opposite to the hypermobile curve X. - A **thin lax tympanic membrane** would indeed show hypermobility, but this doesn't match the flat, non-compliant pattern of curve Y.

Q: The tympanogram shown below is seen in which of the following conditions?

Retracted tympanic membrane. ***Retracted tympanic membrane*** - The tympanogram displays a **Type C** curve, characterized by **normal compliance** but with the peak shifted to **negative pressure**, indicating **Eustachian tube dysfunction**. - This negative pressure shift occurs when the middle ear cannot equalize pressure with the atmosphere, causing the tympanic membrane to retract inward. *Otosclerosis* - Otosclerosis typically causes a **Type As** tympanogram, with **normal pressure** but **reduced compliance** (shallow peak), due to the stiffening of the ossicular chain. - The **stapes fixation** in otosclerosis restricts tympanic membrane vibration, leading to low compliance, not the normal compliance seen here. *Ossicular disruption* - Ossicular disruption causes a **Type Ad** tympanogram with **normal pressure** but **abnormally high compliance** (deep, sharp peak). - This **hypermobile middle ear system** occurs when the ossicular chain is disarticulated, allowing excessive tympanic membrane movement, contrary to the normal compliance shown. *Malleus fixation* - Malleus fixation leads to a **stiffened middle ear system** and would present as a **Type As** tympanogram with **reduced compliance**. - The **inability of the malleus to move freely** impedes sound transmission and reduces eardrum flexibility, not consistent with normal compliance.

Q: The tympanogram shown below is seen in which of the following conditions?

Middle ear fluid. ***Middle ear fluid*** - The tympanogram shown is a **Type B** tympanogram, which is characteristic of **middle ear fluid**. - A Type B tympanogram indicates **severely reduced or no compliance** of the tympanic membrane, suggesting the middle ear is filled with fluid and cannot vibrate normally. *Otosclerosis* - Otosclerosis typically causes a **Type As** tympanogram, characterized by **reduced compliance but normal middle ear pressure**. - This is due to the **stiffening of the ossicular chain**, primarily the stapes footplate. *Ossicular disruption* - Ossicular disruption typically results in a **Type Ad** tympanogram, showing **excessively high compliance** (a deep, exaggerated peak). - This occurs because the ossicular chain is discontinuous, leading to reduced impedance and increased movement of the tympanic membrane. *Eustachian tube dysfunction* - Eustachian tube dysfunction often presents as a **Type C** tympanogram, characterized by a **negative middle ear pressure** with normal or near-normal compliance. - This negative pressure results from the Eustachian tube's inability to ventilate the middle ear, leading to absorption of air and retraction of the eardrum.

Q: Which test is being performed in the patient?

Weber test. ***Weber test*** - The image depicts a **tuning fork placed on the patient's central incisors**, which is a technique used to perform the Weber test. - The Weber test assesses **bone conduction** and helps differentiate between conductive and sensorineural hearing loss by determining if the sound lateralizes to one ear. *Rinne test* - The Rinne test compares **air conduction to bone conduction** in the same ear. - It involves placing a vibrating tuning fork on the **mastoid process** and then holding it in front of the ear canal. *Schwabach test* - The Schwabach test compares the patient's **bone conduction** with that of the examiner, assuming the examiner has normal hearing. - It involves placing a vibrating tuning fork on the **mastoid process** of both the patient and examiner. *Absolute bone conduction test* - This test is a variant of the Schwabach test where the **external auditory canal is occluded** to eliminate air conduction. - It aims to assess bone conduction exclusively, but the method shown in the image (tuning fork on incisors for lateralization) is characteristic of the Weber test.

Q: Which of the following is the diagnosis of the audiogram shown below?

Noise induced hearing loss. ***Noise induced hearing loss*** - The audiogram shows a classic **'noise notch'**, characterized by a dip in hearing at **3000-6000 Hz**, with recovery at 8000 Hz, reflecting damage to hair cells in the cochlea from excessive noise exposure. - Both air conduction (solid line) and bone conduction (dashed line) thresholds are depressed in the same pattern, indicating a **sensorineural hearing loss**. *Otosclerosis* - Otosclerosis typically causes a **conductive hearing loss**, meaning air conduction thresholds would be significantly worse than bone conduction thresholds, showing an **air-bone gap**. - It often results in a characteristic **Carhart notch** (a dip at 2000 Hz) in bone conduction, but this audiogram shows sensorineural loss without a significant air-bone gap. *Ototoxicity* - Ototoxicity usually results in a **high-frequency sensorineural hearing loss**, often affecting frequencies above 4000 Hz first, and typically shows a more gradual, sloping loss rather than a sharp notch. - While it is sensorineural, the specific 'notch' pattern seen here is more characteristic of noise exposure. *Meniere's disease* - Meniere's disease classically presents with a **low-frequency sensorineural hearing loss** that can fluctuate, accompanied by **tinnitus, vertigo, and aural fullness**. - The audiogram does not show a low-frequency loss, nor does it typically present with a noise notch.

Q: Identify the marked structure in the given image.

Coil. ***Coil*** - The marked structure appears to be a **cochlear implant's internal coil**, which is common in X-ray imaging of these devices. - The **cochlear implant internal coil** is crucial for transmitting processed sound signals via electromagnetic induction to the electrode array within the cochlea. *Electrode* - An **electrode array** is typically a thin, flexible wire with multiple contacts inserted into the cochlea, which is not what the arrow is pointing to directly. - While electrodes are part of a cochlear implant, the marked structure's shape and position are more consistent with the **internal coil** that connects to the electrode array. *Magnet* - A **magnet** is present in a cochlear implant system, typically in both the external processor and internal receiver, to hold these two components together through the skin. - Magnets usually appear as dense, circular structures in X-rays, often seen more anteriorly or superiorly to the coil for external component alignment. *Processor* - The **processor** for a cochlear implant is an external device worn behind the ear, not an implanted component visible on an X-ray. It processes sound and sends it to the internal coil. - The structures seen in the X-ray are **implanted components** of the cochlear implant, not the external sound processor.

Q: A 14-year-old female patient presents to the ENT OPD and complains that she can hear sounds clearly but has difficulty processing and understanding what is being said. Her Pure tone audiometry and ABR are normal. What is the likely diagnosis in this patient?

Central Auditory Processing Disorder (CAPD). ***Central Auditory Processing Disorder (CAPD)*** - **CAPD** is characterized by difficulty processing and understanding auditory information despite normal peripheral hearing, as indicated by normal pure tone audiometry and ABR. - The patient's inability to comprehend spoken words despite hearing them clearly is a hallmark symptom of **CAPD**. *Auditory cortex lesion* - While an **auditory cortex lesion** could impair sound processing, it would likely result in more profound and specific deficits in sound localization, discrimination, or recognition, rather than just difficulty understanding speech with otherwise normal hearing tests. - **Unilateral lesions** might cause mild or transient auditory issues, but bilateral lesions typically lead to **cortical deafness**, which contradicts the patient's ability to "hear sounds clearly." *Malingering* - **Malingering** involves deliberately fabricating or exaggerating symptoms for secondary gain, which is unlikely given the consistent presentation of difficulty understanding speech despite normal, objective hearing tests like ABR. - There are no indications in the case of **inconsistent test results** or other behaviors suggestive of feigned symptoms. *Sensorineural hearing loss* - **Sensorineural hearing loss** involves damage to the inner ear or auditory nerve, which would result in abnormal pure tone audiometry results and/or abnormal ABR findings. - The patient's **normal pure tone audiometry and ABR** rule out sensorineural hearing loss as the primary cause of her symptoms.

Q: Dip at 4000 Hz in pure tone audiometry indicates:

Noise induced hearing loss. ***Noise induced hearing loss*** - A characteristic **"4 kHz Notch"** or dip in the audiogram is a hallmark of **noise-induced hearing loss**, resulting from damage to the **cochlear hair cells** in this frequency range. - This specific frequency is most susceptible to damage from loud noise exposure due to the physical properties of the **basilar membrane**. *Meniere's disease* - Typically presents with **low-frequency hearing loss**, often fluctuating, along with **tinnitus**, **vertigo**, and a feeling of **aural fullness**. - A dip at 4000 Hz is not a characteristic audiometric finding for **Meniere's disease**. *Age related hearing loss* - Also known as **presbycusis**, it is typically a **symmetrical, progressive, sensorineural hearing loss** that primarily affects **higher frequencies**, but it usually presents as a more gradual slope rather than a sharp dip at a specific frequency like 4 kHz. - While high frequencies are affected, the pattern is usually a broader high-frequency loss, not an isolated notch. *Otosclerosis* - This condition is a form of **conductive hearing loss** (though it can have a sensorineural component in advanced stages) due to abnormal bone growth around the **stapes footplate**. - Its classic audiometric finding is a **Carhart notch** around 2000 Hz, with a conductive hearing loss pattern, rather than a sensorineural dip at 4000 Hz.

Question 1

Which is correct about the pure tone audiometry tracing given below?

Accepted Answer

A= Conductive hearing loss, B= Sensorineural hearing loss

Answer

A= Sensorineural hearing loss, B= Conductive hearing loss

Answer

A= Normal, B= Conductive hearing loss

Answer

A= Sensorineural hearing loss, B= Normal

Question 2

All are true about the recording shown in the image except:

Accepted Answer

Wave I originates from proximal part of Cranial nerve VIII

Answer

Noninvasive

Answer

Test integrity of central auditory pathways

Answer

Measures hearing in range of 1000-4000 Hz

Question 3

The tympanogram shown below is seen in which of the following conditions?

Accepted Answer

X= Ossicular discontinuity, Y= Middle ear effusion

Answer

X= Retracted tympanic membrane, Y= Middle ear effusion

Answer

X= Thin lax tympanic membrane, Y= Otosclerosis

Answer

X= Malleus fixation, Y= Thin lax tympanic membrane

Question 4

The tympanogram shown below is seen in which of the following conditions?

Accepted Answer

Retracted tympanic membrane

Answer

Otosclerosis

Answer

Malleus fixation

Answer

Ossicular disruption

Question 5

The tympanogram shown below is seen in which of the following conditions?

Accepted Answer

Middle ear fluid

Answer

Otosclerosis

Answer

Ossicular disruption

Answer

Eustachian tube dysfunction

Question 6

Which test is being performed in the patient?

Accepted Answer

Weber test

Answer

Rinne test

Answer

Schwabach test

Answer

Absolute bone conduction test

Question 7

Which of the following is the diagnosis of the audiogram shown below?

Accepted Answer

Noise induced hearing loss

Answer

Otosclerosis

Answer

Ototoxicity

Answer

Meniere's disease

Question 8

Identify the marked structure in the given image.

Accepted Answer

Coil

Answer

Electrode

Answer

Magnet

Answer

Processor

Question 9

A 14-year-old female patient presents to the ENT OPD and complains that she can hear sounds clearly but has difficulty processing and understanding what is being said. Her Pure tone audiometry and ABR are normal. What is the likely diagnosis in this patient?

Accepted Answer

Central Auditory Processing Disorder (CAPD)

Answer

Auditory cortex lesion

Answer

Malingering

Answer

Sensorineural hearing loss

Question 10

Dip at 4000 Hz in pure tone audiometry indicates:

Accepted Answer

Noise induced hearing loss

Answer

Meniere's disease

Answer

Age related hearing loss

Answer

Otosclerosis

Audiology and Speech Disorders — MCQs

Audiology and Speech Disorders — MCQs

On this page

Practice by Chapter

Want unlimited practice?