Hearing Assessment (Audiometry, Tuning Fork Tests, ABR) MCQs

ENT · 70 free questions with answers & explanations.

1. HHIE-S (Hearing Handicap Inventory for the Elderly – Screening) is designed to detect the impact of hearing loss on:
2. Otoacoustic emissions (OAEs) are absent in sensorineural hearing loss exceeding 30–40 dB HL because they specifically test the integrity of:
3. A 25-year-old with normal hearing threshold on pure-tone audiometry cannot follow speech in background noise and performs poorly on dichotic digit testing. ABR is normal. The most likely diagnosis is:
4. On acoustic reflex testing, the reflex is absent ipsilaterally and contralaterally when stimulating the right ear, but present bilaterally when stimulating the left ear. This pattern most likely indicates a lesion of the:
5. On pure tone audiometry of a patient with presbycusis (age-related SNHL), which audiometric configuration is MOST typical?
6. Auditory brainstem response (ABR) testing records far-field potentials from the auditory pathway. Wave V on ABR corresponds to which anatomical generator?
7. On impedance audiometry of a patient with a large eardrum perforation, which tympanogram pattern is expected?
8. In the Stenger test for suspected non-organic (functional/psychogenic) unilateral hearing loss, the test is considered POSITIVE when:
9. In pure tone audiometry, the difference between the air-conduction threshold and the bone-conduction threshold (air-bone gap) in an individual with otosclerosis is typically seen in which frequency range first?
10. In impedance audiometry, a type 'As' tympanogram (shallow peak) suggests:
11. Auditory Brainstem Response (ABR) is used to identify the hearing threshold by identifying Wave V. The neural generator of Wave V is located at the level of the:
12. Stenger's test is used to detect unilateral malingering. The principle is based on:
13. In a patient with a unilateral acoustic neuroma, which ABR finding is most characteristic?
14. On pure tone audiogram, a patient shows air-bone gap of 40 dB at all frequencies with normal bone conduction thresholds. Tympanometry shows a flat (type B) curve with normal ear canal volume. What is the most likely diagnosis?
15. In ABR (Auditory Brainstem Response) testing, Wave I originates from the distal portion of the cochlear nerve, and Wave V is the most robust clinically. Which structure generates Wave III?
16. A 6-month-old infant fails newborn hearing screening. The appropriate NEXT confirmatory test is:
17. On impedance audiometry, a patient with otosclerosis is expected to show which tympanogram type, and what acoustic reflex pattern?
18. In a pure tone audiogram showing an air-bone gap with bone conduction at 0 dB HL and air conduction at 60 dB HL, tympanometry shows a flat (Type B) curve with high compliance and large volume. What is the most likely diagnosis?
19. On auditory brainstem response (ABR) testing, which waveform peak corresponds to the cochlear nerve (CN VIII) action potential and arises from the distal CN VIII near the cochlea?
20. A noise-exposed worker's audiogram shows a characteristic notch at 4000 Hz with relatively better thresholds at 8000 Hz. This 4 kHz notch in noise-induced hearing loss (NIHL) occurs because sound at 1000–2000 Hz (dominant speech frequencies) preferentially damages hair cells at the:
21. In DPOAE (distortion product otoacoustic emissions) testing, the emission frequency most commonly measured to assess outer hair cell function is generated at which frequency relative to the two primary tones f1 and f2?
22. A child has bilateral sensorineural hearing loss detected on neonatal hearing screening. The family history reveals that the parents are first cousins. Genetic testing will most likely identify a mutation in which gene, responsible for the most common cause of non-syndromic autosomal recessive SNHL (DFNB1)?
23. On pure tone audiometry, a patient demonstrates air conduction thresholds of 50 dB at all frequencies with bone conduction thresholds of 20 dB. The Carhart notch (dip at 2000 Hz on bone conduction) is present. What is the diagnosis?
24. ABR (Auditory Brainstem Response) testing is performed in a 6-month-old infant. Waves I, III, and V are identified. Which of the following correctly describes Wave V of ABR?
25. In high-resolution CT of the temporal bone, which structure is identified at the cochlear promontory level that appears as a dark 'halo' around a bright dot — the 'double ring sign'?
26. Otoacoustic emissions (OAEs) are absent in a newborn. What does this finding indicate?
27. A pure tone audiogram shows a 40 dB air-bone gap with normal bone conduction thresholds. Tympanometry shows a flat (type B) pattern with abnormally LARGE canal volume. Ipsilateral and contralateral acoustic reflexes are absent. What is the most likely diagnosis?
28. In Auditory Brainstem Response (ABR) testing, which neural structure generates Wave V?
29. A 6-month-old infant fails newborn hearing screening. Distortion-product OAE (DPOAE) testing is absent bilaterally, but click-ABR shows robust Wave V responses at 35 dB nHL bilaterally. What is the most likely explanation?
30. Speech discrimination score (SDS) obtained at suprathreshold levels (typically 40 dB above SRT) is used clinically to distinguish conductive, cochlear, and retrocochlear hearing losses. Which pattern is MOST suggestive of retrocochlear pathology?
31. On pure tone audiometry, a patient shows an air-bone gap at low frequencies (250 and 500 Hz) with a characteristic notch-shaped depression in the bone conduction curve at 2000 Hz known as the Carhart notch. This finding is MOST suggestive of:
32. A newborn fails the automated ABR (AABR) screening. On diagnostic click-evoked ABR at 3 months, wave I is present but wave V is absent. What is the MOST likely diagnosis?
33. On impedance audiometry (tympanometry) a type As (shallow) tympanogram is found. This pattern is characteristically associated with:
34. In a Stenger test used to detect unilateral functional (non-organic) hearing loss, if the patient has genuine unilateral hearing loss in the right ear, presenting a tone at a level between the thresholds of the two ears (just above right ear threshold, just below left ear threshold) will result in the patient:
35. On tympanometry, a Type Ad (very high compliance) curve is most characteristically associated with which middle ear condition?
36. In auditory brainstem response (ABR) testing, Wave V is generated at which anatomical level and what is its clinical significance?
37. During ABR (auditory brainstem response) testing, Wave V latency is prolonged bilaterally with normal Wave I. This pattern suggests pathology at the level of:
38. In a patient with feigned (non-organic) hearing loss, which tuning fork test will show paradoxical results (e.g., apparent better bone conduction than air conduction in otherwise normal ears)?
39. On impedance audiometry, a Type B tympanogram (flat, no peak) with very low static compliance and large ear canal volume most likely indicates:
40. On pure tone audiometry, a patient shows air-conduction thresholds of 50 dB HL at all frequencies with bone-conduction thresholds of 10 dB HL. The tympanogram is type As (shallow). Which diagnosis is most consistent?
41. Auditory Brainstem Response (ABR) wave V latency is prolonged bilaterally with inter-wave I–V interval increased. Which site of lesion does this most strongly suggest?
42. Otoacoustic emissions (OAEs) are absent in a newborn hearing screen. Which conclusion is most appropriate?
43. On pure-tone audiometry, a patient has air conduction thresholds of 50 dB at 500 Hz and 55 dB at 1000 Hz, with bone conduction thresholds of 5 dB at both frequencies. Acoustic immittance testing shows a type B tympanogram. The most likely diagnosis is:
44. In an auditory brainstem response (ABR) recording, wave V threshold in a cooperative adult is the gold standard for threshold estimation in the clinical setting. The neural generator for wave V of ABR is:
45. In auditory brainstem response (ABR) testing, Wave V has the largest amplitude and longest latency. In a child with auditory neuropathy spectrum disorder (ANSD), the ABR typically shows:
46. Pure tone audiometry shows an air-bone gap of 35 dB at 250 Hz, 2000 Hz, and 4000 Hz bilaterally. Tympanometry shows a type As curve (reduced compliance, normal peak pressure). Stapedial reflexes are absent. What is the most likely diagnosis?
47. The Stenger test is used to detect which condition, and what principle does it use?
48. Auditory brainstem response (ABR) wave I, III, and V originate from which anatomical sites respectively?
49. A 25-year-old has Rinne test negative (BC>AC) in the right ear, and Weber lateralizes to the right. These findings are consistent with:
50. An otoacoustic emission (OAE) test is performed on a 3-day-old neonate and is absent bilaterally. What does absent OAE indicate and what is the NEXT appropriate investigation?
51. On pure tone audiometry, a patient shows an air-bone gap (bone conduction normal, air conduction reduced) with a characteristic 'V-shaped' dip at 2000 Hz. This pattern is most associated with:
52. In auditory brainstem response (ABR) testing, Wave V originates from which neural structure?
53. A 40-year-old male shows the following on impedance audiometry: tympanogram type B (flat) with normal ear canal volume. This is most consistent with:
54. On pure tone audiometry, a patient shows normal air conduction thresholds but elevated bone conduction thresholds with absent acoustic reflexes bilaterally. The most likely diagnosis is:
55. Auditory Brainstem Response (ABR) Wave V represents neural activity generated at the level of:
56. In a patient with unilateral conductive hearing loss, the Stenger test is used to:
57. On Rinne's test with a 512 Hz tuning fork, BC > AC is noted on the right ear. Weber's test lateralises to the right. The most likely diagnosis is:
58. On pure-tone audiometry, a patient has air-bone gap of 35 dB at all frequencies. Tympanometry shows a flat (Type B) tympanogram with normal ear canal volume. The most likely diagnosis is:
59. Auditory Brainstem Response (ABR) Wave V corresponds to which anatomical structure?
60. A patient presents with bilateral sensorineural hearing loss. Audiometry shows a characteristic 'cookie-bite' (mid-frequency dip) pattern. The most likely aetiology is:
61. Speech audiometry shows 100% word recognition score (WRS) at 40 dB above speech reception threshold (SRT). A rollover phenomenon — declining WRS at higher intensities — is observed. This pattern is most suggestive of:
62. In the Stenger test, a 1 kHz tone is presented 10 dB above the claimed threshold in the 'deaf' ear and simultaneously 10 dB below the true threshold in the good ear. A patient with functional (non-organic) unilateral deafness will:
63. Auditory Brainstem Response (ABR) Wave V corresponds to action potentials generated at which anatomical level?
64. A 512 Hz tuning fork is placed on the mastoid process. The patient cannot hear it. The fork is then held in the air next to the ear and the patient still cannot hear it. Rinne's test is therefore:
65. Otoacoustic Emissions (OAEs) are generated by which component of the cochlea?
66. In a patient with otosclerosis, which tuning fork test pattern is expected?
67. The Stenger test is used to detect:
68. In impedance audiometry, acoustic reflex decay (ARD) test is performed at 500 Hz and 1000 Hz. A positive ARD test (decay >50% within 10 seconds at 10 dB above reflex threshold) is most consistent with:
69. In the SISI (Short Increment Sensitivity Index) test, a score above 70% indicates:
70. In auditory brainstem response (ABR), the wave V latency is prolonged by 0.5 ms relative to the contralateral ear. Which parameter, calculated from absolute latencies, is most clinically useful in detecting retrocochlear pathology?