Audiology Practice Quiz

Explanation
Impedance is a measure of the opposition that a circuit presents to the flow of alternating current. It is composed of three components: resistance, which is the opposition to the flow of direct current; mass, which represents the inertia of a system and opposes changes in motion; and stiffness, which is the resistance of an object to deformation. Therefore, all of the given options (mass, stiffness, and resistance) are components of impedance.

Explanation
Normal static admittance refers to the range of values that are considered acceptable for measuring the flow of electricity in a system. A static admittance below 0.3 or above 1.6 indicates an abnormal or faulty condition in the system. Therefore, a normal static admittance would fall within the range of 0.3-1.6.

Explanation
Impedance is a measure of how much a system opposes or resists the flow of energy. It is a property that determines how much resistance, capacitance, and inductance a circuit has. A higher impedance means that the system resists the flow of energy more, while a lower impedance means that the system allows for easier energy flow. Therefore, the statement that "Impedance is the degree to which a system resists the flow of energy" is true.

Explanation
An ECV below 0.3 refers to an Eustachian tube dysfunction, which is not consistent with otosclerosis. Too little impedance also does not align with otosclerosis. Normal SA (stapedial reflex) is also not indicative of otosclerosis. However, a SA below 0.3, indicating a reduced stapedial reflex, is consistent with otosclerosis.

Explanation
Ossicular discontinuity refers to a condition where there is a disruption in the bones of the middle ear, known as ossicles. The MEP (Middle Ear Pressure) is a measure of the pressure within the middle ear. In cases of ossicular discontinuity, the MEP is usually less negative or closer to zero, rather than being more negative than -100. Therefore, the statement that "Ossicular discontinuity has MEP more negative than -100" is false.

Explanation
Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, which can lead to hearing loss. MEP (Maximum Ear-canal Pressure) is a measure of the pressure in the ear canal. In otosclerosis, the bone growth can cause a decrease in the compliance of the middle ear, leading to higher MEP values. Therefore, it is true that otosclerosis has MEP more positive than -100.

Explanation
The correct answer is "symmetrical and over 70%". This means that cochlear pathology, which refers to any disease or abnormality affecting the cochlea (part of the inner ear responsible for hearing), is characterized by symmetrical damage in both ears and the extent of damage is greater than 70%. This suggests that the pathology affects both ears equally and is severe.

Explanation
Retrocochlear pathology refers to any disorder or pathology that affects the neural structures beyond the cochlea, specifically the 8th cranial nerve. This includes conditions such as vestibular schwannoma, which is a tumor that affects the nerve responsible for transmitting auditory and balance information from the inner ear to the brain. Therefore, the term "neural, 8th nerve" accurately describes retrocochlear pathology.

Explanation
The given answer "none" indicates that there is no relationship or association between the given terms (perforation, impacted cerumen, otosclerosis) and the abbreviations (SA, MEP, ECV). It implies that none of the abbreviations correspond to or are related to any of the mentioned terms.

Explanation
The correct answer is SRS. SRS stands for Speech Recognition Threshold, which is a test that uses PB words (phonemically balanced). This test is used to determine the lowest level of speech that a person can understand. The use of PB words ensures that the test is standardized and consistent across different individuals. Therefore, SRS is the test that uses PB words.

Explanation
The Speech Reception Threshold (SRT) test is used to corroborate pure tone findings. It measures the lowest level at which a person can understand speech. This test helps determine the individual's ability to hear and comprehend speech in a quiet environment. By comparing the results of the SRT test with the pure tone findings, clinicians can gain a more comprehensive understanding of the person's overall hearing abilities.

Explanation
The given statement suggests that an honest person will not raise their hand during the Stenger test. However, this statement is incorrect. In the Stenger test, a person is asked to raise their hand if they can hear a sound, even if they are pretending or faking it. Therefore, an honest person would raise their hand if they genuinely hear the sound, while a dishonest person may choose to fake it by not raising their hand. Hence, the correct answer is False.

Explanation
The ABR test, or Auditory Brainstem Response test, is used to assess the function of the auditory nerve and brainstem. Retrocochlear pathology refers to any abnormality or damage beyond the cochlea, such as tumors or lesions affecting the auditory nerve or brainstem. In cases of retrocochlear pathology, the ABR test typically shows abnormal waves, indicating a disruption in the normal auditory pathway. Therefore, the statement "For retrocochlear pathology, the ABR test shows abnormal waves" is true.

Explanation
This question is asking for the characteristics or indicators of impacted cerumen. The correct answers are SA is no response, ECV is under 0.3, and MEP is no response. These indicators suggest that there is no response in the SA (Speech Awareness) test, the ECV (Ear Canal Volume) is under 0.3, and the MEP (Maximum Eustachian Tube Pressure) is no response. These findings are consistent with the presence of impacted cerumen.

Explanation
The correct answer for this question is Type As and Normal ECV. Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, leading to hearing loss. Type As refers to a specific pattern of tympanometry results, indicating reduced compliance of the middle ear system. Normal ECV refers to normal ear canal volume, which can help differentiate otosclerosis from other causes of hearing loss. The other options, SA over 1.6 and too little impedance, are not applicable to otosclerosis.

Explanation
Retrocochlear pathologies refer to conditions that affect the neural pathways beyond the cochlea, such as the auditory nerve or the brainstem. PIPB: rollover is a characteristic finding in retrocochlear pathologies where the speech recognition score (SRS) decreases significantly as the intensity of the speech signal increases. SRS under 70% indicates a significant impairment in understanding speech, which can be seen in retrocochlear pathologies. ABR abnormal waves can be observed in retrocochlear pathologies due to the involvement of the auditory nerve or brainstem. Over 50% decay refers to a significant reduction in the amplitude of the auditory brainstem response over time, which can also be seen in retrocochlear pathologies.

Explanation
Impedance is a measure of opposition to the flow of electric current in a circuit. When there is too much impedance, it indicates that the circuit is resisting the flow of current, making it stiff or difficult for the current to pass through. Therefore, the statement "Too much impedance means too stiff" is true.

Explanation
During Auditory Brainstem Response Testing (ART), a probe tone is used to stimulate the auditory system and measure the response. The correct answer of 220 Hz suggests that during the testing, a tone of 220 Hz was used as the probe tone. This specific frequency was chosen to assess the functioning of the auditory system and gather information about the neural responses to sound stimuli.

Explanation
ART is repeated at frequencies of 500, 1k, and 2k.

Explanation
The question is asking about the starting point for the SRT (Speech Reception Threshold) test. It states that the test should be started at 20 dBSL (decibels sensation level). The PTA (Pure Tone Average) is given as 50. The PTA is the average hearing threshold level at specific frequencies. Since the PTA is higher than the initial starting point of 20 dBSL, the test should be started at a higher level. Therefore, the correct answer is 70 dBSL.

Explanation
The correct answer is "neural." In the context of the question, SRS refers to a scoring system, and the question is asking who scores the lowest on SRS. Among the given options, "neural" is the most likely to score the lowest because it pertains to the nerves or nervous system, which may be associated with lower scores on the SRS. The other options (cochlear, sensory, conductive) are related to different aspects of hearing and are less likely to be associated with lower scores on the SRS.

Explanation
Noise-induced hearing loss is characterized by damage to the hair cells in the inner ear due to exposure to loud noises. The hair cells responsible for detecting high-frequency sounds, such as those at 4k, are particularly vulnerable to damage. Therefore, individuals with noise-induced hearing loss often experience the most significant hearing loss at this frequency. Vestibular schwannoma, Meniere's disease, and ototoxicity can also cause hearing loss, but they may not specifically result in the worst hearing loss at 4k.

Explanation
Vestibular schwannoma is a type of tumor that develops on the vestibular nerve, which is responsible for transmitting signals from the inner ear to the brain. This condition can affect one or both sides of the head, but it is always asymmetric, meaning that the tumor may grow at a different rate or size on each side. This asymmetry is a distinguishing characteristic of vestibular schwannoma, setting it apart from other pathologies listed.

Explanation
When there is a lack of agreement between the Pure Tone Audiometry (PTA) test results and the Speech Reception Threshold (SRT) test results, it can indicate that the patient is pretending to have a hearing loss. PTA measures the softest sounds a person can hear across different frequencies, while SRT determines the level at which a person can understand speech. If the PTA results show a significant hearing loss, but the SRT results indicate normal speech understanding, it suggests that the patient may be faking the hearing loss. This inconsistency between the two tests raises suspicions about the patient's credibility.

Explanation
The statement is false because the patient does not need to be awake when performing Auditory Brainstem Response (ABR) test. ABR is a diagnostic test that measures the electrical activity in the auditory pathway of the brain in response to sound stimuli. It is commonly used to assess hearing in infants, children, and individuals who are unable to provide reliable behavioral responses. ABR is typically performed while the patient is sedated or asleep to obtain accurate results.

Explanation
The signs of vestibular schwannoma include rollover, bilateral asymmetry, and a difference of over 70 dB between AC and ART. Rollover refers to a decrease in speech understanding at higher intensities. Bilateral asymmetry means that there is a difference in hearing between the two ears. A difference of over 70 dB between AC and ART indicates a significant hearing loss.

Explanation
SA (Stapedius Acoustic Reflex) is 1.8, which is within the normal range. MEP (Middle Ear Pressure) is more positive than -100, which is also within the normal range. ECV (External Canal Volume) is 2.4, which is within the normal range.
Given that all the values are within the normal range, none of the listed conditions (Otosclerosis, Ossicular chain discontinuity, Otitis media) would be the correct answer.

Explanation
Pure tone testing and Speech Audiometry Testing (SAT) are distinct audiometric evaluations. In pure tone testing, individuals respond to pure tone sounds at specific frequencies to determine their hearing thresholds, while SAT employs spoken words or sentences to assess a person's ability to hear and comprehend speech. Pure tone testing focuses on quantifying hearing sensitivity across different frequencies, while SAT assesses speech recognition and understanding, making it particularly relevant for evaluating a person's ability to hear and interpret spoken language. Thus, while both tests assess aspects of hearing, they use different stimuli and serve distinct purposes in audiological evaluation.

Explanation
Reflex Decay is a specific test that helps differentiate between cochlear and retrocochlear issues by revealing decay in the acoustic reflex indicative of retrocochlear problems. The other tests provided either assess different aspects of hearing or are not directly related to pinpointing cochlear vs. retrocochlear distinctions.

Explanation
One of the hallmark signs of noise-induced hearing loss is a "notch" at 4000 Hz in the audiogram, where hearing sensitivity is significantly reduced. This notch typically occurs due to damage in the cochlear regions that are sensitive to high frequencies, often exacerbated by noise exposure. Auditory Brainstem Response (ABR) testing in cases of noise-induced hearing loss typically shows normal waveforms, indicating that the auditory nerve and brainstem pathways (which ABR assesses) are functioning normally. NIHL primarily affects the inner hair cells in the cochlea rather than the neural pathways; hence, ABR results are usually normal.