ENT MCQ SET 1 ON FB Drpulkitagarwal's DNB ENT & OSCE

MCQ1

Best response: D

The reference for the intensity level used in plotting pure- tone and speech thresholds on the
audiogram is the expected hearing level (HL) for young normally hearing persons. Thus, 0 dB HL
is not the absence of sound but, rather, the intensity level just heard by a typically normal ear.
Other intensity levels used in physical or audiologic measurements include dB sound pressure
level (SPL) and dB sensation level (SL). The unit dBA is used in measurements of environmental
noise levels. Hz refers to stimulus frequency, not intensity.

MCQ2

Best response: E

The masking dilemma occurs when enough masking to eliminate a response owing to stimulation
of the non-test ear exceeds interaural attenuation and “crosses over” to the test ear, producing an
error in threshold measurement. The other terms (pure-tone average, loudness recruitment,
acoustic reflex, rollover) refer to other audiologic phenomena or measures.

MCQ3

Best response: B

All of the choices except the masking level difference (MLD) are well-established components of
the immittance (impedance) test battery. The MLD is a measure of hearing threshold for pure-tone
or speech signals in the presence of noise that is either in or out of phase with the signal. Masking
is less effective when it is out of phase with the signal. This is referred to as release from masking.
The MLD is mediated primarily at the brainstem level where interactions of input from each ear
first occur.

MCQ4

Best response: A

The work of Aage Moller in the early 1980s delineated our understanding of the generators of the
auditory brainstem response (ABR). The wave V component arises from the lateral lemniscus
fibers just caudal to their arrival at the inferior colliculus. The inferior colliculus is anatomically
complex, consisting of numerous regions and neuron types, and is there- fore not capable of
generating an ABR component. The ABR wave III receives contributions from the superior olivary
complex. The cochlea is distal to, and the thalamus proximal to, the ABR anatomy.

MCQ5
Best response: D

It is now clear that energy related to outer hair cell movement following the presentation of sound
to the ear is propagated outward from the basilar membrane through the ossicular chain and the
tympanic membrane to the ear canal, where it is measured as otoacoustic emissions (OAEs).
Activation of the efferent system typically suppresses outer hair cell motility and thus OAEs.
Traveling waves along the basilar membrane play an important role in activating outer hair cells.
The eighth cranial nerve does not influence OAE production.

MCQ6

Best response: D

All of the choices except for “decreased word identification scores over time” are well-documented
benefits of binaural amplification. In fact, a patient who has been fit monaurally may experience
auditory deprivation in the unaided ear, result- ing in a decline in word identification scores over
time relative to the aided ear.

MCQ7

Best response: B

Real-ear measures, self-assessment inventories, electro- acoustic analysis, and functional gain
measures are all routine procedures used by audiologists to assess hearing aid function and benefit.
Manufacturer specifications merely state what that particular model of hearing aid is designed to
do. Unfortunately, some hearing aids may not necessarily be performing within design
specifications; therefore, it is important to assess its performance.

MCQ8

Best response: B

According to federal law, a customer may return a hearing aid for refund during the 30-day trial
period. However, some hearing aid companies extend the trial period without penalty.

MCQ9

Best response: C

The most popular hearing aid style for children is a behind- the-ear (BTE) hearing aid. This style
offers the most flexibility in terms of hearing aid technology, frequency response characteristics,
and use with assistive listening devices. Additionally, when a new earmold is being made, the child
is not left without a hearing aid to use as he/she would be with the other hearing aid styles. The
other hearing aid styles, ITE, ITC, and CIC, are more limiting. A digital hearing aid is not a type
of hearing aid style but rather a type of hearing aid technology.
MCQ10

Best response: A

Total communication is a communication modality that involves one or more modes of

communication at any given time in the child’s educational program, whether it is man- ual, oral,
auditory only, or written. American Sign Language (ASL) is the common language of the Deaf
community. Cued speech employs eight hand shapes placed at four dif- ferent locations near the
mouth. Auditory oral emphasizes the use of amplified residual hearing and spoken language, using
speechreading cues as a supplement. Signed Exact English uses much of the same vocabulary as
ASL but includes English grammatical features and syntax.