IHS Auditory Assessment 2 — Questions and Answers
Question 1: Which masking noise type is most appropriate when masking for pure-tone air conduction testing?
- White noise
- Narrow-band noise (Correct answer)
- Speech noise
- Pink noise
Correct answer: Narrow-band noise
Narrow-band noise centered at the test frequency is the preferred masking stimulus for pure-tone air conduction testing because it is most effective at masking the specific test tone.
Question 2: A patient's speech reception threshold (SRT) should agree within how many decibels of the pure-tone average (PTA)?
- 5 dB
- 10 dB (Correct answer)
- 15 dB
- 20 dB
Correct answer: 10 dB
The SRT should agree within ±10 dB of the pure-tone average for the results to be considered valid and consistent.
Question 3: When performing tympanometry, a Type B tympanogram with a large ear canal volume most likely indicates:
- Otosclerosis
- Eustachian tube dysfunction
- Tympanic membrane perforation (Correct answer)
- Fluid in the middle ear
Correct answer: Tympanic membrane perforation
A Type B tympanogram with abnormally large equivalent ear canal volume (ECV) is characteristic of a tympanic membrane perforation or patent pressure equalization tube.
Question 4: The occlusion effect is most significant at which frequencies?
- High frequencies (2000–4000 Hz)
- Low frequencies (250–500 Hz) (Correct answer)
- Mid frequencies (1000 Hz)
- Ultra-high frequencies above 6000 Hz
Correct answer: Low frequencies (250–500 Hz)
The occlusion effect predominantly enhances bone-conduction thresholds at low frequencies (250–500 Hz) by increasing the sound pressure in the occluded ear canal.
Question 5: Which test is used to assess the integrity of the efferent auditory pathway?
- Auditory brainstem response (ABR)
- Contralateral suppression of OAEs (Correct answer)
- Acoustic reflex decay
- Bekesy audiometry
Correct answer: Contralateral suppression of OAEs
Contralateral suppression of otoacoustic emissions (OAEs) tests the medial olivocochlear bundle, which is part of the efferent auditory pathway.
Question 6: A word recognition score (WRS) of 0–20% at suprathreshold levels most likely indicates:
- Conductive hearing loss
- Mild sensorineural hearing loss
- Retrocochlear pathology (Correct answer)
- Normal hearing
Correct answer: Retrocochlear pathology
Extremely poor word recognition scores (0–20%) at comfortable listening levels are a classic indicator of retrocochlear pathology, such as an acoustic neuroma.
Question 7: During immittance testing, the probe tone frequency used in standard clinical tympanometry for adults is:
- 226 Hz (Correct answer)
- 678 Hz
- 1000 Hz
- 2000 Hz
Correct answer: 226 Hz
A 226 Hz probe tone is the standard frequency used for adult tympanometry because it is sensitive to middle ear pressure changes in the adult ear.
IHS Auditory Assessment 2
Which masking noise type is most appropriate when masking for pure-tone air conduction testing?