IHS Hearing Loss Assessment 2 — Questions and Answers
Question 1: A patient reports hearing people speak but struggling to understand words, especially in noise. This pattern most likely indicates:
- Conductive hearing loss
- Sensorineural hearing loss affecting high frequencies (Correct answer)
- Mixed hearing loss
- Central auditory processing disorder
Correct answer: Sensorineural hearing loss affecting high frequencies
High-frequency sensorineural hearing loss reduces clarity and speech discrimination, especially in noisy environments, while overall loudness perception may be relatively preserved.
Question 2: Which Weber test result would you expect in a patient with a unilateral conductive hearing loss in the right ear?
- Lateralizes to the left ear
- Lateralizes to the right ear (Correct answer)
- Perceived equally in both ears
- Cannot be determined without audiogram
Correct answer: Lateralizes to the right ear
In conductive hearing loss, the Weber test lateralizes to the affected ear because bone conduction is enhanced when air-conducted background noise is blocked.
Question 3: What is the primary purpose of speech discrimination (word recognition) testing in a hearing assessment?
- To determine the degree of hearing loss in dB HL
- To evaluate the auditory system's ability to recognize speech at suprathreshold levels (Correct answer)
- To identify the type of hearing loss
- To measure middle ear pressure
Correct answer: To evaluate the auditory system's ability to recognize speech at suprathreshold levels
Word recognition testing assesses how clearly a patient understands speech once it is loud enough to hear, revealing auditory clarity beyond simple threshold detection.
Question 4: A tympanogram showing a flat (Type B) curve with normal ear canal volume most likely indicates:
- Eustachian tube dysfunction
- Fluid in the middle ear (otitis media with effusion) (Correct answer)
- Tympanic membrane perforation
- Ossicular chain discontinuity
Correct answer: Fluid in the middle ear (otitis media with effusion)
A Type B tympanogram with normal ear canal volume is the classic finding for middle ear effusion, where fluid dampens tympanic membrane mobility.
Question 5: During pure tone testing, a patient responds to a 1000 Hz tone at 40 dB HL via air conduction and at 15 dB HL via bone conduction. The air-bone gap indicates:
- Sensorineural hearing loss
- Conductive hearing loss (Correct answer)
- Mixed hearing loss
- Normal hearing
Correct answer: Conductive hearing loss
An air-bone gap (air conduction threshold significantly poorer than bone conduction threshold) indicates a conductive component to the hearing loss.
Question 6: Which condition is associated with low-frequency sensorineural hearing loss, aural fullness, tinnitus, and episodic vertigo?
- Noise-induced hearing loss
- Presbycusis
- Ménière's disease (Correct answer)
- Acoustic neuroma
Correct answer: Ménière's disease
Ménière's disease classically presents with the triad of fluctuating low-frequency SNHL, episodic vertigo, and tinnitus, often accompanied by aural fullness.
Question 7: What does a rollover phenomenon in word recognition testing suggest?
- Conductive hearing loss
- Functional (non-organic) hearing loss
- Retrocochlear pathology (Correct answer)
- Noise-induced hearing loss
Correct answer: Retrocochlear pathology
Rollover, where word recognition scores decrease as presentation level increases beyond optimal, is a hallmark of retrocochlear pathology such as an acoustic neuroma.
IHS Hearing Loss Assessment 2
A patient reports hearing people speak but struggling to understand words, especially in noise.
This pattern most likely indicates: