Master Quiz

Pediatric Audiology – MCQs (50 Questions)

1. At what gestational week does the human cochlea reach adult size?
A) 12 weeks
B) 20 weeks
C) 25 weeks ✅
D) 32 weeks

2. Which structure in the inner ear is primarily responsible for balance in infants?
A) Cochlea
B) Semicircular canals ✅
C) Ossicles
D) Eustachian tube

3. The first step in a newborn hearing screening protocol is:
A) Pure-tone audiometry
B) Otoacoustic emissions (OAE) ✅
C) Behavioral observation audiometry
D) Auditory brainstem response (ABR)

4. Which of the following is a risk factor for congenital hearing loss?
A) Prematurity ✅
B) High birth weight
C) Vaginal delivery without complications
D) Exclusive breastfeeding

5. Behavioral Observation Audiometry (BOA) is typically used for children of what age?
A) 0–6 months ✅
B) 6–12 months
C) 1–2 years
D) 3–5 years

6. Visual Reinforcement Audiometry (VRA) is appropriate for children aged:
A) 0–6 months
B) 6–24 months ✅
C) 2–4 years
D) 5–7 years

7. Conditioned Play Audiometry (CPA) is suitable for children:
A) 6–12 months
B) 1–2 years
C) 2–5 years ✅
D) 6–8 years

8. Which of the following is a frequency-specific test for infants?
A) Tympanometry
B) ABR with tone bursts ✅
C) BOA
D) VRA

9. What type of tympanogram is most common in children with otitis media with effusion?
A) Type A
B) Type B ✅
C) Type C
D) Type As

10. The most common cause of conductive hearing loss in children is:
A) Congenital sensorineural loss
B) Otitis media with effusion ✅
C) Meniere’s disease
D) Acoustic trauma

11. A newborn fails OAE screening but passes ABR. What is the likely cause?
A) Sensorineural hearing loss
B) Middle ear effusion ✅
C) Auditory neuropathy
D) Normal variation

12. Which audiologic test evaluates neural integrity from the cochlea to the brainstem?
A) OAE
B) ABR ✅
C) Tympanometry
D) Pure-tone audiometry

13. Which congenital infection is associated with sensorineural hearing loss?
A) Cytomegalovirus (CMV) ✅
B) Strep throat
C) Varicella
D) RSV

14. For high-risk infants, hearing screening should be performed:
A) Only at birth
B) Within 3 months of age ✅
C) At 12 months
D) At school entry

15. In BOA, which behavior indicates detection of a sound?
A) Head turn
B) Eye widening or startle response ✅
C) Vocalization
D) Crawling

16. Which audiology test is non-invasive and objective for detecting outer hair cell function?
A) ABR
B) OAE ✅
C) Pure-tone audiometry
D) CPA

17. At what age can a child reliably participate in pure-tone audiometry?
A) 6 months
B) 12 months
C) 3–5 years ✅
D) 7–8 years

18. What is the typical interpeak latency used in ABR analysis?
A) I–III and I–V ✅
B) II–IV
C) III–V
D) V–VI

19. Auditory Neuropathy Spectrum Disorder (ANSD) is characterized by:
A) Normal OAE, abnormal ABR ✅
B) Abnormal OAE, normal ABR
C) Both OAE and ABR normal
D) Both OAE and ABR abnormal

20. Which of the following is a high-frequency hearing loss pattern often seen in children with congenital CMV?
A) Flat loss
B) Sloping loss ✅
C) Rising loss
D) Notched loss

21. The first line of treatment for chronic otitis media with effusion is:
A) Hearing aids
B) Observation ✅
C) Cochlear implant
D) Tympanoplasty

22. Which bone conduction threshold indicates mild hearing loss in a 4-year-old?
A) 10 dB HL
B) 25 dB HL ✅
C) 50 dB HL
D) 75 dB HL

23. When fitting hearing aids for children, the DSL v5.0 prescription is often used to:
A) Ensure maximum comfort
B) Amplify only low frequencies
C) Provide frequency-specific gain for speech development ✅
D) Reduce background noise only

24. Cochlear implants are most effective when implanted:
A) Before 6 months
B) Between 12–18 months ✅
C) After 3 years
D) After school age

25. Which is a red flag requiring immediate audiology referral?
A) Mild ear wax
B) Parental concern about speech delay ✅
C) Mild temporary threshold shift
D) Routine vaccination

26. Tympanometry in infants <6 months often uses which probe tone?
A) 226 Hz
B) 1000 Hz ✅
C) 500 Hz
D) 2000 Hz

27. Which of the following does not affect speech and language outcomes in children with hearing loss?
A) Age at identification
B) Consistency of hearing aid use
C) Eye color ✅
D) Quality of early intervention

28. The most common genetic cause of congenital hearing loss is:
A) Connexin 26 mutation ✅
B) GJB2 deletion
C) CFTR mutation
D) Pendred syndrome

29. Which behavioral audiometry method uses a toy or visual reinforcer?
A) CPA
B) VRA ✅
C) BOA
D) ABR

30. OAE responses are typically absent in:
A) Normal hearing
B) Conductive hearing loss ✅
C) Mild sensorineural loss
D) Central auditory processing disorder

31. When performing ABR, click stimuli primarily test which frequencies?
A) Low frequencies
B) Mid to high frequencies ✅
C) Low and mid frequencies
D) All frequencies equally

32. Which type of hearing loss is often progressive in children with CMV?
A) Conductive
B) Sensorineural ✅
C) Mixed
D) Central

33. Which of the following is used for hearing screening in NICU infants?
A) Pure-tone audiometry
B) OAE and ABR ✅
C) VRA
D) CPA

34. Tympanostomy tubes are most commonly used for:
A) Sensorineural loss
B) Conductive loss due to fluid ✅
C) Cochlear implantation
D) ANSD

35. The critical period for language development in children is approximately:
A) 0–3 months
B) 0–3 years ✅
C) 3–6 years
D) 6–12 years

36. Which audiology test is least affected by the child’s attention?
A) CPA
B) BOA
C) ABR ✅
D) VRA

37. What is the recommended follow-up interval for high-risk infants who pass initial hearing screening?
A) No follow-up needed
B) Every 3–6 months ✅
C) At school entry
D) Only if symptoms appear

38. Mixed hearing loss refers to:
A) Conductive only
B) Sensorineural only
C) Both conductive and sensorineural ✅
D) Central only

39. Which of the following may affect ABR results in infants?
A) Ear canal debris ✅
B) Hair color
C) Height
D) Eye color

40. Which audiology procedure is most suitable for children with developmental delays?
A) CPA
B) BOA ✅
C) VRA
D) Pure-tone audiometry

41. Which cranial nerve is tested indirectly during ABR?
A) CN V
B) CN VIII ✅
C) CN VII
D) CN IX

42. Speech awareness thresholds (SAT) are typically higher or lower than pure-tone thresholds?
A) Higher ✅
B) Lower
C) Equal
D) Variable

43. A type C tympanogram indicates:
A) Normal middle ear
B) Negative middle ear pressure ✅
C) Fluid in the middle ear
D) Ossicular discontinuity

44. Which hearing aid feature is particularly important for children in classrooms?
A) T-coil and directional microphones ✅
B) Volume lock only
C) Color choice
D) Battery type

45. Auditory brainstem response is measured in:
A) Millivolts
B) Microvolts ✅
C) Hertz
D) Decibels

46. Which of the following does not interfere with newborn OAE screening?
A) Vernix in the ear canal
B) Ambient noise
C) Ear canal debris
D) Infant eye color ✅

47. Which is the most sensitive test for detecting auditory neuropathy?
A) OAE alone
B) ABR alone ✅
C) Tympanometry
D) VRA

48. Children with bilateral severe hearing loss benefit most from:
A) Unilateral hearing aid
B) Bilateral hearing aids or cochlear implants ✅
C) Observation only
D) Sign language only

49. Which of the following cannot be evaluated by OAEs?
A) Outer hair cell function
B) Middle ear pathology ✅
C) Cochlear function
D) Early hearing loss detection

50. Which factor most influences success in pediatric cochlear implantation?
A) Early implantation ✅
B) Hair color
C) Eye color
D) Weight

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Pediatric Audiology – True/False (15 Questions)

1. BOA is reliable for children over 2 years of age.
Answer: False ✅

2. Tympanometry can detect middle ear fluid.
Answer: True ✅

3. OAE testing requires active cooperation from the child.
Answer: False ✅

4. Hearing aids for children should have tamper-resistant battery doors.
Answer: True ✅

5. VRA can be used for children as young as 6 months.
Answer: True ✅

6. Cochlear implants are not effective if implanted before age 2.
Answer: False ✅

7. Mixed hearing loss involves both conductive and sensorineural components.
Answer: True ✅

8. Auditory neuropathy is characterized by abnormal OAE and normal ABR.
Answer: False ✅

9. CMV infection can cause progressive hearing loss in children.
Answer: True ✅

10. CPA is suitable for children around 3–5 years old.
Answer: True ✅

11. Ear canal debris does not affect ABR results.
Answer: False ✅

12. Type B tympanogram usually indicates normal middle ear function.
Answer: False ✅

13. The critical period for language development is roughly 0–3 years.
Answer: True ✅

14. Induction loop systems are used in pediatric audiology clinics for screening.
Answer: False ✅

15. ABR is measured in microvolts.
Answer: True ✅

Adult Hearing & Presbycusis – MCQs (50 Questions)

1. Presbycusis refers to:
A) Sudden hearing loss
B) Age-related hearing loss ✅
C) Noise-induced hearing loss
D) Conductive hearing loss

2. Which part of the cochlea is first affected in presbycusis?
A) Apex
B) Base ✅
C) Middle
D) Entire cochlea equally

3. Which type of hearing loss is most common in presbycusis?
A) Conductive
B) Sensorineural ✅
C) Mixed
D) Central auditory

4. Typical audiogram of presbycusis shows:
A) Low-frequency loss
B) High-frequency sloping loss ✅
C) Flat loss
D) Notched loss

5. The most common complaint of adults with presbycusis is:
A) Vertigo
B) Difficulty understanding speech in noise ✅
C) Ear pain
D) Tinnitus only

6. Which of the following is a risk factor for age-related hearing loss?
A) Hypertension ✅
B) Eye color
C) Blood type
D) Handedness

7. Noise-induced hearing loss often presents as:
A) Flat loss
B) Notched loss at 3–6 kHz ✅
C) Low-frequency loss
D) High-frequency sloping loss

8. Which of the following is a preventive measure for noise-induced hearing loss?
A) Hearing aids
B) Earplugs and earmuffs ✅
C) Cochlear implants
D) Tinnitus therapy

9. Sudden sensorineural hearing loss (SSNHL) is defined as:
A) Loss over years
B) ≥30 dB loss over at least three consecutive frequencies in <72 hours ✅
C) Temporary threshold shift
D) Conductive hearing loss

10. Which is the first-line treatment for SSNHL?
A) Hearing aids
B) Corticosteroids ✅
C) Cochlear implants
D) Surgery

11. Tinnitus is most commonly associated with:
A) Conductive hearing loss
B) Sensorineural hearing loss ✅
C) Otitis media
D) Cholesteatoma

12. Which audiologic test evaluates auditory thresholds across frequencies in adults?
A) ABR
B) OAE
C) Pure-tone audiometry ✅
D) Tympanometry

13. In adults, speech recognition in noise is usually measured using:
A) PTA
B) SRT
C) QuickSIN ✅
D) OAE

14. The typical hearing loss configuration in noise-induced hearing loss is:
A) Flat
B) High-frequency notched at 4 kHz ✅
C) Low-frequency sloping
D) Mid-frequency loss

15. Which of the following can worsen presbycusis?
A) Cardiovascular disease ✅
B) Handedness
C) Eye color
D) Height

16. Which intervention can improve communication for adults with hearing loss?
A) Lip-reading training ✅
B) Surgery for mild presbycusis
C) Diet change
D) Sleep adjustment

17. Which hearing aid feature helps in noisy environments?
A) Directional microphones ✅
B) Telecoil only
C) Volume control only
D) Rechargeable battery

18. Sudden hearing loss requires immediate referral to ENT/audiology because:
A) It may spontaneously recover
B) Early steroid therapy improves prognosis ✅
C) Hearing aids are immediately indicated
D) Surgery is always needed

19. A patient with tinnitus and high-frequency hearing loss is most likely experiencing:
A) Presbycusis ✅
B) Otitis externa
C) Cholesteatoma
D) Meniere’s disease

20. Meniere’s disease is characterized by:
A) Fluctuating low-frequency hearing loss, vertigo, and tinnitus ✅
B) Permanent high-frequency loss
C) Conductive hearing loss only
D) Noise-induced notch

21. Which audiologic test measures outer hair cell function in adults?
A) PTA
B) OAE ✅
C) ABR
D) Tympanometry

22. Which type of tympanogram is expected in a patient with middle ear effusion?
A) Type A
B) Type B ✅
C) Type C
D) Type As

23. Sudden hearing loss can be associated with:
A) Viral infection ✅
B) Chronic noise exposure
C) Age-related hearing loss
D) All of the above

24. Presbycusis usually affects:
A) Men more than women ✅
B) Women more than men
C) Equal prevalence
D) Only elderly over 80

25. Which is not a cause of adult hearing loss?
A) Ototoxic drugs
B) Noise exposure
C) Cardiovascular disease
D) Eye color ✅

26. The speech recognition threshold (SRT) measures:
A) Ability to detect sound
B) Softest speech that can be recognized 50% of the time ✅
C) Maximum loudness tolerated
D) Auditory brainstem function

27. In adults, tinnitus management may include:
A) Sound therapy ✅
B) Hearing aid amplification
C) Counseling
D) All of the above ✅

28. Which audiologic test is objective and not influenced by attention?
A) Pure-tone audiometry
B) ABR ✅
C) Speech audiometry
D) CPA

29. Which pattern on an audiogram suggests otosclerosis?
A) Low-frequency conductive loss ✅
B) High-frequency sensorineural loss
C) Notched loss at 4 kHz
D) Flat sensorineural loss

30. Which medication class is known for ototoxicity?
A) NSAIDs
B) Aminoglycosides ✅
C) Beta-blockers
D) ACE inhibitors

31. Which type of hearing loss may benefit from BAHA (bone-anchored hearing aid)?
A) Conductive or single-sided deafness ✅
B) Sensorineural only
C) Mixed only
D) Central auditory disorders

32. Which of the following is an early sign of noise-induced hearing loss?
A) Vertigo
B) Tinnitus at high frequencies ✅
C) Low-frequency hearing loss
D) Facial nerve paralysis

33. Presbycusis is typically progressive over:
A) Months
B) Years ✅
C) Days
D) Weeks

34. High-frequency hearing loss primarily affects:
A) Vowels
B) Consonants ✅
C) Rhythm
D) Duration

35. Which hearing aid program is most suitable for restaurant environments?
A) T-coil
B) Directional microphone ✅
C) Standard omni-directional
D) Single-channel only

36. Which tool is used for assessing speech understanding in noise?
A) QuickSIN ✅
B) PTA
C) Tympanometry
D) OAEs

37. Which hearing loss type can be reversible with steroid treatment?
A) SSNHL ✅
B) Presbycusis
C) Noise-induced
D) Chronic otitis media

38. Which audiometric pattern is classic for Meniere’s disease?
A) Rising low-frequency sensorineural loss ✅
B) Flat high-frequency loss
C) Notched 4 kHz
D) Mixed low and high loss

39. Which of the following is not a common complaint in adults with hearing loss?
A) Difficulty hearing in noise
B) Tinnitus
C) Vertigo
D) Eye color change ✅

40. Which audiologic measure helps differentiate conductive vs sensorineural loss?
A) Tympanometry
B) Bone conduction vs air conduction thresholds ✅
C) OAEs
D) SRT

41. Which hearing aid feature improves phone communication?
A) Bluetooth connectivity ✅
B) Volume control
C) T-coil only
D) Directional microphones

42. Which age group is most at risk for presbycusis?
A) 20–30
B) 40–50
C) 60+ ✅
D) 10–20

43. Cochlear implant candidacy in adults usually requires:
A) Severe to profound sensorineural hearing loss ✅
B) Mild hearing loss
C) Conductive loss only
D) Single-sided deafness only

44. The speech-in-quiet test measures:
A) Detection of soft sounds
B) Ability to understand speech in quiet ✅
C) Sound localization
D) Tinnitus severity

45. Tinnitus is often associated with:
A) Outer hair cell damage ✅
B) Ossicular chain disruption
C) Eustachian tube dysfunction
D) Vestibular nerve lesion

46. Which of the following is not an audiologic management strategy for adults?
A) Hearing aids
B) Cochlear implants
C) Counseling
D) Eye surgery ✅

47. In noise-induced hearing loss, the 4 kHz notch occurs because:
A) Mechanical resonance of the ear canal ✅
B) Cochlear apex sensitivity
C) Ossicular chain defect
D) Central auditory processing

48. Which audiology test is most useful for objective assessment of tinnitus-related cochlear damage?
A) PTA
B) OAEs ✅
C) ABR
D) Tympanometry

49. Which factor contributes most to difficulty understanding speech in noise in presbycusis?
A) Cognitive decline ✅
B) Eye color
C) Handedness
D) Height

50. Which treatment is recommended for adult bilateral moderate hearing loss?
A) Cochlear implants
B) Bilateral hearing aids ✅
C) BAHA
D) Observation

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Adult Hearing – True/False (15 Questions)

1. Presbycusis primarily affects low frequencies.
Answer: False ✅

2. Noise-induced hearing loss is often associated with a 4 kHz notch.
Answer: True ✅

3. SSNHL requires immediate audiology referral.
Answer: True ✅

4. Tinnitus can occur with normal hearing.
Answer: True ✅

5. Cochlear implants are not effective in adults.
Answer: False ✅

6. High-frequency hearing loss affects consonant perception more than vowels.
Answer: True ✅

7. Directional microphones in hearing aids help in noisy environments.
Answer: True ✅

8. Otosclerosis causes high-frequency sensorineural loss.
Answer: False ✅

9. Bone-anchored hearing aids are useful in single-sided deafness.
Answer: True ✅

10. Presbycusis is sudden in onset.
Answer: False ✅

11. Pure-tone audiometry is subjective and requires attention from the patient.
Answer: True ✅

12. ABR is an objective test not influenced by patient cooperation.
Answer: True ✅

13. OAEs assess cochlear outer hair cell function.
Answer: True ✅

14. Early intervention in adult hearing loss does not improve speech understanding.
Answer: False ✅

15. Meniere’s disease typically presents with low-frequency fluctuating sensorineural hearing loss.
Answer: True ✅

Vestibular System & Balance Disorders – MCQs (50 Questions)

1. BPPV stands for:
A) Benign Paroxysmal Peripheral Vertigo
B) Benign Paroxysmal Positional Vertigo ✅
C) Bilateral Peripheral Positional Vertigo
D) Brainstem Peripheral Positional Vertigo

2. The most commonly affected semicircular canal in BPPV is:
A) Horizontal canal
B) Anterior canal
C) Posterior canal ✅
D) Superior canal

3. The primary cause of BPPV is:
A) Viral infection
B) Dislodged otoconia ✅
C) Inner ear tumor
D) Meniere’s disease

4. Typical BPPV episodes are triggered by:
A) Loud noise
B) Head position changes ✅
C) Exercise
D) Bright light

5. The gold standard test for diagnosing posterior canal BPPV is:
A) Caloric test
B) Dix-Hallpike maneuver ✅
C) Head thrust test
D) Romberg test

6. Nystagmus in posterior canal BPPV is usually:
A) Horizontal
B) Upbeating and torsional ✅
C) Downbeating
D) Absent

7. Canalith repositioning maneuvers for posterior canal BPPV include:
A) Epley maneuver ✅
B) Semont maneuver ✅
C) Brandt-Daroff exercises ✅
D) All of the above ✅

8. Meniere’s disease is characterized by:
A) Vertigo, low-frequency hearing loss, tinnitus, and aural fullness ✅
B) High-frequency hearing loss only
C) Postural instability only
D) Visual disturbances

9. Which test is most useful for evaluating vestibular function in Meniere’s disease?
A) Tympanometry
B) VNG (Videonystagmography) ✅
C) OAE
D) ABR

10. Vestibular migraine often presents with:
A) Episodic vertigo with headache ✅
B) Permanent hearing loss
C) Sudden SNHL
D) Persistent nystagmus

11. Which test records eye movements to assess vestibular function?
A) Audiometry
B) VNG/ENG ✅
C) Tympanometry
D) OAE

12. The cVEMP test primarily evaluates:
A) Lateral semicircular canal
B) Saccule and inferior vestibular nerve ✅
C) Utricle
D) Cochlea

13. The oVEMP test primarily evaluates:
A) Saccule
B) Utricle and superior vestibular nerve ✅
C) Cochlea
D) Posterior canal

14. Which vestibular test uses air or water to stimulate the ear?
A) Caloric testing ✅
B) Dix-Hallpike
C) VEMP
D) Head impulse test

15. The head impulse test (HIT) assesses:
A) Vestibulo-ocular reflex (VOR) ✅
B) Hearing thresholds
C) Balance on one leg
D) Postural sway

16. In BPPV, symptoms typically last:
A) Seconds to minutes ✅
B) Hours
C) Days
D) Weeks

17. Vestibular rehabilitation therapy (VRT) is used for:
A) BPPV only
B) Chronic vestibular hypofunction ✅
C) Meniere’s only
D) Hearing loss

18. Which is a hallmark feature of Meniere’s disease?
A) Low-frequency fluctuating sensorineural hearing loss ✅
B) High-frequency permanent hearing loss
C) Horizontal nystagmus only
D) Postural tremor

19. The primary pathology in BPPV is:
A) Otitis media
B) Otoconia in semicircular canal ✅
C) Labyrinthitis
D) Tumor

20. True or false: BPPV always requires surgery.
A) True
B) False ✅

21. Which canal is least commonly affected in BPPV?
A) Posterior
B) Horizontal
C) Anterior ✅
D) All equally affected

22. Vestibular migraine treatment often includes:
A) Migraine prophylaxis ✅
B) Surgery
C) Cochlear implants
D) Hearing aids

23. Which VNG subtest evaluates spontaneous nystagmus?
A) Caloric test
B) Oculomotor test ✅
C) Dix-Hallpike
D) VEMP

24. During caloric testing, warm water typically produces:
A) Nystagmus toward stimulated ear ✅
B) Nystagmus away from stimulated ear
C) No nystagmus
D) Vertical nystagmus

25. Which vestibular disorder can cause imbalance when walking in the dark?
A) Peripheral vestibular hypofunction ✅
B) Otosclerosis
C) Presbycusis
D) TMJ disorder

26. Brandt-Daroff exercises are primarily used for:
A) Meniere’s disease
B) BPPV ✅
C) Vestibular migraine
D) Labyrinthitis

27. cVEMP is measured from which muscle?
A) Sternocleidomastoid ✅
B) Masseter
C) Trapezius
D) Orbicularis oculi

28. oVEMP is measured from which location?
A) Forehead
B) Inferior oblique muscle below the eyes ✅
C) Neck
D) Sternum

29. The term “vertigo” refers to:
A) Imbalance without spinning
B) Illusion of movement or spinning ✅
C) Hearing loss
D) Tinnitus

30. Which maneuver is first-line for posterior canal BPPV?
A) Semont
B) Epley ✅
C) Brandt-Daroff
D) Gufoni

31. Horizontal canal BPPV often produces:
A) Torsional nystagmus
B) Horizontal nystagmus ✅
C) Upbeating nystagmus
D) Downbeating nystagmus

32. Vestibular migraine may include:
A) Photophobia and phonophobia ✅
B) Conductive hearing loss
C) Otitis media
D) Facial paralysis

33. In VNG testing, the main purpose is to:
A) Assess cochlear function
B) Assess vestibular function via eye movements ✅
C) Measure hearing thresholds
D) Evaluate middle ear pressure

34. Canalith repositioning is effective in:
A) 50–90% of BPPV cases ✅
B) 10%
C) 20%
D) Rarely

35. Chronic vestibular hypofunction may cause:
A) Oscillopsia ✅
B) Ear pain
C) Tinnitus
D) Hearing improvement

36. Which vestibular test can be done bedside without special equipment?
A) Head impulse test ✅
B) VNG
C) Caloric test
D) VEMP

37. Meniere’s disease hearing loss is typically:
A) Conductive
B) Sensorineural ✅
C) Mixed
D) Central

38. The most common age group for BPPV is:
A) Children
B) Adults 50+ ✅
C) Teenagers
D) Newborns

39. Vestibular rehabilitation exercises aim to:
A) Restore hearing
B) Improve gaze stabilization, balance, and habituation ✅
C) Cure tinnitus
D) Treat presbycusis

40. cVEMP latency abnormalities suggest:
A) Cochlear dysfunction
B) Saccular or inferior vestibular nerve dysfunction ✅
C) Conductive hearing loss
D) Meniere’s disease only

41. oVEMP amplitude asymmetry indicates:
A) Utricular or superior vestibular nerve dysfunction ✅
B) Cochlear dysfunction
C) Facial nerve lesion
D) Conductive loss

42. Spontaneous nystagmus in acute vestibular lesions usually beats:
A) Toward affected ear
B) Toward healthy ear ✅
C) Vertically only
D) Torsionally only

43. Which vestibular disorder may be exacerbated by stress?
A) Vestibular migraine ✅
B) BPPV
C) Otosclerosis
D) Presbycusis

44. Repositioning maneuvers for BPPV should avoid:
A) Rapid head movements ✅
B) Quiet rest
C) Gradual exercises
D) Supine positioning

45. True or false: All vertigo in adults is caused by BPPV.
A) True
B) False ✅

46. The Romberg test assesses:
A) Hearing
B) Static balance ✅
C) VOR
D) Tinnitus

47. In VNG, caloric irrigation with cold water produces:
A) Nystagmus toward irrigated ear
B) Nystagmus away from irrigated ear ✅
C) No nystagmus
D) Torsional nystagmus

48. Oscillopsia is:
A) Ringing in ears
B) Illusion of the visual field bouncing during head movements ✅
C) Dizziness without motion
D) Low-frequency hearing loss

49. BPPV can spontaneously resolve in:
A) Days to weeks ✅
B) Years
C) Never
D) Only with surgery

50. Which is an early symptom of vestibular hypofunction?
A) Sudden hearing loss
B) Dizziness when turning head ✅
C) Chronic tinnitus
D) Ear fullness

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Vestibular System – True/False (15 Questions)

1. BPPV is caused by inflammation of the semicircular canals.
Answer: False ✅

2. Posterior canal BPPV is the most common type.
Answer: True ✅

3. Dix-Hallpike maneuver can diagnose posterior canal BPPV.
Answer: True ✅

4. Horizontal canal BPPV is always more severe than posterior canal BPPV.
Answer: False ✅

5. Meniere’s disease hearing loss fluctuates.
Answer: True ✅

6. Vestibular migraine is always associated with hearing loss.
Answer: False ✅

7. cVEMP evaluates the saccule and inferior vestibular nerve.
Answer: True ✅

8. oVEMP evaluates utricle and superior vestibular nerve function.
Answer: True ✅

9. Epley maneuver is used for horizontal canal BPPV.
Answer: False ✅

10. Vestibular rehabilitation improves gaze stabilization and balance.
Answer: True ✅

11. Caloric testing stimulates the semicircular canals with air or water.
Answer: True ✅

12. BPPV symptoms last hours to days continuously.
Answer: False ✅

13. Romberg test measures static balance.
Answer: True ✅

14. Vestibular disorders are never affected by stress.
Answer: False ✅

15. Repositioning maneuvers can cure most cases of BPPV.
Answer: True ✅

Pediatric Audiology – MCQs (50 Questions)

1. The primary goal of newborn hearing screening is:
A) To assess speech development
B) Early identification of hearing loss ✅
C) To measure cochlear function only
D) To check middle ear infections

2. The recommended age for universal newborn hearing screening is:
A) Birth to 1 month ✅
B) 3 months
C) 6 months
D) 12 months

3. The two most common screening tests for newborn hearing are:
A) ABR and OAE ✅
B) Tympanometry and VNG
C) Pure-tone audiometry and speech audiometry
D) cVEMP and oVEMP

4. OAE stands for:
A) Ototoxic Auditory Evaluation
B) Otoacoustic Emissions ✅
C) Otitis Assessment Exam
D) Outer Ear Assessment

5. Which type of OAE is most commonly used for newborn screening?
A) DPOAE
B) TEOAE ✅
C) SFOAE
D) None

6. ABR in newborns assesses:
A) Middle ear function
B) Auditory nerve and brainstem pathways ✅
C) Vestibular function
D) Speech perception

7. Which behavioral audiometry test is suitable for infants 0–6 months?
A) Visual Reinforcement Audiometry
B) Behavioral Observation Audiometry ✅
C) Conditioned Play Audiometry
D) Speech audiometry

8. Visual Reinforcement Audiometry (VRA) is typically used for:
A) Children 6–24 months ✅
B) Infants <3 months
C) Adults
D) Teenagers

9. Conditioned Play Audiometry (CPA) is suitable for:
A) Infants under 6 months
B) Children 2–5 years ✅
C) Adults
D) Teenagers

10. A common cause of congenital hearing loss is:
A) Noise exposure
B) Genetic factors ✅
C) Ear infections in adulthood
D) Aging

11. Congenital CMV infection can lead to:
A) Temporary conductive loss
B) Progressive sensorineural hearing loss ✅
C) Tinnitus only
D) Otosclerosis

12. Which audiometric configuration is most common in pediatric sensorineural hearing loss?
A) Flat
B) Sloping ✅
C) Rising
D) Notched

13. Early amplification for children with hearing loss should ideally occur:
A) After age 3
B) Before 6 months ✅
C) At school entry
D) At 2 years

14. Cochlear implants are recommended for children with:
A) Mild hearing loss
B) Severe-to-profound SNHL who do not benefit from hearing aids ✅
C) Conductive hearing loss only
D) Normal hearing

15. Which test evaluates middle ear function in infants?
A) Tympanometry ✅
B) ABR
C) VRA
D) CPA

16. Risk factors for pediatric hearing loss include:
A) NICU stay >5 days ✅
B) Family history of hearing loss ✅
C) Hyperbilirubinemia ✅
D) All of the above ✅

17. Aural rehabilitation for children focuses on:
A) Listening skills
B) Speech and language development ✅
C) Social communication
D) All of the above ✅

18. The most common type of permanent childhood hearing loss is:
A) Conductive
B) Sensorineural ✅
C) Mixed
D) Central auditory

19. Hearing aids for children often have:
A) Behind-the-ear design ✅
B) Small in-ear only
C) Bone conduction only
D) None

20. FM systems are used in children to:
A) Amplify classroom speech directly to the child ✅
B) Test middle ear function
C) Evaluate vestibular function
D) None

21. The “1-3-6” guideline for early hearing detection refers to:
A) Screen by 1 month, diagnose by 3 months, intervene by 6 months ✅
B) Screen by 6 months, diagnose by 1 year, intervene by 3 years
C) Screen at birth, diagnose by 1 year, intervene by 3 years
D) None

22. OAE absence in newborn screening may indicate:
A) Normal hearing
B) Possible hearing loss ✅
C) Vestibular dysfunction
D) Tympanic membrane perforation only

23. ABR is useful in infants because:
A) Requires active participation
B) Can test while the child sleeps ✅
C) Only detects conductive loss
D) Replaces OAE entirely

24. Genetic hearing loss is often:
A) Syndromic or nonsyndromic ✅
B) Always progressive
C) Only conductive
D) Always unilateral

25. Children with unilateral hearing loss may have:
A) Difficulty in noise ✅
B) Normal speech development always
C) No educational impact
D) None

26. Early cochlear implantation improves:
A) Spoken language outcomes ✅
B) Vestibular function
C) Vision
D) Middle ear aeration

27. Tympanometry in infants often uses which probe tone?
A) 226 Hz
B) 1000 Hz ✅
C) 500 Hz
D) 2000 Hz

28. Auditory brainstem response thresholds can estimate:
A) Visual acuity
B) Hearing thresholds ✅
C) Language comprehension
D) Balance

29. Ototoxic medications in neonates can cause:
A) Temporary conductive loss
B) Sensorineural hearing loss ✅
C) Vestibular loss only
D) No effect

30. Behavioral observation audiometry relies on:
A) Eye widening, startle response ✅
B) Speech recognition
C) Vestibular reflexes
D) Tactile feedback

31. Bilingual children with hearing loss benefit from:
A) Only sign language
B) Exposure to spoken language and early intervention ✅
C) No early amplification
D) None

32. Conductive hearing loss in children is often caused by:
A) Otitis media ✅
B) Genetic mutation
C) Noise exposure
D) CMV

33. The purpose of universal newborn hearing screening is to:
A) Delay intervention
B) Identify hearing loss early ✅
C) Diagnose all ear infections
D) Replace behavioral testing

34. Cochlear implant candidacy is determined by:
A) Degree of SNHL ✅
B) Benefit from hearing aids
C) Age and auditory development
D) All of the above ✅

35. Children with hearing aids need:
A) Regular audiologic follow-up ✅
B) Only annual checks
C) No monitoring
D) Only cochlear implant evaluation

36. Speech perception tests in children include:
A) PBK word lists ✅
B) SRT only
C) PTA
D) Tympanometry

37. Middle ear effusion can affect:
A) OAE results ✅
B) ABR thresholds ✅
C) Hearing aid fitting
D) All of the above ✅

38. Pediatric audiologists play a role in:
A) Testing hearing
B) Counseling families ✅
C) Early intervention planning ✅
D) All of the above ✅

39. Early amplification helps prevent:
A) Speech and language delays ✅
B) Vestibular dysfunction
C) Conductive loss
D) None

40. Visual reinforcement in VRA uses:
A) Sounds only
B) Visual reward like lights or toys ✅
C) Balance response
D) None

41. Conditioned Play Audiometry relies on:
A) Rewards after correct responses ✅
B) Passive observation
C) Middle ear pressure
D) VOR

42. Progressive hearing loss in children requires:
A) Ongoing audiologic monitoring ✅
B) Single-time screening
C) Only cochlear implant
D) None

43. Tympanometry can detect:
A) Middle ear fluid ✅
B) Cochlear loss
C) Vestibular hypofunction
D) None

44. Children with profound bilateral hearing loss often require:
A) Hearing aids
B) Cochlear implants ✅
C) No intervention
D) Only speech therapy

45. Pediatric audiometry often uses:
A) OAE, ABR, VRA, CPA ✅
B) Only pure-tone audiometry
C) Only tympanometry
D) Only speech audiometry

46. OAE can be absent in a child with:
A) Conductive hearing loss ✅
B) Sensorineural hearing loss ✅
C) Both A and B ✅
D) Normal hearing

47. Early intervention programs improve:
A) Academic outcomes ✅
B) Language development ✅
C) Social-emotional development ✅
D) All of the above ✅

48. Behavioral audiometry requires:
A) Subject participation ✅
B) Only machine measurement
C) No response needed
D) None

49. Cochlear implant mapping in children:
A) Should be done regularly ✅
B) Only once
C) Only after age 5
D) Never

50. True or false: Universal newborn hearing screening has reduced delays in language development.
Answer: True ✅

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Pediatric Audiology – True/False (15 Questions)

1. Universal newborn hearing screening should be completed before 1 month of age.
Answer: True ✅

2. OAE tests cochlear outer hair cell function.
Answer: True ✅

3. ABR requires active cooperation from infants.
Answer: False ✅

4. Behavioral Observation Audiometry is used in infants <6 months.
Answer: True ✅

5. VRA is appropriate for children 6–24 months.
Answer: True ✅

6. CPA is suitable for children 2–5 years.
Answer: True ✅

7. Congenital CMV infection can cause progressive SNHL.
Answer: True ✅

8. Early amplification before 6 months can improve language outcomes.
Answer: True ✅

9. Cochlear implants are only recommended for children with mild hearing loss.
Answer: False ✅

10. Tympanometry in infants often uses 1000 Hz probe tone.
Answer: True ✅

11. Ototoxic medications in neonates can cause permanent hearing loss.
Answer: True ✅

12. Early intervention programs do not affect academic performance.
Answer: False ✅

13. Children with unilateral hearing loss have no difficulties in noisy environments.
Answer: False ✅

14. FM systems help amplify speech in classrooms.
Answer: True ✅

15. Progressive hearing loss in children requires ongoing monitoring.
Answer: True ✅

Adult Audiology – MCQs (50 Questions)

1. The most common type of hearing loss in adults is:
A) Conductive
B) Sensorineural ✅
C) Mixed
D) Central

2. Presbycusis primarily affects:
A) Low frequencies
B) High frequencies ✅
C) Mid frequencies
D) All frequencies equally

3. Noise-induced hearing loss typically shows a notch at:
A) 500 Hz
B) 1000 Hz
C) 3000–6000 Hz ✅
D) 8000 Hz

4. The main tool for adult hearing assessment is:
A) Tympanometry
B) Pure-tone audiometry ✅
C) Speechreading
D) OAE

5. Speech audiometry in adults includes:
A) SRT and WRS ✅
B) VRA
C) CPA
D) cVEMP

6. Pure-tone audiometry measures:
A) Hearing thresholds at different frequencies ✅
B) Middle ear pressure
C) Vestibular function
D) Visual acuity

7. Air-bone gap in an audiogram indicates:
A) Sensorineural loss
B) Conductive component ✅
C) Central auditory disorder
D) Normal hearing

8. The first step in adult hearing aid selection is:
A) Counseling only
B) Comprehensive audiologic evaluation ✅
C) Fitting the device
D) Speech therapy

9. Behind-the-ear (BTE) hearing aids are recommended for:
A) Mild loss only
B) Mild-to-profound loss ✅
C) Profound loss only
D) No hearing loss

10. In-the-ear (ITE) hearing aids are suitable for:
A) Mild-to-moderate loss ✅
B) Profound loss only
C) Infants
D) Adults with normal hearing

11. Bone-anchored hearing aids (BAHA) are used for:
A) Conductive hearing loss ✅
B) Sensorineural loss only
C) Presbycusis
D) Vestibular rehabilitation

12. Directional microphones in hearing aids help to:
A) Reduce background noise ✅
B) Amplify all sounds equally
C) Test tympanic membrane
D) Stimulate cochlea

13. Telecoil (T-coil) in hearing aids allows:
A) Direct connection to loop systems ✅
B) Amplification of TV only
C) Cochlear implant mapping
D) OAE measurement

14. Cochlear implants in adults are considered for:
A) Mild hearing loss
B) Severe-to-profound SNHL ✅
C) Conductive loss only
D) Tinnitus

15. Real-ear measurement (REM) is used to:
A) Verify hearing aid output ✅
B) Measure vestibular function
C) Test speechreading
D) Diagnose presbycusis

16. Aural rehabilitation for adults aims to:
A) Improve communication ✅
B) Reduce social isolation ✅
C) Maximize hearing aid benefit ✅
D) All of the above ✅

17. Speechreading in adults involves:
A) Reading lips only
B) Using visual cues, gestures, context, and residual hearing ✅
C) Cochlear implant mapping
D) Tympanometry

18. Which is an example of an assistive listening device for adults?
A) FM system ✅
B) ABR
C) Tympanometer
D) OAEs

19. Acoustic feedback in hearing aids is caused by:
A) Proper insertion
B) Sound leakage from the ear canal ✅
C) Electrical failure
D) Ototoxicity

20. Adult-onset hearing loss may impact:
A) Employment ✅
B) Social interaction ✅
C) Mental health ✅
D) All of the above ✅

21. The speech banana in audiology represents:
A) Frequencies and intensities of common speech sounds ✅
B) The shape of a hearing aid
C) Audiometer calibration
D) Vestibular thresholds

22. Signal-to-noise ratio (SNR) for optimal speech understanding in adults:
A) 0 dB
B) +5 dB
C) +15 dB ✅
D) -10 dB

23. Adult auditory training focuses on:
A) Hearing aid fitting only
B) Improving listening and communication skills ✅
C) Vestibular rehab
D) Pure-tone audiometry

24. Frequency lowering in hearing aids is used to:
A) Improve high-frequency audibility ✅
B) Reduce low-frequency sounds
C) Amplify only mid-frequencies
D) None

25. Presbycusis is typically:
A) Unilateral
B) Bilateral and symmetric ✅
C) Conductive
D) Only mild

26. Recruitment in SNHL refers to:
A) Reduced hearing
B) Abnormal loudness growth ✅
C) Vestibular dysfunction
D) Conductive hearing

27. Tinnitus management in adults may include:
A) Sound therapy ✅
B) Counseling ✅
C) Hearing aids ✅
D) All of the above ✅

28. Counseling for hearing aid users should include:
A) Device handling ✅
B) Realistic expectations ✅
C) Communication strategies ✅
D) All of the above ✅

29. Noise-induced hearing loss is:
A) Always congenital
B) Acquired due to exposure ✅
C) Only affects low frequencies
D) Rare

30. Hidden hearing loss refers to:
A) Difficulty in quiet
B) Difficulty in noise despite normal audiogram ✅
C) Profound deafness
D) Only vestibular problems

31. Sudden sensorineural hearing loss requires:
A) Observation only
B) Immediate medical evaluation ✅
C) Hearing aids only
D) Speech therapy

32. Tympanometry in adults evaluates:
A) Cochlear function
B) Middle ear pressure and mobility ✅
C) Auditory nerve
D) Vestibular function

33. Adults with hearing aids benefit most when:
A) Devices are used consistently ✅
B) Only occasionally
C) Only in quiet
D) Only during therapy

34. Open-fit hearing aids are designed for:
A) Severe-to-profound loss
B) Mild-to-moderate high-frequency loss ✅
C) Children only
D) Cochlear implant users

35. Audiologic rehabilitation includes:
A) Auditory training
B) Communication strategies
C) Support groups
D) All of the above ✅

36. Cochlear implant candidacy in adults often requires:
A) Severe-to-profound bilateral SNHL ✅
B) Limited benefit from hearing aids ✅
C) Motivation and realistic expectations ✅
D) All of the above ✅

37. Hearing loss may increase the risk of:
A) Dementia ✅
B) Depression ✅
C) Social isolation ✅
D) All of the above ✅

38. Directional microphones are most effective in:
A) Quiet rooms
B) Noisy environments ✅
C) Soundproof booths
D) Outdoors only

39. Adult speech audiometry includes:
A) Speech recognition threshold (SRT) ✅
B) Word recognition score (WRS) ✅
C) Both A and B ✅
D) Only pure-tone thresholds

40. Bone conduction testing helps differentiate:
A) Sensorineural vs. conductive loss ✅
B) Vestibular vs. cochlear loss
C) Tinnitus severity
D) Speechreading ability

41. Tele-audiology allows:
A) Remote hearing aid programming ✅
B) Remote diagnostic testing ✅
C) Counseling and rehabilitation ✅
D) All of the above ✅

42. Hearing aid batteries should be replaced:
A) Daily or weekly depending on type ✅
B) Monthly only
C) Yearly
D) Never

43. Audiologists should check hearing aids for:
A) Feedback
B) Proper fit
C) Amplification levels
D) All of the above ✅

44. Speech-in-noise tests help evaluate:
A) Real-world listening difficulties ✅
B) Pure-tone thresholds
C) Vestibular function
D) Tympanic membrane mobility

45. Central auditory processing disorder in adults can cause:
A) Difficulty understanding speech in noise ✅
B) Tinnitus
C) Profound deafness
D) Otitis media

46. Hearing aid fine-tuning includes:
A) Adjusting gain and output ✅
B) Microphone settings ✅
C) Frequency shaping ✅
D) All of the above ✅

47. Adults with unilateral hearing loss may use:
A) Contralateral routing of signal (CROS) aids ✅
B) Cochlear implants only
C) Standard BTE only
D) No intervention

48. Hearing aid follow-up visits are important for:
A) Device maintenance ✅
B) Counseling and troubleshooting ✅
C) Auditory training ✅
D) All of the above ✅

49. Adults with severe SNHL who receive cochlear implants can:
A) Improve speech perception ✅
B) Completely restore normal hearing
C) Not benefit at all
D) Only hear low frequencies

50. True or false: Aural rehabilitation in adults includes both technological and communication strategy components.
Answer: True ✅

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Adult Audiology – True/False (15 Questions)

1. Presbycusis is age-related hearing loss.
Answer: True ✅

2. Noise-induced hearing loss affects high frequencies first.
Answer: True ✅

3. Pure-tone audiometry requires active participation.
Answer: True ✅

4. Hearing aids alone solve all communication problems.
Answer: False ✅

5. Directional microphones help improve speech understanding in noise.
Answer: True ✅

6. Real-ear measurement ensures hearing aids meet prescription targets.
Answer: True ✅

7. Cochlear implants are suitable for mild hearing loss.
Answer: False ✅

8. Aural rehabilitation can reduce social isolation.
Answer: True ✅

9. Telecoil allows connection to induction loop systems.
Answer: True ✅

10. Open-fit hearing aids are ideal for severe low-frequency loss.
Answer: False ✅

11. Speech-in-noise testing evaluates real-world listening abilities.
Answer: True ✅

12. Adult auditory training focuses on improving listening skills.
Answer: True ✅

13. CROS hearing aids are used for unilateral hearing loss.
Answer: True ✅

14. Tinnitus cannot be managed with sound therapy or counseling.
Answer: False ✅

15. Frequent follow-ups are important to maximize hearing aid benefit.
Answer: True ✅

Vestibular & Balance Disorders – MCQs (50 Questions)

1. BPPV stands for:
A) Benign Paroxysmal Positional Vertigo ✅
B) Bilateral Peripheral Positional Vestibulopathy
C) Basic Peripheral Positional Vertigo
D) Benign Postural Peripheral Vertigo

2. The most common cause of vertigo in adults is:
A) Labyrinthitis
B) Vestibular migraine
C) BPPV ✅
D) Acoustic neuroma

3. The semicircular canals most commonly affected in BPPV are:
A) Posterior canal ✅
B) Lateral canal
C) Anterior canal
D) Utricle

4. The Dix-Hallpike maneuver is used to diagnose:
A) Ménière’s disease
B) Vestibular neuritis
C) BPPV ✅
D) Acoustic neuroma

5. Nystagmus is:
A) Hearing loss
B) Involuntary eye movement ✅
C) Balance loss
D) Muscle spasm

6. Vestibular Evoked Myogenic Potentials (VEMP) test:
A) Cochlear function
B) Saccule and inferior vestibular nerve function ✅
C) Semicircular canal function
D) Middle ear function

7. cVEMP is recorded from:
A) Eye muscles
B) Sternocleidomastoid muscle ✅
C) Calf muscles
D) Hand muscles

8. oVEMP is recorded from:
A) Sternocleidomastoid muscle
B) Extraocular muscles ✅
C) Neck muscles
D) Hand muscles

9. Caloric testing evaluates:
A) Semicircular canal function ✅
B) Cochlear function
C) Vestibular nerve integrity
D) Auditory nerve

10. The canal paresis (unilateral weakness) on caloric testing indicates:
A) Normal vestibular function
B) Reduced function on one side ✅
C) Cochlear hearing loss
D) Ménière’s disease

11. The Epley maneuver is a treatment for:
A) Vestibular migraine
B) BPPV ✅
C) Labyrinthitis
D) Ménière’s disease

12. Vestibular neuritis is usually caused by:
A) Bacterial infection
B) Viral infection ✅
C) Trauma
D) Autoimmune disease

13. Ménière’s disease is characterized by:
A) Vertigo, fluctuating hearing loss, tinnitus, and aural fullness ✅
B) Constant hearing loss only
C) Only vertigo
D) Postural instability only

14. The etiology of Ménière’s disease is related to:
A) Endolymphatic hydrops ✅
B) Vestibular nerve tumor
C) BPPV
D) Otitis media

15. VNG stands for:
A) Vestibular Nerve Graph
B) Videonystagmography ✅
C) Visual Neurological Gauge
D) Vestibular Neurology Guide

16. VNG assesses:
A) Eye movements in response to vestibular stimuli ✅
B) Middle ear pressure
C) Cochlear function
D) Pure-tone thresholds

17. Optokinetic testing in VNG evaluates:
A) Caloric response
B) Visual-vestibular interaction ✅
C) Saccule function
D) Cochlear function

18. Dynamic visual acuity testing is used to evaluate:
A) Visual acuity in motion ✅
B) Cochlear thresholds
C) Middle ear function
D) Speech recognition

19. Balance can be assessed with:
A) Romberg test ✅
B) Fukuda stepping test ✅
C) Posturography ✅
D) All of the above ✅

20. Canalithiasis refers to:
A) Otoliths free-floating in semicircular canal ✅
B) Otoliths fixed to utricle
C) Endolymphatic hydrops
D) Vestibular nerve inflammation

21. Cupulolithiasis differs from canalithiasis because:
A) Otoliths adhere to the cupula ✅
B) Otoliths float freely
C) No nystagmus occurs
D) Only affects cochlea

22. Vestibular rehabilitation therapy (VRT) is used to:
A) Reduce dizziness ✅
B) Improve balance ✅
C) Enhance vestibular compensation ✅
D) All of the above ✅

23. Gaze stabilization exercises target:
A) Cervical spine
B) Vestibulo-ocular reflex (VOR) ✅
C) Cochlear function
D) Tinnitus

24. Brandt-Daroff exercises are used for:
A) Vestibular neuritis
B) BPPV ✅
C) Ménière’s disease
D) Tinnitus

25. The head impulse test (HIT) evaluates:
A) VOR function ✅
B) Cochlear function
C) Otolith function
D) Tympanic membrane mobility

26. Bilateral vestibular loss often causes:
A) Vertigo
B) Oscillopsia ✅
C) Fluctuating hearing
D) Hyperacusis

27. The main symptom of vestibular migraine is:
A) Chronic hearing loss
B) Recurrent vertigo with migraine symptoms ✅
C) Otitis media
D) Tympanic membrane perforation

28. Ototoxic medications may cause:
A) Hearing loss ✅
B) Vestibular dysfunction ✅
C) Both A and B ✅
D) Neither

29. Video Head Impulse Test (vHIT) measures:
A) Caloric response
B) High-frequency VOR ✅
C) Cochlear thresholds
D) Speech perception

30. Vestibular schwannoma primarily affects:
A) Cochlea
B) Vestibular nerve ✅
C) Semicircular canal
D) Middle ear

31. Positional testing in BPPV should be avoided in:
A) Recent stroke patients ✅
B) Healthy adults
C) All BPPV patients
D) None

32. cVEMP amplitude asymmetry >35% is considered:
A) Normal
B) Abnormal ✅
C) Mild
D) Irrelevant

33. oVEMP is mainly used to assess:
A) Superior vestibular nerve function ✅
B) Cochlear function
C) Middle ear status
D) Tinnitus

34. Caloric testing uses:
A) Warm and cold air or water ✅
B) Bone conduction
C) Electrical stimulation
D) Visual stimulation

35. Vestibular migraine can mimic:
A) BPPV ✅
B) Ménière’s disease ✅
C) Labyrinthitis
D) Both A and B ✅

36. Endolymphatic sac decompression is a surgical treatment for:
A) BPPV
B) Ménière’s disease ✅
C) Vestibular neuritis
D) Acoustic neuroma

37. Tinnitus is present in:
A) BPPV rarely
B) Ménière’s disease often ✅
C) Vestibular neuritis sometimes
D) All of the above ✅

38. Vestibular hypofunction may cause:
A) Dizziness
B) Imbalance ✅
C) Oscillopsia
D) All of the above ✅

39. Canalith repositioning maneuvers are:
A) Diagnostic
B) Therapeutic ✅
C) Only used in labs
D) Ineffective

40. Posturography evaluates:
A) Balance and postural control ✅
B) Hearing thresholds
C) VOR
D) Speech recognition

41. BPPV episodes are triggered by:
A) Head movements ✅
B) Loud sounds
C) Light exposure
D) Stress

42. Vestibular testing is contraindicated in:
A) Ear infections
B) Severe cervical spine disease ✅
C) Older adults
D) All healthy adults

43. VEMP testing is performed using:
A) Air-conducted sound ✅
B) Bone-conducted vibration ✅
C) Electrical stimulation
D) Both A and B ✅

44. Oscillopsia is:
A) Involuntary eye movement
B) Visual blurring with head movement ✅
C) Hearing loss
D) Balance loss

45. BPPV treatment success rate with Epley maneuver is approximately:
A) 20%
B) 50%
C) 80–90% ✅
D) 100%

46. Vestibular rehab is most effective when:
A) Performed daily ✅
B) Weekly only
C) Once a month
D) Never

47. Spontaneous nystagmus is usually seen in:
A) Vestibular neuritis ✅
B) Ménière’s disease
C) BPPV
D) Hearing aid users

48. Horizontal canal BPPV is treated with:
A) Epley maneuver
B) Lempert (barbecue roll) maneuver ✅
C) Brandt-Daroff
D) Vestibular rehab

49. Acute vestibular syndrome typically presents with:
A) Chronic imbalance
B) Sudden vertigo, nausea, and nystagmus ✅
C) Mild tinnitus
D) Hearing improvement

50. True or false: Vestibular testing can identify peripheral versus central causes of vertigo.
Answer: True ✅

---

Vestibular & Balance Disorders – True/False (15 Questions)

1. BPPV is caused by displaced otoconia in the semicircular canals.
Answer: True ✅

2. Dix-Hallpike maneuver is diagnostic for posterior canal BPPV.
Answer: True ✅

3. Epley maneuver is a treatment, not a diagnostic test.
Answer: True ✅

4. Vestibular neuritis usually affects the cochlea.
Answer: False ✅

5. cVEMP tests saccular function and inferior vestibular nerve.
Answer: True ✅

6. oVEMP evaluates utricular and superior vestibular nerve function.
Answer: True ✅

7. Caloric testing evaluates high-frequency VOR.
Answer: False ✅

8. Ménière’s disease involves fluctuating hearing loss and vertigo.
Answer: True ✅

9. Vestibular rehabilitation can help patients with chronic dizziness.
Answer: True ✅

10. Canalith repositioning maneuvers are ineffective in BPPV.
Answer: False ✅

11. Vestibular migraine can mimic BPPV symptoms.
Answer: True ✅

12. Posturography assesses postural control.
Answer: True ✅

13. Oscillopsia occurs due to bilateral vestibular loss.
Answer: True ✅

14. VEMP is not affected by muscle contraction.
Answer: False ✅

15. Acute vestibular syndrome requires prompt evaluation to rule out stroke.
Answer: True ✅

Pediatric Audiology – MCQs (50 Questions)

1. The inner ear begins to develop around which gestational week?
A) 2nd week
B) 4th week ✅
C) 6th week
D) 8th week

2. The cochlea reaches its adult size by:
A) Birth ✅
B) 6 months
C) 1 year
D) 2 years

3. The ossicles start forming during which period?
A) 4–5 weeks
B) 6–8 weeks ✅
C) 10–12 weeks
D) 16 weeks

4. Which part of the ear is derived from the first pharyngeal pouch?
A) External auditory canal
B) Middle ear cavity ✅
C) Cochlea
D) Vestibule

5. Auditory brainstem response (ABR) can be used to assess:
A) Cochlear function only
B) Auditory nerve and brainstem function ✅
C) Outer ear function
D) Tympanic membrane mobility

6. Behavioral Observation Audiometry (BOA) is suitable for:
A) Newborns to 6 months ✅
B) 6–12 months
C) 1–3 years
D) 3–5 years

7. Visual Reinforcement Audiometry (VRA) is typically used for:
A) Birth–6 months
B) 6–24 months ✅
C) 2–5 years
D) 5–7 years

8. Conditioned Play Audiometry (CPA) is used for:
A) 6–12 months
B) 12–36 months
C) 2–5 years ✅
D) 5–10 years

9. Tympanometry in infants under 6 months often uses which probe tone?
A) 226 Hz
B) 1000 Hz ✅
C) 500 Hz
D) 2000 Hz

10. Otoacoustic emissions (OAEs) assess:
A) Auditory nerve function
B) Cochlear outer hair cell function ✅
C) Middle ear status
D) Inner hair cells only

11. Distortion Product OAE (DPOAE) measures:
A) Response to single tone
B) Response to two tones ✅
C) Auditory nerve function
D) Tympanic membrane compliance

12. Transient Evoked OAE (TEOAE) uses:
A) Click stimuli ✅
B) Pure tones
C) Noise
D) Bone conduction

13. Risk factors for congenital hearing loss include:
A) Family history ✅
B) NICU stay ≥5 days ✅
C) Ototoxic medications ✅
D) All of the above ✅

14. Universal newborn hearing screening should occur:
A) Within 24 hours of birth
B) By 1 month of age ✅
C) By 6 months of age
D) By 1 year of age

15. A confirmed diagnosis of hearing loss should be made by:
A) 1 month
B) 3 months
C) 6 months ✅
D) 12 months

16. Common causes of pediatric conductive hearing loss include:
A) Otitis media with effusion ✅
B) Cholesteatoma ✅
C) Otosclerosis
D) Both A and B ✅

17. Sensorineural hearing loss in children is most often:
A) Genetic ✅
B) Infectious
C) Traumatic
D) Otitis media

18. Which type of hearing loss is usually permanent?
A) Conductive
B) Sensorineural ✅
C) Mixed
D) Temporary

19. The “ABR threshold” refers to:
A) Behavioral response
B) Softest sound that elicits wave V ✅
C) Loudest tolerable sound
D) Tympanic compliance

20. Pediatric amplification devices include:
A) Behind-the-ear hearing aids ✅
B) Cochlear implants ✅
C) BAHA ✅
D) All of the above ✅

21. Cochlear implantation is typically considered for children with:
A) Mild hearing loss
B) Moderate hearing loss
C) Severe-to-profound bilateral sensorineural hearing loss ✅
D) Conductive hearing loss

22. Early intervention improves:
A) Language outcomes ✅
B) Academic success ✅
C) Social-emotional development ✅
D) All of the above ✅

23. Total Communication in children involves:
A) Spoken language only
B) Sign + speech + visual cues ✅
C) Lip reading only
D) Hearing aids only

24. Auditory-verbal therapy emphasizes:
A) Visual cues
B) Listening and spoken language only ✅
C) Sign language
D) Written language

25. Hearing aids in infants must be:
A) Behind-the-ear and tamper-resistant ✅
B) In-the-canal
C) Body-worn only
D) Not recommended

26. Bone-anchored hearing aids (BAHA) are suitable for:
A) Conductive or mixed hearing loss ✅
B) Cochlear nerve deficiency
C) Mild SNHL
D) Tinnitus

27. Behavioral tests for infants rely primarily on:
A) Verbal responses
B) Reflexive or conditioned responses ✅
C) Written instructions
D) Parent report only

28. VRA uses what type of reinforcement?
A) Visual ✅
B) Auditory
C) Tactile
D) Olfactory

29. CPA typically uses:
A) Toys or games as reinforcement ✅
B) Sound clicks only
C) Visual images only
D) None of the above

30. Tympanometry type B indicates:
A) Normal middle ear
B) Middle ear effusion ✅
C) Hypermobile tympanic membrane
D) Ossicular discontinuity

31. Type C tympanogram indicates:
A) Normal middle ear
B) Negative middle ear pressure ✅
C) Effusion
D) Ossicular fixation

32. The goal of pediatric aural rehabilitation is to:
A) Improve auditory skills ✅
B) Enhance speech-language development ✅
C) Maximize social integration ✅
D) All of the above ✅

33. OAE testing is:
A) Invasive
B) Non-invasive ✅
C) Painful
D) Requires sedation

34. ABR can be used to estimate:
A) Pure tone thresholds ✅
B) Speech understanding
C) Tinnitus severity
D) Vestibular function

35. Risk factors for progressive hearing loss include:
A) Family history ✅
B) Cytomegalovirus infection ✅
C) Prematurity
D) All of the above ✅

36. Hearing screening in school-aged children is usually done using:
A) ABR
B) Pure-tone audiometry ✅
C) OAE
D) Tympanometry

37. Cross-hearing must be considered in:
A) ABR
B) Behavioral audiometry ✅
C) Tympanometry
D) OAE

38. Ear molds for hearing aids in children should be:
A) Hard plastic
B) Soft and flexible ✅
C) Metal
D) Disposable

39. Middle ear effusion can cause:
A) Conductive hearing loss ✅
B) Speech delay ✅
C) Behavioral issues ✅
D) All of the above ✅

40. Universal newborn hearing screening programs aim for:
A) Early detection ✅
B) Early amplification ✅
C) Early intervention ✅
D) All of the above ✅

41. Behavioral testing depends on:
A) Developmental age ✅
B) Hearing level
C) Attention and cooperation ✅
D) Both A and C ✅

42. Pediatric hearing aids should be checked:
A) Once a year
B) Every 3–6 months ✅
C) Never
D) Only after malfunction

43. Hearing loss in children can affect:
A) Speech and language ✅
B) Academic achievement ✅
C) Social-emotional development ✅
D) All of the above ✅

44. ABR wave V latency can be used to estimate:
A) Middle ear status
B) Hearing threshold ✅
C) Tympanic compliance
D) Cochlear microphonic

45. Type As tympanogram indicates:
A) Normal compliance
B) Shallow (stiff) middle ear ✅
C) Deep compliance
D) Negative pressure

46. Type Ad tympanogram indicates:
A) Ossicular discontinuity or hypermobile TM ✅
B) Stiff ossicles
C) Normal middle ear
D) Effusion

47. Early hearing aid fitting is recommended by:
A) 3 months ✅
B) 6 months
C) 1 year
D) 2 years

48. Cochlear implant candidacy for children requires:
A) Severe-to-profound bilateral SNHL ✅
B) Minimal benefit from hearing aids ✅
C) Lack of medical contraindications ✅
D) All of the above ✅

49. Auditory brainstem response can be performed:
A) Awake
B) Sedated ✅
C) Both A and B ✅
D) Only under anesthesia

50. Pediatric audiology focuses on:
A) Early detection ✅
B) Diagnosis ✅
C) Management ✅
D) All of the above ✅

---

Pediatric Audiology – True/False (15 Questions)

1. The cochlea reaches full adult size at birth.
Answer: True ✅

2. BOA is reliable for children older than 6 months.
Answer: False ✅

3. VRA is used primarily for children 6–24 months old.
Answer: True ✅

4. CPA is best for children 2–5 years old.
Answer: True ✅

5. Tympanometry in infants under 6 months should use a 1000 Hz probe tone.
Answer: True ✅

6. OAEs are invasive tests.
Answer: False ✅

7. ABR can estimate auditory thresholds in infants.
Answer: True ✅

8. Early intervention improves language outcomes in hearing-impaired children.
Answer: True ✅

9. Hearing aids for infants must be behind-the-ear and tamper-resistant.
Answer: True ✅

10. Middle ear effusion can cause conductive hearing loss and speech delay.
Answer: True ✅

11. Pediatric cochlear implantation is recommended for mild hearing loss.
Answer: False ✅

12. Cross-hearing must be considered during behavioral audiometry.
Answer: True ✅

13. Auditory-verbal therapy emphasizes listening and spoken language only.
Answer: True ✅

14. Type B tympanogram indicates negative middle ear pressure.
Answer: False ✅

15. Pediatric audiology includes screening, diagnosis, and management.
Answer: True ✅

Adult Hearing Loss & Management – MCQs (50 Questions)

1. Presbycusis refers to:
A) Sudden hearing loss
B) Age-related hearing loss ✅
C) Conductive hearing loss
D) Noise-induced hearing loss

2. Which frequencies are first affected in presbycusis?
A) Low frequencies
B) Mid frequencies
C) High frequencies ✅
D) All frequencies equally

3. The most common type of presbycusis is:
A) Sensory ✅
B) Neural
C) Metabolic
D) Conductive

4. Symptoms of presbycusis include:
A) Difficulty understanding speech in noise ✅
B) Tinnitus ✅
C) Hyperacusis
D) All of the above ✅

5. Audiometric configuration typical of presbycusis:
A) Flat
B) Sloping high-frequency loss ✅
C) Low-frequency loss
D) Notched

6. CROS hearing aids are used for:
A) Bilateral SNHL
B) Unilateral profound hearing loss ✅
C) Conductive hearing loss
D) Mixed hearing loss

7. BiCROS differs from CROS in that it:
A) Amplifies sound from the poor ear only
B) Amplifies sound from the poor ear and the better ear ✅
C) Is only for children
D) Is an old technology

8. Verification of hearing aid fitting is done via:
A) Behavioral observation
B) Real-Ear Measurement (REM) ✅
C) Pure-tone audiometry only
D) Tympanometry

9. Real-Ear Measurement (REM) evaluates:
A) Ear canal volume only
B) Actual output of hearing aid in the ear canal ✅
C) Tympanic membrane compliance
D) Middle ear status

10. The REUG (Real-Ear Unaided Gain) measures:
A) Ear canal amplification without a hearing aid ✅
B) Output of a hearing aid
C) Bone conduction thresholds
D) Speech understanding

11. The REAR (Real-Ear Aided Response) measures:
A) Amplification by the hearing aid in the ear canal ✅
B) Cochlear function
C) Tympanic mobility
D) Outer hair cell function

12. Open-fit hearing aids are mainly suitable for:
A) Low-frequency loss
B) High-frequency loss ✅
C) Profound loss
D) Conductive loss

13. Common complications of hearing aids include:
A) Feedback ✅
B) Occlusion effect ✅
C) Ear canal irritation ✅
D) All of the above ✅

14. Signal-to-noise ratio improvement is primarily achieved by:
A) Hearing aid microphones
B) Directional microphones ✅
C) Amplification alone
D) Battery strength

15. Telecoil (T-coil) in hearing aids allows:
A) Direct connection to FM or loop systems ✅
B) Bone conduction
C) Noise reduction
D) Cochlear implant activation

16. Aural rehabilitation goals for adults include:
A) Improve speech understanding ✅
B) Enhance communication strategies ✅
C) Increase confidence and quality of life ✅
D) All of the above ✅

17. Verification ensures:
A) Hearing aid comfort
B) Device meets prescriptive targets ✅
C) Cosmetic appearance
D) Battery life

18. Validation ensures:
A) Hearing aid meets targets
B) Real-life benefit and satisfaction ✅
C) Proper insertion
D) External ear anatomy

19. Which test helps in hearing aid fitting for difficult-to-test adults?
A) Speech audiometry
B) REM ✅
C) Tympanometry
D) OAE

20. Occlusion effect is most prominent in:
A) Open-fit aids
B) Closed-fit aids ✅
C) CROS aids
D) Cochlear implants

21. FM systems in adults improve:
A) Low-frequency hearing
B) Speech understanding in noise ✅
C) Tinnitus
D) Middle ear function

22. Presbycusis typically affects:
A) Cochlear hair cells ✅
B) Ossicles
C) Tympanic membrane
D) External ear canal

23. Which type of presbycusis is due to neural degeneration?
A) Sensory
B) Neural ✅
C) Metabolic
D) Conductive

24. Cochlear implants in adults are recommended for:
A) Mild loss
B) Moderate loss
C) Severe-to-profound SNHL with poor hearing aid benefit ✅
D) Conductive loss

25. Proper hearing aid orientation includes:
A) Device handling ✅
B) Battery change ✅
C) Troubleshooting ✅
D) All of the above ✅

26. Directional microphones:
A) Pick up sound equally from all directions
B) Emphasize sounds from the front ✅
C) Reduce battery life significantly
D) Are only used in cochlear implants

27. Verification of CROS/BiCROS ensures:
A) Comfort
B) Proper routing of sound from poor ear to good ear ✅
C) Cosmetic appearance
D) None of the above

28. Hearing aid fine-tuning is based on:
A) Audiogram only
B) Patient feedback and REM ✅
C) Visual inspection
D) Tympanometry

29. Presbycusis is usually:
A) Symmetrical ✅
B) Unilateral
C) Fluctuating
D) Conductive

30. Age-related changes in the central auditory system affect:
A) Temporal processing ✅
B) Speech-in-noise perception ✅
C) Both A and B ✅
D) None

31. Real-ear measurements should be done:
A) Once in a lifetime
B) Each time hearing aids are fitted ✅
C) Only for children
D) Optional

32. Open-fit hearing aids reduce:
A) Occlusion effect ✅
B) Feedback completely
C) Directionality
D) Amplification

33. Aural rehabilitation includes:
A) Counseling ✅
B) Communication strategy training ✅
C) Listening exercises ✅
D) All of the above ✅

34. Noise reduction in hearing aids:
A) Eliminates all background noise
B) Reduces noise for better SNR ✅
C) Amplifies all sounds
D) Causes cochlear damage

35. Feedback occurs due to:
A) Poor fit ✅
B) High gain ✅
C) Ear mold leaks ✅
D) All of the above ✅

36. Presbycusis affects mainly:
A) Adults over 50 ✅
B) Children
C) Young adults
D) Teenagers

37. CROS systems are suitable for:
A) Single-sided deafness ✅
B) Bilateral SNHL
C) Conductive loss
D) Cochlear implant candidates

38. BiCROS is used when:
A) Poor ear is unaidable ✅
B) Good ear has normal hearing
C) Patient is a child
D) None of the above

39. REM is also called:
A) Real-ear probe microphone measurement ✅
B) Audiogram
C) Tympanometry
D) OAE

40. Verification ensures the hearing aid meets:
A) Cosmetic expectations
B) Prescriptive targets ✅
C) Battery life
D) Patient preference

41. Validation ensures:
A) Real-life benefit ✅
B) Pure-tone thresholds
C) Tympanometry
D) Cochlear health

42. Presbycusis can lead to:
A) Social withdrawal ✅
B) Depression ✅
C) Cognitive decline ✅
D) All of the above ✅

43. Directional microphones:
A) Increase SNR ✅
B) Reduce speech clarity
C) Amplify background noise
D) Are only used in children

44. Tinnitus management can be part of:
A) Hearing aids ✅
B) Counseling ✅
C) Sound therapy ✅
D) All of the above ✅

45. REM is essential for:
A) Objective verification ✅
B) Cosmetic fitting
C) Battery replacement
D) None of the above

46. Occlusion effect can be minimized with:
A) Open-fit aids ✅
B) High gain
C) Ear canal blocking
D) T-coil

47. Audiologists should perform hearing aid orientation:
A) Once, only at purchase
B) Repeated sessions ✅
C) Not required
D) Only if the patient asks

48. Presbycusis is primarily:
A) Reversible
B) Progressive ✅
C) Conductive
D) Temporary

49. Hearing aid fine-tuning improves:
A) Speech understanding ✅
B) Comfort ✅
C) SNR ✅
D) All of the above ✅

50. Adult aural rehabilitation is aimed at:
A) Amplification only
B) Improving communication and quality of life ✅
C) Cosmetic appearance
D) Tympanic health

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Adult Hearing Loss & Management – True/False (15 Questions)

1. Presbycusis primarily affects high frequencies first.
Answer: True ✅

2. CROS hearing aids are used for bilateral symmetrical loss.
Answer: False ✅

3. BiCROS amplifies sound from the poor ear and provides amplification to the better ear.
Answer: True ✅

4. Real-Ear Measurement is essential to verify hearing aid output in the ear canal.
Answer: True ✅

5. Open-fit aids help reduce occlusion effect.
Answer: True ✅

6. Directional microphones improve speech understanding in noise.
Answer: True ✅

7. Validation assesses real-life benefit and satisfaction.
Answer: True ✅

8. Occlusion effect occurs mainly in open-fit aids.
Answer: False ✅

9. Presbycusis is typically symmetrical and progressive.
Answer: True ✅

10. T-coil allows direct connection to loop or FM systems.
Answer: True ✅

11. Noise reduction in hearing aids completely eliminates background noise.
Answer: False ✅

12. Hearing aid orientation includes counseling, battery instruction, and troubleshooting.
Answer: True ✅

13. Presbycusis does not impact social or cognitive function.
Answer: False ✅

14. Verification and validation are equally important for adult amplification.
Answer: True ✅

15. Aural rehabilitation focuses only on amplification and not communication strategies.
Answer: False ✅

Vestibular System & Balance Assessment – MCQs (50 Questions)

1. The vestibular system primarily helps with:
A) Hearing
B) Balance and spatial orientation ✅
C) Vision
D) Taste

2. The semicircular canals detect:
A) Linear acceleration
B) Angular (rotational) acceleration ✅
C) Sound
D) Pressure

3. The otolith organs (utricle and saccule) detect:
A) Linear acceleration and gravity ✅
B) Rotational movement
C) Sound frequency
D) Temperature

4. Videonystagmography (VNG) primarily records:
A) Auditory brainstem response
B) Eye movements ✅
C) Cochlear potentials
D) Tympanic membrane vibration

5. Caloric testing stimulates the:
A) Cochlea
B) Horizontal semicircular canal ✅
C) Utricle
D) Saccule

6. Warm water irrigation during caloric testing causes:
A) Nystagmus toward the irrigated ear ✅
B) Nystagmus away from the irrigated ear
C) No response
D) Hearing improvement

7. Cold water irrigation causes:
A) Nystagmus toward the irrigated ear
B) Nystagmus away from the irrigated ear ✅
C) No response
D) Hearing loss

8. cVEMP assesses the function of:
A) Cochlea
B) Saccule and inferior vestibular nerve ✅
C) Horizontal canal
D) Utricle

9. oVEMP primarily assesses:
A) Saccule
B) Utricle and superior vestibular nerve ✅
C) Cochlea
D) Semicircular canals

10. The vHIT (video Head Impulse Test) evaluates:
A) Low-frequency vestibular function
B) High-frequency semicircular canal function ✅
C) Cochlear function
D) Central vision

11. BPPV is caused by:
A) Infection
B) Dislodged otoconia in semicircular canals ✅
C) Tumor
D) Conductive hearing loss

12. The most commonly affected canal in BPPV is:
A) Anterior semicircular canal
B) Posterior semicircular canal ✅
C) Lateral canal
D) Utricle

13. The Dix-Hallpike maneuver is used to diagnose:
A) Presbycusis
B) BPPV ✅
C) Meniere’s disease
D) Vestibular neuritis

14. Epley maneuver is used to:
A) Diagnose BPPV
B) Treat BPPV ✅
C) Treat vestibular migraine
D) Measure vHIT

15. Nystagmus observed in caloric testing is:
A) Always horizontal
B) Can be horizontal, vertical, or torsional ✅
C) Only vertical
D) Not measurable

16. VNG includes:
A) Saccade testing
B) Smooth pursuit
C) Optokinetic testing
D) All of the above ✅

17. Abnormal VNG results can indicate:
A) Peripheral vestibular dysfunction ✅
B) Central nervous system lesion ✅
C) Both A and B ✅
D) Only cochlear dysfunction

18. cVEMP response is measured in:
A) Eye muscles
B) Sternocleidomastoid muscle ✅
C) Tongue
D) Leg muscles

19. oVEMP response is measured in:
A) Eye muscles ✅
B) Neck muscles
C) Tongue
D) Foot muscles

20. The vestibulo-ocular reflex (VOR) is responsible for:
A) Hearing
B) Stabilizing gaze during head movements ✅
C) Balance on one foot
D) Sound localization

21. vHIT is particularly useful because:
A) It is invasive
B) Evaluates high-frequency VOR function ✅
C) Requires caloric irrigation
D) Only used for children

22. Common symptoms of vestibular disorders include:
A) Dizziness ✅
B) Vertigo ✅
C) Imbalance ✅
D) All of the above ✅

23. Vestibular rehabilitation therapy aims to:
A) Improve hearing
B) Reduce dizziness and improve balance ✅
C) Cure tinnitus
D) Treat BPPV only

24. Canalith repositioning maneuvers are effective in:
A) Vestibular neuritis
B) BPPV ✅
C) Labyrinthitis
D) Presbycusis

25. Labyrinthitis differs from vestibular neuritis because it:
A) Affects hearing and balance ✅
B) Only affects balance
C) Is painless
D) Is chronic

26. Meniere’s disease is characterized by:
A) Vertigo ✅
B) Fluctuating hearing loss ✅
C) Tinnitus ✅
D) All of the above ✅

27. VNG caloric testing is performed at what temperatures?
A) 20°C and 30°C
B) 30°C and 44°C
C) 30°C (cold) and 44°C (warm) ✅
D) 25°C and 50°C

28. The main advantage of vHIT over calorics is:
A) High-frequency canal assessment ✅
B) Low-frequency canal assessment
C) Cheaper equipment
D) Non-video based

29. cVEMP absent response may indicate:
A) Saccule dysfunction ✅
B) Cochlear loss
C) Posterior canal dysfunction
D) Normal vestibular function

30. oVEMP absent response may indicate:
A) Utricle or superior vestibular nerve dysfunction ✅
B) Cochlear dysfunction
C) Saccule dysfunction
D) Posterior canal dysfunction

31. Peripheral vestibular disorders show:
A) Direction-fixed nystagmus ✅
B) Vertical-only nystagmus
C) Torsional-only nystagmus
D) No nystagmus

32. Central vestibular disorders often show:
A) Direction-changing nystagmus ✅
B) No nystagmus
C) Only horizontal nystagmus
D) No vertigo

33. Vestibular migraine may mimic:
A) BPPV ✅
B) Meniere’s disease ✅
C) Labyrinthitis
D) Both A and B ✅

34. Caloric testing primarily evaluates:
A) High-frequency canal function
B) Low-frequency canal function ✅
C) Otolith function
D) Central vestibular pathways

35. VNG testing is contraindicated in:
A) Recent eye surgery ✅
B) Hearing aid users
C) Children
D) Elderly

36. vHIT can evaluate which canals?
A) Lateral ✅
B) Anterior ✅
C) Posterior ✅
D) All three semicircular canals ✅

37. The main goal of vestibular rehabilitation is:
A) Restore normal vestibular function
B) Promote central compensation ✅
C) Eliminate BPPV
D) Improve hearing

38. BPPV symptoms are usually:
A) Continuous dizziness
B) Short, positional vertigo episodes ✅
C) Fluctuating hearing loss
D) Progressive tinnitus

39. Recurrent vertigo with hearing loss and tinnitus suggests:
A) Vestibular migraine
B) Meniere’s disease ✅
C) BPPV
D) Presbycusis

40. VNG includes:
A) Oculomotor testing ✅
B) Positional testing ✅
C) Caloric testing ✅
D) All of the above ✅

41. Caloric testing uses which principle?
A) Thermal convection in endolymph ✅
B) Sound stimulation
C) Electromagnetic induction
D) Mechanical vibration

42. The primary afferent nerve for cVEMP is:
A) Superior vestibular nerve
B) Inferior vestibular nerve ✅
C) Cochlear nerve
D) Facial nerve

43. The primary afferent nerve for oVEMP is:
A) Superior vestibular nerve ✅
B) Inferior vestibular nerve
C) Cochlear nerve
D) Facial nerve

44. Vestibular neuritis usually presents with:
A) Sudden vertigo ✅
B) Nausea and vomiting ✅
C) Normal hearing ✅
D) All of the above ✅

45. Canalith repositioning maneuvers are:
A) Pharmacologic
B) Physical therapy maneuvers ✅
C) Surgery
D) Diet modification

46. cVEMP amplitude is measured in:
A) Microvolts ✅
B) Hertz
C) Decibels
D) Milliliters

47. oVEMP amplitude is measured in:
A) Microvolts ✅
B) Hertz
C) Decibels
D) Milliliters

48. BPPV is more common in:
A) Children
B) Adults over 50 ✅
C) Teenagers
D) Young adults

49. Vestibular testing helps distinguish:
A) Peripheral vs. central lesions ✅
B) Left vs. right hearing loss
C) Low vs. high-frequency hearing loss
D) Tinnitus type

50. Rehabilitation after vestibular loss involves:
A) Balance training ✅
B) Gaze stabilization ✅
C) Habituation exercises ✅
D) All of the above ✅

---

Vestibular System & Balance Assessment – True/False (15 Questions)

1. The vestibular system contributes to balance, posture, and spatial orientation.
Answer: True ✅

2. The semicircular canals detect linear acceleration.
Answer: False ✅

3. cVEMP assesses saccule and inferior vestibular nerve function.
Answer: True ✅

4. oVEMP assesses utricle and superior vestibular nerve function.
Answer: True ✅

5. vHIT evaluates low-frequency canal function.
Answer: False ✅

6. BPPV is caused by displaced otoconia.
Answer: True ✅

7. Posterior canal BPPV is the most common form.
Answer: True ✅

8. Caloric testing assesses high-frequency canal function.
Answer: False ✅

9. Vestibular rehabilitation promotes central compensation after vestibular loss.
Answer: True ✅

10. Dix-Hallpike maneuver is diagnostic for BPPV.
Answer: True ✅

11. Vestibular migraine may mimic BPPV and Meniere’s disease.
Answer: True ✅

12. cVEMP responses are measured from eye muscles.
Answer: False ✅

13. vHIT is performed with small, rapid head impulses while the patient fixes their gaze.
Answer: True ✅

14. Canalith repositioning maneuvers cure vestibular neuritis.
Answer: False ✅

15. Oculomotor, positional, and caloric tests are included in VNG.
Answer: True ✅

Pediatric Audiology – MCQs (50 Questions)

1. The auditory system begins developing in the embryo at approximately:
A) 2 weeks
B) 3 weeks
C) 3–4 weeks ✅
D) 6 weeks

2. By which week of gestation is the cochlea fully formed?
A) 12 weeks
B) 20 weeks
C) 25 weeks ✅
D) 30 weeks

3. Outer ear formation is mostly complete by:
A) 8 weeks
B) 12 weeks ✅
C) 16 weeks
D) 20 weeks

4. The inner ear develops from which embryologic structure?
A) Neural crest
B) Otic placode ✅
C) Mesoderm
D) Endoderm

5. Behavioral observation audiometry (BOA) is typically used for children aged:
A) 0–6 months ✅
B) 6–12 months
C) 1–3 years
D) Over 3 years

6. Visual Reinforcement Audiometry (VRA) is appropriate for children aged:
A) 3–6 months
B) 6–24 months ✅
C) 2–4 years
D) 4–6 years

7. Conditioned Play Audiometry (CPA) is used for children aged:
A) 6–12 months
B) 12–36 months
C) 2–5 years ✅
D) 6–10 years

8. BOA measures:
A) Auditory brainstem responses
B) Reflexive behavioral responses to sound ✅
C) Language comprehension
D) Speech discrimination

9. VRA uses:
A) Reinforcement via toys or lights ✅
B) Headphones only
C) Speechreading
D) Written instructions

10. CPA requires:
A) Passive observation
B) Active participation through play ✅
C) Pure tone thresholds only
D) No attention from child

11. Otoacoustic emissions (OAEs) test:
A) Cochlear outer hair cell function ✅
B) Middle ear function only
C) Auditory nerve
D) Vestibular function

12. Auditory Brainstem Response (ABR) is:
A) Behavioral test
B) Objective electrophysiological test ✅
C) Speech test
D) Pure tone test

13. Newborn hearing screening typically includes:
A) Behavioral audiometry
B) OAEs and/or ABR ✅
C) Pure tone audiometry
D) CPA

14. Risk factors for pediatric hearing loss include:
A) Premature birth ✅
B) NICU stay
C) Ototoxic medication exposure
D) All of the above ✅

15. Cochlear implants are indicated for children with:
A) Mild hearing loss
B) Moderate hearing loss
C) Severe to profound sensorineural hearing loss ✅
D) Conductive hearing loss

16. Early implantation in children leads to:
A) Slower language development
B) Better spoken language outcomes ✅
C) No difference
D) Only improves balance

17. Total Communication in pediatric audiology includes:
A) Sign language only
B) Speechreading only
C) Combination of communication methods ✅
D) Written communication only

18. Auditory-Verbal Therapy focuses on:
A) Teaching sign language
B) Maximizing listening through residual hearing ✅
C) Visual cues only
D) Behavioral observation

19. Hearing aids for children should:
A) Be behind-the-ear, tamper-resistant ✅
B) Only be in-the-ear
C) Not used until age 5
D) Be removed during school

20. BAHA (Bone-Anchored Hearing Aid) is typically used in:
A) Sensorineural hearing loss
B) Conductive hearing loss or single-sided deafness ✅
C) Profound SNHL only
D) Vestibular disorders

21. Pediatric hearing loss can affect:
A) Speech development ✅
B) Academic performance ✅
C) Social skills ✅
D) All of the above ✅

22. The Ling Six Sound Test checks:
A) High-frequency hearing only
B) Full speech spectrum hearing ✅
C) Balance
D) Tinnitus

23. The auditory milestone “turns head to sound” occurs around:
A) 1 month
B) 3–4 months ✅
C) 6–8 months
D) 12 months

24. Children with hearing loss may require which classroom accommodations?
A) Preferential seating ✅
B) FM system use ✅
C) Visual aids ✅
D) All of the above ✅

25. The primary goal of early hearing intervention is:
A) Speech and language development ✅
B) Academic remediation only
C) Behavioral training
D) Vestibular rehabilitation

26. For infants, tympanometry uses which probe tone?
A) 226 Hz
B) 1000 Hz ✅
C) 500 Hz
D) 2000 Hz

27. Binaural amplification in children is important because:
A) Helps localization ✅
B) Improves speech understanding in noise ✅
C) Prevents auditory deprivation ✅
D) All of the above ✅

28. Ototoxicity monitoring is critical in children receiving:
A) Aminoglycosides ✅
B) Loop diuretics ✅
C) Chemotherapy agents ✅
D) All of the above ✅

29. The main principle of pediatric aural rehabilitation is:
A) Compensate only with vision
B) Maximize listening and communication abilities ✅
C) Delay amplification
D) Focus only on language therapy

30. Pediatric ABR thresholds provide:
A) Behavioral responses
B) Estimated hearing sensitivity ✅
C) Speech discrimination scores
D) None of the above

31. Hearing loss in children may be:
A) Congenital ✅
B) Acquired ✅
C) Progressive ✅
D) All of the above ✅

32. Language development in children with hearing loss is best supported by:
A) Early detection ✅
B) Prompt amplification ✅
C) Consistent therapy ✅
D) All of the above ✅

33. Visual Reinforcement Audiometry rewards the child with:
A) Sound only
B) Visual stimulus ✅
C) Touch
D) Food

34. Children with unilateral hearing loss may need:
A) Amplification in the affected ear ✅
B) Classroom accommodations ✅
C) Monitoring for academic challenges ✅
D) All of the above ✅

35. CAPD (Central Auditory Processing Disorder) affects:
A) Peripheral hearing
B) Auditory perception and processing ✅
C) Outer hair cell function
D) Middle ear only

36. Pediatric hearing aids should be:
A) Fitted once and never adjusted
B) Regularly monitored and adjusted ✅
C) Only checked if child complains
D) Removed in noisy environments

37. Cochlear implant mapping is:
A) Setting the device for optimal hearing ✅
B) Physical implant surgery
C) Pure tone testing
D) Speech therapy

38. Hearing screening should occur by:
A) Birth ✅
B) 3 months
C) 6 months
D) 12 months

39. OAEs can detect:
A) Mild to profound SNHL ✅
B) Conductive hearing loss
C) Vestibular disorders
D) Only central lesions

40. Children with auditory neuropathy may have:
A) Normal OAEs ✅
B) Abnormal ABR ✅
C) Difficulties understanding speech in noise ✅
D) All of the above ✅

41. The auditory brainstem matures by approximately:
A) 3 months
B) 12 months ✅
C) 2 years
D) 5 years

42. Behavioral testing for infants relies on:
A) Subjective responses ✅
B) Electrophysiological measures
C) Cochlear implants
D) Hearing aids

43. Early intervention services should start:
A) After 6 months
B) By 3 months of age ✅
C) At age 1
D) At age 2

44. Children with hearing loss may show delays in:
A) Speech ✅
B) Language ✅
C) Cognitive development ✅
D) All of the above ✅

45. Visual cues supplement hearing in:
A) Auditory-Verbal Therapy
B) Total Communication ✅
C) Only ASL
D) CPA only

46. Amplification in infants must be:
A) Immediate after diagnosis ✅
B) Delayed until 1 year
C) Optional
D) Only after cochlear implantation

47. High-risk registry includes children with:
A) NICU stay >5 days ✅
B) Family history of hearing loss ✅
C) Craniofacial anomalies ✅
D) All of the above ✅

48. CAPD is usually assessed with:
A) Pure tone audiometry
B) Speech-in-noise and dichotic listening tests ✅
C) OAE
D) ABR

49. Amplification alone is sufficient for language development in children.
A) True
B) False ✅

50. Family involvement is critical for success in pediatric audiology intervention.
A) True ✅
B) False

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Pediatric Audiology – True/False (15 Questions)

1. The cochlea is fully formed by 25 weeks gestation.
Answer: True ✅

2. BOA is suitable for children aged 1–3 years.
Answer: False ✅

3. VRA uses visual reinforcement to condition auditory responses.
Answer: True ✅

4. CPA requires active participation from the child.
Answer: True ✅

5. OAEs are an objective measure of cochlear outer hair cell function.
Answer: True ✅

6. ABR is a behavioral test.
Answer: False ✅

7. Early amplification improves spoken language outcomes.
Answer: True ✅

8. Ling Six Sound Test checks only high-frequency hearing.
Answer: False ✅

9. Hearing aids for children should be tamper-resistant and behind-the-ear.
Answer: True ✅

10. Pediatric aural rehabilitation focuses on maximizing listening and communication abilities.
Answer: True ✅

11. Visual Reinforcement Audiometry rewards the child with sound only.
Answer: False ✅

12. Unilateral hearing loss does not require classroom accommodations.
Answer: False ✅

13. CAPD affects auditory perception and processing, not cochlear function.
Answer: True ✅

14. Cochlear implant mapping sets the device for optimal hearing.
Answer: True ✅

15. Family involvement is unnecessary for early intervention success.
Answer: False ✅

Adult Audiology – MCQs (50 Questions)

1. Presbycusis primarily affects:
A) Low frequencies
B) High frequencies ✅
C) Mid frequencies
D) All frequencies equally

2. The most common type of presbycusis is:
A) Sensory ✅
B) Neural
C) Metabolic
D) Mechanical

3. Presbycusis is primarily:
A) Congenital
B) Age-related ✅
C) Caused by infection
D) Conductive

4. Noise-induced hearing loss (NIHL) typically affects which frequency first?
A) 500 Hz
B) 1000 Hz
C) 3000–6000 Hz ✅
D) 8000 Hz

5. The classic audiogram pattern for NIHL shows:
A) Flat loss
B) Sloping high-frequency loss ✅
C) Low-frequency loss
D) U-shaped loss

6. Tinnitus is:
A) Hearing loss
B) Ringing or perception of sound without an external source ✅
C) Balance problem
D) Vestibular dysfunction

7. Which of the following can contribute to tinnitus?
A) NIHL ✅
B) Presbycusis ✅
C) Ototoxic medications ✅
D) All of the above ✅

8. Ototoxic drugs include:
A) Aminoglycosides ✅
B) Cisplatin ✅
C) Loop diuretics ✅
D) All of the above ✅

9. Recruitment in hearing loss refers to:
A) Gradual hearing loss over time
B) Abnormal loudness growth ✅
C) Tinnitus perception
D) Vestibular dysfunction

10. Speech discrimination scores are typically poorer in:
A) Conductive hearing loss
B) Sensorineural hearing loss ✅
C) Normal hearing
D) Outer ear malformations

11. The primary goal of adult aural rehabilitation is:
A) Amplify sound only
B) Improve communication and quality of life ✅
C) Cure hearing loss
D) Treat tinnitus only

12. Which type of hearing aid is most commonly recommended for adults with presbycusis?
A) In-the-ear (ITE)
B) Behind-the-ear (BTE) ✅
C) Bone-anchored
D) Cochlear implant

13. Noise exposure exceeding which dB level can increase risk of NIHL?
A) 50 dB
B) 70 dB
C) 85 dB ✅
D) 100 dB

14. Hearing protection for noise exposure includes:
A) Earplugs ✅
B) Earmuffs ✅
C) Custom-molded devices ✅
D) All of the above ✅

15. Auditory rehabilitation strategies for adults include:
A) Hearing aids ✅
B) Assistive listening devices ✅
C) Communication strategies ✅
D) All of the above ✅

16. Central presbycusis primarily affects:
A) Outer ear
B) Inner ear
C) Auditory processing and speech understanding ✅
D) Vestibular system

17. Temporary threshold shift (TTS) occurs:
A) After prolonged noise exposure ✅
B) Permanently
C) Only in children
D) None of the above

18. Permanent threshold shift (PTS) indicates:
A) Temporary hearing loss
B) Permanent damage to hair cells ✅
C) Vestibular damage
D) Auditory nerve regeneration

19. High-frequency hearing loss in adults affects:
A) Vowel perception
B) Consonant perception ✅
C) Both equally
D) None

20. Which of the following is a common consequence of untreated adult hearing loss?
A) Social isolation ✅
B) Cognitive decline ✅
C) Depression ✅
D) All of the above ✅

21. Real Ear Measurement (REM) is used to:
A) Measure cochlear function
B) Verify hearing aid amplification in the ear ✅
C) Assess vestibular function
D) Test OAEs

22. Directional microphones in hearing aids help:
A) Reduce background noise ✅
B) Amplify low frequencies
C) Detect vestibular function
D) Measure bone conduction

23. Telecoils in hearing aids:
A) Amplify all sounds
B) Pick up magnetic signals from loop systems ✅
C) Detect bone conduction
D) Only for pediatric use

24. Tinnitus management can include:
A) Sound therapy ✅
B) Counseling ✅
C) Cognitive behavioral therapy ✅
D) All of the above ✅

25. Cochlear implantation in adults is indicated for:
A) Mild hearing loss
B) Moderate hearing loss
C) Severe-to-profound sensorineural loss not aided by conventional hearing aids ✅
D) Conductive hearing loss

26. Auditory training exercises help adults with:
A) Speech perception in noise ✅
B) Vocabulary acquisition
C) Only children
D) Outer ear protection

27. Sudden sensorineural hearing loss (SSNHL) requires:
A) Immediate ENT referral ✅
B) Delayed evaluation
C) No intervention
D) Only counseling

28. A “notch” at 4 kHz on audiogram suggests:
A) Presbycusis
B) Noise-induced hearing loss ✅
C) Conductive loss
D) Tinnitus

29. Ototoxicity monitoring for adults is recommended during treatment with:
A) Aminoglycosides ✅
B) Cisplatin ✅
C) Loop diuretics ✅
D) All of the above ✅

30. Age-related hearing loss is often:
A) Sudden
B) Gradual ✅
C) Only in left ear
D) Always conductive

31. Speechreading in adults can compensate for:
A) Mild-to-moderate hearing loss ✅
B) Profound hearing loss only
C) Vestibular loss
D) Cognitive decline

32. Adults with high-frequency hearing loss often struggle with:
A) Understanding vowels
B) Understanding consonants ✅
C) Low-frequency sounds
D) Rhythm perception

33. Acoustic trauma is typically caused by:
A) Repeated noise
B) Single high-intensity noise ✅
C) Age
D) Infection

34. Recruitment affects:
A) Loudness tolerance ✅
B) Outer hair cells only
C) Middle ear
D) Vestibular function

35. Hearing aid orientation includes:
A) Device handling ✅
B) Battery management ✅
C) Communication strategies ✅
D) All of the above ✅

36. Assistive listening devices (ALDs) for adults include:
A) FM systems ✅
B) Bluetooth streamers ✅
C) Loop systems ✅
D) All of the above ✅

37. Cognitive decline in older adults can be worsened by:
A) Untreated hearing loss ✅
B) Wearing hearing aids
C) Vestibular rehab
D) None

38. Masking in audiometry is used to:
A) Prevent cross-hearing ✅
B) Amplify sound
C) Measure OAEs
D) Only in children

39. Noise-induced hearing loss is:
A) Preventable ✅
B) Unpreventable
C) Only in industrial workers
D) Only affects children

40. Presbycusis can be classified into:
A) Sensory
B) Neural
C) Metabolic (strial)
D) Mechanical
E) All of the above ✅

41. Amplification can improve:
A) Hearing thresholds ✅
B) Speech understanding ✅
C) Quality of life ✅
D) All of the above ✅

42. Adults with unilateral hearing loss may benefit from:
A) CROS hearing aids ✅
B) Bilateral amplification
C) Vestibular rehab
D) OAE testing

43. Temporary threshold shifts usually recover within:
A) Minutes to hours ✅
B) Days
C) Weeks
D) Permanent

44. Tinnitus perception can be:
A) Subjective ✅
B) Objective ✅
C) Both ✅
D) None

45. Adults with hearing loss should have audiometric evaluations:
A) Every year ✅
B) Every 5 years
C) Only when symptomatic
D) Never

46. Bone-anchored devices are primarily used for:
A) Conductive or mixed hearing loss ✅
B) Sensorineural only
C) Tinnitus
D) Cognitive decline

47. Presbycusis commonly affects:
A) Bilateral symmetric high frequencies ✅
B) Low frequencies only
C) Left ear only
D) Right ear only

48. Counseling in adult AR includes:
A) Realistic expectations ✅
B) Communication strategies ✅
C) Device handling ✅
D) All of the above ✅

49. Amplification alone is sufficient for all adults with hearing loss.
A) True
B) False ✅

50. Speech-in-noise testing helps in:
A) Detecting real-life communication difficulties ✅
B) Only detecting high-frequency loss
C) Tinnitus assessment
D) Vestibular assessment

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Adult Audiology – True/False (15 Questions)

1. Presbycusis is a gradual, age-related hearing loss.
Answer: True ✅

2. Noise-induced hearing loss usually starts in low frequencies.
Answer: False ✅

3. Tinnitus can be a symptom of both NIHL and presbycusis.
Answer: True ✅

4. Recruitment refers to abnormal loudness growth in sensorineural loss.
Answer: True ✅

5. Directional microphones in hearing aids reduce background noise.
Answer: True ✅

6. Cochlear implants in adults are indicated for mild hearing loss.
Answer: False ✅

7. Hearing aid orientation should include counseling on communication strategies.
Answer: True ✅

8. Bone-anchored hearing aids are used for sensorineural hearing loss primarily.
Answer: False ✅

9. Real Ear Measurement verifies hearing aid output in the ear.
Answer: True ✅

10. Untreated hearing loss can contribute to social isolation and cognitive decline.
Answer: True ✅

11. Temporary threshold shifts usually resolve within minutes to hours.
Answer: True ✅

12. Adults with unilateral hearing loss never benefit from amplification.
Answer: False ✅

13. Ototoxicity can result from aminoglycosides, cisplatin, or loop diuretics.
Answer: True ✅

14. Speech-in-noise testing is unnecessary in adult AR.
Answer: False ✅

15. Counseling is an essential part of adult aural rehabilitation.
Answer: True ✅

estibular Disorders & Testing – MCQs (50 Questions)

1. BPPV stands for:
A) Benign Paroxysmal Positional Vertigo ✅
B) Bilateral Peripheral Peripheral Vertigo
C) Brainstem Peripheral Vestibular
D) Basilar Paroxysmal Vestibular

2. The most common cause of BPPV is:
A) Vestibular neuritis
B) Otolith (canalith) dislodgement ✅
C) Meniere’s disease
D) Acoustic neuroma

3. The classic symptom of BPPV is:
A) Constant dizziness
B) Vertigo triggered by head position changes ✅
C) Hearing loss
D) Tinnitus

4. The diagnostic test for BPPV is:
A) VNG caloric testing
B) Dix-Hallpike maneuver ✅
C) Audiometry
D) MRI

5. The canal most commonly affected in BPPV is:
A) Anterior
B) Posterior ✅
C) Horizontal
D) Superior

6. Which maneuver is commonly used to treat posterior canal BPPV?
A) Epley maneuver ✅
B) Semont maneuver ✅
C) Brandt-Daroff exercises ✅
D) All of the above ✅

7. Vestibular neuritis primarily affects:
A) Cochlea
B) Vestibular nerve ✅
C) Outer ear
D) Eustachian tube

8. Symptoms of vestibular neuritis include:
A) Sudden vertigo ✅
B) Nausea and vomiting ✅
C) No hearing loss ✅
D) All of the above ✅

9. Meniere’s disease triad includes:
A) Vertigo, tinnitus, hearing loss ✅
B) Vertigo, headache, nausea
C) Hearing loss, imbalance, tinnitus
D) Tinnitus, dizziness, vision changes

10. The pathophysiology of Meniere’s disease is associated with:
A) Endolymphatic hydrops ✅
B) Otolith dislodgement
C) Vestibular neuritis
D) Acoustic trauma

11. Vestibular migraine is characterized by:
A) Vertigo only
B) Migraine headaches only
C) Vertigo episodes associated with migraine symptoms ✅
D) Tinnitus only

12. The vHIT test evaluates:
A) High-frequency semicircular canal function ✅
B) Low-frequency vestibular function
C) Cochlear function
D) Tinnitus

13. cVEMP measures:
A) Saccule and inferior vestibular nerve function ✅
B) Utricle function
C) Semicircular canal function
D) Auditory nerve

14. oVEMP measures:
A) Saccule function
B) Utricle and superior vestibular nerve function ✅
C) Semicircular canal
D) Hearing thresholds

15. Caloric testing evaluates:
A) Low-frequency horizontal semicircular canal function ✅
B) Utricle function
C) Cochlear thresholds
D) Visual acuity

16. Common VNG subtests include:
A) Oculomotor tests ✅
B) Positional testing ✅
C) Caloric testing ✅
D) All of the above ✅

17. In BPPV, the nystagmus observed is:
A) Always purely vertical
B) Often torsional with vertical components ✅
C) Horizontal only
D) Absent

18. A positive Dix-Hallpike maneuver indicates:
A) Vestibular neuritis
B) Posterior canal BPPV ✅
C) Meniere’s disease
D) Central vertigo

19. Brandt-Daroff exercises are primarily used for:
A) Vestibular migraine
B) BPPV rehabilitation ✅
C) Hearing loss
D) Tinnitus

20. Which symptom is less common in vestibular migraine?
A) Photophobia
B) Phonophobia
C) Constant hearing loss ✅
D) Nausea

21. In Meniere’s disease, hearing loss is typically:
A) Conductive
B) Sensorineural and fluctuating ✅
C) Permanent and flat
D) Only low-frequency

22. BPPV is most common in which age group?
A) Children
B) Young adults
C) Older adults ✅
D) Teenagers

23. VNG stands for:
A) Vestibular Nerve Gain
B) Videonystagmography ✅
C) Vestibular Neural Guide
D) Visual Nystagmus Generator

24. The Semont maneuver is mainly used for:
A) Horizontal canal BPPV
B) Posterior canal BPPV ✅
C) Vestibular neuritis
D) Meniere’s disease

25. Which vestibular test is primarily objective and non-invasive?
A) Audiometry
B) vHIT ✅
C) CT scan
D) MRI

26. Vestibular rehabilitation therapy (VRT) aims to:
A) Cure hearing loss
B) Improve balance and reduce dizziness ✅
C) Eliminate tinnitus
D) Measure vestibular nerve function

27. Canalith repositioning maneuvers are effective because they:
A) Remove endolymphatic hydrops
B) Return displaced otoconia to the utricle ✅
C) Stimulate cochlear hair cells
D) Reduce migraine frequency

28. Vestibular migraine can be triggered by:
A) Stress ✅
B) Hormonal changes ✅
C) Diet and sleep changes ✅
D) All of the above ✅

29. In vHIT, corrective saccades indicate:
A) Normal vestibular function
B) Vestibular hypofunction ✅
C) Cochlear impairment
D) Central vision loss

30. cVEMP response is recorded from:
A) Sternocleidomastoid muscle ✅
B) Extraocular muscles
C) Leg muscles
D) Hand muscles

31. True BPPV episodes last:
A) Seconds to minutes ✅
B) Hours
C) Days
D) Weeks

32. Meniere’s disease typically affects:
A) Both ears simultaneously
B) One ear first ✅
C) Only vestibular nerve
D) Cochlea only

33. Vestibular neuritis typically spares:
A) Vestibular nerve
B) Cochlear function ✅
C) Semicircular canals
D) Utricle

34. Central vertigo features include:
A) Direction-changing nystagmus ✅
B) Peripheral latency
C) Fatigable nystagmus
D) Torsional nystagmus

35. BPPV rarely causes:
A) Vertigo ✅
B) Falls ✅
C) Tinnitus ✅
D) Positional dizziness

36. Canalithiasis refers to:
A) Otoliths freely moving in the semicircular canal ✅
B) Endolymphatic hydrops
C) Vestibular nerve inflammation
D) Central vestibular lesion

37. Vestibular rehabilitation includes:
A) Habituation exercises ✅
B) Gaze stabilization ✅
C) Balance training ✅
D) All of the above ✅

38. vHIT uses:
A) Head impulse test and eye tracking ✅
B) Caloric irrigation
C) Audiometry
D) OAE

39. cVEMP is most sensitive to:
A) Superior vestibular nerve
B) Inferior vestibular nerve ✅
C) Cochlear nerve
D) Facial nerve

40. Oculomotor testing in VNG includes:
A) Smooth pursuit ✅
B) Saccades ✅
C) Optokinetic testing ✅
D) All of the above ✅

41. BPPV can resolve spontaneously in:
A) Days to weeks ✅
B) Months only
C) Years
D) Never

42. Vestibular migraine often mimics:
A) Meniere’s disease ✅
B) BPPV ✅
C) Vestibular neuritis ✅
D) All of the above ✅

43. The primary mechanism of caloric testing is:
A) Heat-induced endolymph flow ✅
B) Electrical stimulation
C) Sound stimulation
D) Light stimulation

44. Meniere’s disease management may include:
A) Salt restriction ✅
B) Diuretics ✅
C) Vestibular suppressants ✅
D) All of the above ✅

45. Positional nystagmus is most indicative of:
A) BPPV ✅
B) Vestibular neuritis
C) Meniere’s disease
D) Central lesion

46. Vestibular migraine diagnosis requires:
A) MRI
B) Clinical history of migraine and vertigo ✅
C) Audiogram only
D) cVEMP

47. vHIT and calorics test different frequency ranges.
A) True ✅
B) False

48. Semont maneuver involves rapid lateral movement from lying to sitting.
A) True ✅
B) False

49. cVEMP amplitude is influenced by muscle contraction strength.
A) True ✅
B) False

50. BPPV nystagmus typically fatigues with repeated maneuvers.
A) True ✅
B) False

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Vestibular Disorders – True/False (15 Questions)

1. BPPV is caused by central nervous system lesions.
Answer: False ✅

2. Dix-Hallpike maneuver is the gold standard for posterior canal BPPV diagnosis.
Answer: True ✅

3. Meniere’s disease causes fluctuating low-frequency hearing loss.
Answer: True ✅

4. Vestibular migraine only occurs with headache.
Answer: False ✅

5. vHIT evaluates high-frequency semicircular canal function.
Answer: True ✅

6. Caloric testing evaluates low-frequency horizontal canal function.
Answer: True ✅

7. cVEMP assesses saccular function and inferior vestibular nerve.
Answer: True ✅

8. Canalith repositioning maneuvers are ineffective in BPPV.
Answer: False ✅

9. Vestibular neuritis usually spares hearing.
Answer: True ✅

10. Vestibular rehabilitation can improve balance and reduce dizziness.
Answer: True ✅

11. Brandt-Daroff exercises are used to treat vestibular migraine.
Answer: False ✅

12. Meniere’s disease is always bilateral at onset.
Answer: False ✅

13. Positional nystagmus indicates peripheral vestibular disorder.
Answer: True ✅

14. Semont maneuver is a rapid movement from side to side to treat BPPV.
Answer: True ✅