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1. Which of the right ear pure tone audiograms shown below most resemble the pattern expected with
Meniere’s disease?
a b
c d
e f
–20
0
128 256 512 1,024 2,048 4,096 8,192
2,896 5,792 11,584
20
40
60
80
100
–20
0
128 256 512 1,024 2,048 4,096 8,192
2,896 5,792 11,584
20
40
60
80
100
–20
0
128 256 512 1,024 2,048 4,096 8,192
2,896 5,792 11,584
20
40
60
80
100
–20
0
128 256 512 1,024 2,048 4,096 8,192
2,896 5,792 11,584
20
40
60
80
100
–20
0
128 256 512 1,024 2,048 4,096 8,192
2,896 5,792 11,584
20
40
60
80
100
–20
0
128 256 512 1,024 2,048 4,096 8,192
2,896 5,792 11,584
20
40
60
80
100
Air conduction (AC)
Bone conduction (BC)
2. Vestibular schwannoma (acoustic neuroma)
most commonly affects which one of the following nerves?
a. Cochlear nerve
b. Facial nerve
c. Inferior vestibular nerve
d. Superior vestibular nerve
e. Trigeminal nerve
3. Vestibular-ocular reflex elicited during a
right head turn is best described by which
one of the following?
a. Relative motion between membranous
labyrinth and endolymph causes right
horizontal canal cupula to deflect towards
the utricle with reflex movement of eyes to
left with saccades to right
176
b. Relative motion between membranous
labyrinth and endolymph causes left horizontal canal cupula to deflect towards the
utricle with reflex movement of eyes to
left with saccades to right
c. Relative motion between membranous
labyrinth and endolymph causes right
horizontal canal cupula to deflect towards
the utricle with reflex movement of eyes to
left with saccades to left
d. Relative motion between membranous
labyrinth and perilymph causes right horizontal canal cupula to deflect towards the
utricle with reflex movement of eyes to
left with saccades to right
e. Relative motion between membranous
labyrinth and perilymph causes right horizontal canal cupula to deflect away from
the utricle with reflex movement of eyes
to right with saccades to right
4. In the brainstem auditory evoked response,
which one of the following structures gives
rise to wave V?
a. Cochlear nerve
b. Inferior colliculus
c. Lateral lemniscus
d. Superior olivary complex
e. Ventral cochlear nucleus
5. A 25-year-old male had occasional difficulty
in understanding speech over the telephone
with his left ear. Brainstem auditory evoked
response is shown for both ears. Which one
of the following is most likely?
RIGHT LEFT
I II III IV–V I
III
IV–V
024 0 2 4 6 8 10
Time in msec
6 8 10
a. Aminoglycoside toxicity
b. Gentamicin ototoxicity
c. Left acoustic neuroma
d. Right cochlear ischemia
e. Right glomus jugulare tumor
6. In which one of the following situations is it
NOT appropriate to use intraoperative
brainstem auditory evoked response
monitoring?
a. Basilar artery aneurysm surgery
b. Microvascular decompression of CN V
c. Posterior fossa surgery
d. Resection of acoustic neuroma in a deaf
patient
e. Vestibular neurectomy for intractable
tinnitus
7. Damage to hair cells in the basal turn of the
cochle?a is likely to result in which one of the
following
a. High frequency hearing loss
b. High-intensity hearing loss
c. Low-frequency hearing loss
d. Low-intensity hearing loss
e. Mid-frequency hearing loss
8. Which one of the following sites in the inner
ear does gentamicin exert its ototoxic effect?
a. Apical turn of cochlea
b. Cochlear nerve
c. Hair cells
d. Macula densa
e. Striavascularis
9. A 34-year-old female presents with a HouseBrackmann grade IV facial palsy. Which one
of the following best describes the clinical
findings?
a. Complete facial paralysis
b. Obvious asymmetry (not disfiguring);
noticeable synkinesis, contracture, or
hemifacial spasm; complete eye closure
with effort.
c. Obvious weakness or disfiguring asymmetry; normal symmetry and tone at rest;
incomplete eye closure.
d. Only barely perceptible motion with
asymmetry at rest
e. Slight weakness noticeable on close
inspection; slight synkinesis
10. Which one of the following best describes
the target region for an auditory brainstem
implant?
a. Cochlear nucleus
b. Inferior colliculus
c. Inferior olivary nucleus
d. Superior olivary nucleus
e. Vestibular nucleus
11. A 35-year-old NF-2 patient has sensorineural hearing loss and paresthesia of the posterior aspect of his right ear canal. MRI shows a
large cerebellopontine angle tumor. Compression of which one of the following best
explains the altered sensation?
a. Facial nerve
b. Glossopharyngeal nerve
c. Inferior vestibular nerve
d. Superior vestibular nerve
e. Vagus nerve
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