Special senses: tuning fork tests: practice question

A Physiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Physiology · Special senses: tuning fork tests

Sample item

A 35-year-old woman has progressive conductive hearing loss in the left ear due to otosclerosis. What do tuning fork tests show?

AWeber is central and Rinne is positive on the leftBWeber lateralises to the left ear and Rinne is negative on the leftCWeber lateralises to the right ear and Rinne is positive on both sidesDWeber lateralises to the right ear and Rinne is negative on the left

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Weber lateralises to the left ear and Rinne is negative on the left

In conductive loss, bone conduction exceeds air conduction in the affected ear, so Rinne is negative. In the Weber test the sound is heard louder in the affected ear because masking by environmental noise is lost. In sensorineural loss, Weber goes to the better ear and Rinne remains positive.

Option by option

A. Weber is central and Rinne is positive on the left
A central Weber and positive Rinne would suggest normal hearing.
B. Weber lateralises to the left ear and Rinne is negative on the left (correct)
Correct. Conductive loss gives a negative Rinne and lateralisation to the affected ear.
C. Weber lateralises to the right ear and Rinne is positive on both sides
This is the pattern of left sensorineural hearing loss.
D. Weber lateralises to the right ear and Rinne is negative on the left
Weber lateralising to the better ear is not seen in conductive loss.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is B, Weber lateralises to the left ear and Rinne is negative on the left. In conductive loss, bone conduction exceeds air conduction in the affected ear, so Rinne is negative.

Why is "Weber is central and Rinne is positive on the left" not the answer?

A central Weber and positive Rinne would suggest normal hearing.

Why is "Weber lateralises to the right ear and Rinne is positive on both sides" not the answer?

This is the pattern of left sensorineural hearing loss.

Why is "Weber lateralises to the right ear and Rinne is negative on the left" not the answer?

Weber lateralising to the better ear is not seen in conductive loss.

What concept does this question test?

It tests Special senses: tuning fork tests in Physiology. In the Weber test the sound is heard louder in the affected ear because masking by environmental noise is lost. In sensorineural loss, Weber goes to the better ear and Rinne remains positive.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Special senses: tuning fork tests?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.