Audiology: false negative Rinne: practice question

A ENT 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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ENT · Audiology: false negative Rinne

Sample item

A patient has a negative Rinne on the left, but pure tone audiometry shows a dead left ear with a normal right ear. What explains the false negative Rinne?

AThe tympanic membrane on the dead side is hypermobileBThe tuning fork was struck too softlyCAir-conducted sound is amplified by the middle ear on the dead sideDBone-conducted sound crosses the skull and is heard by the opposite cochlea

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

The answer and the reasoning

D. Bone-conducted sound crosses the skull and is heard by the opposite cochlea

In a profoundly deaf ear, the fork placed on the mastoid is heard by the good ear through transcranial bone conduction. The patient therefore reports bone conduction as louder than air conduction on the deaf side. Masking the better ear with a Barany noise box corrects this.

Option by option

A. The tympanic membrane on the dead side is hypermobile
Drum mobility does not give hearing in a dead cochlea.
B. The tuning fork was struck too softly
A soft strike would affect both tests equally and does not explain the pattern.
C. Air-conducted sound is amplified by the middle ear on the dead side
Air conduction on a dead ear is not amplified; there is no perception from that cochlea.
D. Bone-conducted sound crosses the skull and is heard by the opposite cochlea (correct)
Correct. The better cochlea hears the bone-conducted sound, giving a false negative Rinne.

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 ENT question

What is the answer to this ENT question?

The best answer is D, Bone-conducted sound crosses the skull and is heard by the opposite cochlea. In a profoundly deaf ear, the fork placed on the mastoid is heard by the good ear through transcranial bone conduction.

Why is "The tympanic membrane on the dead side is hypermobile" not the answer?

Drum mobility does not give hearing in a dead cochlea.

Why is "The tuning fork was struck too softly" not the answer?

A soft strike would affect both tests equally and does not explain the pattern.

Why is "Air-conducted sound is amplified by the middle ear on the dead side" not the answer?

Air conduction on a dead ear is not amplified; there is no perception from that cochlea.

What concept does this question test?

It tests Audiology: false negative Rinne in ENT. The patient therefore reports bone conduction as louder than air conduction on the deaf side. Masking the better ear with a Barany noise box corrects this.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Audiology: false negative Rinne?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.