Question

A 35-year-old patient presents with unilateral hearing loss. Weber reveals lateralization to the right ear. Rinne test reveals the following: RIGHT: bone conduction = 10 seconds, air conduction = 5 seconds; LEFT: bone conduction = 5 seconds, air conduction = 10 seconds. Which of these other physical exam findings is to be expected?

A. cerumen impaction in the right ear
B. effusion in the left ear
C. otitis media in the left ear
D. pain on palpation of tragus or mastoid area

Answer 1

Based on the Weber and Rinne tests indicating conductive hearing loss in the right ear, the expected additional physical exam finding is likely cerumen impaction in the right ear.

Step-by-step explanation:

The question involves interpreting the results of a Weber test and a Rinne test to deduce additional physical exam findings related to hearing loss. In the scenario provided, the patient has unilateral hearing loss. The Weber test lateralizes to the right ear, which indicates that either there is conductive hearing loss in the right ear or sensorineural hearing loss in the left ear. The Rinne test shows that on the right side, bone conduction lasts longer than air conduction (BC > AC), which is indicative of conductive hearing loss. On the left side, air conduction lasts longer than bone conduction (AC > BC), which is normal. Therefore, the expected finding would be related to a problem with conducting sound in the outer or middle ear on the right side.

Given this information, the most likely additional physical exam finding would be A. cerumen impaction in the right ear, as it would obstruct sound conduction, leading to conductive hearing loss and causing the Rinne test to reveal BC > AC and the Weber test to lateralize to the right ear.