“MRCPCH Part 2 Exam: Structure, OSCEs, and Clinical Skills”
MRCPCH Part 2 exam is a crucial milestone for pediatric trainees, and proper preparation for the MRCPCH Part 2 exam can make all the difference.”
Recall- A 5 months old baby passed the neonatal hearing screening, came with parental concern about hearing. What is the best test to be done?
A. OAE
B. ABR
C. Visual evoked potential
D. Distraction test
E. Pure tone audiometry
show answerAns- B
Explanation
Key facts in the question:
- Age: 5 months old.
- Passed neonatal hearing screening (so no major congenital hearing loss detected at birth).
- Now parents are concerned — could be late-onset or progressive hearing loss.
- We need the best test for this age group.
Understanding the options:
| Test | What it measures | Age suitability | Notes |
| OAE (Otoacoustic Emissions) | Outer hair cell function in cochlea | Any age, quick screening | Good for screening, but if concern is high, we need a diagnostic test |
| ABR (Auditory Brainstem Response) | Electrical activity from cochlea to brainstem | Any age, gold standard for infants | Can detect sensorineural hearing loss, even if mild; not dependent on cooperation |
| Visual evoked potential | Visual pathway function | Not relevant for hearing | |
| Distraction test | Behavioral response to sound | Reliable from ~6 months to 2 years | Baby is too young (5 months) for accurate results |
| Pure tone audiometry | Behavioral hearing test | From ~4–5 years | Not suitable for infants |
Key reasoning:
- At 5 months, behavioral tests like distraction test are not yet reliable.
- Since there is parental concern, we need a diagnostic rather than a screening test.
- ABR is the gold standard for confirming hearing loss in infants — it’s objective, works at any age, and can detect even mild losses.
- OAE is useful for screening, but ABR is preferred here because the baby already passed newborn screening and now has new concerns — we need to check the entire auditory pathway.
Best answer:B. ABR (Auditory Brainstem Response)
