Deck 2: Developmental, Congenital, and Childhood Diseases and Disorders

ملء الشاشة (f)
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سؤال
CP is

A) a result of damage to the CNS.
B) a condition that can be cured with treatment.
C) a condition that primarily affects intelligence.
D) all of the above.
استخدم زر المسافة أو
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سؤال
Cryptorchidism is

A) a congenital malignant tumor.
B) also known as phimosis.
C) the failure of the testicle(s) to descend into the scrotum.
D) Wilms' tumor.
سؤال
Hyaline membrane disease refers to

A) bronchomalacia.
B) infant respiratory distress syndrome (IRDS).
C) retinopathy of prematurity (ROP).
D) necrotizing enterocolitis (NEC).
سؤال
Down syndrome is

A) a congenital form of mild to severe mental retardation.
B) associated with distinctive physical abnormalities and heart defects.
C) caused by a chromosomal abnormality.
D) all of the above.
سؤال
Down syndrome, a genetic syndrome, is the result of the child having ______ pairs of chromosomes.

A) 45
B) 46
C) 47
D) 48
سؤال
The most common crippler of children is

A) spina bifida.
B) muscular dystrophy (MD).
C) Down syndrome.
D) cerebral palsy (CP).
سؤال
Some warning signs of lead poisoning include

A) loss of appetite and vomiting.
B) irritability and ataxic gait.
C) anemia.
D) all of the above.
سؤال
The collapse of a seemingly healthy young athlete during a strenuous sporting event or other period of stressful exercise is often caused by

A) patent ductus arteriosis (PDA).
B) hypertrophic cardiomyopathy.
C) respiratory distress syndrome.
D) atrial septal defect (ASD).
سؤال
Which of the following statement(s) is/are true about asthma?

A) The bronchial tubes are hyperactive and hypersensitive.
B) Severe attacks require hospitalization.
C) It is a leading cause of absenteeism in school children.
D) All of the above are true.
سؤال
Duchenne MD

A) is usually the result of trauma.
B) is progressive and causes crippling and immobility.
C) affects males and females equally.
D) is not a genetic condition.
سؤال
The diagnostic investigation of a congenital heart defect may include

A) physical examination and patient history.
B) radiographic studies of the chest and blood tests.
C) heart catheterization and electrocardiogram (ECG).
D) all of the above.
سؤال
Congenital hip dysplasia (CHD)

A) causes cleft lip.
B) is a nontraumatic deformity of the foot.
C) is more common in male infants.
D) is an abnormal development of the hip joint.
سؤال
Childhood immunizations are important because

A) they are needed to obtain a passport.
B) they help prevent colds.
C) they prevent epidemics of serious contagious diseases.
D) of all of the above.
سؤال
Symptoms of Wilms' tumor may include

A) nasal regurgitation during feeding.
B) hematuria, pain, and hypertension.
C) a shortening of the femur.
D) projectile vomiting, loss of weight, and skin rash.
سؤال
The symptoms and signs of anemia include

A) pallor, weakness, fatigability, and listlessness.
B) an abnormal reduction of red blood cells (RBCs).
C) tachycardia, jaundice, and mental sluggishness.
D) all of the above.
سؤال
All females of childbearing age capable of becoming pregnant are encouraged to take the recommended amount of

A) calcium.
B) vitamin D.
C) folic acid.
D) iron.
سؤال
Attempts to halt premature labor include

A) having the mother on complete bedrest.
B) using drug therapy to slow or halt contractions.
C) giving the mother a short course of steroids to aid fetal lung maturation.
D) all of the above.
سؤال
The birth defect in which there is a hole in the middle of the roof of the mouth is

A) cleft palate.
B) cri-du-chat syndrome.
C) Robinow's syndrome.
D) meningocele.
سؤال
Congenital diseases

A) are always fatal.
B) are always genetic.
C) are always nongenetic.
D) can be physical or mental.
سؤال
The most common cyanotic congenital heart defect that is actually a combination of four defects is called

A) ventricular septal defect (VSD).
B) PDA.
C) tetralogy of Fallot.
D) transposition of the great arteries.
سؤال
Causes of infantile colic may be

A) sensitivity to cow's milk.
B) sensitivity to iron.
C) excessive swallowing of air during feeding process.
D) a and c.
سؤال
Cystic fibrosis (CF), a chronic dysfunction of the exocrine glands, primarily attacks the

A) nervous system.
B) lungs and digestive system.
C) blood vessels.
D) immune system.
سؤال
Serious side effects of uncontrolled diarrhea in the infant or child include

A) intestinal obstruction and rhonchi.
B) dehydration and electrolyte imbalance.
C) diaper rash and Reye's syndrome.
D) all of the above.
سؤال
Causes of prematurity include

A) incompetent cervix, bicornuate uterus, and premature rupture of membranes.
B) maternal physical conditions including infection and hypertension.
C) multiple gestation.
D) all of the above.
سؤال
Sudden infant death syndrome (SIDS) is

A) most likely to occur in a sick infant.
B) not known to have any risk factors.
C) the number one cause of death of infants between ages 1 month and 12 months.
D) predictable and preventable.
سؤال
Prompt and complete treatment of acute tonsillitis caused by group A beta-hemolytic streptococci is necessary to prevent

A) rheumatic fever.
B) rheumatic heart disease.
C) kidney complications.
D) all of the above.
سؤال
The most common fatal genetic disease is

A) hypertrophic cardiomegaly.
B) CF.
C) Down syndrome.
D) tetralogy of Fallot.
سؤال
Which of the following statements is/are true about leukemia?

A) It is the most common childhood malignancy.
B) It is a primary malignant disease of bone marrow.
C) The diagnosis is confirmed by microscopic examination of the bone marrow.
D) Both a and c are true
سؤال
Conjoined twins may be joined

A) head to head (cranial).
B) posteriorly at the sacrum and coccyx.
C) chest to chest.
D) at all of the above points.
سؤال
The production of copious thick and sticky mucus that accumulates and blocks glandular ducts is characteristic of

A) Wilms' tumor.
B) PKU.
C) pyloric stenosis.
D) CF.
سؤال
The disease that involves impairment of intestinal motility, which causes obstruction of the distal colon, is called

A) Hirschsprung's disease.
B) pyloric stenosis.
C) cryptorchidism.
D) phimosis.
سؤال
Conditions often resulting from premature birth include

A) NEC, IRDS, and ROP.
B) spina bifida, hydrocephalus, and anencephaly.
C) MD, CF, and Down syndrome.
D) all of the above.
سؤال
Which of the following statements is true about lead poisoning?

A) The child suffering from acute lead intoxication presents a medical emergency.
B) It is hard to detect, since lead is normally present in the blood.
C) It is a silent disease, because there are no warning signs or chronic symptoms.
D) There is no evidence of mental retardation resulting from brain damage.
سؤال
Pregnant women should be isolated from individuals infected with _________ to prevent perinatal infection.

A) rubeola.
B) rubella.
C) chickenpox.
D) diphtheria.
سؤال
The most common childhood malignancy is

A) Wilms' tumor.
B) leukemia.
C) anemia.
D) neuroblastoma.
سؤال
Klinefelter's syndrome and Turner's syndrome are examples of

A) inherited chromosomal diseases.
B) genetic, chromosomal diseases that are not inherited.
C) chromosomal diseases that affect females only.
D) inherited diseases of no significant consequence.
سؤال
A systemic disease with superficial cutaneous lesions that begin as red macules that progress to papules then to vesicles that form crusts is

A) rubeola.
B) rubella.
C) chickenpox.
D) diphtheria.
سؤال
Which of the following statements is/are true about erythroblastosis fetalis?

A) Antibodies in the mother's blood destroy the RBCs of the fetus.
B) It is characterized in the fetus by anemia, jaundice, and enlargement of the liver and spleen.
C) There is no destruction of fetal blood cells.
D) Both a and b are true.
سؤال
Cardiac cyanotic defects include

A) VSD and PDA.
B) tetralogy of Fallot and transposition of the great arteries.
C) coarctation of the aorta
D) ASD.
سؤال
The primary treatment of phenylketonuria (PKU) includes

A) oxygen therapy.
B) a high-sodium chloride diet.
C) a protein-restricted diet.
D) surgical intervention.
سؤال
The infant born with fetal alcohol syndrome (FAS) may experience alcohol withdrawal shortly after birth.
سؤال
Bronchiolitis, inflammation of the bronchioles, the smallest air passages of the lungs, is usually caused by

A) bacteria.
B) viruses.
C) fungi.
D) protozoa.
سؤال
Tetanus is an acute, potentially deadly systemic infection characterized by painful involuntary contraction of skeletal muscles.
سؤال
Closure of PDA may be achieved by medication or by surgical closure of the ductus.
سؤال
A congenital spinal defect in which no herniation of spinal cord or meninges exists is called a myelomeningocele.
سؤال
Rh factor incompatibility occurs when the mother, through prior pregnancy, has become sensitized to the Rh factor of the fetal RBCs.
سؤال
When a person is diagnosed with leukemia, there will be a/an

A) increase in WBCs.
B) decrease in WBCs.
C) normal WBC count.
D) decrease in platelets.
سؤال
The most common progressive form of MD is

A) occulta.
B) Duchenne.
C) Down.
D) myotonic.
سؤال
Leukemia is characterized by an abnormal decrease in the number of immature WBCs.
سؤال
Because anemia is a symptom of various diseases, it is important to determine the cause of the anemia.
سؤال
In hydrocephalus, a large amount of cerebrospinal fluid (CSF) accumulates in the skull, causing increased intracranial pressure.
سؤال
Mumps is a childhood disease that is best prevented by

A) the measles-mumps-rubella (MMR) vaccine.
B) Gardasil vaccine.
C) broad-spectrum antibiotics.
D) cough medicines.
سؤال
The lungs of the neonate lack the surfactant needed to allow the alveoli to expand.
سؤال
Chickenpox is spread by virus being transmitted by

A) bacillus entering through damaged skin.
B) a toxin formed in respiratory mucosa.
C) direct or indirect droplet nuclei from the respiratory tract of the infected person.
D) group A beta-hemolytic streptococci.
سؤال
Genetic disorders and syndromes are the result of an abnormal gene taking up residence on one of the 22 pairs of nonsex chromosomes.
سؤال
Reye's syndrome has been linked with the use of aspirin to treat chickenpox and influenza.
سؤال
Symptoms and signs of rubeola include

A) tenderness in the neck and below the ears.
B) Koplik's spots on the buccal mucosa.
C) a violent cough ending in a high-pitched inspiratory whoop.
D) red macules that progress to papules and then vesicles that form crusts.
سؤال
The procedure that allows amniotic fluid to be tested and cells to be microscopically examined for abnormal substances or chromosomal abnormalities is

A) fetal monitoring.
B) amniocentesis.
C) acupuncture.
D) ultrasound studies.
سؤال
PKU is an inborn error in metabolism of amino acids causing brain damage and mental retardation when not corrected.
سؤال
One way to prevent epidemics of contagious diseases is

A) aspirin.
B) immunizations.
C) multivitamins.
D) cold and cough medications.
سؤال
It is recommended that all adults receive the Tdap immunization every 10 years to reduce the incidence of whooping cough.
سؤال
Asthma is a leading cause of chronic illness and school absenteeism in children.
سؤال
Helminth infestation may be detected through stool specimens.
سؤال
Treatment of hydrocephalus consists of placing a ventriculoatrial shunt.
سؤال
During fetal circulation, blood bypasses the lungs.
سؤال
Epiglottitis typically strikes children between ages 3 and 7 years.
سؤال
Status asthmaticus is not considered a medical emergency.
سؤال
Young individuals with hypertrophic cardiomyopathy usually exhibit obvious symptoms of the disorder.
سؤال
Cryptorchidism may be treated with hormonal therapy.
سؤال
Turner's syndrome can be cured with proper treatment.
سؤال
Chickenpox is caused by a member of the herpes virus group.
سؤال
Neural tube defects include spina bifida occulta, meningocele, and myelomeningocele.
سؤال
Tetanus is not a possible fatal condition.
سؤال
NEC is an acute inflammatory process resulting from ischemic necrosis of the lining of the bronchial tubes.
سؤال
Down syndrome children's hands appear normal.
سؤال
Symptoms of pyloric stenosis include episodes of projectile vomiting and failure to gain weight.
سؤال
Abdominal distension is not a symptom of Hirschsprung's disease.
سؤال
MD affects only males.
سؤال
Hydrocephalus is easily diagnosed prenatally.
سؤال
Adenoid hyperplasia can contribute to recurrent otitis media and conductive hearing loss.
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ملء الشاشة (f)
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Deck 2: Developmental, Congenital, and Childhood Diseases and Disorders
1
CP is

A) a result of damage to the CNS.
B) a condition that can be cured with treatment.
C) a condition that primarily affects intelligence.
D) all of the above.
A
CP, the most common crippler of children, is a condition consisting of a group of disorders possibly involving the brain and nervous system functions that deal with movement, learning, hearing, sight, and thinking.
2
Cryptorchidism is

A) a congenital malignant tumor.
B) also known as phimosis.
C) the failure of the testicle(s) to descend into the scrotum.
D) Wilms' tumor.
C
Cryptorchidism is failure of one or both of the testicles to descend from the abdominal cavity into the scrotum.
3
Hyaline membrane disease refers to

A) bronchomalacia.
B) infant respiratory distress syndrome (IRDS).
C) retinopathy of prematurity (ROP).
D) necrotizing enterocolitis (NEC).
B
IRDS, or hyaline membrane disease, is similar to adult respiratory distress syndrome in that the patient suffers acute hypoxemia caused by infiltrates within the alveoli.
4
Down syndrome is

A) a congenital form of mild to severe mental retardation.
B) associated with distinctive physical abnormalities and heart defects.
C) caused by a chromosomal abnormality.
D) all of the above.
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5
Down syndrome, a genetic syndrome, is the result of the child having ______ pairs of chromosomes.

A) 45
B) 46
C) 47
D) 48
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6
The most common crippler of children is

A) spina bifida.
B) muscular dystrophy (MD).
C) Down syndrome.
D) cerebral palsy (CP).
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فتح الحزمة
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7
Some warning signs of lead poisoning include

A) loss of appetite and vomiting.
B) irritability and ataxic gait.
C) anemia.
D) all of the above.
فتح الحزمة
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فتح الحزمة
k this deck
8
The collapse of a seemingly healthy young athlete during a strenuous sporting event or other period of stressful exercise is often caused by

A) patent ductus arteriosis (PDA).
B) hypertrophic cardiomyopathy.
C) respiratory distress syndrome.
D) atrial septal defect (ASD).
فتح الحزمة
افتح القفل للوصول البطاقات البالغ عددها 85 في هذه المجموعة.
فتح الحزمة
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9
Which of the following statement(s) is/are true about asthma?

A) The bronchial tubes are hyperactive and hypersensitive.
B) Severe attacks require hospitalization.
C) It is a leading cause of absenteeism in school children.
D) All of the above are true.
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10
Duchenne MD

A) is usually the result of trauma.
B) is progressive and causes crippling and immobility.
C) affects males and females equally.
D) is not a genetic condition.
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11
The diagnostic investigation of a congenital heart defect may include

A) physical examination and patient history.
B) radiographic studies of the chest and blood tests.
C) heart catheterization and electrocardiogram (ECG).
D) all of the above.
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12
Congenital hip dysplasia (CHD)

A) causes cleft lip.
B) is a nontraumatic deformity of the foot.
C) is more common in male infants.
D) is an abnormal development of the hip joint.
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13
Childhood immunizations are important because

A) they are needed to obtain a passport.
B) they help prevent colds.
C) they prevent epidemics of serious contagious diseases.
D) of all of the above.
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14
Symptoms of Wilms' tumor may include

A) nasal regurgitation during feeding.
B) hematuria, pain, and hypertension.
C) a shortening of the femur.
D) projectile vomiting, loss of weight, and skin rash.
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15
The symptoms and signs of anemia include

A) pallor, weakness, fatigability, and listlessness.
B) an abnormal reduction of red blood cells (RBCs).
C) tachycardia, jaundice, and mental sluggishness.
D) all of the above.
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16
All females of childbearing age capable of becoming pregnant are encouraged to take the recommended amount of

A) calcium.
B) vitamin D.
C) folic acid.
D) iron.
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17
Attempts to halt premature labor include

A) having the mother on complete bedrest.
B) using drug therapy to slow or halt contractions.
C) giving the mother a short course of steroids to aid fetal lung maturation.
D) all of the above.
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18
The birth defect in which there is a hole in the middle of the roof of the mouth is

A) cleft palate.
B) cri-du-chat syndrome.
C) Robinow's syndrome.
D) meningocele.
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19
Congenital diseases

A) are always fatal.
B) are always genetic.
C) are always nongenetic.
D) can be physical or mental.
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20
The most common cyanotic congenital heart defect that is actually a combination of four defects is called

A) ventricular septal defect (VSD).
B) PDA.
C) tetralogy of Fallot.
D) transposition of the great arteries.
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21
Causes of infantile colic may be

A) sensitivity to cow's milk.
B) sensitivity to iron.
C) excessive swallowing of air during feeding process.
D) a and c.
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22
Cystic fibrosis (CF), a chronic dysfunction of the exocrine glands, primarily attacks the

A) nervous system.
B) lungs and digestive system.
C) blood vessels.
D) immune system.
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23
Serious side effects of uncontrolled diarrhea in the infant or child include

A) intestinal obstruction and rhonchi.
B) dehydration and electrolyte imbalance.
C) diaper rash and Reye's syndrome.
D) all of the above.
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24
Causes of prematurity include

A) incompetent cervix, bicornuate uterus, and premature rupture of membranes.
B) maternal physical conditions including infection and hypertension.
C) multiple gestation.
D) all of the above.
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25
Sudden infant death syndrome (SIDS) is

A) most likely to occur in a sick infant.
B) not known to have any risk factors.
C) the number one cause of death of infants between ages 1 month and 12 months.
D) predictable and preventable.
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26
Prompt and complete treatment of acute tonsillitis caused by group A beta-hemolytic streptococci is necessary to prevent

A) rheumatic fever.
B) rheumatic heart disease.
C) kidney complications.
D) all of the above.
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27
The most common fatal genetic disease is

A) hypertrophic cardiomegaly.
B) CF.
C) Down syndrome.
D) tetralogy of Fallot.
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28
Which of the following statements is/are true about leukemia?

A) It is the most common childhood malignancy.
B) It is a primary malignant disease of bone marrow.
C) The diagnosis is confirmed by microscopic examination of the bone marrow.
D) Both a and c are true
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29
Conjoined twins may be joined

A) head to head (cranial).
B) posteriorly at the sacrum and coccyx.
C) chest to chest.
D) at all of the above points.
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30
The production of copious thick and sticky mucus that accumulates and blocks glandular ducts is characteristic of

A) Wilms' tumor.
B) PKU.
C) pyloric stenosis.
D) CF.
فتح الحزمة
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31
The disease that involves impairment of intestinal motility, which causes obstruction of the distal colon, is called

A) Hirschsprung's disease.
B) pyloric stenosis.
C) cryptorchidism.
D) phimosis.
فتح الحزمة
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32
Conditions often resulting from premature birth include

A) NEC, IRDS, and ROP.
B) spina bifida, hydrocephalus, and anencephaly.
C) MD, CF, and Down syndrome.
D) all of the above.
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33
Which of the following statements is true about lead poisoning?

A) The child suffering from acute lead intoxication presents a medical emergency.
B) It is hard to detect, since lead is normally present in the blood.
C) It is a silent disease, because there are no warning signs or chronic symptoms.
D) There is no evidence of mental retardation resulting from brain damage.
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34
Pregnant women should be isolated from individuals infected with _________ to prevent perinatal infection.

A) rubeola.
B) rubella.
C) chickenpox.
D) diphtheria.
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35
The most common childhood malignancy is

A) Wilms' tumor.
B) leukemia.
C) anemia.
D) neuroblastoma.
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36
Klinefelter's syndrome and Turner's syndrome are examples of

A) inherited chromosomal diseases.
B) genetic, chromosomal diseases that are not inherited.
C) chromosomal diseases that affect females only.
D) inherited diseases of no significant consequence.
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37
A systemic disease with superficial cutaneous lesions that begin as red macules that progress to papules then to vesicles that form crusts is

A) rubeola.
B) rubella.
C) chickenpox.
D) diphtheria.
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38
Which of the following statements is/are true about erythroblastosis fetalis?

A) Antibodies in the mother's blood destroy the RBCs of the fetus.
B) It is characterized in the fetus by anemia, jaundice, and enlargement of the liver and spleen.
C) There is no destruction of fetal blood cells.
D) Both a and b are true.
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39
Cardiac cyanotic defects include

A) VSD and PDA.
B) tetralogy of Fallot and transposition of the great arteries.
C) coarctation of the aorta
D) ASD.
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40
The primary treatment of phenylketonuria (PKU) includes

A) oxygen therapy.
B) a high-sodium chloride diet.
C) a protein-restricted diet.
D) surgical intervention.
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41
The infant born with fetal alcohol syndrome (FAS) may experience alcohol withdrawal shortly after birth.
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42
Bronchiolitis, inflammation of the bronchioles, the smallest air passages of the lungs, is usually caused by

A) bacteria.
B) viruses.
C) fungi.
D) protozoa.
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43
Tetanus is an acute, potentially deadly systemic infection characterized by painful involuntary contraction of skeletal muscles.
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44
Closure of PDA may be achieved by medication or by surgical closure of the ductus.
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45
A congenital spinal defect in which no herniation of spinal cord or meninges exists is called a myelomeningocele.
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46
Rh factor incompatibility occurs when the mother, through prior pregnancy, has become sensitized to the Rh factor of the fetal RBCs.
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47
When a person is diagnosed with leukemia, there will be a/an

A) increase in WBCs.
B) decrease in WBCs.
C) normal WBC count.
D) decrease in platelets.
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48
The most common progressive form of MD is

A) occulta.
B) Duchenne.
C) Down.
D) myotonic.
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49
Leukemia is characterized by an abnormal decrease in the number of immature WBCs.
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50
Because anemia is a symptom of various diseases, it is important to determine the cause of the anemia.
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51
In hydrocephalus, a large amount of cerebrospinal fluid (CSF) accumulates in the skull, causing increased intracranial pressure.
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52
Mumps is a childhood disease that is best prevented by

A) the measles-mumps-rubella (MMR) vaccine.
B) Gardasil vaccine.
C) broad-spectrum antibiotics.
D) cough medicines.
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53
The lungs of the neonate lack the surfactant needed to allow the alveoli to expand.
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54
Chickenpox is spread by virus being transmitted by

A) bacillus entering through damaged skin.
B) a toxin formed in respiratory mucosa.
C) direct or indirect droplet nuclei from the respiratory tract of the infected person.
D) group A beta-hemolytic streptococci.
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55
Genetic disorders and syndromes are the result of an abnormal gene taking up residence on one of the 22 pairs of nonsex chromosomes.
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56
Reye's syndrome has been linked with the use of aspirin to treat chickenpox and influenza.
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57
Symptoms and signs of rubeola include

A) tenderness in the neck and below the ears.
B) Koplik's spots on the buccal mucosa.
C) a violent cough ending in a high-pitched inspiratory whoop.
D) red macules that progress to papules and then vesicles that form crusts.
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58
The procedure that allows amniotic fluid to be tested and cells to be microscopically examined for abnormal substances or chromosomal abnormalities is

A) fetal monitoring.
B) amniocentesis.
C) acupuncture.
D) ultrasound studies.
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59
PKU is an inborn error in metabolism of amino acids causing brain damage and mental retardation when not corrected.
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60
One way to prevent epidemics of contagious diseases is

A) aspirin.
B) immunizations.
C) multivitamins.
D) cold and cough medications.
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61
It is recommended that all adults receive the Tdap immunization every 10 years to reduce the incidence of whooping cough.
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62
Asthma is a leading cause of chronic illness and school absenteeism in children.
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63
Helminth infestation may be detected through stool specimens.
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64
Treatment of hydrocephalus consists of placing a ventriculoatrial shunt.
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65
During fetal circulation, blood bypasses the lungs.
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66
Epiglottitis typically strikes children between ages 3 and 7 years.
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67
Status asthmaticus is not considered a medical emergency.
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68
Young individuals with hypertrophic cardiomyopathy usually exhibit obvious symptoms of the disorder.
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69
Cryptorchidism may be treated with hormonal therapy.
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70
Turner's syndrome can be cured with proper treatment.
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71
Chickenpox is caused by a member of the herpes virus group.
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72
Neural tube defects include spina bifida occulta, meningocele, and myelomeningocele.
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73
Tetanus is not a possible fatal condition.
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74
NEC is an acute inflammatory process resulting from ischemic necrosis of the lining of the bronchial tubes.
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75
Down syndrome children's hands appear normal.
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76
Symptoms of pyloric stenosis include episodes of projectile vomiting and failure to gain weight.
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77
Abdominal distension is not a symptom of Hirschsprung's disease.
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78
MD affects only males.
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79
Hydrocephalus is easily diagnosed prenatally.
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80
Adenoid hyperplasia can contribute to recurrent otitis media and conductive hearing loss.
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