A 38 year old gentleman reports of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork the rinne’s test without masking is negative on the right ear and positive on the left ear. With the weber’s test the tone is perceived as louder in the left ear. The most likely patient has –

**Core Concept**
The question tests the understanding of hearing loss and the use of tuning fork tests, specifically Rinne's test and Weber's test, to differentiate between conductive and sensorineural hearing loss. **Hearing loss** can be categorized into conductive, sensorineural, or mixed, depending on the underlying cause.

**Why the Correct Answer is Right**
Given that the Rinne's test is negative on the right ear, it suggests **conductive hearing loss** because in conductive loss, bone conduction is better than or equal to air conduction. The Weber's test lateralizing to the left ear indicates that the better ear is the left one, suggesting the right ear has hearing loss.

**Why Each Wrong Option is Incorrect**
**Option A:** Would be incorrect if it suggested sensorineural loss, as the tests point towards conductive loss.
**Option B:** Might be considered if it implied a different type of hearing loss or incorrect test interpretation.
**Option C:** Could be a plausible incorrect choice if it represented an unrelated condition or incorrect diagnosis.
**Option D:** Would be incorrect as it might represent an opposite or unrelated diagnosis.

**Clinical Pearl / High-Yield Fact**
Remember, in **conductive hearing loss**, the Rinne's test is negative, and in **sensorineural hearing loss**, it is positive. The Weber's test helps identify the better ear, which is crucial for diagnosing unilateral hearing loss.

**Correct Answer:** D. Conductive hearing loss.

✓ Correct Answer: B. Right sensorineural hearing loss