Pediatrics
Which of the following best identifies the appropriate tools to screen for newborn hearing loss in accordance with the Joint Committee on Infant Hearing Guidelines?
In the well-baby nursery: OAE and ABR
In the NICU: ABR
A patient fit with hearing aids for the first time returns for a two-week follow-up appointment. The patient reports feeling uncomfortable when doors slam.
Which of the following is the most likely cause for the patient’s complaint?
(A) The maximum power output (MPO) is set too high.
(B) The dynamic range of the hearing aid is too narrow.
(C) The patient is experiencing the occlusion effect. (D) The attack and release times are too fast.
A -- The maximum power output (M P O) is set too high.
Which THREE of the following can known types of presbycusis be attributed to?
(A) Degeneration of sensory hair cells
(B) Degeneration of auditory neurons
(C) Degeneration of the stria vascularis
(D) Degeneration of the ossicular joint
(E) Degeneration of the tectorial membrane
A, B, and C
The reliability of an obtained waveform on the auditory brainstem response is best checked by doing which of the following?
(A) Obtaining another waveform under identical conditions
(B) Increasing the stimulation rate
(C) Opening the filters
(D) Using digital filters after completing the test
A) Obtaining another waveform under identical conditions
The accuracy of a hearing screening test in correctly identifying those individuals who actually have a hearing disorder is referred to as the screening test’s
Sensitivity
An Individualized Family Service Plan (IFSP) is mandated under which of the following provisions of the Individuals with Disabilities Education Act (IDEA) ?
IDEA Part C
A 38-year-old patient with a moderate midfrequency hearing loss was fit with bilateral in-the-canal hearing aids. The patient complains of difficulty finding the person speaking when in a social or work situation where there are more than three or four people. Which of the following is most likely to be responsible for the patient’s reported problem?
(A) Distorted pinna filtering
(B) Absent ear-canal resonance
(C) Inability to process spatial cues
(D) Decreased frequency selectivity
(C) Inability to process spatial cues
Which of the following assessments best determines the integrity of the inferior branch of the vestibular nerve?
(A) Bithermal caloric test
(B) Horizontal head shake test
(C) Cervical vestibular evoked myogenic potential (c VEMP) testing
(D) Ocular vestibular evoked myogenic potential (o VEMP) testing
(C) Cervical vestibular evoked myogenic potential (c VEMP) testing
What is the difference between rarefaction and condensation wave forms?
Amplitude is enhanced with rarefaction compared to condensation. Further, rarefaction latencies for waves I, III, and V are shorter.
The measurement of distortion product otoacoustic emission (D P O A E) involves the presentation of pairs of pure tones to the patient’s ear. Which auditory response does this test measure?
Cubic Difference Tone
A 6-month-old child born with bilateral bony atresia is seen for an audiological evaluation and treatment recommendation. Radiological evidence indicates the probable presence of an intact middle ear and cochlea. ABR responses have been obtained at near-normal levels to bone-conducted signals.What should the course of treatment be?
nvestigate the use of a bone-conduction hearing aid until audiological test results can be confirmed and surgery initiated when the child is older
A person with a hearing loss who requires speech to be 12 dB higher than noise to achieve a 50 percent correct sentence recognition score most likely has an SNR loss of ...?
10 dB
Which of the following symptoms is most indicative of superior semicircular canal dehiscence?
(A) Dizziness associated with loud sounds
(B) Persistent feeling of spinning
(C) Inability to walk in a straight line
(D) Fluctuating low-frequency hearing loss
(A) Dizziness associated with loud sounds
What is the cochlear microphonic and where can we see it?
CM is predominantly generated by the outer hair cells
Occurs before wave I of the ABR and follows the phase of the presented stimulus
In the measurement of real-ear sound pressure levels with a probe-tube microphone system, insufficient probe-tube depth will tend to
Decrease the high-frequency response
A child comes to the clinic due to problems understanding the teacher at school. The child has a moderate hearing loss and wears bilateral hearing aids. Aided speechrecognition scores at 55 d B H L in quiet were 88 percent correct, with scores being 60 percent correct with a +5 S N R. Which of the following would be the best recommendation for the child?
(A) Increase the gain of the hearing aid.
(B) Utilize directional microphones with the hearing aids.
(C) Utilize a personal frequency modulation (F M) system with the hearing aids.
(D) Utilize a low-gain frequency modulation (F M) system with headphones.
(C) Utilize a personal frequency modulation (F M) system with the hearing aids.
Which of the following is typically the best choice of amplification for a person with bilateral moderate conductive hearing loss and chronic drainage from both ears?
(A) Behind-the-ear aids with vented earmolds
(B) A body-worn hearing aid
(C) A bone-conduction hearing aid
(D) A multichannel cochlear implant
(C) A bone-conduction hearing aid
A client with a history of bilateral profound sensorineural hearing loss, lack of vestibular function, and progressive retinal deterioration is scheduled for an audiological assessment. Which etiology is consistent with the client’s history?
Usher syndrome
What does the ABR look like in individual with normal hearing? Conductive hearing loss? Cochlear
hearing loss? Retrocochlear pathologies?
Draw on board
Which of the following statements about a caloric response yielding a left unilateral weakness in the interpretation of videonystagmography results is most accurate?
(A) It suggests a right peripheral vestibular disorder of the labyrinth.
(B) It suggests a nonspecific (nonlocalizing) vestibular disorder.
(C) It suggests a left peripheral vestibular disorder of either the labyrinthine or the VIIIth nerve.
(D) It suggests a central vestibular disorder.
(C) It suggests a left peripheral vestibular disorder of either the labyrinthine or the VIIIth nerve.
Describe Pendred syndrome
Congenital bilateral, sensorineural hearing loss and goiter with euthyroid or mild hypothyroidism (decreased thyroid gland function). It can also create problems with balance. Enlarged vestibular aqueduct.
A patient fitted with hearing aids for the first time returns for a two-week follow-up appointment. The patient reports feeling uncomfortable when doors slam.
Which of the following strategies is most appropriate for addressing the patient’s complaint?
(A) Using expansion
(B) Decreasing the output compression threshold
(C) Decreasing the input compression ratio
(D) Increasing the input compression threshold
(B) Decreasing the output compression threshold
Because...
Decreasing the output compression threshold effectively lowers the M P O of the hearing aid so that loud sounds do not receive any additional gain above the output compression threshold. Setting the output compression threshold below the patient’s loudness discomfort level ensures that loud sounds are not too loud
Carol is a 34-year-old woman with a sudden onset, left-sided facial paralysis that has been diagnosed as Bell’s palsy. Acoustic reflexes are present at normal levels bilaterally for both ipsilateral and contralateral stimulation. Which of the following statements accurately applies to this situation?
(A) The pathology is proximal to the stapedial branch of the VIIth nerve.
(B) The pathology is distal to the stapedial branch of the VIIth nerve.
(C) The facial paralysis is probably nonorganic in nature.
(D) No reliable statement can be made about VIIth nerve function, since the responses could be due to Vth nerve activity.
(B) The pathology is distal to the stapedial branch of the VIIth nerve.
How can we improve our wave I?
Reducing the stimulus rate to 9 or 11/s may improve the amplitude
and morphology of wave I.
Describe tympanogram types:
Type A, Type B (with volumes), Type C
Type A: Normal compliance
Type B: With big volume -- could mean perforation/PE tube, with small volume could mean wax/occlusion -- middle ear problem such as otitis media
Type C: Negative pressure -- Eustachian tube dysfunction or retracted TM
Type A(d): Big volume -- hypermobile TM -- ossicular disarticulation/ really scarred TM
Type A(s): Small volume -- not too mobile -- otosclerosis (not always)/ ossicular fixation