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SLP373- Audiology > Exam 2: Treatments etc > Flashcards

Exam 2: Treatments etc Flashcards

1
Q

Ototoxic drugs: the basics and the 4 classes

A
  • Certain medications and chemical substances cause hearing loss through sensory cell damage and interference with inner ear metabolism
  • Changes can be permanent and severe or may be reversed once use of the medication has stopped
  • 4 classes of drugs in this category:
    - -Antineoplastic drugs
    - -Aminoglycoside antibiotics
    - -Loop diuretics
    - -Analgesics and Antimalarials
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2
Q

Ototoxic drugs: Antineoplastics

A

-cisplatinum: used in chemotherapy to reduce/inhibit the growth of cancer cells and tumors

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3
Q

Ototoxic drugs: Aminoglycoside antibiotic drugs

A
  • streptomycin: used to fight tuberculosis

- gentamycin or amikacin: combats bacterial infection

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4
Q

Ototoxic drugs: analgesics and antimalarials

A
  • aspirin and other salicylates: used for pain and fever reduction
    • quinine: treats malaria and blood-related leg cramps
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5
Q

How is atresia treated?

A

-bone conduction hearing aids

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6
Q

What is asked while gathering a case history? (5 questions, know generally)

A

1: Hearing history
- how long has this problem lasted?
- sudden or gradual onset?
- specific environments that make the hearing loss less noticeable
- unilateral or bilateral?
2: Medical history
- history of ear infections?
- past medical or surgical treatment on ears?
- medications taken for dizziness or ear issues?
- dizziness, tinnitus, facial numbness?
3: History of noise trauma
- recent acoustic trauma?
- military service?
- hobby or employment exposure over time?
4: Family history
- are there hereditary factors?
- those w/ presbycusis and noise exposure don’t apply
5: Rehabilitation/academic history
- hearing aid experience?
- aural rehab?
- SLP therapy?

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7
Q

How is sudden sensorineural hearing loss treated?

A
  • because the cause is unknown, the treatment is multimodal:
    • antibiotic drug
    • antiinflammatory drug
    • antiviral therapy
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8
Q

What are the 4 Parameters of HL?

A
  • Degree: severity of the impairment
    • configuration: shape of the hearing loss (flat, sloping, steeply sloping etc)
      • type of hearing loss: conductive, sensorineural, or mixed
    • symmetry: comparison of results between ears
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9
Q

What are some reasons a person might self-refer to the audiologist? (5 things)

A
  • difficulty understanding speech, esp in background noise
    • asking for repetition during conversation
    • increased volume on TV or radio
    • difficulty on telephone
    • problems communicating with coworkers
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10
Q

What are some questions that patients will want from the audiologist? (4 of them)

A
  • Patients and their families usually have very similar questions:
    • do i really have a problem?
    • how serious is my problem?
    • why am i having this problem/what is the cause?
    • how can this problem be fixed/what is the treatment?
  • Patients need answers, the audiologist’s job is the investigate their case and give them answers
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11
Q

Transducers: Standard / supra-oral headphones: Pros and Cons

A

-look like big headphones like i use
Pros:
-easiest/fastest placement on the patient

Cons:

  • have to wipe them down between patients
    • ear canal collapse can occur, looking like hearing loss
    • require masking more frequently
    • small children may not cooperate
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12
Q

Transducers: Insert Headphones: Pros and Cons

A

-tiny insertable ear plug things with a hole in the center like a churro
Pros:
-masking required less frequently
-no risk of canal collapse
-more hygienic for patient as tips are disposable

Cons:

- small children may not cooperate
- slightly more time consuming
- more expensive for provider
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13
Q

Transducers: bone vibrator: Pros and cons

A

-headband vibratey bone thing
Pros:
-our ONLY option to test via bone conduction
Cons:
-inconsistent placement due to rounded surface of the mastoid process
-obstruction from hair can affect accuracy

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14
Q

Transducers: speakers in sound field: Pros and cons

A

Pros:
-can be used with anyone
-no cooperation needed with headphones or insert earphones
Cons:
-doesn’t provide ear specific information

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15
Q

Pure Tone Testing: The Order We Test (first step)

A
  • 1000, then 2000, 4000 and 8000 (the octaves)
    • retest 1000 to confirm reliability
    • if 1000 has changed, take a closer look at other frequencies too
    • 500, 250
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16
Q

Pure Tone Testing: The Order We Test (second step): When do we test the interoctave frequencies?

A
  • 1500, 3000, 6000 are tested in the following situations:
    - when difference between 2 octaves is 20db or more
    - to identify the effect of noise exposure in the high frequencies
17
Q

Pure Tone Testing: Familiarization

A

-start testing at a tone you know the patient will hear
-when they respond, confirm they have responded appropriately, then descend to their threshold
Examples:
-Start at 25 dBHL, if patient responds move down (softer) in 10 dB steps until they stop responding
-Start at 25 dBHL if patient does NOT respond move up to 50 dBHL. If still NO response, keep moving up (louder) in 5 dB steps until you achieve a response.
Once the patient responds, THEN move down in 10 dB steps until the patient no longer responds.

18
Q

Pure Tone Testing: How do we find the threshold?

A

-use the “down ten, up 5” method (after second response, you have the threshold)
-An example:
Present at 30 dB, and patient responds
Present at 20 dB, and patient responds
Present at 10 dB, and patient responds
Present at 0 dB, and patient does NOT respond
Present at 5 dB, and patient does NOT respond
Present at 10 dB, and patient responds
10dB is your threshold for that frequency

19
Q

Pure Tone Testing: why do we mask?

A
  • from a clinical perspective, the whole purpose of masking is to rule out participation of the non-mask ear by making a masking noise (competing sound) in that ear
    • masking is particularly important for bone conduction testing because the boen conductor stimulates both ears no matter where it is placed on the skull: forehead, right mastoid, left mastoid
20
Q

Pure Tone Testing: What type of noise is used for masking?

A
  • Most commonly Narrow Band Noise
  • Has a particular bandwidth related to the frequency being tested
  • Sometimes audiologists choose White Noise
  • This sounds like static, but is less efficient because it is a random representation of ALL frequencies of equal intensity

-Speech-weighted Noise is used for masking during speech testing
It is similar to white noise, but is shaped to mirror the spectrum of speech

21
Q

Audiograms: what symbols are for used for the right ear?

A
  • AC Unmasked: O
  • AC Masked: triangle
  • BC Mastoid Unmasked: <
  • BC Mastoid Masked: [
22
Q

Audiograms: what symbols are used for the left ear?

A
  • AC Unmasked: X
  • AC Masked: square
  • BC Mastoid Unmasked: >
  • BC Mastoid Masked: ]
23
Q

Audiograms: what symbols are examples of no response symbols?

A
  • Right Ear: O with arrow pointing off of it, [ with arrow pointing off of it, etc
  • Left Ear: X with arrow pointing off of it, > with arrow pointing off of it, etc
  • Basically arrows are for no response
24
Q

Family referral to audiologist and denial

A
  • when a parent or family member is referring a patient, things can get complicated
    • if the patient is an adult, you should be aware that the patient may be unwilling to accept their family member’s advice, these cases are always interesting
    • patient’s denial can be interesting depending on the family dynamic
25
Q

What Causes Tympanic Membrane Perforations? (5 things)

A
  • Spontaneous: secondary to middle ear infection or fluid buildup (like a zit popping)
    • Direct trauma: from an object i.e. q-tip, foreign object, welding slag etc
    • Concussive incident: slap to the head, explosion, waterskiing
    • Barotrauma: changes in pressure frequently seen with diving
    • Temporal Bone Fracture
26
Q

What area of the auditory system is affected in a conductive loss vs. a sensorineural loss?

A

Conductive: outer/middle ear

Sensorineural: inner/nerve/brain

27
Q

Ototoxic drugs: loop diuretics

A

-furosemide: promotes the excretion of urine for patients with kidney disease

28
Q

Sudden Sensorineural Hearing Loss: Causes/Treatment

A

-many times cases are idiopathic, but physicians typically consider three causes:
1 viral infection
2 vascular insult, such as blood vessel occlusion
3 inner ear membrane rupture (fistula)

- because the cause is unknown, the treatment is multimodal: 
* antibiotic drug
* antiinflammatory drug
* antiviral therapy

- treatment needs to occur almost immediately after onset for maximum potential effectiveness
- ⅓ of these patients will show no recovery
29
Q

Non organic hearing loss

A
  • also termed a functional hearing loss
    • a fake or exaggerated hearing impairment usually for some ulterior motive like attention or money
    • some may also term this hysterical deafness or conversion deafness
    • can be the result of severe anxiety or emotional trauma
30
Q

Conductive Hearing Loss

A

Conductive Hearing Loss:

- involves the structures in the ear that are responsible for conducting sound to the cochlea
- can be caused by obstruction, abnormality, or disease and is found in the outer or middle ear
- loss is typically temporary, but left untreated it can lead to a permanent condition
31
Q

Sensorineural Hearing Loss:

A
  • involves both the cochlear function of sensory function and the function of the auditory nerve
    • most often the problem is due to damage to the the inner or outer hair cells and or other structures in the cochlea
    • sometimes the problem occurs because of problems with auditory nerve fibers, in the auditory nerve, or centrally in the auditory central nervous system extending through the brain stem to the cerebral cortex
    • because of its location, SNHL is usually permanent and most often untreatable medically or surgically
32
Q

Mixed Hearing Loss:

A
  • a problem of cochlear dysfunction compounded by disorder in the outer or middle ears
    • a simple example of this would be a patient with a SNHL who has an earful of occluding wax
    • the result: a mixed hearing loss
    • once the wax is removed the loss would return to being sensorineural

SLP373- Audiology (3 decks)

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