Exam Questions Flashcards
What two sites of lesion can be potentially differentiated by word recognition scores? Select the best answer.
cochlear vs. retrocochlear
Why is it important to have a high level of confidence that the word recognition score we obtain represents the patient’s best performance (PB max)? Select the best answer.
The score is used in multiple comparisons so it’s important that we are comparing the best score.
According to the SPRINT chart for 25-item word list, using NU-6 materials, two PB max scores of 48% and 68% ARE significantly different.
false
According to the SPRINT chart for 25-item word list, using NU-6 materials, two PB max scores of 44% and 72% ARE significantly different.
true
According to the SPRINT chart for 25-item word list, using NU-6 materials, a word recognition score of 68% with a pure tone average of 40 dB would likely be PB max (NOT disproportionately low).
true
According to the SPRINT chart for 25-item word list, using NU-6 materials, a word recognition score of 16% with a pure tone average of 76 dB would likely be PB max (NOT disproportionately low).
true
How is a screen for rollover administered?
How is the rollover index calculated?
What rollover index suggests retrocochlear pathology (assuming NU-6 word list)? Include the cutoff and if values greater than or less than that would be considered significant for rollover.
Rollover is administered at two levels and can only be completed if the patient doesn’t have too much of a hearing loss. We do SRT score and add 40 to it, if this is too large we cannot complete rollover. If we are able to complete two levels, the first level of rollover is found using our protocol for WRS. We determine the presentation level by taking SRT + 40. We check to make sure this is audible at all frequencies (at least 10dB above). We then determine if masking is needed. After this, we present the full 50 word list and keep track of their % correct. We note this % on the audiogram form. To find the second level, we complete the full 50 word list at the patient’s UCL - 5 level. We then compare the scores and calculate the rollover index.
calculated by taking second level - first level score divided by second level score
if >.25 suggestive of retrocochlear
What does UCL stand for and why would we measure UCL for speech testing?
uncomfortable loudness level. This is the level that a patient experiences speech uncomfortably. We want to measure UCL for speech testing in order to complete rollover to find the second level. We also want to measure UCL if the patient has a significant hearing loss so that we can make sure we do not exceed this uncomfortable level for the PT when testing.
Research shows that scores obtained using word recognition using recorded materials vs. monitored live voice are equally valid.
false
clinical uses of word recognition scores to differentiate cochlear from retrocochlear site of lesion?
Use the SPRINT chart to compare PB max scores obtained at each ear for significant asymmetry
Consider word recognition (PB max) below 80% with a PTA of 30 dB or better as a red flag for retrocochlear pathology.
Screen for rollover by presenting word recognition at two different presentation levels, including UCL-5 as one of the levels.
Describe the process (protocol for this course) for determining word recognition presentation level.
First we want to calibrate the material we will be using for WRS. Then, to determine presentation level, we take our SRT score and add 40dB to it. We make sure this level we found will be audible and at least 10dB above the thresholds. If the level is not audible at the low frequencies, we add 10dB to the poorest low threshold. If the level when we took SRT + 40 was not audible in the high frequencies, we take the threshold at 2000 Hz and add 15dB to it. If the individual has a severe to profound hearing loss or we cannot get audibility, we present WRS at their UCL-5.
consider loudness to the PT
Briefly explain how a word recognition score overestimates a patient’s speech understanding ability outside of the booth. Briefly explain how this score may underestimate a patient’s speech understanding ability. Answer in bullet points or short phrases.
A WRS can overestimate a patient’s speech understanding ability because it is done at high presentation levels compared to conversation speech levels. It is done in a quiet sound treated booth with no competing noise when conversation happens in varying levels of noisy environments with other competing noises.
A WRS can underestimate a patient’s speech understanding ability because there are no cues or context or redundancy when testing compared to conversational speech. For example, “say the word pig” is harder to understand than if someone were to say “My dad’s favorite farm animal is a pig.” Another way it can underestimate their ability is because there are no visual cues like lip reading, as well as WRS is established monaurally and conversational speech occurs binaurally.
nonsense syllables
open set
single-syllable digits in English
closed set
picture-pointing task with 4 choices
closed set
single-syllable words in English
open set
Recall that there are several recorded word lists that audiologists use for word recognition testing. NU-6, W-22, and CID words lists are commonly used. We have been using the NU-6 word lists in class.
True or false: The SPRINT chart is based on NU-6 words lists and can not be used for other word lists
true
Recall that there are several recorded word lists that audiologists use for word recognition testing. NU-6, W-22, and CID words lists are commonly used. We have been using the NU-6 word lists in class.
True or false: A rollover index of .25 being suggestive of retrocochlear pathology applies to using NU-6 word lists and does not apply to other word lists.
true
magine you are testing a patient following a medical procedure that could impact word recognition ability. The patient has moved from another location and you have the audiogram that was completed before the procedure. You are doing the follow-up testing so the scores obtained before and after the procedure can be compared to see if a significant drop has occurred. You note that the previous audiologist used recorded materials and that they administered 1/2 of a word list to each ear. Which one of the scores below would you be MOST concerned about as NOT being a reliable baseline measurement due to test-retest variability?
64%
what could the previous audiologist have done to improve the reliability of the word recognition score?
Present a full word list of 50 words to each ear
Consider the instrumentation for immittance measures. What are the three components to the probe?
- Tone that plays the sound
- Air pressure that changes the pressure
- Microphone that measures
Completing immittance measures carries little to no risk to a patient with recent ear surgery.
false
tympanometric peak pressure
pressure in ME space/ET
static admittance
stiffness of ossicles & TM
ear canal volume
integrity of the TM
When measuring an acoustic reflex, each of the following can be observed:
- no change (relatively flat line)
- a change where admittance drops below .00
- a change where admittance goes above .00
True/False: the direction of the change does not matter as long as the amount of change is measured at .02 or more
falase
When measuring the acoustic reflex threshold, what immitance measure is being monitored for change during the reflex?
admittance
Imagine you have the following:
right ear: 30 dB hearing loss
left ear: hearing thresholds at 0 dB HL and no air-bone gaps
Match the type of loss with the acoustic reflex result that would be seen or could be seen.
retro: abs reflex when stim is R ear
cochlear: reflex <70-90SL when stim is T ear
conductive: abs reflex when probe ear is R ear
If a patient has the following:
right ear: 35 dB conductive hearing loss
left ear: 0 dB hearing thresholds and no air-bone gaps
In which condition(s) would you expect to see an acoustic stapedial reflex at 70-90 dB HL (the level on the equipment)? Select all that apply.
left ipsi
Which of the following are likely to cause the ear canal volume measurement to be outside of normal range?
tm perf
occluding cerumen
flow of energy
immittance
opposition to energy flow
impedance
ease of energy flow
admittance
sensitivity
ability of test to correctly identify those with it
specificity
ability of test to correctly identify those without it
For testing the extended high frequencies, meaning the frequencies above 8,000 Hz, which transducers can be used (assuming they are calibrated)?
circumaural headphones
What is a common use of extended high frequency audiometry?
monitoring for ototoxicity
