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AUDE 5460 > final exam new info > Flashcards

final exam new info Flashcards

1
Q

screening protocol

A

objective is to separate people with auditory dysfunction from those who do not
-results are P or F (or refer)
-3/4 bands P for a passing result
-with pass, assumed ME and IE are functioning properly
-with fail/refer could be a sign of abnormal ME function, more than mild HL, obstruction, poor testing or too much noise

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2
Q

you get a fail/refer in a screening, what is next

A

check the probe fit and ensure the environment and child is quiet
-if does not pass after another attempt, conduct another screening within 2 weeks

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3
Q

what are prerequisites for a population screening program

A

condition has a high frequency within the population, condition is serious without intervention, condition must be treatable/preventable and an effective follow up program must be possible

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4
Q

diagnostic protocol

A

included in the test battery with more frequencies tests and it assesses more octaves with a stricter P/F criteria
-we must interpret the data in regards to their hearing
-gives ear specific information
-provides the cross check principle for comparison

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5
Q

when do we use a diagnostic OAE test

A

with patients that are unable to complete traditional tests, monitoring cochlear status during ototoxic medications, using in the usage of differential diagnoses for cochlear vs. retrocochlear pathologies and for ANSD assessments

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6
Q

what are the pros and cons of a screening

A

pros : fast, ear specific, frequency specific, relatively inexpensive, versatile and portable
cons : not a true test of hearing, not a diagnostic test and not inclusive

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7
Q

OAEs and NBHS

A

DPOAE is most effective in the 2-4 kHz region however TEOAEs are most often used as they are quicker
-high enough to escape negative influence of measurement noise and low enough to minimize likelihood of standing waves
-not testing below 2000 Hz

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8
Q

OAE screening and preschoolers

A

through the ECHO initiative (early childhood hearing outreach)
-extending benefits of hearing screening to children between the NBHS and school aged
-people are taught and they go out to screen kiddos
-there is the gap between the two ages of testing and this initiative aims to shrink that

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9
Q

OAE screening and school aged children

A

inexpensive and sensitive technique for screening of this group
-used within school systems
-quick
-automated P/F criteria

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10
Q

OAE screening and adults

A

you can screen them but it is not optimal
-OAEs deteriorate with age
-OAEs can be impacted in a variety of ways with different HL

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11
Q

neonate NBHS and OAEs

A

the average test time is 5-15 minutes for each baby and it is most reliable when performed at least 12 hours after birth

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12
Q

NBHS : OAEs and ABR

A

all babies are screened with OAEs and those who fail will receive an ABR screening prior to leaving the hospital
-this reduces the refer rate
-initial cost is higher than OAEs or ABR screening alone

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13
Q

if you only use OAEs for NBHS, what can be missed

A

ANSD, mild losses, atypical configurations, delayed onset/progressive losses and neural/genetic OHC loss only

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14
Q

what is the efferent system’s role with the auditory system

A

protection from acoustic trauma, hearing in noise assistance, role in attention and a role in auditory training

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15
Q

explain the anatomy of the efferent auditory system

A

-first population of efferent neurons arise from the lateral superior olivary complex and synapses with the neuron dendrites close to the IHCs
-second population of neurons, known as the medical olivocochlear system, arises from the superior olivary complex and project to the OHCs

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16
Q

what fibers are responsible for suppressing/inhibiting OHC motility and therefore the OAE?

A

medial olivary cochlea fibers

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17
Q

MOC goes to the ______ hair cells and the LOC goes to the _______ hair cells

A

outer ; inner

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18
Q

within cases of ANSD, what role do OAEs play

A

they are almost always present in cases of ANSD
-however they can be absent when compromised blood flow to the hair cells occur

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19
Q

what is the importance of ototoxicity monitoring

A

there are no safe levels of know ototoxic drugs, severity of HL is difficulty to predict (most often bilateral), may be unaware of a HL present until the patient reports it, it gives physicians an opportunity to modify or change medications and it allows audiologists to counsel on hearing loss and treatment options

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20
Q

with ototoxicity monitoring, what is important to get

A

a baseline !!!
-baseline testing ensures that we are monitoring properly

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21
Q

why are OAEs used for monitoring

A

they are quick, due to patients not feeling well enough to do an additional length of testing it is something easily administered, and DPOAEs are useful as they have a high frequency protocol

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22
Q

aminoglycoside antibiotics and the effects on the auditory system

A

permanent
-hair cell death, begins with HF loss and is progressive

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23
Q

salicylates and the effects on the auditory system

A

non-permanent and in most cases the return to baseline occurs after cessation
-threshold shift in hearing and tinnitus

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24
Q

cisplatin and the effects on the auditory system

A

permanent
-dose and age dependent
-HL begins at the base of the stria/OHCs, HF and progressive

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25
Q

carboplatin and the effects on the auditory system

A

permanent but affects IHC along with the OHCs
-both OHC and IHC damage
-this drugs slows/stops the growth of cancerous cells in the body

26
Q

quinine and the effects on the auditory system

A

typically reversible
-seen with street drugs
-SNHL, tinnitus and vertigo can be present

27
Q

how do drugs damage the ear

A

formation of free radicals and metabolic stress, toxicity can have platinum or other metal accumulate (leading to the drug not being able to be filtered out of the inner ear), ischemia due to compromised blood flow (leading to hair cells becoming damaged) and mechanical damage (breaks hair cells or the basilar membrane)

28
Q

what age populations are more susceptible to ototoxicity damage

A

very old and very young patients

29
Q

schedule for proper monitoring appointments

A

gaining a baseline prior to any treatment/therapy then appointments occur prior to appointments or at regular intervals in treatment

30
Q

what are challenges with ototoxicity monitoring

A

patients may be too ill, bedside testing may be unavailable and baseline data is often not available

31
Q

what are some scales that are used to track ototoxicity

A

ASHA, NCI, brock’s HL grades, chang, SIOP (most common) and the muenster scale

32
Q

explain a oto-protection/protective agent

A

pedmark
-protects the inner ear and it is administered while the patient is undergoing ototoxicity treatment
-however only a small group of individuals can receive it as it can only be used on certain tumor types

33
Q

suppression OAEs

A

occurs when presenting a noise to the contralateral ear of what is being tested and a reduced/suppression occurs to the amplitude of the OAE
-this is a normal phenomenon
-forward masking is used

34
Q

what does the lack of suppression mean

A

it can be a pathologic finding implicating dysfunction of the efferent system

35
Q

pressurized OAEs

A

OAEs are presented at tympanic peak pressure which compensated for any negative or positive ME pressure, this equalized pressure on both sides of the TM
-puts pressure into the ear canal
-allows for compensation to occur

36
Q

with a retracted TM, this means negative ME pressure meaning …..

A

there is a stiffness problem which results in abnormal lower frequency responses

37
Q

when do we use a pressurized OAE

A

for kids with negative or positive ME pressure
-do not use with effusion

38
Q

stimulus frequency OAEs (SFOAEs)

A

a long lasting version of the TEOAE, elicited with one low level pure tone stimulus
-a type of evoked emission that provides the most direct and clear measurement of the reflection component
-might be more predictive of behavioral hearing thresholds

39
Q

what are the three ways that SFOAEs can be measured

A

nonlinear compression : makes use of compressive growth of the emission amplitude relative to linear growth of the stimulus
two tone suppression : using 2 tones, 1 is going to suppress the other to get the tone out (higher tone will want to suppress the lower tone)
spectral smoothing : involves convolving the complex ear canal pressure spectrum with a smoothing function

40
Q

in SFOAEs, where does the emission originate

A

within the cochlea in the same region of the evoking stimulus

41
Q

HEAR report

A

history : relevant background
evaluation : what you did
assessment : what you found
recommendations

42
Q

important considerations of report writing

A

consider who it is going to, the level of sophistication needed, what the purpose if, why you are sending it, etc.

43
Q

important notes of report writing

A

writing in the language of the recipient, do not hide behind professional jargon, use functional terms when possible, don’t spend time teaching the audiogram and relate comments/recommendations to things the reader can easily identify

44
Q

why type of hearing loss can we miss if we are using OAEs for NBHS

A

ANSD, mild losses, atypical configurations

45
Q

T or F : adding pressurization to OAE recordings to overcome negative ME pressure is routinely done clinically

A

false

46
Q

what is pedmark

A

an injectable therapy for children to reduce the risk of cisplatin ototoxicity

47
Q

T or F : there is only 1 scale available to grade the degree of HL from ototoxic drugs

A

false

48
Q

which is the recommendation for ototoxicity monitoring given by AAA

A

audiogram (standard), HFA and DPOAE

49
Q

T or F : efferent auditory system protects the cochlea from acoustic trauma and is involved in hearing in the presence of noise

A

true

50
Q

efferent neurons from medial olivocochlear system innervates which of the following

A

outer hair cells

51
Q

T or F : persons with ANSD have no efferent suppression of TEOAEs with binaural, contra or ipsi noise

A

true
-we will not see suppression in any presentation with these patients

52
Q

T of F : persons with ANSD have no efferent suppressions of TEOAEs with a forward, backward, or simultaneous masking paradigm

A

true

53
Q

how do ototoxic medications damage the inner ear

A

ischemia due to compromised blood flow, toxicity (platinum or other metal accumulation) and formation of free radicals and metabolic stress

54
Q

T or F : the use of salicylates can cause ototoxic hearing loss, which usually returns to baseline after drug cessation

A

true

55
Q

T or F : efferent neurons from lateral superior olivary complex synapse near the inner hair cells

A

true

56
Q

why type of OAE occurs without external stimulation

A

SOAE
-spontaneous

57
Q

T or F : the absence of spontaneous OAEs is consistent with cochlear damage

A

false

58
Q

negative middle ear pressure can affect the OAE response in which way

A

decrease the amplitude, especially in the lower frequencies

59
Q

T or F : 1 issue impacting NBHS data and protocols is no ANSI standards for the use in calibration of OAE equipment

A

true

60
Q

which type of noise is most effective in suppressing TEOAEs

A

broadband noise

61
Q

T or F : cisplatin based chemo will cause HL in approx. 1% of recipients

A

false
-affects hearing in around 40-80% of treated patients

62
Q

T or F : TEOAEs are preferred to monitor ototoxicity in patients receiving chemo

A

false
-DPOAEs are recommended due to HF protocol

AUDE 5460 (2 decks)

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