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Study Guide Final Exam This course (and thus this final exam) is about our being able to link disorders (of outer, middle, inner ear, and the auditory nervous system), to patterns of audiologic results, and for you to know on a basic level the kinds of steps we can take once we know about the disorder from those results. 1. Look at the Air Conduction thresholds given below. Where would you expect the Bone Conduction thresholds to be given Type B tympanograms bilaterally? Type A bilaterally? In each case, how likely do you think it would be that you need to mask (any of the thresholds)? RE AC LE AC 250 50 55 500 55 55 1000 70 75 2000 80 85 4000 95 100 8000 110 105 2. 3. 4. 5. 6. By the way, I expect you still remember how to plot audiometric thresholds like these. Know word recognition, PIPB testing and the rollover index. Know SRT, and how it should relate to the PTA. What is the acoustic reflex? How is it useful clinically? Know your tympanograms (A, B, C, As, Ad), and know the meaning of physical volume measures. 7. Know the various etiologies of cochlear hearing loss (e.g: presbycusis, noise, ototoxicity, genetics/familial, and Menieres disease) 8. Know the various etiologies of neural hearing loss (e.g., vestibular Schwannoma, kernicterus, multiple sclerosis, vascular disorders, etc.) 9. What are some of the audiologic findings, and patient symptoms that are red flags for an VIIIth nerve tumor? 10. What happens to the ABR when there is a tumor on the VIIIth cranial nerve? 11. Know some potential explanations for functional hearing disorders: e.g., malingering, psychogenic hearing loss, cortical damage/stroke. 12. What are the possible inconsistencies that might suggest someone is malingering? 13. Be able to describe the nature of counseling in audiologic practice. 14. Understand the relationship between pure tone, speech and site of lesion testing and how they relate to disorders of the outer, middle and inner ear and the central auditory nervous system. 15. Know in general the options regarding amplification and assistive devices for individuals with hearing loss. 16. A Case to Play with: Mrs. R. (a 69 year old female) comes in complaining that she can’t understand speech except when speaking one-on-one. She is particularly concerned about sessions in which she counsels individuals: they often look down so she can’t read lips. She wears two hearing aids which she has had for the past 6 years. She says they don’t seem to help much anymore. What additional questions might you want to ask her? What tests are you going to conduct? Given a type A tympanogram, what kind hearing loss would you expect to see on the audiogram? What kind of OAEs (again assuming the type A tymp)? If you found acoustic reflex thresholds at 50 dB SL, what would it mean to you? Would that be more or less consistent with absent or present OAEs?