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Grand Rounds Series - Complex Adult Hearing Aid Cases

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1.  Verification options for a bone conduction aid include but are not limited to:
  1. Real-Ear to Coupler Difference measurement
  2. Real-Ear Aided Response measurement
  3. Aided soundfield testing
  4. Real-Ear Insertion Gain measurement
2.  Although cochlear implant candidacy testing revealed Father K. was a candidate for an implant on the right side, he ultimately chose to be fit with?
  1. BiCROS devices (transmitter on the left ear and traditional hearing aid on the right ear)
  2. Traditional amplification - right ear only
  3. Traditional amplification - left ear only
  4. Bilateral amplification
3.  What device did Father K. find most ineffective with his amplification trial?
  1. CROS transmitter on the left ear
  2. Traditional hearing aid on left ear
  3. Cochlear implant right ear
  4. New amplification on right ear
4.  Which of the following option(s) may be reasonable when fitting a patient with unilateral fluctuating sensorineural hearing loss due to Menieres Disease?
  1. Avoid fitting the fluctuating ear with amplification as it is too variable to be successful
  2. Always keep the fitting as simple as possible - avoid using multiple programs or volume controls
  3. In a binaural fitting, focus on verifying audibility for the non-fluctuating ear under the rationale that the person will primarily rely on their non-fluctuating ear so it must be fit as effectively as possible
  4. Always fit the fluctuating ear to the maximum gain required when the fluctuating hearing is at the worse to ensure the patient notices benefit
5.  All of the following issues commonly reported by patients experiencing unilateral, fluctuating low-frequency hearing loss may be addressed with the use of amplification on the affected ear, EXCEPT?
  1. Recruitment/Reduced dynamic range
  2. Bothersome tinnitus
  3. Difficulty in background noise
  4. Vertigo
6.  The Advanced Bionics Naida processor is compatible with which hearing aid device?
  1. Phonak Naida Link CROS
  2. Widex hearing aids
  3. Oticon OPN BTE
  4. Phonak Audeo B
7.  What should be tested prior to consideration of cochlear implantation compared to traditional hearing aids for a patient with MELAS?
  1. Auditory processing testing
  2. Distortion Product Otoacoustic Emissions
  3. The integrity of brainstem and cortical auditory pathways
  4. Neural Response Telemetry
8.  Which device did patient Mr. F (case 5) chose?
  1. CROS hearing aid
  2. Bilateral air conduction hearing aids
  3. Bone conduction hearing aids
  4. Cochlear implant
9.  The symptoms of semicircular canal dehiscence include:
  1. Tinnitus
  2. Migraines
  3. Sensitivity to loud sound and hypersensitivity to bone conducted sounds
  4. None of the above
10.  MELAS stands for:
  1. Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes
  2. Mitochondrial elevated lactic acidosis, and strokes
  3. Middle ear lactic acidosis and semi-circular canals
  4. Mitochondrial elevated lactic acid syndrome
11.  When considering hearing loss and stethoscope use:
  1. Breath sounds are less than 150 Hz
  2. Breath sounds are approximately 600-1000 Hz
  3. Breath sounds are not frequency specific
  4. No one needs to hear breath sounds
12.  You have fit the patient to NAL-NL2 targets using REM. The patient complains of sensitivity to overall sound. You slightly adjust gains in office and encourage the patient to try her new hearing aid settings. The patient continues to have complaints of sound sensitivity. You don't want to sacrifice anymore gain. What would be the next best hearing aid adjustment?
  1. Apply frequency allocation
  2. Decrease low frequency gain at all outputs
  3. Adjust attack and release times (if software allows)
  4. Enable volume control
13.  When considering an aid for someone who is used to a more linear power aid:
  1. Find a hearing aid that is analog because they will not accept a compression aid
  2. Find a hearing aid that mimics the last hearing aid that they got
  3. Find an aid with a high MPO
  4. Find an aid with a low MPO
14.  Which of the following may lead to poorer outcomes with a cochlear implant?
  1. Consistent hearing aid use
  2. Adult with pre-lingual profound hearing loss
  3. Sudden hearing loss
  4. Short duration of hearing loss
15.  When completing word-level testing, like the W22, what difference in score between ears is considered an asymmetry?
  1. 30%
  2. 15%
  3. 10%
  4. 5%

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