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Managing the Musician with Hearing Loss, presented in partnership with Salus University

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1.  The term "damage-risk criteria" (DRC) specifies: The combination of sound level and duration that is considered to have equivalent hearing loss risk The maximum sound level of allowable exposure in a given country The maximum sound duration of allowable exposure in a given industry How much hearing loss can be expected from a sound exposure

2.  What is the effect of a slit-leak of a musician's earplug that is not snuggly fitting in the ear canal? Increased attenuation in the high frequencies Loss of attenuation in the low frequencies Loss of attenuation in the high frequencies Increased attenuation in the low frequencies

3.  Which of the following is NOT a reason for immediate medical referral for an adult musician presenting with hearing loss? Concomitant dizziness Conductive component to the hearing loss Bilateral, symmetric tinnitus with a history of noise exposure Poor word recognition score with hearing loss asymmetry

4.  What is the minimum amount of attenuation needed by a hearing protection device to reduce a 97 dBA, 8-hour exposure, to 50% dose or less according to the NIOSH damage risk criterion? 25 dB 9 dB 3 dB 15 dB

5.  What technique did the presenter recommend be used when verifying performance of custom hearing protection by MIRE/real-ear system to help manage the measurement artifact created by introduction of possible slit leak from a probe microphone tube? Insert the probe tube through the musician's earplug filter Have the earmold lab build the probe tube into the body of the custom sleeve Liberal use of water-based lubricant along the sleeve and at the face of the earplug where the probe tube interfaces with the ear canal and earplug No intervention is needed: we don't care about low-frequency isolation

6.  Which of the following earmold impression techniques can be used to improve the comfort and performance of custom hearing protection devices? Take impression while musician is playing his/her instrument Let the impression material harden a little in the syringe before injecting it into the ear canal Place the otoblock no deeper than the 1st bend of the ear canal If using two-part silicone earmold impression material, use double the material for Part 1 as for Part 2.

7.  Which audiological test is illustrative for organic hyperacusis, if the patient can tolerate it (so approach use of this test with caution)? ABR Acoustic reflex threshold Pure-tone audiometry SISI

8.  Which of the following patients likely needs an ER-25 musicians earplug instead of the more modest attenuation provided by the ER-15? Casual concert goer Guitarist in a garage band Drum tech for a touring rock group Back up vocalist for a musical group who uses wedge stage monitors

9.  Conventional hearing aids (BTE, RIC, IIC, CIC, ITE) have a low-frequency roll-off about what frequency range (i.e., they do not transduce sound below this frequency range, which is problematic for some music but not problematic for speech intelligibility)? 20,000 Hz 1000 - 3000 Hz 150 - 200 Hz 6k - 10 kHZ

10.  Which of the following characteristics of a hearing aid determines the maximum level of the music or speech that can be processed by the hearing aid without distortion? Noise reduction algorithm Feedback management strategy Directional microphone array Peak input limit

11.  Anti-anxiety and anti-depressant medications, such as Klonopin and Prozac, assist in tinnitus management by: Decreasing how loud the tinnitus sounds Lessening the negative reaction to tinnitus (as well as generally lessening reaction to stress) Increasing perception of ambient noise Decreasing susceptibility for future noise-induced hearing loss

12.  Sound enhancement, through the use of tinnitus maskers, soundfield white noise generators, and the like, help manage tinnitus suffering by: Toughen the ear against future noise insult Cause habituation of perception Cause habituation of reaction Offering a sense of control over the perception of tinnitus

13.  How might hearing aid gain settings be adjusted to improve acceptability of music? Linear gain where hearing thresholds exceed a moderate hearing loss Higher compression ratio relative to that prescribed for speech intelligibility, in light of higher expected input levels Wide-dynamic range compression with 20 dB SPL kneepoint and binaurally presented fractile music Linear gain with greater amplification of low-frequency signals relative to the prescribed gain for speech intelligibility based on pure-tone thresholds

14.  Which area of the brain is responsible for inappropriately assigning importance to the perception of tinnitus, resulting in a fear reaction, when tinnitus is bothersome/tinnitus suffering occurs? Prefrontal cortex Auditory cortex Brainstem Limbic system

15.  Which of the following signal processing strategies is most disadvantageous for music listening? Frequency compression/frequency transposition Directional microphones Omnidirectional microphones Feedback cancellation/feedback suppression