Praxis Audiology cheat sheet

Decibel notation: dB SPL references 20 µPa; dB HL references the normative threshold of 0 dB at each frequency; dB SL references the listener's own threshold.

Frequency and pitch relation: pitch roughly doubles per octave; the audiometric octave frequencies from 250 to 8000 Hz are 250, 500, 1000, 2000, 4000, and 8000 Hz.

Scope of practice: audiologists diagnose and treat hearing and balance disorders; assistants/aides perform support tasks and do not independently interpret test results.

ASHA certification requires a doctoral degree (AuD), supervised clinical practicum, and passing the Praxis examination; CCC-A denotes Certificate of Clinical Competence in Audiology.

Informed consent and confidentiality derive from HIPAA (privacy of health information) and the ethical principles of beneficence, nonmaleficence, autonomy, and justice.

Universal precautions treat all blood and body fluids as potentially infectious; hand hygiene and glove use apply to cerumen management and probe-tip handling.

Validity means a test measures what it intends; reliability means it yields consistent results across repeated administrations.

Sensitivity is the proportion of true cases correctly identified; specificity is the proportion of non-cases correctly identified as normal.

Conductive loss: air conduction thresholds are elevated while bone conduction thresholds are normal; the air-bone gap is the difference between them.

Sensorineural loss: air and bone conduction thresholds are equally elevated with no significant air-bone gap.

Mixed loss: both air and bone thresholds are elevated, and an air-bone gap of 10 dB or more is present.

Noise-induced hearing loss classically shows a 3000-6000 Hz notch, greatest at 4000 Hz, with preserved low frequencies.

Presbycusis is bilateral, symmetric, high-frequency sensorineural loss; the most common type is sensory (outer hair cell) loss.

Otosclerosis produces a conductive loss from stapes fixation, often with a Carhart notch (apparent bone-conduction dip near 2000 Hz).

Meniere disease triad: episodic vertigo, fluctuating sensorineural hearing loss, and tinnitus, with aural fullness; low frequencies are often affected first.

Acoustic neuroma (vestibular schwannoma) typically causes unilateral sensorineural loss and asymmetric speech recognition scores; retrocochlear signs warrant imaging.

Pure-tone average (PTA) is the mean of thresholds at 500, 1000, and 2000 Hz; degree of loss is often classified from this value.

Tympanometry types: Type A normal peak near 0 daPa; Type B flat (effusion or perforation); Type C peak shifted negative (eustachian tube dysfunction).

Acoustic reflex: stapedius contraction is bilateral; reflex decay of 50% or more within 10 seconds suggests retrocochlear pathology.

Otoacoustic emissions (OAEs) reflect outer hair cell function; present OAEs indicate cochlear health and suggest loss greater than about 30 dB HL is unlikely.

Auditory brainstem response (ABR): Wave V is the most robust and is used for threshold estimation and retrocochlear screening; interpeak latencies assess neural conduction.

Speech recognition testing: the word recognition score reflects clarity, not degree of loss, and rollover (decline at high levels) suggests retrocochlear involvement.

Masking rule: mask the non-test ear when the air-bone gap of the test ear exceeds interaural attenuation (about 40 dB for headphones, 0 dB for bone).

Immittance measures middle-ear status; pure-tone audiometry measures hearing sensitivity; both are needed to classify loss type accurately.

Hearing aid gain is prescribed to match target amplification; real-ear measurement verifies the aided output against prescriptive targets.

Hearing aid styles trade cosmesis against power and feedback risk: behind-the-ear offers the most gain and features; completely-in-canal offers the least.

Cochlear implants are indicated for severe-to-profound sensorineural loss with limited benefit from amplification; candidacy includes aided speech perception criteria.

Tinnitus management includes masking, sound therapy, and cognitive behavioral therapy; there is no single curative treatment.

Aural rehabilitation includes communication strategies, speechreading, and counseling to reduce activity limitations and participation restrictions.

Cerumen management requires direct visualization, appropriate irrigation or instrumentation, and caution when a perforation or tympanostomy tube is present.

Vestibular rehabilitation uses habituation and balance exercises to reduce dizziness; it is not a treatment for active infection or acute vertigo of unknown cause.

Assistive listening devices (FM, loop, and infrared systems) improve signal-to-noise ratio in noisy or distant listening environments.

Universal newborn hearing screening uses OAE or automated ABR before hospital discharge; a refer result requires rescreening and diagnostic evaluation.

The Joint Committee on Infant Hearing (JCIH) 1-3-6 guideline: screen by 1 month, diagnose by 3 months, and begin early intervention by 6 months.

Auditory neuropathy spectrum disorder shows present OAEs or cochlear microphonic with absent or abnormal ABR, often with poor speech perception.

Behavioral testing by age: visual reinforcement audiometry (about 6 months to 2-3 years) and play audiometry (about 2-5 years); conditioned orientation response is used in very young infants.

Educational audiology provides classroom accommodations such as preferential seating, FM systems, and acoustic treatment to improve signal-to-noise ratio.

The Individuals with Disabilities Education Act (IDEA) mandates free appropriate public education, individualized education programs (IEPs), and related services including audiology.

Section 504 provides accommodations for students who do not require special education but need access supports.

Otitis media with effusion is common in young children and can cause fluctuating conductive loss; tympanometry and pneumatic otoscopy aid identification.