Medical Referral Criteria and Follow-up Flashcards
7 cards from real CAOHC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medical Referral Criteria and Follow-up flashcards as text
A worker's annual audiogram reveals significant asymmetric hearing loss — the right ear is substantially worse than the left with no change from last year. What is the most appropriate action?
Answer: Refer the worker to a physician due to the risk of retrocochlear pathology
Significant unexplained asymmetric hearing loss can indicate retrocochlear pathology such as acoustic neuroma, requiring physician evaluation even without a confirmed STS.
A worker reports a sudden, total loss of hearing in one ear that was not present at their last annual audiogram six months ago. What is the most urgent action?
Answer: Refer the worker urgently to a physician for evaluation of possible sudden sensorineural hearing loss
Sudden sensorineural hearing loss is a medical emergency requiring urgent physician evaluation since prompt treatment can improve outcomes.
Under OSHA 29 CFR 1910.95, at whose expense must physician or audiologist referrals be provided when a worker has a confirmed STS?
Answer: The employer, at no cost to the worker
OSHA mandates that referrals resulting from STS determinations must be provided at no cost to the employee — the employer bears the expense.
Which type of audiometric finding would most warrant referral due to suspected non-noise etiology?
Answer: A progressive low-frequency hearing loss pattern in both ears
Progressive low-frequency bilateral hearing loss is not typical of noise-induced hearing loss and suggests a non-noise etiology such as Meniere's disease or endolymphatic hydrops, warranting physician referral.
Which of the following should NOT typically appear in a referral letter sent from an OHC to a physician?
Answer: The worker's wage, salary, and benefit information
A medical referral letter should include clinically relevant information such as audiometric history and noise exposure data, but salary and benefits are not medically pertinent.
A worker's follow-up audiogram conducted 30 days after a suspected STS shows all thresholds have returned to baseline levels. What is the most likely explanation for the initial finding?
Answer: A temporary threshold shift (TTS) that resolved after adequate rest from noise
A threshold shift that resolves with removal from noise exposure is consistent with a temporary threshold shift (TTS), not a permanent threshold shift.
After a physician evaluates a referred worker and determines the hearing loss is caused by a non-occupational medication (ototoxic drug), what is the OHC's appropriate follow-up?
Answer: Continue monitoring the worker within the program and document the physician's findings in the audiometric record
Workers with any degree of hearing loss — regardless of cause — should remain in the hearing conservation monitoring program, and the physician's findings must be documented.