17 - dizziness and vertigo

Question 1

What 2 things maintain blood pressure

Answer 1

Cardiac output

vascular resistance

Question 2

Name 3 locations of baroreceptors

Answer 2

heart, vena cavae, carotid sinuses, aortic arch.

Question 3

physiology of renin angiotensin aldosterone raising blood presssre

Answer 3

Regulation of blood Na and hence blood pressure.

Low blood sodium or flow entering juxtaglomerular apparatus triggers conversion of prorenin into renin which is released into the blood.

Removes angiotensin I from angiotensinogen.

ACE in lungs removes angiotensin II from this.

Angiotensin II triggers aldosterone release.

Sodium reabsorbed and potassium secreted.

Blood pressure rises

Question 4

Dizzy vs vertigo

Answer 4

Vertigo is the sensation that the room is spinning. It is an illusion caused by damage to the vestibular system.

Dizziness is lightheadedness or a loss of balance and has many causes.

Question 5

What causes BPPV?
Triggers?
Diagnosis?
mx?

Answer 5

Otolith breaks off loose in the canal and floats around, triggering the sensation and producing vertigo.

Caused by infection, flights, trauma or at random.

Triggered by lying down in bed or adjusting posture.

Dix-Hallpike to diagnose and Eply manoeuvres to treat. Do three times a day for a week.

Question 6

triad in meniere’s

Answer 6

vertigo, tinnitus, hearing loss

Question 7

Mx meniere’s

Answer 7

Betahistidine and antiemetics to control symptoms

Question 8

What is vestibular neuronitis also called?
Features?
Cause?
mx?

Answer 8

labyrinthitis

Vertigo with hearing loss, nausea, vomiting, nystagmus and tinnitus.

Usually viral but plenty of other causes.

Manage with physiotherapy and await remission

Question 9

Define postural hypotension?

Answer 9

fall in systolic 20mmHg and 10mmHg for diastolic