Clinical Conditions II Final

Question 1

BPV cupulolithiasis

Answer 1

debris attached to the cupula - sitting on top of the cupula
no delay

Question 2

BPV canalithiasis

Answer 2

otoconia are inside the canal and moves the endolymph
debris within long arm
there is a delay

Question 3

BPV vestibulithiasis

Answer 3

debris within the short arm (type 2)

Question 4

what maneuver will help with nystagmus

Answer 4

Epley maneuver/canalith repositioning procedure, rotating in four different directions

Question 5

Vestibular Neuritis

Answer 5

no hearing loss
right-beating nystagmus/ intensity increased w/gaze to the right
caused by viral infection of CN VIII
nausea/vomiting, severe vertigo

Question 6

treatment of vestibular neuritis

Answer 6

medications and vestibular rehab

Question 7

Labryinthitis

Answer 7

viral or bacterial infection of the inner ear
COMPLETE HEARING LOSS - unilateral profound sensorineural
severe vertigo, nausea/vomiting

Question 8

symptoms of unilateral vestibular deficit

Answer 8

increased tone of the contralateral extensor muscles due to inadequate postural muscles
possible oscillopsia
unidirectional nystagmus
chronic= 5 days to 8 years

Question 9

head impulse test (HIT)

Answer 9

rotate the head quickly to one side and the catch up saccade is towards the side of the lesion
use for BPV, unilateral peripheral vestibular deficit

Question 10

dynamic visual acuity test/dynamic illegible E Test

Answer 10

reading while rotating, if they can’t read during rotation but they can when static then it could be BILATERAL but it would be alongside oscillopsia

Question 11

tests for vestibular tone imbalance

Answer 11

spontaneous nystagmus and head shaking nystagmus

Question 12

postural imbalance tests

Answer 12

dynamic gait index

modified clinical test of sensory interaction and balance

Question 13

Bithermic Caloric Testing

Answer 13

test of lateral SCC and superior vestibular nerve 
cold/warm air or water (more accurate) 
unilateral weakness 
>25% difference b/w sides 
measures of movements

Question 14

video head impulse test (vHIT)

Answer 14

test of lateral and vertical SSCs (all of the canals)

measure movements 5-6 Hz

Question 15

Cervical Vestibular Evoked Myogenic Potential (cVEMP)

Answer 15

test for saccule and inferior vestibular nerve function

Question 16

(oVEMP) ocular vestibular evoked myogenic potential

Answer 16

test for utricle and superior vestibular nerve
stimulus on C/L side
acoustic stimulus elicits eye movements

Question 17

Rotary Chair Testing

Answer 17

lateral canal test
head is tilted forward 30 degrees to bring it into horizontal position
tests for bilateral vestibular weakness
check for compensation from unilateral vestibular loss

Question 18

platform posturography

Answer 18

an objective eval of the vestibular system

Question 19

common cause of bilateral peripheral vestibular deficit

Answer 19

toxic exposure to aminoglycosides, loop diuretics IV, IV erthromycin, Quinine, Neoplastics

Question 20

symmetric bilateral peripheral vestibular deficit

Answer 20

no vertigo, no nystagmus

Question 21

testing for bilateral peripheral vestibular deficit

Answer 21

postural imbalance
look for oscillopsia
dynamic visual acuity

Question 22

Meniere’s Disease

Answer 22

episodic, spontaneous
sensorineural hearing loss
possible neuritis
aural fullness

Question 23

long term treatment of Meniere’s

Answer 23

diuretics, low sodium diet, beta-histamine
intratympanic steroid/gentamicin
surgery

Question 24

perilymphatic fistula

Answer 24

leak of perilymph into the middle ear
most of the time from blast injury/barotrauma
hearing loss, tinnitus, vertigo, disequilibrium
worse with coughing, nose blowing
presents like meniere’s disease

Question 25

superior semicircular canal dehiscence (SCDS)

Answer 25

``` dizziness, chronic disequilibrium pulse-synchronous oscillopsia hyperacusis low-frequency conductive hearing loss pulsatile tinnitus brain fog/fatigue oculophilia (hear your eyes move) ```

Question 26

central nystagmus

Answer 26

``` vertical- up or down beating sustained, gaze evoked- nystagmus- inability to maintain stable conjugate eye deviation away from primary position central position may mimic benign positional nystagmus EYES GO TOWARDS GROUND Dysmetria ocular tilit gait/limb ataxia lateropulsion ```

Question 27

first degree burn appearance

Answer 27

``` pink or red edema no blisters blanches skin/sensation intact pain is tender ```

Question 28

first degree superficial burn healing

Answer 28

3-5 days through epithelization

Question 29

second degree/superficial partial thickness appearance/pain

Answer 29

pink or red, edema, moist with blisters, blanches with quick refill , sensation intact very painful

Question 30

second degree/superficial partial thickness healing

Answer 30

1-2 weeks through epithelization | changes in pigmentation

Question 31

second degree/deep partial thickness appearance, pain

Answer 31

pink or ivory, dry with blisters, can feel deep pressure but not light touch, decrease pinprick, hair easily removed, black with a slower refill pain present but less with more depth

Question 32

second degree/deep partial thickness healing

Answer 32

2-3 weeks with epithelization | likely will need graft and scar is likely

Question 33

Third or Fourth degree/full thickness appearance/pain

Answer 33

white, red, brown or black dry with possible blisters, no blanching, no sensation no pain

Question 34

Third or fourth degree/full thickness healing

Answer 34

>3 weeks with granulation and epithelization, usually requires surgery

Question 35

First degree burn injuries the _____

Answer 35

epidermis

Question 36

partial thickness/second degree superficial injures the

Answer 36

dermis

Question 37

partial thickness/second degree deep injures which layer?

Answer 37

dermis with hair follicles and sweat glands intact

Question 38

full thickness third degree burn injures the ____

Answer 38

entire dermis

Question 39

Full thickness/fourth degree injures ______

Answer 39

all the layers plus the muscle and bone

Question 40

zone of coagulation

Answer 40

occurs at the point of maximum damage/ damage is irreversible tissue loss due to coagulation of the constituent proteins

Question 41

zone of stasis

Answer 41

characterized by decreased tissue perfusion damage is potentially salvageable main aim of burns resuscitation is to increase tissue perfusion here and prevent any damage becoming irreversible zone can be converted into complete tissue loss

Question 42

zone of hyperemia

Answer 42

outermost zone tissue perfusion is increased tissue will recover unless there is severe sepsis or prolonged hypoperfusion these three zones of a burn are three dimensional and loss of tissue in the zone of stasis will lead to the wound developing as well as widening