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First Aid: Step 2 CS > Differential & Work-up: Dizziness, LoC > Flashcards

Differential & Work-up: Dizziness, LoC Flashcards

1
Q

35 yo F presents with intermittent episodes of vertigo, tinnitus, nausea, and hearing loss within the past week. Examination is normal.

A
  1. Meniere disease
  2. Benign positional vertigo
  3. Labyrinthitis
  4. Vestibular neuronitis
  5. Acoustic neuroma
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2
Q

WORK UP FOR:

  1. Meniere disease
  2. Benign positional vertigo
  3. Labyrinthitis
  4. Vestibular neuronitis
  5. Acoustic neuroma
A
  1. Dix-Hallpike maneuver
  2. Audiometry
  3. Electronystagmography
  4. CBC
  5. VDRL/RPR (syphilis is a cause of Meniere disease)
  6. MRI-brain
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3
Q

55 yo F c/o dizziness for the past day upon standing. She feels faint and has severe diarrhea that started 2 days ago. She takes furosemide for hypertension. On examination, she feels dizzy upon standing.

A
  1. Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
  2. Vertebrobasilar insufficiency
  3. Cardiac arrhythmias
  4. Vestibular neuronitis
  5. Labyrinthitis
  6. Benign positional vertigo
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4
Q

WORK UP FOR:

  1. Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
  2. Vertebrobasilar insufficiency
  3. Cardiac arrhythmias
  4. Vestibular neuronitis
  5. Labyrinthitis
  6. Benign positional vertigo
A
  1. Orthostatic vital signs
  2. Rectal examination
  3. CBC
  4. Urea, electrolytes
  5. ECG
  6. Stool for occult blood
  7. Stool leukocytes
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5
Q

65 yo M presents with postural dizziness and unsteadiness. He has hypertension and was started on furosemide 2 days ago.

A
  1. Drug-induced orthostatic hypotension
  2. Furosemide ototoxicity
  3. Vertebrobasilar insufficiency
  4. Vestibular neuronitis
  5. Labyrinthitis
  6. Benign positional vertigo
  7. Brain stem or cerebellar tumor
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6
Q

WORK UP FOR:

  1. Drug-induced orthostatic hypotension
  2. Furosemide ototoxicity
  3. Vertebrobasilar insufficiency
  4. Vestibular neuronitis
  5. Labyrinthitis
  6. Benign positional vertigo
  7. Brain stem or cerebellar tumor
A
  1. Orthostatic vital signs
  2. CBC
  3. Urea, electrolytes
  4. ECG
  5. Echocardiography
  6. MRI-brain
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7
Q

44 yo F c/o episodes of dizziness on moving her head to the left. She feels that the room is spinning around her head. Dix-Hallpike maneuver reproduces the symptoms and elicits nystagmus.

A
  1. Benign positional vertigo
  2. Meniere disease
  3. Vestibular neuronitis
  4. Labyrinthitis
  5. Acoustic neuroma
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8
Q

WORK UP FOR:

  1. Benign positional vertigo
  2. Meniere disease
  3. Vestibular neuronitis
  4. Labyrinthitis
  5. Acoustic neuroma
A
  1. Audiometry
  2. Electronystagmograph
  3. MRI-brain
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9
Q

55 yo F c/o dizziness that started this morning. She is nauseated and has vomited once in the past day. She had a URI 2 days ago and has experienced no hearing loss or tinnitus.

A
  1. Vestibular neuronitis
  2. Labyrinthitis
  3. Benign positional vertigo
  4. Meniere disease
  5. Vertebrobasilar stroke/TIA
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10
Q

WORK UP FOR:

  1. Vestibular neuronitis
  2. Labyrinthitis
  3. Benign positional vertigo
  4. Meniere disease
  5. Vertebrobasilar stroke/TIA
A
  1. Audiogram
  2. Electronystagmography
  3. CT-head
  4. MRI/MRA-brain
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11
Q

55 yo F c/o dizziness that started this morning and of “not hearing well” She feels nauseated and has vomited once in the past day. She had a URI 2 days ago.

A
  1. Labyrinthitis
  2. Vestibular neuronitis
  3. Meniere disease
  4. Acoustic neuroma
  5. Vertebrobasilar stroke/TIA
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12
Q

WORK UP FOR:

  1. Labyrinthitis
  2. Vestibular neuronitis
  3. Meniere disease
  4. Acoustic neuroma
  5. Vertebrobasilar stroke/TIA
A
  1. Audiogram
  2. Electronystagmography
  3. CT-head
  4. MRI/MRA-brain
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13
Q

26 yo M presents after falling and losing consciousness at work. He had rhythmic movements of the limbs, bit his tongue, and lost control of his bladder. He was subsequently confused after regaining consciousness (as witnessed by his colleagues).

A
  1. Generalized tonic-clonic seizure
  2. Convulsive syncope
  3. Substance abuse/ overdose
  4. Malingering
  5. Hypoglycemia
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14
Q

WORK UP FOR:

  1. Generalized tonic-clonic seizure
  2. Convulsive syncope
  3. Substance abuse/ overdose
  4. Malingering
  5. Hypoglycemia
A
  1. CBC
  2. Electrolytes, glucose
  3. Urine toxicology
  4. EEG
  5. MRI-brain
  6. CT-head
  7. LP-CSF analysis
  8. ECG
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15
Q

55 yo M c/o falling after feeling dizzy and unsteady. He experienced transient loss of consciousness. His past medical history is significant for hypertension and diabetes mellitus.

A
  1. Drug-induced orthostatic hypotension (causing syncope)
  2. Hypoglycemia
  3. Cardiac arrhythmia
  4. Syncope (vasovagal, other causes)
  5. Stroke
  6. MI
  7. Pulmonary embolism
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16
Q

WORK UP FOR:

  1. Drug-induced orthostatic hypotension(causing syncope)
  2. Hypoglycemia
  3. Cardiac arrhythmia
  4. Syncope (vasovagal, other causes)
  5. Stroke
  6. MI
  7. Pulmonary embolism
A
  1. Orthostatic vital signs
  2. CBC
  3. Electrolytes, glucose
  4. Echocardiography
  5. CT-head
  6. ECG
  7. V/Q scan
  8. CTA-chest with IV contrast
  9. D-dimer
17
Q

65 yo M presents after falling and losing consciousness for a few seconds. He had no warning before passing out, but recently had palpitations. His history includes a coronary artery bypass graft.

A
  1. Cardiac arrhythmia {causing syncope)
  2. Severe aortic stenosis
  3. Syncope (other causes)
  4. Seizure
  5. Pulmonary embolism
18
Q

WORK UP FOR:

  1. Cardiac arrhythmia {causing syncope)
  2. Severe aortic stenosis
  3. Syncope (other causes)
  4. Seizure
  5. Pulmonary embolism
A
  1. ECG
  2. Holter monitoring
  3. CBC
  4. Electrolytes, glucose
  5. Echocardiography
  6. CT-head

First Aid: Step 2 CS (23 decks)

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