Dizziness

Question 1

What question would you ask to assess a patients’; equilibrium?

Answer 1

How is your balance?

Question 2

What question would you ask to assess a patients’; vertigo symptoms?

Answer 2

Do you have any sensations of the room moving?

Question 3

What are 3 very common side effects of opiates?

Answer 3

1. Nausea and vomiting
2. Constipation
3. Itchy skin

Question 4

What can we advise for patients who have constipation to do?

Answer 4

1. Increase physical activity
2. Fruit, vegetable, fibre and wholegrain intake can help - apples, apricots, grapes, peaches, pears, plums, raspberries and strawberries
3. Increase water intake
4. Raise feet so the knees are above the hips when defecating
5. Don’t hurry when defecating and relax

Question 5

What condition is most likely with the following symptom; unilateral tinnitus ?

Answer 5

Acoustic neuroma

Question 6

What condition is most likely with the following symptom; neurological signs/symptoms with dizziness?

Answer 6

MS

Question 7

What condition is most likely with the following symptom; severe constant vertigo and sudden unexplained hearing loss with CVS risk factors?

Answer 7

Stroke

Question 8

What condition is most likely with the following symptom; Developing after head injury?

Answer 8

Intracranial bleed

Question 9

What is the Dix-Hallpike manoeuvre used to diagnose?

Answer 9

Benign paroxysmal positional vertigo (BPPV)

Question 10

What is Benign Paroxysmal Positional Vertigo (BPPV)?

Answer 10

BPPV is one of the most common causes of vertigo. A patient will have episodes of mild-intense dizziness. This is usually triggered by alterations in the patients’ head position. It gives them the sudden sensation that the inside of their head is spinning.

Question 11

What are we looking for in the Dix-Hallpike test?

Answer 11

If the patient is quickly dropped backwards and their eyes remain open, there should be an obvious nystagmus in patients with BPPV, the nystagmus can occur for up to 60 seconds.

Question 12

How do you conduct a lying and standing BP?

Answer 12

1. Check the BP lying
2. Check the BP standing at intervals of 1, 3 and 5 minutes
3. Continually ask about symptoms

Question 13

What cardiac problem can commonly cause dizziness in patients?

Answer 13

Paroxysmal atrial fibrillation (PAF)

Question 14

Which medications may help with vertigo?

Answer 14

1. Vestibular sedative - cyclazine, cinnarazine, prochlorperazine
2. Inner ear vasodilator - Betahistine