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Dizziness Flashcards

0
Q

Key to bppv

A

Only reproduced in 1 direction

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1
Q

How to r/o meneires

A

Hearing loss

No tinnitus.

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2
Q

Key to acute neuritis

A

Typical takes awhile longer than three days to resolve

Has a uti component

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3
Q

Ddx for differential

A

Hsv
Acute neuritis
Stoke min

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4
Q

Metabolic cause of ataxia

A 
Heavy metal - murcury
Vitamins b and e 
Pth
Phenytoin 
Chemo
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5
Q

Lesions affecting vertigo are 7

A 
Middle
Inner ear
Vestibular nucleus
Cerebellar
Eye
Forebrain 
Artery
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6
Q

How long does bppv last

A

One minute

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7
Q

Assoc with bppv

A

Rolling in be

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8
Q

Suggested by several bouts of vertigo

A

Vestibular neuritis

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9
Q

How long does vestibular neuritis last

A

1 week

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10
Q

Define disequilibrium

A

Unsteady balance

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11
Q

What is benign paroxysmal positional vertigo NOT associated w/

A

Hearing
Tinnitus low
Aural pressure
Headache

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12
Q

Diagnosis step for bppv

A

Dix hall pike maneuver

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13
Q

Therapy for bppv

A

Cawthorne exercises

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14
Q

Stones floating around in bppv

A

Calcium Otoliths

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15
Q

Dysarthria with bowel movement

A

Basal vagal

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17
Q

Bppv aka

A

Top shelf syndrome

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18
Q

Nystagmus and central vs peripheral differences

A

Central goes up

Peripheral go horizontal, fatiquable

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19
Q

Describe bppv nystagmus 3

A

Latent
geotropic - toward ground
Rotary nystagmus

Immediate - central

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20
Q

Tests for vertigo

A

Dixen hall pike
Fukuda march eyes closed lean toward cerebellar
Head shaking

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21
Q

Can you get dizzy w seizure

A

Yes it is call vestibular epilepsy

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22
Q

Dizzy associated with cholesterol

A

Vertebrobasilar insufficiency

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23
Q

Signs of Vertiberbal insufficiency

A

Lasts sec
Repeats for weeks
Assoc with dysarthria, cerebellar cn

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24
Q

Dizzy ASsoc w vomiting

A

Viral vestibular neuritis

Acute supportive labyrinthitis

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25
Q

Dizzy assoc w loc

A

Vestibular epilepsy

Vestibrobasilar insufficiency

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26
Q

Basic test for vestibular fx.

A

Eng

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27
Q

What does eng tell you

A

Central vs peripheral

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28
Q

Other vestibular tests

A

Rotary chair test

Posturography

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29
Q

Goal of rocket maneuver

A

To put ball back in the saccule

30
Q

Summary of bppv

A

30, recurring, disabling, 30 min, roaring tinnitus, aural, low freq hearing loss

31
Q

How long does meniere last

A

20 min at least

32
Q

If vertigo last longer than days 3

A

Viral vestibular
Acute suppurative labrum hits
Acute serous labyrinth
Herpes

33
Q

If bppv does go away

A

Neuro otolaryngologist

34
Q

Symptoms of bppv

A 
Benign, just a few days, just 30 sec
Paroxysm, severe burst
Positional, 1 direction
Associated w: rolling, looking up
No tinnitus, hearing loss
35
Q

Mnemonic for types of dizziness

A

Vaginas dislike little penises!

36
Q

How often is dizziness in diagnoses

A

1 in 5

37
Q

What type of dizziness does trauma cause

A

All of them

38
Q

How often does whiplash cause vertigo

A

80 percent

39
Q

Differential for presyncopal

A

Orthostatic
Cardiogenic arrythmia EKG
Associated with loc 30 percent

40
Q

If you think dizziness is do to psych what do you call dizziness

A

Light headed ness

41
Q

Triad of meniere

A

Heavy
Hearing loss
Tinnitus
More than 20

42
Q

Explain vestibular neuritis

A

A nerve in your head called the vestibular nerve got infected by a virus. Which messes up your balance
Cn 8

43
Q

Cause of meniere disease

A

Increase in endo lymphatic fluid

44
Q

Explain meniere

A

Fluid in the inner ear

45
Q

Vertigo plus hearing loss equals

A 
Meniere 20 minutes (many min, many times)
Labyrinthitis days ( long time)
46
Q

Vertigo without hearing loss

A

Bppv - episodic

Vestibular neuritis -persistent

47
Q

Episodic vertigo is suggestive of

A

Meniere

Bppv

48
Q

How often is dizziness a stroke

A

3 percent

49
Q

How often is dizziness without any localized finding a stroke

A

.7 percent

50
Q

Differential for disequilibrium 6

A 
Vision
Stroke
Parkinson
Neuropathy
Benzodiazepines
Tricyclics antidepressants
51
Q

Disequilibrium aka

A

Off balance or wobbly

52
Q

Presyncope aka

A

Faint

53
Q

Lightheadedness

A

Vague, out of it

Disconnected

54
Q

Romberg sway suggests

A

Vestibular dysfx on ipsilateral side

55
Q

Why is gait important for dizzy

A

Wide base
Ataxia
Parkinson

56
Q

Cardiac tests if you suspect Presyncope

A

No cus - no anterior can cause stroke
EKG
Holter monitor
O/s

57
Q

Are labs important for dizziness

A

No. .6%

58
Q

If you suspect psych and dizziness

A

Hyperventilation

Anxiety

59
Q

Treatment for bppv

A

Antivert 25 q 6 no evidence
Vest rehab
Ep key

60
Q

Ttreatment for meniere

A

2 g of salt
Dyazidel diuretic
Steroid drop

61
Q

Treatment for vestibular neuritis

A

Methylprednisolone 100 to 10 over three weeks

62
Q

Treatment for o/s

A

Hydrate

Midodrine 10 mg tid

63
Q

How does midodrine mechanism

A

Alpha a1 agonist
constrict
interact with tizanadine

64
Q

How do you avoid supine hypotension with midodrine

A

Don’t take last pill after 5 pm

65
Q

What do you monitor with fludtocortisone

A

Htn, k, chf

66
Q

If midodrine and fludtocortisone aren’t option for o/s

A

Paxil!

67
Q

Non pharm for o/s

Ways to help your

A

Get up slowly
Ted hose
Sleep w head elevated

68
Q

Treatment for light headed ness

A

Bag and beta blocker

Bolo for asthma

69
Q

What do you have to worry about with beta blocker

A

Asthma

Diabetes

70
Q

Low dose meclazine

A

12.5 mg bid

71
Q

Treatment for menieres

A

ENT doctor

Meclazine 12.5. Skip a pill see if you feel better

stroke (13 decks)

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