dizziness

Question 1

when should acute otitis media be treated w antibiotics

Answer 1

children over two can be observed, children

Question 2

maxillary sinusitis is usually preceded by

Answer 2

upper resp tract infection

Question 3

3 categories to differentiate btwn when pt presents with dizziness

Answer 3

presyncope, disequilibrium, syncope

Question 4

pts w peripheral neuropathy can have dizziness why

Answer 4

lose position sense (as if lost balance)

Question 5

orthostatic hypotension defined as

Answer 5

drop in systolic >20 or diastolic >10

Question 6

vestibular neuritis

Answer 6

commonly assoc w viral URI. Nystagmus would not change direction w/ gaze

Question 7

BPPPV

Answer 7

episodic and resolves w position change

Question 8

vestibular migraine

Answer 8

variant of migraine that can cause central vertigo. look for hx of migraines

Question 9

how to differentiate btwn central and peripheral vertigo

Answer 9

nystagmus: in peripheral, unidirectional and rotational and doesn’t change direction w/ gaze, inhibited by fixing on a point, Frenzel glasses prevent fixation and bring out nystagmus. in central, it’s purely horizontal/vertical/rotational, doesn’t lessen when pt focuses on fixed point, persists for longer time.

Question 10

Meniere’s dis triad

Answer 10

unilateral hearing loss, tinnitus, vertigo

Question 11

Otitis media can cause vertigo: true or false

Answer 11

true

Question 12

peripheral vertigo-long duration dizziness (20 min, longer)-causes?

Answer 12

labyrinthitis, vestibular neuritis

Question 13

most common cause of vertigo in primary practice

Answer 13

BPPV

Question 14

vestibular neuritis

Answer 14

usu when viral infection of inner ear causes inflam of vestibular branch of CN8

Question 15

acute labyrinthitis

Answer 15

infection affects both branches of CN8 resulting in tinnitus and/or hearing loss and vertigo

Question 16

head thrust test

Answer 16

if facing pt and ask him to fix gaze on your nose and turn pt’s head to one side, eyes will move w head and saccade back to center (in peripheral vertigo)

Question 17

when is imaging for pts w/ vertigo needed?

Answer 17

if central vertigo

Question 18

acute vestibular neuritis will go away in how long

Answer 18

days to a wekk

Question 19

management of peripheral vertigo

Answer 19

Meniere’s dis: diuretics and low salt. BPPV: positioning. Vestibular rehabilitation and vestibular suppressant medications