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PDX 2 > Dizziness > Flashcards

Dizziness Flashcards

1
Q

Presyncope

A

Feeling faint or almost fainting

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2
Q

Dysequilibrium

A

Unsteadiness or feeling off-balance when walking

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3
Q

Vague Lightheadedness/Other

A

Ill defined, lacks specific characteristics of the other 3

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4
Q

What will help reveal the cause of dizziness?

A

A detailed history!

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5
Q

What questions will you ask to get a detailed history?

A
  1. Complete description of what the patient means by dizziness (room spins? Fainting? Unsteadiness?)
  2. Timing - Setting & Circumstances?
  3. Duration
  4. Aggravating/alleviating factors
  5. Medication History
  6. Past Medical Hx
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6
Q

Peripheral Vertigo

A

Most common recurrent vertigo from otoconia in canals (posterior canal)

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7
Q

What causes Benign Positional Vertigo (BPV)?

A

Sudden onset of vertigo provoked by quick head movement

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8
Q

How long does BPV last?

A

Seconds to a minute (BRIEF!)

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9
Q

Symptoms of BPV?

A

Nausea/vomiting

NO tinnitus or hearing loss

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10
Q

BPV Physical Exam tests?

A

Dix-Hallpike is positive

Delayed unidirectional nystagmus is positive

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11
Q

How can you treat BPV?

A

Epley’s Maneuver when Dix-Hallpike is positive.. Just continue on!

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12
Q

What are you trying to move w/Epley’s Manuever and to where?

A

Otoconia will hopefully move into the utricle from the posterior canal

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13
Q

What are symptoms of Meniere’s Disease?

A

Recurrent attacks of severe vertigo WITH HEARING LOSS

Onset of vertigo lasts hours (long time)

Nausea, vomiting, fullness/pressure/pain in the ear, tinnitus

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14
Q

What is Meniere’s disease?

A

Sensorineural hearing loss possibly from excess endolymph (fluid) in the inner ear

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15
Q

Do we treat Meniere’s Disease?

A

Nope, refer out to ENT

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16
Q

Which type of vertigo is associated with one-sided hearing loss?

A

Acoustic Neuroma (CN VIII tumour)

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17
Q

Which of the causes of vertigo occur after a viral illness?

A

Acute labyrinthitis/vestibular neuronitis

18
Q

Which type of vertigo is due to medications?

A

Ototoxicity due to medications

19
Q

How frequent is dizziness in cases of whiplash?

A

41%-48%

20
Q

What will come up during the exam to suggest cervicogenic vertigo?

A

Positive swivel chair test

Sore neck

21
Q

What would an abnormal neuro finding tell you about the patient’s dizziness?

A

It is a form of central vertigo

22
Q

Patient walks in with a staggering gait, motor weakness and difficulty articulating what they are experiencing but they can let you know they are dizzy. What do they have?

A

Central Vertigo

23
Q

What is nystagmus?

A

The eyes involuntarily look away from the point of gaze

24
Q

What is the main difference between central and peripheral vertigo?

A

Peripheral has a normal neuro exam except hearing loss and unidirectional nystagmus

Central has neuro exam abnormalities and nystagmus changes direct w/gaze (gaze fixation may make it worse!)

25
Q

What may cause central vertigo?

A

Transient Ischemic Attack (TIA)
Posterior Fossa Tumour
MS (autoimmune demyelination)

26
Q

Dysarthria

A

Speech difficulties

27
Q

Dysmetria

A

Past-pointing

28
Q

Gaze evoked nystagmus

A

Asking patient to focus their gaze evokes oscillations of their eyes or asking the patient to following your finger and their eyes move in different directions

29
Q

Presyncope

A

Feeling faint or almost fainting

30
Q

Syncope

A

Fainting/loss of consciousness

31
Q

Causes of Presyncope dizziness

A
  1. Vasovagal reaction (most common) dizziness often for minutes before fainting
  2. Orthostatic hypotension
  3. Cardiogenic - dizziness prodrome is very brief (
32
Q

Vasovagal reaction

A

Vagal “over-reaction”

Recover within a few seconds

33
Q

Orthostasis

A

Brief dizziness from sitting to standing - or from dehydration, eating, medications, autonomic dysfunction

34
Q

Cardiogenic Presyncope

A

Prodrome

35
Q

Cardiogenic syncope from exertion because?

A

Aortic stenosis
Heart failure
Pulmonary emboli
Anemia

36
Q

Causes of dysequilibrium

A

Medications
Sensory deficits
Motor abnormalities
Orthopedic disorders

37
Q

Vertigo

A

False sense of spinning or motion

38
Q

T/F There is no need to instruct the patient on where to look during Dix-Hallpike

A

False - if they look at one point, their nystagmus may go away

39
Q

What are 3 signs of Meniere’s disease?

A

Sensorineural hearing loss
Lasts a long time
Ringing in the ears (tinnitus)

40
Q

Patient had presyncope for under 5 seconds and then they passed out. They have also been having heart palpitations. Should you be worried?

A

Yes - could be arrhythmia and you want to send them to their PCP

41
Q

Pt had presyncope for a couple of minutes and then passed out when their blood was being drawn. Should you be worried?

A

No, this is probably a vasovagal reaction?

PDX 2 (5 decks)

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