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Y2 ENT > Dizziness > Flashcards

Dizziness Flashcards

1
Q

List the main ENT causes of dizziness

A 
Benign paroxysmal positional vertigo
Meniere's disease
Vestibular neuritis
Labrynthitis
Migrainous vertigo
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2
Q

List the main optic causes of dizziness

A

Cataracts

Retinopathy in DM

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3
Q

In basic terms, how does the vestibulo-cochlear reflex prevent dizziness?

A

Keeps eyes fixed despite head movements

Turning head to right inhibits left-sided firing + excites right-sided firing

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4
Q

What is the main clinical sign of impaired vestibulo-cochlear reflex? State its definition

A

Nystagmus

Uncontrolled continuous to-and-fro movement of eyes

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5
Q

List the main examinations that may be carried out when investigating dizziness

A 
Otoscopy
Neurological
Blood pressure
Balance system
Audiometry
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6
Q

What happens in benign positional paroxysmal vertigo (BPPV)?

A

Dizziness on looking up/turning a certain way

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7
Q

How long does dizziness usually last in BPPV?

A

A few seconds (max 1 min)

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8
Q

What is the supposed pathophysiology behind BPPV?

A

Otolith material from utricle breaks off + traps in posterior semicircular canal

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9
Q

List movements that typically illicit BPPV

A 
Turning in bed
Looking up
Lying down
Rising from bending (gardening)
Sudden head movement in 1 direction
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10
Q

BPPV is associated with tinnitus, aural fullness and hearing loss. True/False?

A

False

Not usually

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11
Q

What is the main examination test done for BPPV?

A

Hallpike test

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12
Q

Describe the Hallpike test

A

Lie on couch with head hanging off edge;
Turn head 45’;
Don’t close eyes if dizzy;
Will usually see nystagmus, but only 1st time

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13
Q

Which 2 manoeuvres can be used to treat BPPV?

A

Epley

Brandt-Daroff exercise (do at home)

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14
Q

What happens in vestibular neuritis?

A

Prolonged vertigo (days)

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15
Q

Which is more likely to be associated with hearing loss and tinnitus - vestibular neuritis or labrynthitis?

A

Labyrinthitis

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16
Q

List the criteria that must be met for diagnosing Meniere’s disease

A

2 episodes of recurrent/spontaneous/rotational vertigo (>20 minutes, usually hours)
Worsening tinnitus
Aural fullness
SNHL on 1 occasion or more

17
Q

Meniere’s disease involves progressive deafness, tinnitus and vertigo. Outline management

A 
Support with vestibular sedatives during episodes
Tinnitus therapy
Hearing aids
Salt/caffeine/alcohol restriction
Grommet insertion, surgery
Intratympanic gentamicin/ steroids
18
Q 
BPPV has (select all appropriate):
Aural fullness
Hearing loss/tinnitus
Short duration
Long duration
Positional trigger
A 
Short duration (minutes)
Positional trigger
19
Q 
Vestibular neuritis has (select all appropriate):
Aural fullness
Hearing loss/tinnitus
Short duration
Long duration
Positional trigger
A

Long duration (days - weeks)

20
Q 
Meniere's disease has (select all appropriate):
Aural fullness
Hearing loss/tinnitus
Short duration
Long duration
Positional trigger
A

Aural fullness
Hearing loss/tinnitus
Short duration (hours)

21
Q 
Labyrinthitis has (select all appropriate):
Aural fullness
Hearing loss/tinnitus
Short duration
Long duration
Positional trigger
A 
Long duration (days - weeks)
Hearing loss/tinnitus
22
Q

Labyrinthitis and vestibular neuritis are usually precipitated by…

A

Viral infection

Can be viral prodromal symptoms

23
Q

Outline management for labyrinthitis and vestibular neuronitis

A

Support with vestibular sedatives during episodes

Self-limiting

24
Q

What is the supposed pathophysiology behind Menieres’s disease?

A

Perilymphatic space gets compressed and allows mixing of perilymph with other fluids

25
Q

List features of vestibular migraine

A

Phonophobia
Fluctuating/ acute hearing loss
Motion sickness

26
Q

State the main cardiac cause of dizziness

A

Postural hypotension

Y2 ENT (12 decks)

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