Dizziness, Cohen

Question 1

Definition of dizziness

Answer 1

altered sense of orientation in space

Question 2

descriptions of dizziness

Answer 2

spinning
off balance
light headed
feathery
woozy
can't walk
sick
merry-go-round
high
cheap drunk

Question 3

common causes light headedness

Answer 3

CV: Hypotension, intermittent drops in BP from antiHTN meds
arrhythmias, dec CO, valvular disease
autonomic: orthostatic hypotension
polyneuropathy or spinal disorders

Question 4

psychogenic dizziness

Answer 4

no known cause dizziness

panic disorder

Question 5

Vertigo

Answer 5

more than spinning
misperception of his orientation to the environment
some sense of spinning

Question 6

Common causes vertigo

Answer 6

• peripheral

- central

Question 7

peripheral vertigo

Answer 7

semicircular canals and utricle, saccule

benign parozysmal positional vertigo, vestibular neuritis, menieres disease, trauma

Question 8

central vertigo

Answer 8

brainstem or cerebellar
strok hemorrhage
MS tumors alcohol degenerative disorders migraine

Question 9

What is positional vertigo

Answer 9

benign paroxysmal positional vertigo

Question 10

positional vertigo

Answer 10

intermittent vertigo lasting less than a minute assoc with changes in head position, looking up or down

Question 11

positional vertigo cc

Answer 11

when getting up out of bed in the AM

nausea and vomiting too

Question 12

Sx positional vertigo

Answer 12

cant walk well
recent cold or upper resp infection
get relief by being completely still
lasts 1-2 weeks

Question 13

path behind benign paroxysmal positional vertigo

Answer 13

detachment of otolithic crystals of maculae of the utricle or saccule detach and gloat to post semicircular canal

Question 14

is there loss of hearing with positional vertigo

Answer 14

no

sometimes have nystagmus

Question 15

what can cause vertigo in someone with benign paroxysmal positional vertigo

Answer 15

quick head turn

Dix-Hallpike maneuver

Question 16

non-Rx Tx of BPPV

Answer 16

epley maneuver, but cna also worsen it

Question 17

Medications for tx BPPV

Answer 17

meclinzine
scopolamine patch
promethazine
dizepam

Question 18

Menieres disease

Answer 18

recurrent attacks for years of vertigo, tinnitus and decline in hearing and a sense of fullness or P in one ear
hearing loss!

Question 19

length of menieres disease

Answer 19

minutes or hours long separated by weeks or mo with no vertigo at all between attacks

Question 20

cochlear variant menieres disease

Answer 20

prominent hearing loss without vertigo

Question 21

Path menieres disease

Answer 21

increased volumne endolymph fluid– buldging throughout inner ear

Question 22

endolymphatic hydrops

Answer 22

menieres

Question 23

what can happen during attack in menieres

Answer 23

rupture of membranes
spill K rich liquid into perilymph
damaging both vestibular nerve and cochlear hair cells

Question 24

is menieres genetic

Answer 24

no

sporadic

Question 25

during attack in menieres what is Tx

Answer 25

meclizine, promethazine or scopolamine patches

Question 26

prophylaxis of menieres

Answer 26

low salt diet and K sparing diuretic

Question 27

prognosis menieres

Answer 27

majority of patients seem to lose their attacks without surgery

Question 28

central causes of dizziness

Answer 28

vertigo arising from the brain | including cerebellum, due to stroke, hemorrhage tumors

Question 29

degenerative diseases causing central dizziness

Answer 29

alzheimers parkinsons CJD

Question 30

one of most common cause of intermittent vertigo in young adults and children

Answer 30

migraine

Question 31

acoustic schwannoma

Answer 31

benign tumor of vestibular portion of VIII CN | "vestibular neuroma"

Question 32

complaints of acoustic schwannoma

Answer 32

hearing loss at first later vertigo or HA and P in one ear chronic sense imbalance roaring tinnitus!!

Question 33

acoustic schwannoma originates where

Answer 33

close to brainstem in internal auditory canal may compress VII and V CN

Question 34

acoustic schwannomas grow where

Answer 34

cerebello pontine angle

Question 35

Tx acoustic schwannoma

Answer 35

surgery for almost all patients gamm knife radiation used for smaller tumors meningiomas or malignant tumors in region

Question 36

b/l acoustic schwannoma

Answer 36

NF II

Question 37

primary functions cerebellum

Answer 37

coordination of movements regulation of muscular tone maintenance of posture and equilibrium

Question 38

Primary cerebellar Sx

Answer 38

ataxia: lack of coordination | intention tremor

Question 39

stroke causing vertigo

Answer 39

vertebral basilar system brainstem strokes cerebellar strokes

Question 40

dangerous about cerebellar stroks

Answer 40

not on CT for 24 hours so may be sent home with fatal condition

Question 41

HA diplopia vertigo difficulty walking

Answer 41

cerebellar stroke

Question 42

72 hours after cerebellar stroke

Answer 42

size of infarct increase and if 4th ventricle closed patients may have hydrocephalus and fatal brainstem herniation

Question 43

Tx cerebellar stroke

Answer 43

removal of one cerebellar hemisphere | emergency ventriculo-peritoneal shunt