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Year 2 neuro exam 2 > Dizziness, Cohen > Flashcards

Dizziness, Cohen Flashcards

1
Q

Definition of dizziness

A

altered sense of orientation in space

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2
Q

descriptions of dizziness

A 
spinning
off balance
light headed
feathery
woozy
can't walk
sick
merry-go-round
high
cheap drunk
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3
Q

common causes light headedness

A

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

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4
Q

psychogenic dizziness

A

no known cause dizziness

panic disorder

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5
Q

Vertigo

A

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

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6
Q

Common causes vertigo

A
  • peripheral

- central

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7
Q

peripheral vertigo

A

semicircular canals and utricle, saccule

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

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8
Q

central vertigo

A

brainstem or cerebellar
strok hemorrhage
MS tumors alcohol degenerative disorders migraine

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9
Q

What is positional vertigo

A

benign paroxysmal positional vertigo

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10
Q

positional vertigo

A

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

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11
Q

positional vertigo cc

A

when getting up out of bed in the AM

nausea and vomiting too

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12
Q

Sx positional vertigo

A

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

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13
Q

path behind benign paroxysmal positional vertigo

A

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

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14
Q

is there loss of hearing with positional vertigo

A

no

sometimes have nystagmus

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15
Q

what can cause vertigo in someone with benign paroxysmal positional vertigo

A

quick head turn

Dix-Hallpike maneuver

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16
Q

non-Rx Tx of BPPV

A

epley maneuver, but cna also worsen it

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17
Q

Medications for tx BPPV

A

meclinzine
scopolamine patch
promethazine
dizepam

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18
Q

Menieres disease

A

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

19
Q

length of menieres disease

A

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

20
Q

cochlear variant menieres disease

A

prominent hearing loss without vertigo

21
Q

Path menieres disease

A

increased volumne endolymph fluid– buldging throughout inner ear

22
Q

endolymphatic hydrops

A

menieres

23
Q

what can happen during attack in menieres

A

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

24
Q

is menieres genetic

A

no

sporadic

25
Q

during attack in menieres what is Tx

A

meclizine, promethazine or scopolamine patches

26
Q

prophylaxis of menieres

A

low salt diet and K sparing diuretic

27
Q

prognosis menieres

A

majority of patients seem to lose their attacks without surgery

28
Q

central causes of dizziness

A

vertigo arising from the brain

including cerebellum, due to stroke, hemorrhage tumors

29
Q

degenerative diseases causing central dizziness

A

alzheimers
parkinsons
CJD

30
Q

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

A

migraine

31
Q

acoustic schwannoma

A

benign tumor of vestibular portion of VIII CN

“vestibular neuroma”

32
Q

complaints of acoustic schwannoma

A

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

33
Q

acoustic schwannoma originates where

A

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

34
Q

acoustic schwannomas grow where

A

cerebello pontine angle

35
Q

Tx acoustic schwannoma

A

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

36
Q

b/l acoustic schwannoma

A

NF II

37
Q

primary functions cerebellum

A

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

38
Q

Primary cerebellar Sx

A

ataxia: lack of coordination

intention tremor

39
Q

stroke causing vertigo

A

vertebral basilar system
brainstem strokes
cerebellar strokes

40
Q

dangerous about cerebellar stroks

A

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

41
Q

HA diplopia
vertigo
difficulty walking

A

cerebellar stroke

42
Q

72 hours after cerebellar stroke

A

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

43
Q

Tx cerebellar stroke

A

removal of one cerebellar hemisphere

emergency ventriculo-peritoneal shunt

Year 2 neuro exam 2 (23 decks)

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