Dizziness/Syncope Lecture Flashcards
Fall in systolic BP >20mmHg
Fall in diastolic BP >10 mmHg
Increase in heart rate 10-25 beats per minute
Orthostatic hypotension
How long must a pt lie for then stand for when checking orthostatics?
Lie for 10 mins
Stand for 2 mins
MC cause of orthostatic hyptension?
Dehydration
Tx of orthostatic hypotension?
Mineralcorticoids
(ie Fludrocortisone)
Best way to fix cardiac syncope?
Implantable defibrillator
Impaired vestibular system
May be due to disturbance of inner ear
Altered head position in space, via alteration of CN VIII**
Vertigo
Vertigo is associated with what CN?
CN VIII
*Visual input
*Somatosensory input:
Skin
Joints
Muscles
Spinal cord
*Cerebellum
*Cerebrum
Maintains normal balance
Alteration of eye movement
Oscillation to lateral gaze
Normal 2-3 beats
If more, consider abnormal
Nystagmus
Abnormal input to stabilize (i.e.: Car sickness)
Unfamiliar head position (Sea sickness)
Unusual head position (Painting ceiling)
Spinning
..these describe what kind of vertigo?
Physiologic
Disturbance of vision
Disturbance of somatosensory system
Disturbance of vestibular system
CNS tries to correct
Change in frequency of normal firing (homeostasis is disrupted), unequal signal results, abnormal head sensation
Worse with rapid head movement
Often nausea and ataxia
..what type of vertigo?
Pathological
In vertigo…
does fast phase nystagmus go towards or away affected side (lesion)?
AWAY
Cochlear disease
Progresssive hearing loss (LOW FREQUENCY HEARING LOSS)
Tinnitus
Dizziness
Meniere’s disease
Old people lose what frequency with hearing loss?
What frequency do Meinere’s dz patient’s lose?
Old ppl lose high frequency
Meniere’s disease pts lose low frequency
Tx= diuretics, very low Na diet (under 1 g)
Meniere’s disease
