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Otorhinolaryngology > Dizzy Patient > Flashcards

Dizzy Patient Flashcards

1
Q

____ is very common and __________ disease is very uncommon

A

BPPV is very common and MÉNIÈRE’S disease is very uncommon

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2
Q

non-specific term, which may cover vertigo, pre-syncope, disequilibrium, etc. defines what?

A

dizziness

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3
Q

define vertigo

A

a sensation of movement, usually spinning

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4
Q 
visual
cardiovascular
proprioceptive
vestibular
vestibulospinal tract
vestibule-ocular reflex

all contribute to what?

A

balance

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5
Q

the following conditions are under what umbrella contributing to balance:

BPPV
Ménière’s
vestibular neuronitis

A

vestibular

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6
Q

the following conditions are under what umbrella contributing to balance:

cataracts
DM

A

visual

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7
Q

the following conditions are under what umbrella contributing to balance:

DM
arthritis
neurology

A

proprioceptive

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8
Q

the following conditions are under what umbrella contributing to balance:

arrhythmias
postural hypertension

A

cardiovascular

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9
Q

the following conditions are under what 2 umbrellas contributing to balance:

stress
migrane
SOL
MS

A

vestibulospinal tract

vestibule-ocular reflex

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10
Q

a duration of vertigo lasting seconds

diagnosis?

A

BPPV

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11
Q

a duration of vertigo lasting hours

diagnosis?

A

Ménière’s

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12
Q

a duration of vertigo lasting days

diagnosis?

A

vestibular neuritis or labyrinthitis

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13
Q

a duration of vertigo lasting variable duration

diagnosis?

A

migrane associated vertigo

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14
Q

Do you get dizzy rolling over in bed?

if the answer was yes…

diagnosis?

A

BPPV

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15
Q

Was your first attack severe, lasting hours with nausea & vomiting?

if the answer was yes…

diagnosis?

A

vestibular neuritis

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16
Q

Do you get light-sensitive during the dizzy spells?

if the answer was yes…

diagnosis?

A

vestibular migraine

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17
Q

Does one ear feel full or do you get hearing loss before or during the dizzy spell?

the answer was yes…

diagnosis?

A

Ménière’s

18
Q

name the 2 unusual but urgent referals of dizziness when you look in the ear

A

AOM

cholesteatoma

19
Q

BPPV is the commonest cause of vertigo when looking in what direction?

A

up

20
Q

what are the 3 causes of BPPV?

A

head trauma
ear surgery
idiopathic

21
Q

BPPV pathophysiology?

A

otolith material from utricle displaced into semicircular canals

most commonly in posterior SCC

22
Q

BPPV can be confused with vertebrobasilar insufficiency. for a diagnosis of VBI, what other symptom is needed?

A

visual disturbance
weakness
numbness

23
Q

vertigo on:

looking up
turning in bed - often worse to one side
first lying down in bed at night
on first getting out of bed in the morning
bending forward
rising from bending
moving head quickly – often only in one direction

diagnosis?

A

BPPV

24
Q

name the test and manœuvre performed in BPPV

A

dix hallpike test and epley manœuvre

25
Q

is there associated tinnitus or hearing loss in vestibular neuronitis?

A

no

26
Q

is there associated tinnitus or hearing loss in labyrinthitis?

A

yes

27
Q

vestibular neuronitis/labyrinthitis treatment?

A

self limiting

supportive with vestibular sedatives

28
Q

what rule is associated with vestibular neuronitis/labyrinthitis?

A

rule of 3:

3 days in bed
3 weeks of work
3 months off balance

29
Q

history of recurrent, spontaneous, rotational vertigo with at least two episodes >20mins (often lasting hours)

occurrence of or worsening of tinnitus on the affected side

ocurrence of aural fullness on the affected side

documented SNHL on at least one occasion

diagnosis?

A

Ménière’s disease

30
Q

is high or low frequencies that is lost in Ménière’s disease?

A

low frequencies

31
Q

Ménière’s disease management?

A

supportive
tinnitus therapy
hearing aids
salt restriction

ITS - injected steroid to middle ear

ITG - injected gentamicin

grommet

surgery

32
Q

is there a clear positional trigger in BPPV?

A

yes

33
Q

in what condition is there aural fullness?

A

Ménière’s disease

34
Q

in what 2 conditions is there associated hearing loss or tinnitus?

A

Ménière’s disease and labyrinthitis

35
Q

rare, benign tumour of VIII nerve sheath

causes progressive imbalance and HL with tinnitus

diagnosis?

A

vestibular schwannoma

36
Q

what is the gold standard to investigate the dizzy patient?

A

MRI

37
Q

BPPV duration?

A

minutes

38
Q

Ménière’s disease duration?

A

hours

39
Q

labyrinthitis and vestibular neuronitis duration?

A

days-weeks

40
Q

vestibular schwannoma presses against what nerve?

A

CN VIII

Otorhinolaryngology (17 decks)

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