'dizzy patient'

Question 1

what is vertigo

Answer 1

mismatch of vestibular system and other senses

Question 2

types of vertigo

Answer 2

peripheral: damaged vestibular apparatus or vestibluar nerve
central: damaged brainstem or cerebelum

Question 3

peripheral vertigo causes

Answer 3

BPPV
labyrinthitis
Meniere's
Acoustic neuroma (schawannoma of CN VIII)
Drugs

Question 4

central vertigo causes

Answer 4

stroke
polocytic astrocytoma (tumour compressing vestibular part of brainstem)
MS - damages cerebellum

Question 5

BPPV: duration, associated hearing loss +/- tinitis, aural fullness, positional trigger

Answer 5

duration: secs - mins
no associated HL or tinnitis
no aural fullness
clear positional trigger

Question 6

Meniere’s disease: duration, associated hearing loss +/- tinitis, aural fullness, positional trigger

Answer 6

duration: hours
associated HL +/- tinnitus
aural fullness
no clear positional trigger

Question 7

Labyrinthitis: duration, associated hearing loss +/- tinitis, aural fullness, positional trigger

Answer 7

duration: days-wks
associated HL +/- tinnitis
no aural fullness
no clear positional trigger

Question 8

Vestibular neuronitis: duration, associated hearing loss +/- tinitis, aural fullness, positional trigger

Answer 8

duration: days - wks
no associated HL oor tinnitis
no aural fullness
no clear positional trigger

also have N+V

Question 9

pathophysiology of BPPV

Answer 9

otoconia (crystals) from utricle displaced into semi-circular canals (commonly posterior) where move fluid and stimulate movement at ampulla

Question 10

diagnostic test for BPPV

Answer 10

Dix Hallpike test: +ve result sees nystagmus + vertigo

Question 11

management of BPPV

Answer 11

Epley Manoeuvre
Semont Manoeurve
Brandt-Daroff exercises

all aim to reposition crystals back into utricle

Question 12

what is labyrinthitis and vestibular neuronitis associated with

Answer 12

preceding URTI

Question 13

pathophysiology of meniere’s disease

Answer 13

excess endolymph due to impaired resorption of endolymphatic fluid - can damage cochlea or vestibular system

Question 14

what type of hearing loss occurs in Meniere’s

Answer 14

low frequency sensorineural

Question 15

what is acoustic neuroma

Answer 15

schwannoma of CN VIII which is usually slow growing and benign

Question 16

what can acoustic neuroma be associated with

Answer 16

NF 2 - deletion on chromosome 22 inactivating Merlin, so nothing to stop division of cells

Question 17

does drug induced dizziness tend to cause vertigo

Answer 17

rarely as both ears affected equally so cancels out