Examinations

Question 1

What examinations should you perform on patients presenting with dizziness?

Answer 1

CN (bc close proximity)
Cerebellar testing: Romberg’s, disdiadoko-kinesis
Unterburger’s test- localizes dysfunction to 1 labyrinth
Positional test- Dix Hallpike manoeuvre- ask for dizziness and look for nystagmus on lying patient down. Remember that nystagmus onset is often delayed. (confirms BBPV)
Gait: tandem walk

Question 2

When performing otoscopy, what are you looking for?

Answer 2

EAM: condition of skin, pus, crusts, swelling, excessive tenderness
TM: umbo, handle of malleus, cone of light, pars tensa- colour, visible vessels, tympanosclerosis- white deposits, perforations, alectasis- thinned and retracted segments
pars flaccida- retraction pocket, granulations, cholesteatoma, “wax”- cholesteatoma which is usually white goes yellow.

Question 3

What tuning fork do you use to test hearing? What is it called when the patient hears the sound loudest on one side when performing the weber’s test?

Answer 3

512 hz

lateralisation