Pt who is dizzy

Question 1

It is important to ask a patient if their dizziness is

other ?s

Answer 1

constant or motion induces
easing, worsening
other symptoms
intensity, frequency, duration

Question 2

Symptoms of ______ tend to
indicate a peripheral pathology

Answer 2

short duration

Question 3

______ symptoms tend to indicate a central pathology

Answer 3

constant

Question 4

Find out if any of the following affect their symptoms 7

Answer 4

changes in position, the valsalva
maneuver, head rotation, tracking moving targets, changes in temperature or the weather,
driving or moving down an aisle

Question 5

An accurate ______ will often provide all the information that is needed to make a
diagnosis of the source of a patient’s dizziness

Answer 5

history

Question 6

The first question

it is important to start with an

Answer 6

describe what you are experiencing addresses the character of the
dizziness

open ended question

Question 7

True vertigo is a
- problem

Answer 7

vestibular

Question 8

A slight dizziness or imbalance not related to head position or activity

Answer 8

Dysequilibrium

Question 9

Vertigo

Answer 9

illusionary sense of motion or rotation

Question 10

Dizziness of a second or less is most likely the result of

Answer 10

of disequilibrium due to an
imbalance in the peripheral vestibular inputs

Question 11

Function of a normal labyrinth

damaged

Answer 11

sends signals about
head position to ocular muscles for visual fixation during movement

sends only a fraction

Question 12

Vertigo usually only persists _______ but
disequilibrium may continue ____

Answer 12

for 48 – 72 hours

until central vestibular compensation is complete

Question 13

Causes of immediate-duration vertigo

Answer 13

Meniere’s disease, panic attacks, migraine

Question 14

Causes of short-duration vertigo (conditions)

Answer 14

BPPV, orthostatic hypotension, VBI, SSCD, or perilymph fistula

Question 15

Causes of Long duration vertigo

Answer 15

trauma, post-surgery, viral infection

Question 16

Otologic symptoms include

neurologic symptoms

Answer 16

tinnitus, hearing loss, aural fullness, otalgia, otorrhea

tremors, dysphonia

Question 17

Motor and/or sensory signs that
accompanying the dizziness are considered

Answer 17

red flags

Question 18

People with psychological dizziness frequently report being dizzy when

Answer 18

on a continuous basis

Question 19

Drugs that are ototoxic affect the

Answer 19

peripheral vestibular system

Question 20

This group of antibiotics is the
most common cause of irreversible ototoxicity and most common cause of bilateral
vestibular dysfunction.

Answer 20

Aminoglycosides antibiotics

Question 21

Examples of ototoxic drugs

Answer 21

loop diuretics (Lasix), vancomycin (currently used to
treat MRSA), anti-neoplastics, NSAID’s (aspirin – tinnitus – reversible), tetanus antitoxin,
erythromycin (rare and reversible)

Question 22

It is most useful for treating mild to moderate episodes of vertigo and for
prevention of motion sickness

Answer 22

Diphenhydramine Hydrocholride (Benadryl)

Question 23

Most useful in preventing nausea and vomiting associated with motion
sickness

Answer 23

Scopolamine

Question 24

It is effective for treating mild to moderate episodes
of vertigo and for suppressing motion sickness

Answer 24

Meclizine (antivert)

Question 25

This is a vestibular suppressant and anti-emetic agent that is primarily used for prevention of motion sickness

Answer 25

Dimenhydrinate (Dramamine)

Question 26

Useful for treating severe vertigo with recurrent nausea and vomiting.

Answer 26

Phenergan

Question 27

This medication has long been used for treating vertigo, especially vertigo associated with Meniere’s disease

Answer 27

Betahistine

Question 28

A necessary starting point in testing and diagnostic

Answer 28

Audiometric Evaluation

Question 29

The faintest sound level at which a patient can understand and repeat speech at 50% accuracy

Answer 29

Speech recognition threshold

Question 30

Excessive (20% or more) decline in speech understanding as intensity increases

Answer 30

Rollover

Question 31

Scored as the percentage of repeated correctly of a list of monosyllabic words presented as varying intensities

Answer 31

Speech recognition tests

Question 32

A significant difference in hearing levels between the ears and indicates the possibility of peripheral vestibular or auditory nerve pathology

Answer 32

Auditory asymmetry

Question 33

Auditory evoked potentials are used to

Answer 33

used to determine the integrity of the auditory and vestibular nerve

Question 34

the recording of eye movements during a variety of tests performed to elicit nystagmus.

Answer 34

Nystagmography

Question 35

To assess smooth pursuit eye movements, ask the patient to track

Answer 35

a small object about 3 feet

Question 36

Should be examined to detect the presence of characteristic eye movement abnormalities suggestive of either central or peripheral vestibular system dysfunction

Answer 36

ocular motor system

Question 37

Primary symptoms and signs of individuals with vestibular dysfunction

Answer 37

Vertigo Dizziness/lightheadedness Nausea and vomiting Oscillopsia Nystagmus Impaired balance

Question 38

Relevant items in the past medical history include

Answer 38

allergies, illnesses (such as cardiac or neurological), medications, and surgeries

Question 39

This tool provides a method of quantifying the symptoms evoked by a set series of movements

Answer 39

Motion Sensitivity Quotient

Question 40

Was developed in response to a perceived to have a standardized measure of self-report activity limitation and participation restriction resulting from dizziness and unsteadiness

Answer 40

Dizziness Handicap Inventory

Question 41

One can easily assess all three canals for BPPV quickly with the following test procedure.

Answer 41

1. Perform the Hallpike-Dix Maneuver on the left side 2. Perform the Hallpike-Dix Maneuver on the right side 3. If the patient has not vertigo: before sitting the patient up from the right side, perform a roll test by having the patient turn the head quickly to the left 4. After 30 seconds, have the patient quickly turn the head back to the right 5. After 30 seconds, have the patient sit up

Question 42

Because there is no definitive test for __________, the diagnosis is based on the individual’s signs and symptoms and on the absence of otologic and neurologic causes for the clinical findings they may present with

Answer 42

cervicogenic dizziness ataxia, unsteadiness, nystagmus, disequilibrium