Subjective Examination

Question 1

Subjective Examination Purpose:

Answer 1

develop clinical hypothesis

Question 2

Patient Information

Answer 2

age
fall history
occupation
referral source
medical records
medical diagnosis

Question 3

Stage of Dizziness

Answer 3

(Tempo)
acute: =  3  days or less than
chronic: is more than 3 days.
constant
spells: seconds/minutes/hours

Question 4

Type of Dizziness

Answer 4

Vertigo: 
Light headedness: 
Disequilibrium: 
Oscillopsia: 
Pre-syncope

Question 5

Vertigo:

Answer 5

false sense of movement or spinning (defined as the illusion of environmental movement or a spinning/twisting/turning sensation)

Question 6

Disequilibrium:

Answer 6

the feeling of being unsteady in balance or coordination

Question 7

Intensity of Dizziness

Answer 7

Modified Visual Analog Scale (mVAS)
0-10/10 verbal scale
0/10 = no dizziness
10/10 = most dizziness possible
obtain verbal range and current number

Question 8

Impact of Dizziness

Answer 8

Dizziness Handicap Inventory (DHI)
-0-100 scale
-dizziness psychological impact
Activities-specific Balance Confidence scale (ABC)
-0-100% scale
-dizziness functional confidence impact

Question 9

Past Medical History:

Answer 9

(potentiallydrivingdizziness)
trauma
infection
metabolic disorders
vascular disorders
degenerative disorders
tumors
congenital disorders
neurogenic
psychogenic

Question 10

Ototoxic Drugs

Answer 10

(destructive to sterocilia and kinocilium)

• aminoglycoside antibiotics (gentamycin)
• antineoplastics(cisplatin)
• diuretics (mannitol)
• environmental toxins (carbon monoxide)

Question 11

Antihistamines

Answer 11

improves dizziness by decreasing fluid in ears

• antivert
• dramamine
• benadryl
• phenergan

Question 12

Benzodiazepines

Answer 12

improves dizziness by decreasing CNS response

• valium
• ativan

Question 13

Anticholinergics

Answer 13

(improves dizziness by decreasing acetylcholine)

-scopolamine

Question 14

Social History

Answer 14

home environment
smoking and drinking
sleeping pattern

Question 15

Patient History

Answer 15

tempo
symptoms
circumstances

Question 16

Tempo=acute

Answer 16

labrynthitis
vestibular neuritis
Wallenberg infarct

Question 17

Tempo=chronic constant

Answer 17

unilateral vestibular hypofunction (UVH)
bilateral vestibular hypofunction (BVH)
mal de debarquement
anxiety/depression

Question 18

Tempo=chronic spells last seconds

Answer 18

benign paroxysmal positional vertigo (BPPV)
orthostatic hypotension
perilymphatic fistula (PLF)

Question 19

Tempo=chronic spells last minutes

Answer 19

migraine
panic attack
transient ischemic attack

Question 20

Tempo=chronic spells last hours

Answer 20

motion sickness

Meniere’s disease

Question 21

Oscillopsia:

Answer 21

blurred vision

Question 22

Pre-syncope

Answer 22

is a more extreme form of lightheadedness. The patient senses a looming loss of consciousness or a feeling as if your are about to faint