Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT > The dizzy patient > Flashcards

The dizzy patient Flashcards

1
Q

what is the prevalence of dizziness?

A

it is the most common cause of presentation to the primary care physician in people over 74 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the percentage of people in the community that suffer from dizziness?

A

17%

>25% of 50-64 year olds state that they currently suffer dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how many people in the UK consult their GP with vertigo?

A

5/1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

by the age of 80…

A

2/3 women and 1/3 men will have experienced episodes of vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is etiology of dizziness?

A 
Cardiovascular system
Haematological and metabolic
Anxiety
Neurological conditions
Drug side-effects / interactions
Migraine
Otological
Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the definition of dizziness?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the definition of vertigo?

A

a sensation of movement, usually spinning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the central pathways of the balance systems of the body?

A 
visual
cardiovascular 
vestibular
vestibule-ocular reflex 
vestibulospinal tract 
proprioceptive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the conditions that affect the vestibular balance system?

A

BPPV
menieres
vestibular
neuronitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the conditions that affect the vestibulospinal tract and vestibule-ocular reflex?

A

stress
migraine
SOL
MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the conditions that affect the proprioceptive balance systems?

A

DM
arthritis
neurology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are conditions that affect the visual balance system?

A

cataracts

DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the conditions that affect the cardiovascular balance systems?

A

arrthymias

postural hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how can we use history the differentiate between cardiac, neurological & vestibular?

A

Lightheadedness, syncope, palpitations

Blackouts, visual disturbance, paraesthesia, weakness, speech & swallow problems

Vertigo is a sensation of motion: spinning, falling, being pushed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

things to ask in the history?

A 
Triggers?
Time Course?
Associated symptoms?
Precipitators?
Alleviating factors?
Medication?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

vertigo episodes…

A

duration of episodes is the key

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

which condition has vertigo episodes that last seconds?

A

BPPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which condition has vertigo episodes that last hours?

A

Menieres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

which condition has vertigo episodes that last variable?

A

migraine associated vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

vertigo history:

A

Associates symptoms also important:
Hearing loss , tinnitus, aural pressure
Migraines or sensory sensitivity
Sound or pressure induced symptoms

21
Q

Do you get dizzy rolling over in bed?

A

BPPV

22
Q

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

A

Vestibular neuritis

23
Q

Do you get light-sensitive during the dizzy spells?

A

Vestibular Migraine

24
Q

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

A

Meniere’s

25
Q

Examination of dizzy patient:

A 
Otoscopy
Neurological
Blood pressure including lying/standing
Balance system
Audiometry
26
Q

what are vestibular end organs?

A

Ampullae of lateral, posterior & superior semicircular canals

Maculae of the utricle & saccule

Different functions

27
Q

what is the vestibule-ocular reflex?

A

head movement to the right causes right side excitation and left Side inhibition

28
Q

what are the common causes of dizziness?

A 
Postural dizziness
History, Hb, Na, BP lying/standing
Side effect of medication
History
Psychogenic & interaction with imbalance
29
Q

what is the commonest cause of vertigo on looking up?

A

BPPV

30
Q

what are the causes of BPPV?

A

it is very common,

head trauma, ear surgery, idiopathic

31
Q

what is the pathophysiology of BPPV?

A

otolith material from article displaced into semicircular canals

most commonly in posterior SCC

32
Q

what is BPPV confused with?

A

vertebrobasilar insufficiency

33
Q

what is required for a diagnosis of VBI?

A

other symptoms of impaired circulation in posterior brain associated with the vertigo such as visual disturbance, weakness, numbness

34
Q

BPPV causes vertigo on:

A

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

35
Q

what is the Dix hall pike test?

A 
Sit up, enough room to lay down on couch
Eyes open!
Short latency
Symptomatic or nystagmus
Vertical/torsional geotropic
They will be dizzy & maybe sick!
36
Q

what are tests used to confirm BPPV?

A

Hallpike’s Test
Epley Manoeuvre
Semont Manoeuvre
Brandt-Daroff Exercises

37
Q

employ manoeuvre:

A

70-75% successfully treated with single manoeuvre.
90% symptom free after two manoeuvres
Most easily & successfully treated ‘dizzy patient’

38
Q

vestibular neuronitis:

A

prolonged vertigo (days)
with no associated tinnitus or hearing loss
probable viral etiology
may be viral prodromal symptoms

39
Q

labyrinthitis:

A

prolonged vertigo (days)
may be associated with tinnitus or hearing loss
probable viral etiology may be vial prodromal symptoms

40
Q

management of vestibular neuritis/labyrinthitis

A

Supportive management with vestibular sedatives
Generally self-limiting
If prolonged or atypical may require further investigation
May be helped by rehabilitation exercises if prolonged
Rule of 3s: In bed 3 days, off work 3 weeks, off balance 3 months

41
Q

Menieres disease:

A

cause unknown
pathophysiology
incidence - 50-200/100,000

42
Q

how to diagnose menieres disease?

A

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
Occurrence of aural fullness on the affected side
Documented SNHL on at least one occasion
Other causes excluded

43
Q

what is the management of Menieres disease?

A 
Supportive treatment during episodes
Tinnitus therapy
Hearing Aids
Prevention
Salt restriction / Betahistine / caffeine / alcohol / stress

Grommet insertion / Meniette
Intratympanic Steroids / Gentamicin
Surgery

44
Q

what is the incidence of migraines?

A

15-20%

45
Q

what is the estimated percentage of migraine sufferers that have spontaneous attacks of vertigo and ataxia?

A

25%

46
Q

what is the most common auditory symptom?

A

photophobia

47
Q

Fluctuating hearing loss and acute permanent hearing loss occur in a small percentage.

A

Migraine and Vertigo

48
Q

migraine and vertigo:

A

Motion sensitivity with bouts of motion sickness occurs in about 2/3 of patients with migraine.
Episodes of vertigo occur in about one quarter of patients

ENT (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions