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otolaryngology > Vertigo > Flashcards

Vertigo Flashcards

1
Q

Dizzy when rolling over in bed

A

BPPV

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2
Q

First attack severe, lasting hours and associated with N+V

A

Vestibular neuritis

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3
Q

Light sensitive during dizzy spells

A

Vestibular migraine

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4
Q

Feeling of fullness in one ear and difference in hearing around the time of the dizzy spell

A

Ménière’s disease

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5
Q

What is dizziness

A

Non-specific term used to describe a sensation of unsteadiness, lightheadedness, or a feeling of spinning or imbalance

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6
Q

What is vertigo

A

A sensation of motion

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7
Q

How might people describe vertigo

A

Spinning, falling, feeling of being pushed

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8
Q

Vertigo that lasts seconds

A

BPPV

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9
Q

Vertigo that lasts hours

A

Meniere’s

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10
Q

Vertigo that lasts days

A

Vestibular neuritis

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11
Q

Vertigo that lasts for variable amounts of time

A

Migraine associated vertigo

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12
Q

Name some associated symptoms of vertigo

A

Hearing loss, tinnitus, aural pressure
Migraines or sensory sensitivity
Sound or pressure induced symptoms

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13
Q

How might we investigate vertigo

A

Otoscopy
Blood pressure
Neurological exam
Test balance systems
Audiometry

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14
Q

What is BPPV

A

Benign positional paroxysmal vertigo

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15
Q

What causes BPPV

A

Otoconia from the utricle is displaced into the semi-circular canals

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16
Q

What are otoconia

A

Calcium carbonate crystals

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17
Q

Where is otoconia most commonly displaced to

A

Posterior semi-circular canals

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18
Q

Name 3 things that can cause BPPV

A

Head trauma
Ear surgery
Idiopathic

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19
Q

How does BPPV present

A

Vertigo when looking up, movement in bed, bending forward, moving head quickly

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20
Q

Other associated symptoms of BPPV

A

N+V

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21
Q

Diagnostic examination for BPPV

A

Dix-hallpike manoeuvre

22
Q

Positive test for Dix-hallpike manoeuvre

A

Will invoke symptoms and cause geotropic, torsional nystagmus

23
Q

What is nystagmus

A

Uncontrolled repetitive movements of the eyes

24
Q

What is used to treat BPPV

A

Repositioning manoeuvres

25
Q

Name 3 repositioning manoeuvres used to treat BPPV

A

Epley manoeuvre
Selmont manoeuvre
Brandt-daroff exercises

26
Q

What is the epley manoeuvre

A

A series of head and body movements designed to reposition displaced otoliths in the inner ear

27
Q

How often should a patient do Brandt-daroff exercises

A

10 reps 3x a day, usually for a week

28
Q

What is vertebrobasilar insufficiency

A

Describes a temporary set of symptoms due to ischaemia in the posterior circulation of the brain

29
Q

What is the most common cause of vertebrobasilar insufficiency

A

Atherosclerosis

30
Q

Clinical presentation of VBI

A

Causes vertigo on looking up

31
Q

What is VBI

A

vertebrobasilar insufficiency

32
Q

What is needed for a diagnosis of VBI

A

Vertigo + symptoms of impaired circulation in the posterior brain

33
Q

Give examples of symptoms that suggest impaired circulation in the posterior brain

A

Visual disturbance
Weakness
Numbness

34
Q

What is labyrinthitis

A

Inflammation of the labyrinth of the inner ear

35
Q

What is vestibular neuritis

A

Inflammation of the vestibular nerve

36
Q

What is the probable cause of labyrinthitis and vestibular neuritis

A

Viral infection

37
Q

What symptoms are associated with labyrinthitis

A

Tinnitus or hearing loss

38
Q

Clinical presentation of vestibular neuritis and labyrinthitis

A

Prolonged vertigo
First attack severe, lasting hours with N+V

39
Q

What is the management of vestibular neuritis and labyrinthitis

A

Supportive- vestibular sedatives
Rehabilitation exercises if prolonged

40
Q

What is Ménière’s disease

A

An idiopathic disorder causing vertigo

41
Q

What is Ménière’s disease thought to be caused by

A

Excess of endolymph within the membranous labyrinth caused by dysfunctioning sodium channels
Causes increase in pressure

42
Q

Clinical presentation of Ménière’s disease

A

Triad of severe paroxysmal vertigo, sensorineural hearing loss and tinnitus on the affected side
Sensation of ear being full

43
Q

Investigation for Ménière’s disease

A

Audiology

44
Q

Positive testing for Ménière’s disease shows…

A

Low frequency sensorineural hearing loss

45
Q

Management of Ménière’s disease

A

Supportive
Tinnitus therapy
Hearing aids

46
Q

Lifestyle prevention of Ménière’s disease

A

Reduce salt, avoid chocolate and caffeine, avoid stress

47
Q

What is a vestibular migraine

A

Episode of vertigo in someone who has a history of migraines

48
Q

Clinical presentation of vestibular migraine

A

Light sensitive during dizzy spells
Fluctuating hearing loss
Phonophobia

49
Q

Lifestyle management of vestibular migraines

A

Avoid: alcohol, caffeine, chocolate, citrus fruits, lack of sleep

50
Q

Pharm management of vestibular migraines

A

Abortive agents e.g. triptans
Prophylaxis e.g. propranolol, amitriptyline

51
Q

Which way does nystagmus occur

A

Away from the damaged side

otolaryngology (18 decks)

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