Vertigo

Question 1

what is vertigo

Answer 1

sensation that the room is spinning around you / sensation of movement
hallucination of movement

Question 2

the duration of BPPV is sec/hr/days/variable

Answer 2

seconds

Question 3

the duration of Menieres is sec/hr/days/variable

Answer 3

hours

Question 4

the duration of vestibular neuronitis and labyrinthitis is sec/hr/days/variable

Answer 4

days

Question 5

the duration of vestibular migraine is sec/hr/days/variable

Answer 5

variable

Question 6

all dizziness is vertigo, true or false

Answer 6

false

Question 7

list the systems that can cause dizziness

Answer 7

CVS
Neuro 
ENT 
Ophtho
DM
Haem 
drugs 
anxiety

Question 8

define dizziness

Answer 8

non-specific term which can cover vertigo, pre-syncope, dysequilibrium

Question 9

dizziness symptoms in CVS disease

Answer 9

light headed
syncope
palpitations

Question 10

dizziness symptoms in neurological disease

Answer 10

black out 
visual disturbance 
paraesthesia 
weakness 
speech and swallow disturbance

Question 11

what should you ask in a history of dizziness

Answer 11

triggers 
time course 
associated symptoms - hearing loss, tinnitus, aural pressure, migraines
precipitators 
alleviating factors 
medications

Question 12

what is the top question for BPPV

Answer 12

do you get dizzy rolling over in bed

Question 13

what is the top question for vestibular neuronitis

Answer 13

was your first attack severe lasting hours with N+V

Question 14

what is the top question for vestibular migraine

Answer 14

do you get light sensitive with the dizzy spells

Question 15

what is the top question for Menieres

Answer 15

does one ear feel full, do you notice a change to your hearing / tinnitus at the time of dizziness

Question 16

examination of dizziness

Answer 16

otoscopy
BP + SLBP
Neuro
audiometry

Question 17

what is BPPV

Answer 17

benign positional paroxysmal vertigo
very common
crystals from utricle become displaced in SCC

Question 18

causes of BPPV

Answer 18

head trauma
ear surgery
idiopathic

Question 19

triggers of BPPV

Answer 19

looking up 
head movements 
bending forwards
getting out of bed 
rising from bed 
moving head too quickly

Question 20

Dix-Hallpike test is diagnostic/therapeutic for BPPV

Answer 20

diagnostic

Dix - Diagnostic (D)

Question 21

what treatments are available for BPPV

Answer 21

Epley manoeuvre
Semont
Brandt-Daroff

Question 22

describe features of vestibular neuronitis / labyrinthitis

Answer 22

prolonged vertigo for days
viral aetiology
viral prodromal symptoms

Question 23

tinnitus or hearing loss can be associated with vestibular neuronitis/viral labyrinthitis

Answer 23

viral labyrinthitis

Question 24

management of vestibular neuronitis + viral labyrinthitis

Answer 24

self limiting
supportive
rest
vestibular sedatives/anti emetics - cyclizine, prochloperaxine, cinarazine

Question 25

what is Menieres disease

Answer 25

unknown cause

? endolymphatic hydrops

Question 26

Menieres is very common, true or false

Answer 26

false, it is uncommon

Question 27

symptoms of Menieres

Answer 27

At least 2 episodes of recurrent rotational vertigo >20min
Tinnitus precedes the attack 
Aural fullness 
SNHL on at least 1 occasion 
Other causes excluded

Question 28

In Menieres, there is loss of high/low frequency hearing

Answer 28

low

Question 29

Management of Menieres

Answer 29

supportive
tinnitus therapy
hearing aids
prevention - salt restriction, betahistine, caffiene, alcohol, stress
Intra-tympanic steroid ITS
Intra-tympanic gentamicin ITG
anti-emetics: bucastem - buccal prochloperazine

Question 30

what is the most common auditory symptom in migraine

Answer 30

phonophobia