Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical med > HEENT vertigo > Flashcards

HEENT vertigo Flashcards

(79 cards)

Start Studying
1
Q

some differential diagnosis from the cochleovestibular system for vertigo

A

infection: serous otitis media, vestibular neuronitis, syphilis,

degenerative: aging

developmental: arnold-chiari malformation

tumor: cholesteaoma, acustic neuroma, glomus tumors,

vascular: infarction of labyrinthine artery, intralabyrinthine hemorrhage

ototoxins: aminoglycosides: loop diuretics

disorders of bone metabolisums

menieres disease

trauma: perilymph (labyrinthine) fistula, superior canal dehiscence

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

some differential diagnosis from the nervous system for vertigo

A

vascular: hyperventilation (anxiety) , migraine,

tumor: neoplasia, metastatic carinoma,

developmental: malformation of the base of the skull

peripheral neuropathy: DM, ethanol, B3/12 deficiency, Tabes dorsalis

infection: meningitis

seicure disorders: temporal lobe

dymyelinating disorders: MM sclerosis

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

some differential diagnosis from the cardiovascular system for vertigo

A

circulatory : hypovolemia, anemia, polycythemia, OTHORSTATIC HYPOTENSION

Great vessels: subclavian steal

cardiac: arrhythmias, valvular disease:

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

some differential diagnosis from the ocular system for vertigo

A

changes in fraction,

cataracts

glucoma

EMO neuropathy

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

some differential diagnosis from the allergy system for vertigo

A

inhalant

food

drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

some differential diagnosis from the autoimmune system for vertigo

A

autoimmune inner ear disease

collagen vascular disorder

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

old age syndrome (multisensory deficit) can cause vertigo… t/f

A

t

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

some differential diagnosis from the endocrine system for vertigo

A

DM

hypoglycemia

hyperlipidemia

hyperthyroidism

menstruations-pregnancy-menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

can chronic anxiety and hysteria cause vertigo?

A

yes

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

what is a genetic cause for vertigo?

A

usher syndrome

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

if the duration of vertigo is seconds and you hear auditory symptoms, then it can be

A

perilymphatic fistula :

refers to a hole or tear in one of the membranes that separate your middle ear and inner ear

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

if the duration of vertigo is seconds and you CANT hear auditory symptoms, then it can be

A

BPPV

cervical vertigo

vertebrobasilar insufficiency

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

if the duration of vertigo is hours and you hear auditory symptoms, then it can be

A

endolymphatic hydrops (Meniere’s disease)

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

if the duration of vertigo is hours and you CANT hear auditory symptoms, then it can be

A

Recurrent vestibulopathy,
Vestibular migraine

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

if the duration of vertigo are DAYs and you CANT hear auditory symptoms, then it can be

A

vestibular neuronitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if the duration of vertigo are days and you CAN hear auditory symptoms, then it can be

A

labyrinthitis,
labyrinthine concussion

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

if the duration of vertigo is months and you CANT hear auditory symptoms, then it can be

A

MS, cerebellar degeneration

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

if the duration of vertigo is months and you CAN hear auditory symptoms, then it can be

A

acoustic neuroma, ototoxicity

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

during the history, asking the pt. to describe their symptoms without using the word dizzy is important. t/f

A

T

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

during HPI, ask the pt if they feel or had

A

syncope

presyncope

light headedness

unsteadiness

disequilibrium

motion intolerance

floating sensation

drunk feeling

rocking on a boat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is vertigo?

A

subtype of dizziness.

one will feel like they are moving or the environment is (cardinal symptom)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

HPI : ask if onset and progression is slow or acute because …

A

slow = cns

acute = vestibular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HPI : ask if vertigo is continuous or ..

A

episodic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HPI : ask if their dizziness has other associated Sx. like

A

hearing loss

tinnitus

aural fullness

diaphoresis

nausea

emesis

(hearing fluctate: Meniere’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
on HPI, ask if dizzy when turning their head (....), lying supine, or sitting upright
BPPV
26
asking the pt if they can ambulate during an acute episode of dizziness can help to see if it is
cerebellar problem if they cant move
27
what are some brainstem symptoms in a HPI for dizzy
diplopia dyarthria (difficulty speaking) facial paresthesia extrem. numb / warm
28
asking a pt if they feel their vertigo duriing nose blowing can help rule in
fistula
29
asking a pt if they feel their vertigo with pressure or noise can help rule in
superior canal dehiscience (true vertigo)
30
asking a pt if they feel aura or warning signs before vertigo can help rule in
migraine
31
asking a pt if they have visual symptoms with their vertigo can help rule in
scintillating scotoma
32
asking a pt if they feel vertigo with neck movement can help rule in ?
cervical vertigo
33
asking a pt if they had head trauma that started their vertigo can help rule in
post traumatic hydrops fistula basilar skull fracture labyrinthine concussion
34
asking a pt if they had an URI or flu-like illness prior to their vertigo can help rule in?
vestibular neuronitis
35
vestibular cause of vertigo will have the following history:
sudden onset spinning hearing loss aural fullness tinnitus
36
non vestibular cause of vertigo will have the following history:
gradual onset ill defined symptoms passing out cant ambulate numbness/ weakness
37
important past medical history you want to ask the pt who has vertigo is
headaches/ migraines ear disease: chronic ear infections, cholesteatoma anxiety/depression diabetes HTN CV or cerebrovascular disease Neurologic disease (MS)
38
ask the pt with vertigo if they had any ear surgery because surgery for cholesteatoma may result in ...
iatrogenic or acquired labyrinthine fistula
39
ask the pt with vertigo if they had any ear surgery because surgery for otosclerosis or tympanosclerosis may result in ...
vestibular symptoms bc of perilympathic fistula
40
what FHx should you ask a pt with vertigo?
CV, peripheral vascular disease, migraine, otosclerosis, Meniere's disease
41
what Medication history should you ask a pt with vertigo?
new meds/ change in dose OTC herbal med prescribed med
42
what 3 things play a role in equilibrium
visual system vestibular system proprioceptive system
43
what vital signs should you look at for someone with vertigo
orthostatic BP and pulse
44
for vertigo, you will do the following physical exam
vital signs CV exam - hear heart and cervical vessels neurologic exam - reflexes, EOM, CN neck exam: ROM / flexibility ENT exam: middle ear or external infection? retracted or perforated TM? test hearing
45
peripheral nystagmus is .... pure vertical nystagmus is ...
torsional (rotary) sign of brainstem disease
46
acquired nystagmus is caused by
manières disease BPPV labyrinthitis vesitbular neuronitis
47
which walking test will you do for vertigo pt
gait: watch out for staggering and leaning romberg: standing heel to toe in front of each other w. eyes closed tandem romberg: walk heal to toe with arms opened for balance
48
which test will ID BPPV ?
dix-Hallpike maneuver have pt sitting with head 45 degrees to one side, rapidly lay them supine ---> vertigo & torsional rotary nystagmus once they lay,,,, lay for 1 min, then bring them to sit = goes away
49
fistula test is
to see abnormal connection of the labyrinth and surrounding apply pressure to pts ear canal (press the tragus) and observe eye movement
50
fukada test is
stepping in place with your eyes closed for 100 steps and then measuring how much you turned during the test. peripheral vestibular dysfunction likely consistent with the side to which the patient has rotated
51
— Saccadic test — Gaze test — Pursuit eye movement test — Optokinetic nystagmus test (OKN) — Head-shake nystagmus test — Positional nystagmus test — Positioning nystagmus test (Dix Hallpike) — Bithermal caloric tests are all considered
electronystagmongraphy (ENG) testing
52
— Vestibular autorotation testing (VAT) — Computerized platform posturography — Electrocochleography (Ecog) — Auditory brainstem response (ABR) — Vestibular evoked myogenic potentials (VEMP)
vestibular lab tests
53
what diagnostic study will you do for vertigo?
MRI of the brain IAC with contrast -pts younger than 50 = 1% ct brain and temproal bones lab test
54
what home exercises can you give the pt to manage vertigo
cawthorne cooksey/ Brandt Daroff
55
antihistamine for vertigo are
vestibular suppressant (should not be longterm) Antivert (meclizine) dramamine
56
bezodiazephine for vertigo is
depresses CNS Valium (diazepam)
57
Phenothiazine for vertigo
treats emesis promethazine (phenergan) prochlorperazine (compazine)
58
peripheral vertigo DDx: Onset: Nystagmus:
labyrinthitis, menieres, BPPV, vestibular neuonitis onset: slow rotary
59
central vertigo DDx: Onset: Nystagmus:
DDx: acoustic neuroma, brainstem vascular disease, arteriovenous malformation, tumors of the brain stem or cerebellum, MS, vertiginous migraine Onset: slower Nystagmus: pure vertical = sign of brainstem disease
60
benign paroxysmal positional vertigo (BPPV) cause: onset: DDx:
cause: otolith debris floating in semicircular canals (canalithiasis) or to cupula (cupulolithiasis) onset: spontaneous DDx: vestibular neuronitis, manières disease/ head trauma (otoconia)
61
does posterior canalithiasis happen 90% of the time in BPPV?
yes
62
is canalithiasis worse than cupulolithiasis?
no, cupulolithiasis cause is worse in BPPV
63
acute vertigo with episodes less than 1 minute due to changing head and body no medication to help resolves alone to diagnosis: dix-hallpike (rotary nystagus) is
BPPV
64
how do you treat BPPV
epley manever: to reposition canalith out of semicircular canal vestibular rehab
65
severe vertigo that begins acutely after an URI can last 24-28 hrs - unsteadiness for weeks hearing is not affected pt cant perform work 1/3 of ppl develope BPPV
vestibular neuronitis
66
how do you treat vestibular neuronitis
medications, antiemetics, vestibular suppressants, corticosteroids vestibular rehab
67
acute onset of continuous, severe vertigo lasting several days sudden hearing loss and tinnitus hearing loss can be permanent one or both ears caused by bacteria or virus = inflammation of the labyrinth
Labyrinthitis
68
how do you treat labyrinthitis
antimetic medications vestibular supressant (meclizine/antivert) steriods (oral/ intratympanic)
69
meniere's disease (endolymphatic hydrops) has four s/s ...
fluctate, low frequency hearing loss in affected ear tinnitus and fullness in affected ear epis. of vertigo that lasts hours at a time RULE syphilis: refer to ENT if negative for vestibular testing VNG/VEMP/ Electrocochelography
70
cause of meniere's disease and patho?
cause: unknown, head trauam patho: over production or underabsorption of endolymph -> distention of the endolymphatic sac
71
if menieres disease (endolymphatic hydrops) is untreated, it can lead to
unilateral SNHL
72
treatment for menieres disease is
80% respond to salt restriction = less than 2 grams per day / ETHOL and Cafe acute attacks = prednisone diuretics (dyazide) vestibular rehab antiemetics and short term vestibular suppressants (meclinzine/antivert)
73
perilymphatic fistula, is an abnormal connection due to a tear between the perilymph filled inner ear and the middle ear. caused s/s diagnosis;
trauma induced (child birth, barotruama, weight lifting), idiopathic s/s worsen with pressure changes, dizzy, tinnitus, hearing loss (treated surgically) explore surgery after CT/MRI, vestibular testing, audtiogram, fistula test
74
noise induced dizziness with perilympatic fistula is
tullio phenomenon
75
Superior semicircular canal dehiscence (SSCD) is: s/s cause: diagnosis treatment
no bone overlying the superior semicircular canal facing towards the dura of the middle cranial fossa tullio phenomeno (noise induced vertigo) , pessure induced vertigo, fullness, CHL, flucatuating SNHL congenital, head trauma, barotruama audiogram, vestibular testing, noncontrast CT temporal bone, MRI Tx: surgical
76
central vertigo is cause
disease from CNS, brain stem/cerebellum CNS tumor (acoustic neuroma) migraines MS hemorrhaic or ischemic insults to cerebellum tia infection drugs (anticonvulsants, aspirin, ETHOL) seizures psych disorder vertebrobasilar circulation problems
77
acoustic neuroma (vestibular schwannoma) is: s/s: diagnosis: Tx:
CN8 tumor -benign in the CPA (cerebopontine angle) unilateral SHL, tinnitus/ vertigo (late s/s) MRI with IAC with or without contrast observation, gamma knife tx, srgical excision
78
vestibular migraine is: affects: s/s: tx:
episodic vertigo lasting 5 min to 72 hrs younger pt with hx of migraine s: +/- headache, sensitivity to light/sound w. N/V spinning, rocking, swaying, or disequilibirum migraine medication
79
cervical vertigo is: cause s/s tx/tests/diagnosis
veritgo or dizziness from cervical spine ... moving head/neck cause: close head or whiplash injuries/ migraines, cervical arterial issues, surgery dizziness mins to hours no test or Tx diagnosis of exclusion

Clinical med (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions