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ENT Week 2 2017/18 > 4: Dizzy patient > Flashcards

Flashcards in 4: Dizzy patient Deck (43)
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1

Is dizziness the same as vertigo?

Dizziness is the patient's word for how they feel

Vertigo is the sensation of spinning

2

When a patient says they're dizzy, what might they mean?

Vertigo

Pre-syncope

Seizures

3

What is vertigo?

Sensation of spinning

4

Vertigo has a good chance of being related to which organ?

Ear

5

Which structures do the vestibular nerves supply?

Semicircular canals

Urticle

Saccule

6

Which vestibular structures detect

a) head movements

b) horizontal motion

c) vertical motion?

a) Semicircular canals

b) Urticle

c) Saccule

7

What systems control balance?

Ear

Eyes

Joints (proprioception)

Heart

8

What eye conditions upset balance?

Anything causing vision loss (cataracts, diabetic retinopathy, glaucoma, macular degeneration...)

9

What diseases can affect joint sensation, which itself affects balance?

Arthritis

Neurological disorders

10

Which cardio conditions affect balance?

Arrythmias

Postural hypotension

11

What brain disorders can cause balance problems?

Migraine

Space-occupying lesions

Multiple sclerosis

12

What is the vestibulocular reflex?

Ability to keep focused on an object when your head is moving

13

What are the sensory organs of rotation found in the semicircular canals?

Crista ampullaris

14

What eye sign is caused by an impaired vestibulo-ocular reflex?

Nystagmus

15

Which eye sign indicates a vestibular problem?

Nystagmus

16

What is the most common GP presenting complaint in people over 75?

Dizziness

17

What questions should you ask when taking a history from someone with dizziness?

Triggers?

Duration?

Associated symptoms? pain, hearing loss, vision, cardio

Alleviating factors?

Medication?

18

What should be examined in someone who is dizzy?

Ear exam

Neuro exam

Blood pressure (lying/standing)

19

What is the most common ENT cause of dizziness?

Benign positional paroxysmal vertigo (BPPV)

20

What is the symptom of BPPV?

Veritgo on changing position, looking up

21

What is the most common cause of BPPV?

Idiopathic

22

What is the pathophysiology of BPPV?

Movement of otolith (calcium carbonate crystals) from urticle into semicircular canals, causing sensation of motion

23

How long do episodes of BPPV last?

Never more than 30s

24

Does BPPV have any associated symptoms?

No

25

What test is used to detect BPPV?

Hallpike test

26

What is the Hallpike test used to detect?

How do you do it?

What are you looking for?

BPPV

Lie head over end of couch, turn head 45 to one side then return as quickly as possible, EYES OPEN

Nystagmus

27

What do you need to see on performing a Hallpike test to diagnose BPPV?

Nystagmus

patient saying they're dizzy isn't enough

28

Why must you wait 30s before finishing a Hallpike test?

Nystagmus can be delayed by up to 30s

29

Which manoeuvre can be used to alleviate BPPV?

Epley manoeuvre

30

How are patients with BPPV advised to sleep?

Sitting up slightly