dizziness

Question 1

CRITERIA FOR HINTS

Answer 1

• prolonged vertigo
• nystagmus
  has to have these at the time of presentation

Question 2

most common cause of vertigo

Answer 2

BPPV

Question 3

Diagnois of BPV

Answer 3

DIX HALLPIKE

Question 4

Management of BPV

Answer 4

EPLEY m

Question 5

cause of bpv

Answer 5

otoliths which become loose and stimulate the cilia in the canals

Question 6

RF FOR BPV

Answer 6

elderly
>50
women

Question 7

trigger for bpv

Answer 7

moving the head,

Question 8

def of labrynthitis

Answer 8

inner ear infection

Question 9

symptoms of labyrinthitis

Answer 9

hearing loss
vertigo/balance
naseaus
tinnitus
nystagmus

Question 10

causes of labrynthitis

Answer 10

viral infection - cold, flu
bacterial infection - less common

Question 11

what med do we give for people who have vertigo

Answer 11

prochlorperazine - antisickness

Question 12

labyrinthitis is it usallay symmetrical or asymmetrical

Answer 12

usually 1 ear

Question 13

labrynthitis vs vestibular neuritis

Answer 13

labrynthiis - affects hearing whereas VN does not

both sudden onset
both cause vertigo
both can be triggered by infection

Question 14

what is meniers

Answer 14

inner ear disorder that cause vertigo caused by increase in pressure of lymph

Question 15

symptoms of Meniere’s

Answer 15

vertigo -12-24 h lasting
hearing loss
tinnitus

Question 16

tx of meniers

Answer 16

controller - betahistine
reliver- - prochlorperazine

Question 17

somone comes in with dizziness what is your dx

Answer 17

Meniere’s
labyrinthitis
BPPV

Question 18

what is vasovagal syncope

Answer 18

when you faint because of hyoperfusion to the brain usually by a trigger , needles, strong emotion OR STANDING FOR LONG PERIODS OF TIME

Question 19

what usually precedes vasovagal syncope

Answer 19

a prodrome- like feeling dizzy, pale, ringing in ears, hearing loss, starnge sounds, palpitations

Question 20

PATHOPHYS OF ORTHOSTATIC HYPOTENSION

Answer 20

when you suddenly change postion the veins delay a little to constrict so blood pools in the legs delaying venous return to the heart and thus brain

Question 21

when someone presents with syncope what do w ehave to rule out

Answer 21

arrythmias or heart abnormalities
seizure - mimic syncope
stroke - imic syncope

Question 22

first aid response to syncope

Answer 22

elevate the legs to increase venous return

Question 23

central causes of vertigo

Answer 23

vascular- posterior circulation/cerebllar stroke, lateral medullary syndrome
non vascular - ms

Question 24

peripheral cause of vertigo

Answer 24

inner ear
labrythinits
vestibular neuritis (CN 8 )

Question 25

what direction is the nystagmus in peripheral vertigo

Answer 25

unidirectional

Question 26

what direction is the nystagmus in central l vertigo

Answer 26

bidrectional

Question 27

normal head impluse indicates

Answer 27

central vertigo

Question 28

abnorma head impluse means

Answer 28

peripheral

Question 29

HINTS EXAM IS FOR WHAT

Answer 29

ESTABLISHING WHETHER VETIGO IS PERIPHERAL OR CENTRAL?

Question 30

causes ofpostural hypotension

Answer 30

1. exclude heart problems 2.ENDO hypothyroidism, diabetes (uncontrolled) , addiosns nb!! 3. parkinsons 4. simple dehydation 0 not enough fluids in body to control bp 5. on bp tablets

Question 31

any drugs we can use to treat postural hypotension?

Answer 31

fludriocrotisone ( also used to treat addisons )

Question 32

NICE HEAD INURY

Answer 32

1. LOC 2 VOMITTING >1 EPISODE 3. MEMORY LOSS 4. SEIZURE 4. BLOOD THINNERS? 5. GCS HAS DROPPED 2 HOURS AFTER FROM 15 6. SIGNS OF BASAL SKULL FRACTURE 7. GCS IS LESS THAN 13 AT ANY POINT 8.focal signs

Question 33

history of a patient coming in with dizziness

Answer 33

1. how often does it happen 2. anything triggering 3. worse in the morning - vertigo 4. is it worse when you move ur head- vertigo 5. any hearing loss or eye changes /vision/nystagmus/ringing in ears 6 7 8 9 10

Question 34

whats the first thing you need to estalish when a patient comes in with dizzines

Answer 34

is it vertigo or actual dizziness

Question 35

brain causes for dizziness

Question 36

in terms of dizziness what systems are you narrowing it down too

Answer 36

cardio neeuro