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Flashcards in Dizziness Deck (79)
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1

What is dizziness?

?

2

What is giddiness?

?

3

What does a complaint of dizziness cause tell medical providers?

Nothing, the complaint of “dizziness” is often viewed as a source of frustration for medical providers as it encompasses many potential disease states.

4

What are common disorders that are usually lumped together with dizziness?

Vertigo, presyncope/lightheadedness and disequilibrium.

5

What are other terms the patient might use to describe dizziness?

Lightheaded
Faint
Swimmy headed
Foggy headed
Swooning
Off balance
Woozy

6

What are the main causes of dizziness?

vertigo
presyncope
disequilibrium

7

What is the definition of vertigo?

The sensation of moving or spinning

8

What is the definition of presyncope?

The sensation associated with near fainting.
Lightheaded
Feeling foggy
Feeling “faint”

9

What is the definition of disequilibrium?

The sense of imbalance, usually while walking

10

How do we chose the best category for a complaint of dizziness?

Take a good history

11

What aspects of history taking allow us to differentiate the cause of dizziness?

Asking open ended questions
Allowing the patient to describe their “dizzy” sensation to you with out any prompting
Avoid leading the patient with words like spinning or lightheaded
Extrapolate associated symptoms

12

What do we have to keep in mind when allowing them to describe their dizziness?

give them time

13

What other factors do we need to get from them about their dizziness?

Precipitating factors
Associated symptoms

14

What are possible precipitating factors of dizziness?

Does it only occur upon rising from seated position, only while walking, only when turning the head

15

What are possible associated symptoms with dizziness?

Nausea, vomiting, hearing loss, tinnitus, chest pain, palpitations, dyspnea, headache, parasthesias, ataxia

16

What is pertinent to find out in the past medical history?

DM, Seizures, Migraines, Arrhythmia, MS, TIA/CVA, CAD, Anemia
antidepressants
Social Hx
Family Hx

17

What medications could cause these symptoms?

Digoxin, BB, some antibiotics, diuretics,

18

What in their social history can effect dizziness?

EtOH, drugs

19

What is pertinent to find out in the family history?

Arrhythmia, CAD, CVA, Migraine, DM, etc.

20

What do we need to include with the vitals?

orthostatics

21

What do we focus on with the PE?

HEENT
Neck
Pulmonary
Cardiac
Neuro

22

What do we look for with HEENT?

Focus on the ears, could be OM

23

What do we look for in the neck when assessing dizziness?

Carotid bruits, elevated JVP

24

What do we look for in pulmonary when assessing for dizziness?

Wheezes, basilar rales, tachypnea

25

What do we look for in cardiac when assessing for dizziness?

Irregular rhythm, murmur

26

What do we look for in neuro when assessing for dizziness?

Cerebellar findings, upper motor neuron signs, decreased sensation

27

What additional tests do we need to do in the PE when assessing for dizziness?

Hearing test
Visual acuity
Dix Hallpike maneuver

28

What labs do we run when we suspect dizziness?

CBC, BMP, d-dimer, cardiac enzymes, tox screen

29

When would you do an MRI when a patient comes in with dizziness?

If neoplasm or CVA suspected. Also may order an MRA if considering vascular phenomenon

30

When would you run an EKG on a patient that comes in with dizziness?

Suspect Arrhythmia or MI