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Flashcards in Dizziness Deck (34)
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1

The sense of imbalance, usually while walking

disequilibrium

2

the sensation of moving/spinning

vertigo

3

sensation of near fainting or lightheadedness

pre-syncope

4

This is a special test that keeps patients from focusing their vision. It is used to help elicit certain types of nystagmas

Frenzel Goggles

5

MS and migraine with vertigo are types of _______ vertigo

central

6

Name 3 types of peripheral vertigo:

1) BPV
2) Menieres dz
3) vestibular neuritis
4) Ototoxic meds
5) Acoustic neuroma

7

Do you expect a patient with peripheral vertigo to have other neurological s/s (like dysarthria, vision change, etc)?

No, peripheral lesion is outside the CNS.

8

What direction is nystagmus in peripheral vertigo, if present?

HORIZONTAL and Unidirectional, toward normal ear

9

If you see nystagmus going in a purely vertical or torsional pattern, what can you say with high confidence?

Central source of vertigo

10

Patients with _______ vertigo can suppress nystagmus if they are allowed to focus on an object.

peripheral

11

Patients with nystagmus that persists even after vertigo resolves have likely experienced __________ vertigo.

central

12

During an acute vertigo episode, patients with ________ vertigo can still walk with only minor instability

peripheral

13

Deafness or tinnitus is ONLY present during an episode of _______ vertigo

peripheral

14

benign positional vertigo is commonly attributed to ________ in the posterior semicircular canal

calcium debris

15

How long do episodes of BVP last?

< 1 min/episode, intermittent episodes x months

16

The ________ maneuver can be done in the office to reposition the calcium debris

Epley

17

The ________ maneuver can be done in the office to reproduce and therefore diagnose BPV.

Dix-Hallpike

18

What medication provides the best relief of BPV?

Meclizine

19

Your patient reports having had 2 spontaneous episodes of vertigo that lasted about 25 minutes each. During each episode, she reports a full feeling in her ears and heard ringing. What are you thinking?

Meniere's Dz

20

What causes Meniere's?

"endolymphatic hydrops" aka fluid buildup in the labyrinth system...most common onset in 20-40's.

21

Rapid onset of vertigo with n/v and gait instability following a virus....

Vestibular neuritis

22

How will you tx vestibular neuritis?

steroids

23

How will you tx Meniere's?

diuretic

24

A 50 year old male pt who works in a loud construction site comes in c/o tinnitus in one ear, he has vertigo and numbness in his face. After you r/o stroke, what is the next most likely cause?

Acoustic Neuroma
(Vestibular schwannoma)

25

Construction man from before wants to know how serious this is, and what you are going to do about it...

Typically benign, tx only if symptoms are intolerable. Then the options include radiation or surgery

26

Name a few ototoxic meds:

GENTAMICIN
Pretty much anything that ends in "mycin"

27

Marcus Gunn Pupil. That is all you know....what should you be thinking?

optic neuritis-->MS

28

How do you tx acute MS exacerbation?

IV steroids, methotrexate

29

Vertigo a/w Posterior circulation problems....highest risk is with pt's who have stroke risk.

vertebrobasilar insufficiency

30

Is vertebrobasilar insufficiency central or peripheral?

central....poor perfusion of posterior circulation will include CNS symptoms like ataxia, dysmetria