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Dizziness Flashcards

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0
Q

Key to bppv

A

Only reproduced in 1 direction

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1
Q

How to r/o meneires

A

Hearing loss

No tinnitus.

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2
Q

Key to acute neuritis

A

Typical takes awhile longer than three days to resolve

Has a uti component

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3
Q

Ddx for differential

A

Hsv
Acute neuritis
Stoke min

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4
Q

Metabolic cause of ataxia

A 
Heavy metal - murcury
Vitamins b and e 
Pth
Phenytoin 
Chemo
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5
Q

Lesions affecting vertigo are 7

A 
Middle
Inner ear
Vestibular nucleus
Cerebellar
Eye
Forebrain 
Artery
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6
Q

How long does bppv last

A

One minute

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7
Q

Assoc with bppv

A

Rolling in be

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8
Q

Suggested by several bouts of vertigo

A

Vestibular neuritis

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9
Q

How long does vestibular neuritis last

A

1 week

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10
Q

Define disequilibrium

A

Unsteady balance

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11
Q

What is benign paroxysmal positional vertigo NOT associated w/

A

Hearing
Tinnitus low
Aural pressure
Headache

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12
Q

Diagnosis step for bppv

A

Dix hall pike maneuver

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13
Q

Therapy for bppv

A

Cawthorne exercises

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14
Q

Stones floating around in bppv

A

Calcium Otoliths

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15
Q

Dysarthria with bowel movement

A

Basal vagal

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17
Q

Bppv aka

A

Top shelf syndrome

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18
Q

Nystagmus and central vs peripheral differences

A

Central goes up

Peripheral go horizontal, fatiquable

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19
Q

Describe bppv nystagmus 3

A

Latent
geotropic - toward ground
Rotary nystagmus

Immediate - central

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20
Q

Tests for vertigo

A

Dixen hall pike
Fukuda march eyes closed lean toward cerebellar
Head shaking

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21
Q

Can you get dizzy w seizure

A

Yes it is call vestibular epilepsy

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22
Q

Dizzy associated with cholesterol

A

Vertebrobasilar insufficiency

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23
Q

Signs of Vertiberbal insufficiency

A

Lasts sec
Repeats for weeks
Assoc with dysarthria, cerebellar cn

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24
Q

Dizzy ASsoc w vomiting

A

Viral vestibular neuritis

Acute supportive labyrinthitis

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25
Dizzy assoc w loc
Vestibular epilepsy | Vestibrobasilar insufficiency
26
Basic test for vestibular fx.
Eng
27
What does eng tell you
Central vs peripheral
28
Other vestibular tests
Rotary chair test | Posturography
29
Goal of rocket maneuver
To put ball back in the saccule
30
Summary of bppv
30, recurring, disabling, 30 min, roaring tinnitus, aural, low freq hearing loss
31
How long does meniere last
20 min at least
32
If vertigo last longer than days 3
Viral vestibular Acute suppurative labrum hits Acute serous labyrinth Herpes
33
If bppv does go away
Neuro otolaryngologist
34
Symptoms of bppv
``` Benign, just a few days, just 30 sec Paroxysm, severe burst Positional, 1 direction Associated w: rolling, looking up No tinnitus, hearing loss ```
35
Mnemonic for types of dizziness
Vaginas dislike little penises!
36
How often is dizziness in diagnoses
1 in 5
37
What type of dizziness does trauma cause
All of them
38
How often does whiplash cause vertigo
80 percent
39
Differential for presyncopal
Orthostatic Cardiogenic arrythmia EKG Associated with loc 30 percent
40
If you think dizziness is do to psych what do you call dizziness
Light headed ness
41
Triad of meniere
Heavy Hearing loss Tinnitus More than 20
42
Explain vestibular neuritis
A nerve in your head called the vestibular nerve got infected by a virus. Which messes up your balance Cn 8
43
Cause of meniere disease
Increase in endo lymphatic fluid
44
Explain meniere
Fluid in the inner ear
45
Vertigo plus hearing loss equals
``` Meniere 20 minutes (many min, many times) Labyrinthitis days ( long time) ```
46
Vertigo without hearing loss
Bppv - episodic | Vestibular neuritis -persistent
47
Episodic vertigo is suggestive of
Meniere | Bppv
48
How often is dizziness a stroke
3 percent
49
How often is dizziness without any localized finding a stroke
.7 percent
50
Differential for disequilibrium 6
``` Vision Stroke Parkinson Neuropathy Benzodiazepines Tricyclics antidepressants ```
51
Disequilibrium aka
Off balance or wobbly
52
Presyncope aka
Faint
53
Lightheadedness
Vague, out of it | Disconnected
54
Romberg sway suggests
Vestibular dysfx on ipsilateral side
55
Why is gait important for dizzy
Wide base Ataxia Parkinson
56
Cardiac tests if you suspect Presyncope
No cus - no anterior can cause stroke EKG Holter monitor O/s
57
Are labs important for dizziness
No. .6%
58
If you suspect psych and dizziness
Hyperventilation | Anxiety
59
Treatment for bppv
Antivert 25 q 6 no evidence Vest rehab Ep key
60
Ttreatment for meniere
2 g of salt Dyazidel diuretic Steroid drop
61
Treatment for vestibular neuritis
Methylprednisolone 100 to 10 over three weeks
62
Treatment for o/s
Hydrate | Midodrine 10 mg tid
63
How does midodrine mechanism
Alpha a1 agonist constrict interact with tizanadine
64
How do you avoid supine hypotension with midodrine
Don't take last pill after 5 pm
65
What do you monitor with fludtocortisone
Htn, k, chf
66
If midodrine and fludtocortisone aren't option for o/s
Paxil!
67
Non pharm for o/s | Ways to help your
Get up slowly Ted hose Sleep w head elevated
68
Treatment for light headed ness
Bag and beta blocker | Bolo for asthma
69
What do you have to worry about with beta blocker
Asthma | Diabetes
70
Low dose meclazine
12.5 mg bid
71
Treatment for menieres
ENT doctor | Meclazine 12.5. Skip a pill see if you feel better

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