Dizziness

Question 1

dizzy

Answer 1

sensation of lightheadedness, spinning, or impending syncope

Question 2

who is more prone to get dizzy?

Answer 2

older adults- rely on vision and as that goes it can get worse

Question 3

classifications of dizziness?

Answer 3

vertigo, nonvertigo

Question 4

vertigo?

Answer 4

the sensation of rotational movement of self or surrounding

Question 5

nonvertigo

Answer 5

presyncope, disequilibrium, unsteadiness, floating , or lightheadedness

Question 6

what should exam include when working up dizziness?

Answer 6

orthostatics, observation of gait, check for nystagmus, +/- cardiac and neuro

Question 7

peripheral causes of vertigo?

Answer 7

labyrinthine or vestibular disequlibrium

• “illusion of movement”
• BPPV
• Meniere’s dz
• acoustic neuroma
• viral labyrinthitis

Question 8

BPPV

Answer 8

responsible for 50% of all cases of peripheral disequilibrium

-breif spells of vertigo triggered by changes in head position: caused by loose debries (otoliths) in inner ear

Question 9

Meniere’s dz

Answer 9

intermittent vertigo from dilation and periodic rupture of the inne ear

**hearing loss and tinnitus

Question 10

central neurologic lesion

Answer 10

illusion of movement

-brainstem or cerebellar process such as stroke, tumor, or MS

Question 11

nonvertiginous

Answer 11

disequilibrium is a sensation of unsteadiness and is caused by vestibulopathies, visual and MSK disorders

Pd, ataxia

Question 12

presyncope

Answer 12

sensation that a faint is imminent and caused by a decrease cerebral perfusion, usually bc of orthostatci hyptension or vagally mediated cardiac events

Question 13

presyncope etiologies

Answer 13

hypotension, MI, vasovagal rxn, cardiac conduction abnormalities, valvular dz

Question 14

light headedness

Answer 14

more vague sensation and often is psychiatric in orgicn

may need a trail of antidepressants

Question 15

light headedness etilogy

Answer 15

anxiety, depression, psychosis, hyperventilation, hypochondriasis

Question 16

illusion of movement (peripheral)

Answer 16

intermittent, severe

Question 17

illusion of movement (centra)

Answer 17

constant, usually less severe

Question 18

nystagmus (peripheral)

Answer 18

unidicrectional or rotary, Never vertical

Question 19

nystagmus (central)

Answer 19

uni or bidirectional, may be vertical

Question 20

hearing loss of tinnitus (peripheral)

Answer 20

often present

Question 21

hearing loss of tinnitu(central)

Answer 21

rarely present

Question 22

Brainstem signs (peripheral)

Answer 22

absent

Question 23

brainstem signs (central )

Answer 23

often present

Question 24

work up for vertigo/syncope

Answer 24

dix-hallpike maneuver for BPPV
Romberg test
MRI if signs of central

Question 25

syncope

Answer 25

sudden transient loss of consciousness inot resulting from trauma,

Question 26

what are common causes of syncope?

Answer 26

arrhythmias, orthostatic hypotension, posprandial hypotension, psychogenic

Question 27

dx test for syncopy

Answer 27

EKG, holter, echo, tilt-table test, electrophysiologic studies, CT or MRI of the brain