Dizziness and Vertigo Flashcards Preview

ENT Year 2 Medicine > Dizziness and Vertigo > Flashcards

Flashcards in Dizziness and Vertigo Deck (27)
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1

What is vertigo?

Sensation of motion.
e.g. falling spinning being pushed

2

What should be asked about in a history taking of someone complaining of vertigo?

Tiggers
Duration
Associated symptoms
Precipitating facers
Alleviating factors
Medication

3

If someones vertigo lasts seconds it is usually ?

BPPV
Benign Positional Paroxysmal Vertigo

4

If someones vertigo lasts hours it is usually?

Menieres

5

If someones vertigo lasts days it is usually?

Vestibular neuritis

6

If someones vertigo duration is variable it is likely to be?

Vestibular migraines

7

If someones ear feels full and has vertigo it is likely to be?

Menieres

8

If someone has light sensitivity and vertigo it is likely to be?

Vestibular migraines

9

If someone says they experience vertigo when rolling over in bed what is the likely diagnosis?

BPPV
Benign Positional Paroxysmal Vertigo

10

If someone has severe nausea and vomiting for days alongside vertigo what is the likely diagnosis?

Vestibular neuritis

11

If a patient presents in clinic with vertical nystagmus what is the risk?

RED FLAG
Indicates brain stem involvement

12

What is the cause of BPPV?

Otoconia have broken off the sensory hair cells and are loose within the semi circular canals.

13

In a clinical investigations what will someone with BPPV show?

Vertical and torsional nystagmus
+ve dix hallpike test - nausea and vomiting

14

What is the treatment for someone with BPPV

Repositioning manoeuvres
Epley - moves the otoconia out of the semicircular canals
Brandt Darrof - Acclimatises the patient

15

What is the rule of three associated to vestibular neuritis?

In bed 3 days
Off work 3 weeks
Off balance 3 months

16

What is the disease history of someone with vestibular neuritis?

Flu like illness prior
Generally self limiting

17

Is there hearing loss associated with vestibular neuritis?

No, if there is hearing loss it indicates labryinthitis, which means the virus has also infected the cochlear region.

18

What is the cause of menieres?

Unknown cause, but a rupture causes mixing of the endolymph and perilymph.

19

What is the disease profile of menieres?

Recurrent spontaneous rotational vertigo
New tinnitus
Hearing loss
Aural fullness and pressure on affected side.

20

What hearing loss is associated with menieres?

Low frequency

21

What is the supportive management for menieres?

Tinnitus therapy
Hearing aids

22

What is the best treatment for menieres?

ITS Intra tympanic steriod injections
ITG Intra tympanic gentamicin injections

23

What is the idea behind ITG?

Gentamicin damages the ear, aim is to ablate the semicircular canals to stop vertigo.

24

What is the risk associated with ITG?

Gentamicin also causes deafness so could result in total healing loss.

25

What is the abortive treatment for migraines?

Triptans

26

What treatment is used prophylactically in migraines?

Propanolol
Amitriptyline

27

What is the most common auditory symptom linked to vestibular migraines?

Phenophobia- dislike of loud noises