Dizzyness/syncope

Question 0

Vasovegal vs. cardio syncope

Answer 0

• vaso vegal ~ 2.5 minutes
• cardiogenic ~ 3 seconds
  ~ as soon as the go down, brain reprofuses
  ~ postural syncope has better prognosis

Question 1

syncope vs. seizure

Answer 1

• post ictal confusion is strong indicator of seizure and NOT syncope
• seizure will probably have aura
• diaphoresis and amnesia

Question 2

Post ictal confusion in syncope

Answer 2

• should not last longer than a few seconds

Question 3

Syncope -> seizure

Answer 3

• seizure like symptoms can occur if held in upright position
• don’t misdiagnose for seizure

Question 4

Positional hypotension criteria

Answer 4

• orthostatic drop in 20/10

- increase in hr < 20 BPM

Question 5

Peripheral vs. central vertigo

Answer 5

• central: occulocephalic reflex is intact, intact visual acuity with head movements
• peripheral: occulocephalic reflex not intact
  ~ usually vomiting and begging for it to stop

Question 6

Dix-Hallpike

Answer 6

Positioning test to establish benign paroxysmal positional vertigo

Question 7

BPPV

Answer 7

• benign paroxysmal positional vertigo

- typically will have poor balance, and prefer to lie down during spell

Question 8

Miniers disease triad

Answer 8

• episodic vertigo
• tinnitus
• hearing loss

Question 9

Miniers disease: pathenogenesis, trt

Answer 9

• lots of etiologies
• chronic otolethiasis
• corticosteroid, salt reduction

Question 10

Vestibular neuronitis

Answer 10

• most common cause of acute vertigo
• generally viral, and self resolving in a few days
• vertigo without auditory symptoms
• roids and antiemetics

Question 11

Bilateral vestibular loss

Answer 11

• complaints of mild symptoms (since both sides are lost)
• include gait and postural abnormalities
• always positive rhomberg (eyes open/eyes closed, no difference)

Question 12

Central causes of vertigo

Answer 12

• migraine
• CVD
• MS
• masses/malformations (uncommon, slow progressive
• psych (will be associated with psych symptoms; hyperventilation will recreate these symptoms)