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13 Cards in this Set
- Front
- Back
In regards to Vertigo, which is correct?
A. CT is 45% sensitive for acute stroke. B. between 10-12% of patients presenting to ED with isolated vertigo have cerebellar infarction. C. The 2 Clinical signs that indicate cerebellar infarction are severe ataxia and vomiting. D. Cerebellar infarction makes up 2% of strokes overall. |
D.
A. 26% B. 0.3 -7.0% C. Severe ataxia and gaze evoked nystagmus |
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In regards to vertigo, which is incorrect?
A. 17% patients with vertigo do not report the Classical 'rotational vertigo"-rather episodic imbalance / dizziness. B. BPPV is caused by an otolith in the anterior semicircular canal. C. The Dix-Hallpike Test is positive if it provokes symptoms and nystagmus. D. Even without a Positive dix-Hallpike Test, BPPV patients can be differentiated from cerebellar infarction by their "episodic and positional symptoms". |
B. Otolith in the POSTERIOR semicircular canal.
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Which is incorrect regarding vertigo and cerebellar infarction?
A. Factors in the history suggesting cerebellar infarction include vascular risk factors (e.g.. HTN) B. 10% of cerebellar infarcts present with ISOLATED VERTIGO. C. Gaze-evoked nystagmus = "multidirectional " or "direction-changing" nystagmus. D. CT is only 10% sensitive for acute cerebellar stroke in patients presenting with vertigo. |
D. 26%
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Which is incorrect regarding Vertigo?
A. Peripheral vertigo can tinnitus and partial hearing loss. B. All vertigo is made worse with positional changes. C. The Dix-Hallpike manoeuvre is performed in all vertigo presentations. D. The nystagmus of peripheral vertigo is suppressed with fixation. |
C. It is reserved only for those in whom BPPV is being considered.
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What are the 5 "D's" of Centrally mediated vertigo?
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1. Diplopia
2. Dysarthria 3. Dysphagia 4. Dysphonia 5. Dysmetria |
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Which is not a feature of BPPV?
A. Vertigo lasting for periods of 20-30 seconds B. The nystagmus can be purely vertical. C. Precipitated by sudden head movements. D. It has nystagmus that is vertical and torsional towards downward ear. |
B. Typical of cerebellar / brainstem lesion.
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Which is not a feature of centrally mediated vertigo?
A. Diplopia B. Sudden onset vertigo C. Ataxic gait D. vertical nystagmus with torsional component. |
D. Nystagmus is usually vertical or gaze evoked.
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What type of nystagmus does Ketamine produce?
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Gaze-evoked (all directions of gaze)
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Which is not a feature of Acute Vestibular neuritis?
A. Preceding viral illness B. Gradual onset vertigo C. relapsing remitting , short duration vertigo D. Mild ataxia- improved with gait adjustment. |
C. Duration usually hours
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Which is incorrect regarding Acute Vestibular syndrome (Vestibular neuritis)and vertigo?
A. It has prominent autonomic symptoms. B. It can have a positive head impulse test - a "catch-up, re-fixation" saccade on the affected side. C. Acute vestibular neuritis has a gradual onset, persistent and ongoing vertigo- with characteristic positional exacerbations. D. The fast phase of nystagmus is toward the affected ear. |
D. It is :
- Unidirectional - horizontal and torsional - OPPOSITE the affected ear. |
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In regards to the HINTS examination, which of the following is correct?
A. A 'normal' vestibular-ocular reflex suggests a peripheral vertigo. B. With the Head impulse test. the presence of no refutation "catch-up" saccade has a likelihood ratio of 10 for a central vertigo. C. Gaze evoked nystagmus is highly sensitive, but poorly specific. D. Vertical ocular misalignement when performing a test of skew, is 30% sensitive BUT 98% specific for a central vertigo. |
D.
A = central B = LR of 18.4 C = Poorly sensitive ( 38%) highly specific (92%) |
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In regards to the HINTS examination, which of the following is incorrect?
A. Abnormal skew deviation is highly suggestive of a central vertigo. B. Gaze-evoked nystagmus = central cause C. The presence of a refixation "catch-up" saccade suggests a central cause. D. Both gaze evoked nystagmus and an abnormal test of skew have a specificity for central vertigo of > 95% if positive. |
C. peripheral
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In regards to the "infarct" acronym, which is incorrect?
A. It has a sensitivity of 80 % for a central cause , if any of the criteria are abnormal. B. It stands for Impulse Normal, Fast-phase Alternating, Refixation on Cover Test. C. It has a 96% specificity for central vertigo if any 1 of the 3 are abnormal. D. Fast-phase alternating = gaze-evoked nystagmus. |
A. = 100%
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