Session 3 Cm- Ent-4- Disorders Of The Inner Ear

Front 1

What is vertigo

Back 1

illusion that the body or environment is tumbling or spinning

Front 2

What are the two types of vertigo

Back 2

central or peripheral

Front 3

What is central vertigo

Back 3

vertigo caused by disruption of the CNS this will often present with cranial nerve findings

Front 4

What is peripheral vertigo

Back 4

vertigo involving the inner ear vestiublar system. Often accompanies ear related head trauma, hearing loss, tinnitus, barotrauma, labyrinthitis, Benign paroxysmal positional vertigo (BPPV)

Front 5

Pt presents with a complaint that the it feels like the room is spinning around them the feeling happened after they got hit in the head by a ball. If this disorder is being caused by displaced otoliths what is the problem

Back 5

benign paroxysmal positional vertigo

Front 6

What is meniere's triad

Back 6

fluctuating low frequency sensorineural hearing loss, fluctuating tinnitus and episodic vertigo can last days with episodes lasting from 30 minutes to several hours

Front 7

If you hear that someone has a low frequency senorineural hearing loss what disorder should come to mind

Back 7

meniere's disease

Front 8

This is causd by a nonspecific viral illness that damages the vestiublar nerve causing severe vertigo, and possible permanent vestibular and hearing impairement.

Back 8

Labyrinthitis

Front 9

If the viral infection that caused vestibular nerve damage doesn’t cause hearing loss it is not called labyrinthitis but what

Back 9

it is called vestibular neuronitis

Front 10

Pt presents with a complaint of hearing loss, tinnitus, vertigo, dysequilibrium, fullness or pressure in the ears and facial numbness/paralysis what condition may they have

Back 10

Acoustic neuroma

Front 11

What is the Gold standard way to dx acoustic neuroma

Back 11

MRI

Front 12

What is the tx for an acoustic neuroma

Back 12

1. observe, 2. microsurgical removal, 3. stereotactic radiation therapy

Front 13

You suspect pt has peripheral vertigo what on the Hx would help lead you to this conclusion

Back 13

Hx of draining ear, ear disease, ear surgery, ear pain, hearing loss, acute infection, barotrauma or head trauma with complaint of vertigo

Front 14

You suspect pts vertigo is central vertigo what in the Hx would sway you toward this conclusion

Back 14

Hx of headaches, visual symptoms, sensory or motor deficits, muscle weakness, and incoordination

Front 15

If the vertigo is not a vestibular disease what would you expect on the hx

Back 15

Hx of drug use, cardiac symptoms, hypoglycemia, psychiatric disorders, secondary gain issues, and anxiety

Front 16

What is the one question you absolutely have to ask about the vertigo

Back 16

how long does it last (duration)

Front 17

If the vertigo lasts for seconds what is the likely dx

Back 17

BPPV

Front 18

If the vertigo last for minutes what is the likely Dx

Back 18

TIA

Front 19

If the vertigo lasts for hours what is the likely DX

Back 19

Meniere's

Front 20

If the vertigo lasts for days what is the likely Dx

Back 20

Labyrinthitis

Front 21

If the vertigo lasts for inconsistent time it varies how long it lasts what is the likely cause

Back 21

migraines

Front 22

What exam would you perform on physical exam if you suspected BPPV and what results would you expect

Back 22

perform the Dix-Hallpike maneuver. Nystagmus should be evident after maneuver if BPPV is present

Front 23

What PE findings will be unique to labyrinthitis

Back 23

unilateral weakness on fukuda testing

Front 24

If you suspect the vertigo is do to a congenital abnormaility of the ear what test would be better to order MRI or Temporal bone CT

Back 24

Temporal Bone CT

Front 25

What is the tx for BPPVq

Back 25

epley maneuver or canalith repositioning this is 90% effective if performed correctly

Front 26

What is the tx for menire's disease

Back 26

low sodium diet, diuretics, meclizine or benzos for acute phase of illness. Hearing conservation is imperative, audiogram during acute illness makes the dx

Front 27

What is the tx for labyrinthitis

Back 27

admission, benzos, steroids, antivirals, antiemetics and acute hearing test. Pt should be very sick and may have permanent hearing loss and vertigo