Term
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Definition
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Term
| ____________ is a disturbed relationship to space associated with syncope, pre-syncope, dysequilibrium, unsteadiness, or lightheadedness. |
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Definition
| Dizziness is a disturbed relationship to space associated with syncope, pre-syncope, dysequilibrium, unsteadiness, or lightheadedness. |
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Term
| ___________ is the sensation of movement (rotation, spinning, rotary, rocking) |
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Definition
| Vertigo is the sensation of movement (rotation, spinning, rotary, rocking) |
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Term
True vertigo is secondary to ________________ .
Peripheral causes (2)
Central cause (1) |
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Definition
True vertigo is secondary to vestibular dysfunction.
Peripheral causes: inner ear or CN VIII
Central cause: brainstem |
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Term
| what 3 Sx tell you that vertigo is due to an inner ear issue? |
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Definition
vertigo
hearing loss
tinnitus
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Term
#1 benign paroxysmal positioning vertigo
#2 Labyrinthitis & vestibular neuronitis (what would you look for on the HPI/PMH?)
top 2 causes of what?
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Definition
peripheral vestibular disease
Labyrinthitis & vestibular neuronitis...common with URI |
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Term
what drugs are ototoxic and can cause dizziness?
ABX: (2)
used in HTN:
OTC drugs:
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Definition
ABX:
aminoglycosides** (hearing loss, tinnitus, vertigo)
minocycline (tetracyclines--used for tick diseases, dermatology, anthrax)
used in HTN:
diuretics (furosamide)
OTC drugs:
NSAIDs (aspirin at high doses) |
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Term
| dizziness, dipoplia, and dysarthria are the "3 D's" associated with the ______________ system, which is involved in dizziness caused by migraines and TIAs/strokes. |
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Definition
dizziness, dipoplia, and dysarthria are the "3 D's" associated with the vertebrobasilar (V-B) system, which is involved in dizziness caused by migraines and TIAs/strokes.
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Term
| vomiting, HA, confusion, inability to concentrate, and dizziness are _______________ symtoms associated with recent head trauma. |
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Definition
| vomiting, HA, confusion, inability to concentrate, and dizziness are post-concussive symtoms associated with head trauma. |
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Term
| ____________ is a visual disturbance in which objects in the visual field are oscillating. |
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Definition
| Oscillopsia is a visual disturbance in which objects in the visual field are oscillating. |
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Term
| what symtom associated with dizziness would make you think of brainstem disease as the underlying cause of the dizziness? |
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Definition
| facial numbness (trigeminal nerve) |
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Term
What are you looking for by doing and EOM exam in a pt w/ dizziness? What system is associated with eye movements?
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Definition
Nystagmus
vestibular system associated w/ eye movements |
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Term
| rotary or horizonal nystagmus that is suppresssed by fixation with associated tinnitus or deafness is indicative of what type of vestibular nystagmus? |
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Definition
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Term
| vertical or torsional nystagmus not suppressed with fixation suggests what type of nystagmus? |
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Definition
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Term
| What is a manuever done in family practice when looking for nystagmus that should not be done with c-spine disease or recent MVA? |
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Definition
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Term
| Electronystoagmo-graph (ENG), Vestibular autorotation testing (VAT), and Brainstem Auditory Envoked Potentials (BSER/BAER, VEMP) are diagnostic studies would you order for a pt with what? |
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Definition
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Term
| Meclizine, transdermal scopolamine, benzos, and promethazine (antiemetic) are drugs that can be used to treat what? |
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Definition
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Term
| dizziness, diplopia, drop attachs, dysarthria, ataxic gait, and extremity weakness are the hallmark signs of what? |
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Definition
vestibrobasillary Insufficiency
(posterior circulation TIA, CVA) |
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Term
otoliths in the semicircular canal, fistula from inner to middle ear, or vascular compression of CN VIII are causes of what?
What population is this common in?
What is the onset, duration, precipitating, and relieving factors?
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Definition
Benign Paroxysmal Positional Vertigo (BPPV) -- Positional Vertigo
most common cause of vertigo
common in head trauma and geriatric populations
sudden onset of vertigo/dizziness lasting 30-60sec, precipitated by position change and relieved by stopping motion and visual fixation.
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Term
| canalith repositioning procedure is used to tx what? |
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Definition
| Benign Paroxysmal Positional Vertigo (BPPV) |
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Term
intermittent, unilateral low fx hearing loss, fluctuating roaring tinnitus, aural fullness, and severe vertigo lasting 20min to several hours.
Dx?
Causes?
Tx? |
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Definition
Meniere' Disease
Causes:
autoimmune
too much inner ear fluid
syphillis
head trauma
Tx:
Diuretics
Meclisine
Benzos
Corticosteroids
low Na+ diet |
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Term
pt compains of being too dizzy to get out of bed, hearing loss, and tinnitus. PMH of recent URI. Nystagmus toward unaffected ear. (+) Romberg toward affected ear
Dx?
Prognosis & Management? |
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Definition
Acute Labyrinthitis
Prognosis:
will get worse if new onset, the will get better, will resolve in 4-6wks, minor positional residual veritgo for years afterwards
Tx:
Meclizine
benzos
scopolamine
balance exercises and fixation |
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Term
unilateral hearing loss, tinnitus, and vertigo that progresses to ataxia, facial numbness, and extremity weakness
Cause? |
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Definition
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Term
| loss of corneal reflex is an early finding associated with what disease? |
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Definition
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Term
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Definition
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Term
| what is a common reflex-mediated cause of syncope? |
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Definition
| Vasovagal / Neurocardiogenic syncope |
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Term
| what is a common cause of syncope in the elderly related a cardiac structure abnormality that is made worse with exertion? |
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Definition
| Aortic Stenosis (LV outflow obstruction) |
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Term
| What genetic heart abnormaly is associated with sudden death in young people and athletes? Not HCOM |
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Definition
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Term
| what must you test during the PE for a pt with syncope? |
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Definition
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Term
| venous pooling, low preload, and sympathetic response are the underlying mechanisms of what type of syncope? |
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Definition
| neurocardiogenic (vasovagal, vasodepressor) |
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Term
| what do you suspect as the cause of sycope if a pt has a systolic mumur at the apex and lower LSB that increases with the valsalva maneuver? |
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Definition
| Hypertrophic Cardiomyopathy |
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Term
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Definition
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Term
what is an important and often common disease to look for in children that can lead to speech and language development impairment?
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Definition
| chronic otitis media with effusion (impairs hearing) |
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Term
| what are the causes of acquired speech/language problems in adulthood? (3) |
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Definition
head trauma (motorcycle, car, gunshot wound, war)
stroke
**language centers on the L hemisphere**
**frontal lobe lesion = appropriateness, meaning of words**
cancer of the esophaus or larynx |
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Term
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Definition
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Term
| _________is cx by recurrent episodes of upper airway obstruction associated with reduction in ventilation |
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Definition
| Obstructive Sleep Apnea (OSA) is cx by recurrent episodes of upper airway obstruction associated with reduction in ventilation |
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Term
| what is the "two-hit' defect that develops with OSA? |
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Definition
upper airway mechanical defect + neuromuscular response defect
mechanical defect due to obesity, tonsillary hypertrophy, retrognathia, or craniofacial features
neuromuscular factors: impaired response to hypercapnia and hypoxemia, loss of "wakefullness stimulus" to pharyngeal dilator muscles |
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Term
Menopausal women
African Americans
Obesity
collar size > 17in (men) >15 in (women)
+FH
Smoking
EtOH and benzos
risk factors for what?
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Definition
OSA
obstructive sleep apnea |
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Term
daytime fatigue, AM headaches
restless sleep, insomnia
snoring
Sx of what |
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Definition
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Term
| What are some of the clinical signs (seen on PE) associated with OSA? |
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Definition
crowded pharyngeal airspace
retrognathia
macroglossia
tonsillary hyperplasia
lateral peritonsillar narrowing
pretty logical!!! |
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Term
| what is the most common symptom of OSA? |
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Definition
hypersomnolence
intrusion of sleep during sedentary activities and during normally active situations |
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Term
| What is the gold standard test for the Dx of OSA? |
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Definition
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Term
____________ is the sudden onset of B/L muscle weakness triggered by humor, surprise, or excitement.
used to Dx what? |
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Definition
Cataplexy is the sudden onset of B/L muscle weakness triggered by humor, surprise, or excitement.
used to Dx Narcolepsy |
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Term
Cataplexy
Sleep paralysis
Hypnagogic and hynopompic hallucinations
cx of what disorder? |
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Definition
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