GNRS 5669 EXAM 3 QUESTIONS AND ANSWERS
Lab evaluation in patients with delirium: - CORRECT ANSWER✅✅electrolytes
creatinine
glucose
calcium
CBC
urinalysis and urine culture
Vertigo: - CORRECT ANSWER✅✅sensation of spinning or motion
Prescyncopal lightheadedness: - CORRECT ANSWER✅✅sensation of impending faint
Disequilibrium: - CORRECT ANSWER✅✅sensation of unsteadiness
Continuous dizzy symptoms: - CORRECT ANSWER✅✅stroke
Episodic or brief dizziness: - CORRECT ANSWER✅✅BPPV, labryinthitis
Hours or days of dizziness: - CORRECT ANSWER✅✅menieres disease
Dix-Hallpike maneuver: - CORRECT ANSWER✅✅-help differentiate benign vertigo vs. vertigo from a CNS
lesion
-expect vomiting
-BPPV treatment
-CNS lesion: longer duration nystagmus, continues with each repetition of hallpike, does not decrease in
intensity
-benign vertigo: rotation nystagmus during head rotation, resolves quickly and cannot be reproduced
after 2-3 repetitions of hallpike
, BPPV: - CORRECT ANSWER✅✅-episodic w/ no vertigo
-N/V, worse with movement
-positive dix-hallpike maneuver
-using anti-emetics may prolong BPPV course
Labyrinthitis: - CORRECT ANSWER✅✅-ABRUPT onset of dizziness
-sometimes occurs with viral URI
Postural hypotension: - CORRECT ANSWER✅✅-20mm drop in SBP, 10mm drop in DBP without pulse
change
-wait 2 min after standing from lying position
Diseased vestibular nerve: - CORRECT ANSWER✅✅Menieres disease
-loss of low frequencies
-dizzy, N/V, diaphoresis, difficulty with balance, vertigo, tinnitus, fluctuating hearing loss, feeling of
pressure in the ear, diplopia
Basilar CVA: - CORRECT ANSWER✅✅facial numbness, hemiparesis, diplopia, dysarthria, HA, N/V
Veterbrobasilar stroke syndromes: - CORRECT ANSWER✅✅nausea, vertigo, facial numbness, hearing
loss
Cerebellar infaction: - CORRECT ANSWER✅✅severe vomiting, vertigo, ataxia
Tx of dizziness: - CORRECT ANSWER✅✅-antihistamines- meclizine, benadryl, phenergan
-take medication for a week and then taper to PRN
-antiemetics- for n/v
-sedation precautions!
Lab evaluation in patients with delirium: - CORRECT ANSWER✅✅electrolytes
creatinine
glucose
calcium
CBC
urinalysis and urine culture
Vertigo: - CORRECT ANSWER✅✅sensation of spinning or motion
Prescyncopal lightheadedness: - CORRECT ANSWER✅✅sensation of impending faint
Disequilibrium: - CORRECT ANSWER✅✅sensation of unsteadiness
Continuous dizzy symptoms: - CORRECT ANSWER✅✅stroke
Episodic or brief dizziness: - CORRECT ANSWER✅✅BPPV, labryinthitis
Hours or days of dizziness: - CORRECT ANSWER✅✅menieres disease
Dix-Hallpike maneuver: - CORRECT ANSWER✅✅-help differentiate benign vertigo vs. vertigo from a CNS
lesion
-expect vomiting
-BPPV treatment
-CNS lesion: longer duration nystagmus, continues with each repetition of hallpike, does not decrease in
intensity
-benign vertigo: rotation nystagmus during head rotation, resolves quickly and cannot be reproduced
after 2-3 repetitions of hallpike
, BPPV: - CORRECT ANSWER✅✅-episodic w/ no vertigo
-N/V, worse with movement
-positive dix-hallpike maneuver
-using anti-emetics may prolong BPPV course
Labyrinthitis: - CORRECT ANSWER✅✅-ABRUPT onset of dizziness
-sometimes occurs with viral URI
Postural hypotension: - CORRECT ANSWER✅✅-20mm drop in SBP, 10mm drop in DBP without pulse
change
-wait 2 min after standing from lying position
Diseased vestibular nerve: - CORRECT ANSWER✅✅Menieres disease
-loss of low frequencies
-dizzy, N/V, diaphoresis, difficulty with balance, vertigo, tinnitus, fluctuating hearing loss, feeling of
pressure in the ear, diplopia
Basilar CVA: - CORRECT ANSWER✅✅facial numbness, hemiparesis, diplopia, dysarthria, HA, N/V
Veterbrobasilar stroke syndromes: - CORRECT ANSWER✅✅nausea, vertigo, facial numbness, hearing
loss
Cerebellar infaction: - CORRECT ANSWER✅✅severe vomiting, vertigo, ataxia
Tx of dizziness: - CORRECT ANSWER✅✅-antihistamines- meclizine, benadryl, phenergan
-take medication for a week and then taper to PRN
-antiemetics- for n/v
-sedation precautions!
