Vestibular Certification Test Questions and Answers Fully Solved Graded A+
Vestibular sedatives are most likely to be helpful with addressing what kind of symptoms: - Answers1.
Vertigo
Sedative such as Diazepam (Valium) and Meclizine (Antivert) are helpful in reducing acute vertigo.
Valium is typically utilized for severe vertigo, followed by Meclizine.
2. Nausea and emesis
Sedatives have an anti-emetic property which can increase patient comfort while suffering from acute
vertigo. With acute peripheral vestibular loss, patients may struggle with nausea and emesis for several
days to one week.
When would it be pointless for a patient to start taking vestibular suppressants after an acute vestibular
event? - AnswersWith acute peripheral vestibular loss, use of agents (Benzodiazipines and
Antihistimines) is only helpful for approximately one week. Typically after one week, central nervous
system compensation has sufficiently reduced spontaneous vertigo.
Antihistamines are sometimes prescribed for chronic vertigo and motion sickness as well.
*** Vestibular neuritis typically presents with ___________ because it typically damages the
________________. Which of the following structures are likely to be involved? - Answers1. Horizontal,
Anterior canal, and Utricle deficits such as ***
2. superior vestibular nerve
List all possible positive tests for a Central NS vestibular dysfunction. - Answers1. Smooth pursuit
2. Saccades
3. Vergence
4. Pure torsional or downbeating nystagmus (cerebellar)
5. Nystagmus that changes direction based on gaze position is suggestive of central nervous system
dysfunction.
***
Diagnose the Case:
72 year old female
c/o dizziness for 2 months.
, PMH: osteoporosis, atrial fib, CAD, HTN, hypercholesterolemia, and lumbar spinal stenosis.
MVA with mild head trauma which preceded the dizziness by 3 days.
Sx: A sense of imbalance with the majority of the episodes, occasionally experiences a sense of vertigo,
with the following activities: supine to sit transitions, lying in bed, rolling from right to left in bed,
stooping and pitching her head back. The episodes last less than a minute. - AnswersBPPV
Notes:
- Elderly patients with BPPV frequently do not report a sense of vertigo. Frequently patients complain of
non-rotary imbalance with BPPV. This is more common in patients with chronic BPPV or the patient with
diminished vestibular sensitivity.
- BPPV can be active for varying periods of time. The natural course can vary highly from a day to over a
year.
Duration for canalithiasis vs cupulolithiasis - AnswersCanal: Nystagmus lasting up to 15 seconds with
associated vertigo. Otoconia freely migrating within the semicircular canal (canalithiasis) should settle
within seconds.
With cupulolithiasis, the debris is adherent to the cupula and the nystagmus will last greater than one
minute.
What type of nystagmus is seen with BPPV - AnswersGeotrophic nystagmus
Geotropic nystagmus involves nystagmus with the fast phase directed toward the earth. This finding
would suggest likely involvement of the horizontal canal (canalithiasis-type). Roll testing should be
completed to determine the affected side.
Diagnose the case:
- 70 yo male
- 3 week history of dizziness.
- Acute spontaneous episode of vertigo with nausea/emesis and imbalance at onset lasting
approximately 4 days.
- Residually c/o gait instability and head motion related unsteadiness.
- Denies any preceding upper respiratory or GI infection.
Vestibular sedatives are most likely to be helpful with addressing what kind of symptoms: - Answers1.
Vertigo
Sedative such as Diazepam (Valium) and Meclizine (Antivert) are helpful in reducing acute vertigo.
Valium is typically utilized for severe vertigo, followed by Meclizine.
2. Nausea and emesis
Sedatives have an anti-emetic property which can increase patient comfort while suffering from acute
vertigo. With acute peripheral vestibular loss, patients may struggle with nausea and emesis for several
days to one week.
When would it be pointless for a patient to start taking vestibular suppressants after an acute vestibular
event? - AnswersWith acute peripheral vestibular loss, use of agents (Benzodiazipines and
Antihistimines) is only helpful for approximately one week. Typically after one week, central nervous
system compensation has sufficiently reduced spontaneous vertigo.
Antihistamines are sometimes prescribed for chronic vertigo and motion sickness as well.
*** Vestibular neuritis typically presents with ___________ because it typically damages the
________________. Which of the following structures are likely to be involved? - Answers1. Horizontal,
Anterior canal, and Utricle deficits such as ***
2. superior vestibular nerve
List all possible positive tests for a Central NS vestibular dysfunction. - Answers1. Smooth pursuit
2. Saccades
3. Vergence
4. Pure torsional or downbeating nystagmus (cerebellar)
5. Nystagmus that changes direction based on gaze position is suggestive of central nervous system
dysfunction.
***
Diagnose the Case:
72 year old female
c/o dizziness for 2 months.
, PMH: osteoporosis, atrial fib, CAD, HTN, hypercholesterolemia, and lumbar spinal stenosis.
MVA with mild head trauma which preceded the dizziness by 3 days.
Sx: A sense of imbalance with the majority of the episodes, occasionally experiences a sense of vertigo,
with the following activities: supine to sit transitions, lying in bed, rolling from right to left in bed,
stooping and pitching her head back. The episodes last less than a minute. - AnswersBPPV
Notes:
- Elderly patients with BPPV frequently do not report a sense of vertigo. Frequently patients complain of
non-rotary imbalance with BPPV. This is more common in patients with chronic BPPV or the patient with
diminished vestibular sensitivity.
- BPPV can be active for varying periods of time. The natural course can vary highly from a day to over a
year.
Duration for canalithiasis vs cupulolithiasis - AnswersCanal: Nystagmus lasting up to 15 seconds with
associated vertigo. Otoconia freely migrating within the semicircular canal (canalithiasis) should settle
within seconds.
With cupulolithiasis, the debris is adherent to the cupula and the nystagmus will last greater than one
minute.
What type of nystagmus is seen with BPPV - AnswersGeotrophic nystagmus
Geotropic nystagmus involves nystagmus with the fast phase directed toward the earth. This finding
would suggest likely involvement of the horizontal canal (canalithiasis-type). Roll testing should be
completed to determine the affected side.
Diagnose the case:
- 70 yo male
- 3 week history of dizziness.
- Acute spontaneous episode of vertigo with nausea/emesis and imbalance at onset lasting
approximately 4 days.
- Residually c/o gait instability and head motion related unsteadiness.
- Denies any preceding upper respiratory or GI infection.
