NR 603 Exam Questions With Correct Answers
// // // // // //
Vestibular /
/neuritis/labyrinthitis //- //CORRECT //ANSWERS(S)✔✔Acute //unilateral //labryinthine //dysfunction
Sx: /
/severe /
/vertigo, /
/nausea, /
/vomiting /
/and /
/disequilibrium /
/lasting /
/few /
/days, /
/unbalance /
/with //rapid //head //movement; //lasts //weeks //to //months; //probs //w/ //walking/balance
Causes: /
/by //viral //infection //in //vestibular //nerve, //otitis //media //sometimes //another //cause; //HSV-
1 //of //vestibular //ganglia
Assessment: //
-Thorough //ear, //nose //throat //exam
-Neuro //exam //(including //balance //testing //with //Romberg)
-Hearing //screen //should //be //normal //
-Abnormal //neuro //exam //should //suggest //a //central //cause //and //referred //to //Neuro
Diagnostics: //
Labs: //CBC //with //diff
,Imaging: //MRI //or //CT
Differential //dx:
-BPPV
-Meniere //disease
-Migranous //vertigo
-Vascular //d/o
-Trauma
-Toxins
-Demyelinating //disease //(MS)
-Ramsay //Hunt //Syndrome
-Cerebellar //disorder
-Tumors
Tx: //
-
Symptom /
/relief //- /
/use /
/only /
/for //
3/
/days /
/(more /
/than /
/that /
/can /
/just /
/mask /
/sx): /
/anticholinergics /
, /(first /
/line), /
/antihistamines(first /
/line), /
/long /
/acting /
/benzos /
/(reserved /
/for //pts //who //cant //take //anticholinergics) //or //antiemetics //(added //to //relieve //vomiting)
-Acute //treatment: //Methylpredisone //taper //(100mg //every //3 //days)
Meniere's /
/disease //- /
/CORRECT /
/ANSWERS(S)✔✔Excessive /
/fluid //and //pressure //in //labyrinth //of //inner //ear; //autoimmune //process
Sx: /
/Vertigo /
/that /
/last //min //to //hours, //a/w //nausea //and //vomiting, //accompanied //by //pressure //in //ear; //low-
pitched //= //unilateral //hearing //loss; //hearing //loss //is //constant //in //later //stages
Assessment:
-Head //and //neck //exam //to //exclude //acute //otitits //media
-Neuro //exam
-Weber //test //- //sound //will //laterlize //to //unaffected //ear //
-Rinne //test //- //air //conduction //> //bone //conduction
Diagnostics:
-Initial: //Audiogram
// // // // // //
Vestibular /
/neuritis/labyrinthitis //- //CORRECT //ANSWERS(S)✔✔Acute //unilateral //labryinthine //dysfunction
Sx: /
/severe /
/vertigo, /
/nausea, /
/vomiting /
/and /
/disequilibrium /
/lasting /
/few /
/days, /
/unbalance /
/with //rapid //head //movement; //lasts //weeks //to //months; //probs //w/ //walking/balance
Causes: /
/by //viral //infection //in //vestibular //nerve, //otitis //media //sometimes //another //cause; //HSV-
1 //of //vestibular //ganglia
Assessment: //
-Thorough //ear, //nose //throat //exam
-Neuro //exam //(including //balance //testing //with //Romberg)
-Hearing //screen //should //be //normal //
-Abnormal //neuro //exam //should //suggest //a //central //cause //and //referred //to //Neuro
Diagnostics: //
Labs: //CBC //with //diff
,Imaging: //MRI //or //CT
Differential //dx:
-BPPV
-Meniere //disease
-Migranous //vertigo
-Vascular //d/o
-Trauma
-Toxins
-Demyelinating //disease //(MS)
-Ramsay //Hunt //Syndrome
-Cerebellar //disorder
-Tumors
Tx: //
-
Symptom /
/relief //- /
/use /
/only /
/for //
3/
/days /
/(more /
/than /
/that /
/can /
/just /
/mask /
/sx): /
/anticholinergics /
, /(first /
/line), /
/antihistamines(first /
/line), /
/long /
/acting /
/benzos /
/(reserved /
/for //pts //who //cant //take //anticholinergics) //or //antiemetics //(added //to //relieve //vomiting)
-Acute //treatment: //Methylpredisone //taper //(100mg //every //3 //days)
Meniere's /
/disease //- /
/CORRECT /
/ANSWERS(S)✔✔Excessive /
/fluid //and //pressure //in //labyrinth //of //inner //ear; //autoimmune //process
Sx: /
/Vertigo /
/that /
/last //min //to //hours, //a/w //nausea //and //vomiting, //accompanied //by //pressure //in //ear; //low-
pitched //= //unilateral //hearing //loss; //hearing //loss //is //constant //in //later //stages
Assessment:
-Head //and //neck //exam //to //exclude //acute //otitits //media
-Neuro //exam
-Weber //test //- //sound //will //laterlize //to //unaffected //ear //
-Rinne //test //- //air //conduction //> //bone //conduction
Diagnostics:
-Initial: //Audiogram