Answers:
Vertigo that only lasts seconds and is accompanied by hearing loss is most likely to be?
A) Lyme Disease
B) Labyrinithitis
C) Meniere Disease
D) Perilymphatic Fistula
E) BPPV
Vertigo lasting seconds with associated hearing loss is most likely to be either a perilymphatic fistula or a cholesteatoma. BPPV also has vertigo lasting seconds, but has no associated hearing loss. Meniere disease has both but vertigo lasts hours.
What is the most common cause of peripheral vertigo?
MC Questions:
What is the primary treatment of BPPV?
A) Semicircular Canal Occlusion
B) Epley Maneuvers
C) Diuretics
D) Avoiding inciting head positions
E) Vestibular Suppressants
A) Lyme Disease
B) Labyrinithitis
C) Meniere Disease
D) Perilymphatic Fistula
E) BPPV
Vertigo lasting seconds with associated hearing loss is most likely to be either a perilymphatic fistula or a cholesteatoma. BPPV also has vertigo lasting seconds, but has no associated hearing loss. Meniere disease has both but vertigo lasts hours.
What is the most common cause of peripheral vertigo?
BPPV is the most common type of peripheral vertigo. It is due to debris in posterior semicircular canal and the vertigo lasts seconds, with no hearing loss. Symptoms are associated with position.
What is the primary treatment of BPPV?
A) Semicircular Canal Occlusion
B) Epley Maneuvers
C) Diuretics
D) Avoiding inciting head positions
E) Vestibular Suppressants
Free Response Question:
What are Ewald's three laws?
Quick Facts:
Meniere Disease
-Idiopathic.
-Attacks of vertigo, fluctuating hearing loss, tinnitus and aural fullness.
-Often presents in 5th decade.
Pathogenesis
-Idiopathic, possible due to impaired reabsorption of endolymphatic fluid in the
endolymphatic duct/sinuses, utricle and saccule.
-Endolymphatic sac in Meniere patients are smaller, have less absorptive tubular epithelium and have increased perisaccular fibrosis.
-Meniere patients have decreased Type II hair cells.
-Meniere patients have increased IgM complexes and C1q component, low IgA
levels.
-30% have autoantibodies to inner ear antigen.
Clinical Findings
-4 signs/symptoms:
-unilateral fluctuating SNHL
-vertigo lasting minutes-hours
-constant or intermittent tinnitus increaing in intensity before/during
vertiginous attacks.
-Aural fullness
-Pt often feels exhausted after attacks.
Diagnostic Scale of Meniere Disease:
-Certain Disease
-definitive disease + histopath confirmation
-Definitive Disease
-2+ episodes of vertigo that are 20+min
-Audiogram confirmed hearing loss
-Tinnitus and aural fullness
-Probable Disease
-One definite episode of vertigo
What are Ewald's three laws?
Quick Facts:
Meniere Disease
-Idiopathic.
-Attacks of vertigo, fluctuating hearing loss, tinnitus and aural fullness.
-Often presents in 5th decade.
Pathogenesis
-Idiopathic, possible due to impaired reabsorption of endolymphatic fluid in the
endolymphatic duct/sinuses, utricle and saccule.
-Endolymphatic sac in Meniere patients are smaller, have less absorptive tubular epithelium and have increased perisaccular fibrosis.
-Meniere patients have decreased Type II hair cells.
-Meniere patients have increased IgM complexes and C1q component, low IgA
levels.
-30% have autoantibodies to inner ear antigen.
Clinical Findings
-4 signs/symptoms:
-unilateral fluctuating SNHL
-vertigo lasting minutes-hours
-constant or intermittent tinnitus increaing in intensity before/during
vertiginous attacks.
-Aural fullness
-Pt often feels exhausted after attacks.
Diagnostic Scale of Meniere Disease:
-Certain Disease
-definitive disease + histopath confirmation
-Definitive Disease
-2+ episodes of vertigo that are 20+min
-Audiogram confirmed hearing loss
-Tinnitus and aural fullness
-Probable Disease
-One definite episode of vertigo
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