Everybody now! “You spin me right round, like a record baby!”. Have a go at this quiz on dizziness and vertigo, some are more challenging! As always, read that question stem carefully!
Reviewed by: awaiting review
Approach to the patient with Dizziness and Vertigo
Stem 1, question 1 of 6
Claudia, a 32 year old female, presents to her GP complaining of vertigoWhich of the following is NOT a cause of vertigo?
Alcohol related cerebellar degeneration
Stem 1, question 2 of 6
Claudia states she also has mild hearing loss in her left ear, nausea, vomiting and coryzal symptoms. She denies any otorrhoea.What is the most likely cause of her vertigo?
Benign paroxysmal positional vertigo
Bacterial vestibular neuronitis
Viral vestibular neuronitis
Stem 1, question 3 of 6
Claudia is given a vestibular suppressant, anti-emetic and corticosteroids.Which of the following is a vestibular suppressant?
Stem 1, question 4 of 6
20 years later Claudia returns to GP with severe episodes of vertigo which started following a fall in the garden a week ago where she bumped her head. She states the vertigo is only comes on when looking over her right shoulder.What is the most likely diagnosis?
Benign Paroxysmal Positional Vertigo (BPPV)
Stem 1, question 5 of 6What is the most likely examination finding in BPPV?
Positive erect lateral head turn
Positive Epley manoeuvre
Negative Epley manoeuvre
Stem 1, question 6 of 6
The GP sees another patient also complaining of vertigo, accompanied by right sided facial numbness, hearing loss and tinnitusWhere is the lesion?
Peripheral Vestibulocochlear nerve
Stem 2, question 1 of 4
Paul, a 74 year old man, presents to his GP following an episode of dizziness. His husband states Paul lost consciousness momentarily and was slumped.What is the most likely cause of Paul's dizziness?
Stem 2, question 2 of 4Orthostatic hypotension is another cause of dizziness. What is orthostatic hypotension?
Fall in diastolic blood pressure of at least 30mmHg within 2 minutes of standing
Fall in systolic blood pressure of at least 20mmHg and/or a fall in diastolic blood pressure of at least 10mmHg within 3 minutes of standing
Fall in diastolic blood pressure of at least 15mmHg within 3 minutes of standing
Fall in systolic blood pressure of at least 20mmHg within 4 minutes of standing
Fall in systolic blood pressure of at least 30mmHg and/or a fall in diastolic blood pressure of at least 10mmHg within 3 minutes of standing
Stem 2, question 3 of 4Which of the following is NOT an appropriate initial investigation for someone presenting with dizziness?
Urea and Electrolytes
Full blood count
Stem 2, question 4 of 4
2 months later, Paul's husband calls the GP surgery saying that Paul has vertigo, double vision, hearing loss, difficulties speaking and numbness down his right sideWhat investigation does Paul require immediately?
Arterial blood gas