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on 02-Oct-2016 (Sun)

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Flashcard 1402802933004

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Question
What are the 2 important things to check on general inspection for abdo pain?
Answer
  • Change in mental status (infection - UTI)
  • Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

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General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis)

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss







Flashcard 1402805292300

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Question
What should you look for on an abdo exam for a patient coming in with abdo pain? (7 pts)
Answer
  • peritoneal signs
  • Carnett’s sign (high ppv for abdo wall pain)
    • ↑ pain when supine pt raises head & shoulder, tensing abdo wall
  • Murphy’s sign (high ppv for choleycystitis)
  • Psoas sign (high ppv for appendicitis)
  • Sever pain out of proportion (ischemic bowel, pancreatitis)
  • restless/writhing (biliary/renal colic, testicular torsion)
  • LLQ tenderness (diverticulitis)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

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Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis)

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss







Flashcard 1402809224460

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Question

Rectal & pelvic exams if [...] pain

Answer
lower abdo & pelvic


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss







Flashcard 1402811583756

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Question
What are you checking for on a DRE for abdo pain?
Answer
fecal impaction, palpable mass, occult blood in stool


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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scheduled repetition interval               last repetition or drill

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Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss







Flashcard 1402813943052

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Question

DRE - Tenderness & fullness on R of rectum suggests [...]

Answer
retrocecal appendix


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) <

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss







Flashcard 1402816302348

Tags
#fm
Question
What are you looking for on a pelvic exam for pt with abdo pain?
Answer
vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

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ms if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - <span>vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) <span><body><html>

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss







Flashcard 1402822855948



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Flashcard 1402827574540



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Flashcard 1402830458124



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statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402835963148



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statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402838846732



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Flashcard 1402844351756

Tags
#fm
Question
CONSIDER IN ALL OLDER PTS w/ abdo pain (3 pts)
Answer
occult UTI

perforated viscus

ischemic bowel dz

*often missed or dx late in elderly pt - potentially fatal*


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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*occult UTI, perforated viscus, ischemic bowel ds* - potentially fatal, often missed or dx late in elderly pt CONSIDER IN ALL OLDER PTS w/ abdo pain

Original toplevel document

Abdo Pain
#13; Appendicitis Acute cholecystitis Diverticulitis Acute pancreatitis Perforated ulcer Bowel infarction <span>Plan (for acute abdo pain) - acute abdo = sudden, non-traumatic disorder needing urgent dx & tx Labs CBC (infection/blood loss) Amylase + lipase (pancreatitis) LFT (RUQ pain) Urinalysis (hematuria, dysuria, flank pain - UTI/kidney stone) Beta hcg (women in childbearing age) Chlamydia + gonorrhea (women @ risk of STIs) Imaging (based on location) U/S (RUQ pain) abdo/transvag ultrasound for pregnant women, even for LLQ/RLQ pain Transvag u/s for ectopic pregnancy CT w/ IV contrast media (adults w/ acute RLQ pain) CT w/ oral + IV contrast media (LLQ pain) - for sigmoid diverticulitis LUQ pain (many causes so depends) Suggested esophageal/gastric patho = endoscopy or upper GI series Others = CT (can image pancreas, spleen, kidneys, intestines, vasculature) Xray Free air under diaphragm (=perforation of GI tract) Abn calcifications (10% gallstones, 90% kidney stones) Mult dilated loops of bowel & air-fluid lvls (bowel obstruction) May see with paralytic ileus *occult UTI, perforated viscus, ischemic bowel ds* - potentially fatal, often missed or dx late in elderly pt CONSIDER IN ALL OLDER PTS w/ abdo pain Initial investigations & basic management for chr/recurrent abdo pain IBS Exercise: vigorous 3-5/week (all types of IBS)







Flashcard 1402847759628

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#fm
Question
In pt with HA on on >/= 15d/mo for >3mo & normal neuro exam, dx ... (2 pts)
Answer
- chr migraine if HA meets migraine dx criteria or are quickly aborted by migraine meds (triptans/ergots) on >/= 8d/mo
- chr TT HA if meets episodic TT HA criteria, except mild nausea may be present


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402849594636

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Question
chr migraine w/ med overuse if:
Answer
uses ergots/triptans/opioids/combo analgesics on >/= 10d/mo or plain acetaminophen/NSAIDs on >/= 15d/mo


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402852478220

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Question
When med-overuse h/a suspected, evaluate pt for presence of: (3 pts)
Answer
-psych comorbidities (anxiety/depression) - might need to be considered in planning overall rx strategy
-psychological/physical drug dependence
-use of inappropriate coping strategies - might benefit from training & development of more adaptive self-management strategies (manage controllable triggers, activity pacing, etc)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402854313228

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Question
headache diaries that record [...] are important in the prevention & tx of med-overuse h/a
Answer
acute medication intake


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402856148236

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#fm
Question
adult Migraine management (4pts)
Answer
- acute meds
- monitor for med overuse
-prophy meds (when to use on other flash card)
-behav management (specifics on other card)


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Migraine management -acute meds -monitor for med overuse -prophy meds if: ---HA >3d/mo and acute meds not effective OR ---HA >8d/mo b/c risk of overuse OR ---disabil

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402858507532

Tags
#fm
Question
Migraine management

-acute meds
-monitor for med overuse
-prophy meds if:
---[...]
OR
---HA >8d/mo b/c risk of overuse
OR
---disability despite acute meds

behavioural management
-HA diary - freq, intensity, triggers, meds
-lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals
-stress management strategies - relaxation training, CBT, pacing activity, biofeedback
Answer
HA >3d/mo and acute meds not effective


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Migraine management -acute meds -monitor for med overuse -prophy meds if: ---HA >3d/mo and acute meds not effective OR ---HA >8d/mo b/c risk of overuse OR ---disability despite acute meds behavioural management -HA diary - freq, intensity, triggers, meds -lifesty

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402860080396

Tags
#fm
Question
Migraine management

-acute meds
-monitor for med overuse
-prophy meds if:
---HA >3d/mo and acute meds not effective
OR
---[...]
OR
---disability despite acute meds

behavioural management
-HA diary - freq, intensity, triggers, meds
-lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals
-stress management strategies - relaxation training, CBT, pacing activity, biofeedback
Answer
HA >8d/mo b/c risk of overuse


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

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Migraine management -acute meds -monitor for med overuse -prophy meds if: ---HA >3d/mo and acute meds not effective OR ---HA >8d/mo b/c risk of overuse OR ---disability despite acute meds behavioural management -HA diary - freq, intensity, triggers, meds -lifestyle factors - reduce caffeine, regular exercise, r

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402861653260

Tags
#fm
Question
Migraine management

-acute meds
-monitor for med overuse
-prophy meds if:
---HA >3d/mo and acute meds not effective
OR
---HA >8d/mo b/c risk of overuse
OR
---
[...]
behavioural management
-HA diary - freq, intensity, triggers, meds
-lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals
-stress management strategies - relaxation training, CBT, pacing activity, biofeedback
Answer
disability despite acute meds


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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l>Migraine management -acute meds -monitor for med overuse -prophy meds if: ---HA >3d/mo and acute meds not effective OR ---HA >8d/mo b/c risk of overuse OR ---disability despite acute meds behavioural management -HA diary - freq, intensity, triggers, meds -lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals -stress management

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402863226124

Tags
#fm
Question
Migraine management

-acute meds
-monitor for med overuse
-prophy meds if:
---HA >3d/mo and acute meds not effective
OR
---HA >8d/mo b/c risk of overuse
OR
---disability despite acute meds

behavioural management
-HA diary - [...]
-lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals
-stress management strategies - relaxation training, CBT, pacing activity, biofeedback
Answer
freq, intensity, triggers, meds


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

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-monitor for med overuse -prophy meds if: ---HA >3d/mo and acute meds not effective OR ---HA >8d/mo b/c risk of overuse OR ---disability despite acute meds behavioural management -HA diary - <span>freq, intensity, triggers, meds -lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals -stress management strategies - relaxation training, CBT, pacing activity, biofeedback</s

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402864798988

Tags
#fm
Question
Migraine management

-acute meds
-monitor for med overuse
-prophy meds if:
---HA >3d/mo and acute meds not effective
OR
---HA >8d/mo b/c risk of overuse
OR
---disability despite acute meds

behavioural management
-HA diary - freq, intensity, triggers, meds
-lifestyle factors - [...]
-stress management strategies - relaxation training, CBT, pacing activity, biofeedback
Answer
reduce caffeine, regular exercise, regular/adequate sleep/meals


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
>3d/mo and acute meds not effective OR ---HA >8d/mo b/c risk of overuse OR ---disability despite acute meds behavioural management -HA diary - freq, intensity, triggers, meds -lifestyle factors - <span>reduce caffeine, regular exercise, regular/adequate sleep/meals -stress management strategies - relaxation training, CBT, pacing activity, biofeedback<span><body><html>

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402866371852

Tags
#fm
Question
Migraine management

-acute meds
-monitor for med overuse
-prophy meds if:
---HA >3d/mo and acute meds not effective
OR
---HA >8d/mo b/c risk of overuse
OR
---disability despite acute meds

behavioural management
-HA diary - freq, intensity, triggers, meds
-lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals
-stress management strategies - [...]
Answer
relaxation training, CBT, pacing activity, biofeedback


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

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---disability despite acute meds behavioural management -HA diary - freq, intensity, triggers, meds -lifestyle factors - reduce caffeine, regular exercise, regular/adequate sleep/meals -stress management strategies - <span>relaxation training, CBT, pacing activity, biofeedback<span><body><html>

Original toplevel document

Headache
Headache Adult Headache Algorithm Subjective Objective Plan







Flashcard 1402880789772

Tags
#fm
Question
What is pattern 1 back pain?
Answer
disc pain


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Flashcard 1402882624780

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Question
Meds for pattern 1 (disc pain) back pain (2pts)
Answer
acetaminophen, NSAID


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402884459788

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Question
Pattern 1 back pain recovery position + starter exercises
Answer

repeated prone lying passive extensions (hips on ground, arms straight)
-10 reps, 3x day


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402886294796

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Question
Pattern 1 back pain exercises resources (3pts)
Answer
ISAEC, health link BC, sask pattern 1


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Flashcard 1402888129804

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Question
Pattern 1 backpain functional activities (3)
Answer
-encourage short freq walking
-reduce sitting activities
-use extension roll for short duration sitting


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402889964812

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Question
pattern 1 back pain follow up (2)
Answer
- 2-4 wks if referred to therapy or prescribed med
- PRN if given home program & relief noted in office visit


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Flashcard 1402891799820

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Question
in pattern 1 back pain, engage pt for self management goals [when?]
Answer
once pain is reduced


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402893634828

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#fm
Question
what is pattern 2 back pain?
Answer
facet joint pain


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Flashcard 1402895469836

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#fm
Question
What meds can you give for pattern 2 backpain? (2)
Answer
acetaminophen
NSAID


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402897304844

Tags
#fm
Question
What are the recovery position & starter exercises for pattern 2 backpain?
Answer

-sitting in a chair, bend forward & stretch in flexion
-use hands on knees to push trunk upright
-small freq repetitions through the day


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1402899139852

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#fm
Question
what are exercise resources for pattern 2 backpain?
Answer
isaec
health link bc
sask pattern 2


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Flashcard 1402900974860

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Question
what functional activities are recommended for pattern 2 backpain? (2)
Answer
-encourage sitting or standing with foot stool
-reduce back extension and overhead reach


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Flashcard 1402902809868

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Question
follow up for pattern 2 back pain
Answer
- 2-4 wk if referred to therapy or prescribed meds
-prn if given home program & relief noted in office visit


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Flashcard 1402904644876

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Question
self management can be initiated for pattern 2 back pain [when?] ​ with most patients
Answer
in 1st or 2nd session


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Flashcard 1402906479884

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Question
What is pattern 3 back pain?
Answer
compressed nerve pain (sciatica)


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Flashcard 1402908314892

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Question
meds for pattern 3 back pain
Answer
may require opioids if 1st line pain meds not sufficient
(not sure what 1st line meds are yet)


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Flashcard 1402910149900

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Question
what are the recovery positions & starter exercises for pattern 3 backpain?
Answer

"Z" lie
*caution: exercise will aggravate the pain so start w/ pain reducing positions


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Question
what is the functional activity for pattern 3 back pain?
Answer
change positions freq from sit to stand to lie to walk


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Flashcard 1402913819916

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Question
follow up plan for pattern 3 back pain
Answer
2 wks for pain management & neuro review


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Flashcard 1402915654924

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Question
self management plan for pattern 3 back pain
Answer
pt not usually suitable for self management d/t high pain lvls & possible surgical intervention


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Flashcard 1402917489932

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Question
what is pattern 4 back pain?
Answer
symptomatic spinal stenosis (neurogenic claudication)


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Flashcard 1402919324940

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Question
what are meds for pattern 4 back pain?
Answer
acetaminophen
NSAID


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Flashcard 1402921159948

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Question
what are the recovery position & starter exercises for pattern 4 back pain?
Answer

rest in a seated position or other flexed position to relieve the leg pain


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Flashcard 1402923519244

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Question
what is the functional activity recommended for pattern 4 back pain?
Answer
use support w/ walking or standing. use freq sitting breaks


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Flashcard 1402925354252

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Question
what is the follow up plan for pattern 4 back pain?
Answer
6-12 wks for sx management & determination of functional impact


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Flashcard 1402927189260

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Question
self management can be intiated for pattern 4 back pain [when] ​ w/ most patients
Answer
in 1st or 2nd session


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Flashcard 1402929024268

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Question
how can you divide up non-mechanical back pain? (2)
Answer
-non-spine related pain
-spine pain does not fit mechanical pattern


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Question
non-spine related pain (non-mechanical back pain):
what are other etiologies to consider prior to pain meds? (4)
Answer
internal organ pain referral
-kidney
-uterus
-bowel
-ovaries


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Question
what should you consider when a spine pain does not fit any of the mechanical patterns?
Answer
consider centralized pain meds (anti-depressants, anti-seizure, opioids)
-consider pain disorder


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Question
back pain


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Flashcard 1402977783052



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Question
back pain


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scheduled repetition interval               last repetition or drill






Flashcard 1402981977356



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Question
back pain


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scheduled repetition interval               last repetition or drill






Flashcard 1402986171660



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back pain


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scheduled repetition interval               last repetition or drill






Flashcard 1402992463116



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Question
back pain


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Flashcard 1402996657420



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Question
back pain


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scheduled repetition interval               last repetition or drill






Flashcard 1403000851724



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back pain


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scheduled repetition interval               last repetition or drill






Flashcard 1403005046028



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Question
back pain


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Flashcard 1403009240332



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Question
back pain


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Flashcard 1403013958924



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Question
back pain


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Flashcard 1403018677516

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Question
what are specialist referrals for back pain? (5)
Answer
-physiatry
-cbt
-pain specialist
-multidisciplinary pain clinic
-rheumatologist
-other


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Question
what are the red flags (NIFTI) in back pain?
Answer
-neuro (diffuse motor/sensory loss, progressive neuro deficits, cauda equina syndrome)
-infection (fever, IV drug use, immune suppressed)
-fracture (trauma, osteoporosis risk/fragility fracture)
-tumour (hx of cancer, unexplained wt loss, sig unexpected night pain, severe fatigue)
-inflammation (chr low back pain >3mo, age of onset <45, morning stiffness >30min, improves w/ exercise, disproportionate night pain)


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Flashcard 1403022347532

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Question
neuro back pain red flag - investigation = [...]
Answer
urgent MRI


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Flashcard 1403024182540

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Question
back pain red flag: infection investigation = [...]
Answer
xray & MRI


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Flashcard 1403026017548

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Question
back pain red flag - fracture investigation = [...]
Answer
xray, may require ct


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1403027852556

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Question
back pain red flag: tumour investigation = [...]
Answer
xray & MRI


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Flashcard 1403029687564

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Question
back pain red flag: inflammation investigation = [...]
Answer
rheum consult & guidelines


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Question
what are sx's of acute cauda equina syndrome? (3)
Answer
-urinary retention followed by insensible urinary overflow
-unrecognized fecal incontinence
-distinct loss of saddle/perineal sensation


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Flashcard 1403033619724

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Question
yellow flags in back pain are [...] ​ for developing chronicity
Answer
psychosocial risk factors


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Question
back pain yellow flags


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back pain yellow flags


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back pain yellow flags


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back pain yellow flags


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back pain yellow flags


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Question
What qn's can you ask to determine presence of vertigo? (2)
Answer
“Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?”


statusnot learnedmeasured difficulty37% [default]last interval [days]               
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Parent (intermediate) annotation

Open it
Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiti

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403061406988

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Question
What are the 4 types of vertigo?
Answer

BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common)

  • [brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting]

Vestibular Neuritis

  • [rapid onset, severe, persistent (days), N/V, imbalance]

Ménière’s Disease

  • [recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness]

Vestibular Toxicity

  • [aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin]


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo <span>BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403063766284

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Question

BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common type of vertigo) consists of [what sx's?]

Answer
brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo <span>BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurren

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403066125580

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Question

Vestibular Neuritis (form of vertigo) is [like what?]

Answer
rapid onset, severe, persistent (days), N/V, imbalance


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting <span>Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Ves

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403068484876

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Question

Ménière’s Disease ​(form of vertigo) consists of [...]

Answer
recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

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; brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance <span>Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = o

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403070844172

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Question

Vestibular Toxicity (cause of vertigo) is caused by [...]

Answer
aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
stent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness <span>Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403073203468

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Question
Other than vertigo, what are other forms of dizziness? (3)
Answer

Presyncopal Dizziness – “feels like nearly fainting or blacking out”

Disequilibrium Dizziness – “unsteadiness while walking”

Nonspecific Dizziness – “woozy”, “giddy”, “light-headed


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
13; Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness <span>Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications &

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403075562764

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Question
What investigation should you do for presyncopal dizziness?
Answer
ECG


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

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Open it
uretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” <span>ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If y

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403077922060

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Question
What qn's should you ask a pt with presyncopal dizziness? (5)
Answer
Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
darone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG <span>Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. med

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403080281356

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Question

presyncopal dizziness:
Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice)

  • If yes to any, [suspect what, and do what?]

Answer
suspect cardiac etiology. Refer to Emergency


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
darone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG <span>Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situat

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403082640652

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Question

Presyncopal dizziness:
Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice)

  • If no, [what should you check for?]

Answer
orthostatic hypotension


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
darone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG <span>Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injur

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403084999948

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Question
If a pt with presyncopal dizziness has orthostatic hypotension, what should you do?
Answer
investigate underlying cause. meds/alcohol? Consider CBC/ lytes


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
den death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? <span>Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo)

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403087359244

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Question
What is the likely etiology in a pt with presyncopal dizzness and no orthostatic hypotension?
Answer
likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes <span>No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out periph

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







Flashcard 1403089718540

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Question

Disequilibrium Dizziness is often multifactorial, [common in who? a risk for ...? what exams should you do to rule out what?]

Answer

common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, et


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) <span>Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, al

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s







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Question
What is the ddx for nonspecific dizziness? (8)
Answer
  • DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma


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s – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc <span>Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications &

Original toplevel document

Dizziness/Vertigo
Dizziness/Vertigo Approach to patient with Dizziness Subjective “Does it feel like either the room is spinning or that you are spinning?” and/or “Is it triggered or worsened by turning your head or rolling over in bed?” Yes = vertigo BENIGN PAROXYSMAL POSITIONAL VERTIGO (most common) brief, recurrent episodes (seconds to minutes), +/- nausea and vomiting Vestibular Neuritis rapid onset, severe, persistent (days), N/V, imbalance Ménière’s Disease recurrent episodes (minutes to hours), fluctuating hearing loss, tinnitus, and sensation of aural fullness Vestibular Toxicity aminoglycosides (eg. gentamycin), loop diuretics, ASA, NSAIDs, amiodarone, quinine, cisplatin No = other forms of dizziness Presyncopal Dizziness – “feels like nearly fainting or blacking out” ECG Triggered by exertion? Chest pain/palpitations? Known structural heart dz? FmHx of sudden death? Abnormal ECG? (if pt stable, fax ECG for urgent advice) If yes to any, suspect cardiac etiology. Refer to Emergency If no, orthostatic hypotension? Yes = investigate underlying cause. meds/alcohol? Consider CBC/lytes No = likely vasovagal/situational etiology. If recurrent episodes or pt is at risk of injury, consider referral for tilt test (+/- carotid sinus massage if >40 yo) Disequilibrium Dizziness – “unsteadiness while walking” Often multifactorial, common in elderly, risk of falls. Complete neuro and MSK exams to rule out peripheral neuropathy, Parkinsonism, MSK d/o, CVA, etc Nonspecific Dizziness – “woozy”, “giddy”, “light-headed” DDx: hypoglycemic (glucose), thyroid disease (TSH), pregnancy (β-HCG), meds, psychiatric disorders, alcohol/drugs, menstruation, previous head trauma Ask about: onset, duration, nausea, vomiting, hearing loss, tinnitus, headache, imbalance, aural fullness, ear pain, rash, facial paralysis, medications Objective Assessment viral labyrinthitis benign positional vertigo Eustachian tube dysfunction (often with s