Topic Info - BotMed Application

TopicName

Dizziness

ClinicalTests

CBC (dehydration, hypovolemia, anemia);
Electrolytes (acute renal failure);
hCG (r/o ectopic pregnancy);
Serology (syphilis); 
Blood gases (hyperventilation);

ImagingStudies

MRI (MS. brain stem dysfunction, acoustic neuroma, TIA);
CT w/o contrast (stroke);
CT (brain tumor, trauma);
Audiometry (Meniere's, Labirintus, perilymph fistula, cholesteatoma, salt retaining drugs);

PhysicalExams

Vital signs; complete neurologic exam, including Romberg test, nystagmus, tilt test (eg, Dix-Hallpike maneuver), gait, hearing, and Weber and Rinne tests; ENT exam; cardiovascular exam.

Comment

What the cause? 
- Move in the bed: vertigo; 
- Change position from sitting to standing: near-syncope;
- During walk: disbalance;

Hearing loss?
- Yes: peripheral (except BPPV);
- No: central;

Lightheadedness vs. vertigo, ± auditory symptoms (hearing loss, tinnitus), duration of episodes, context (occurs with positioning, following head trauma); 
other associated symptoms (visual disturbance, URI, nausea); 
neck pain or injury;
medications; 
history of atherosclerotic vascular disease.

WebLink

https://www.aafp.org/afp/2017/0201/p154.html