EMQs in Clinical Medicine.pdf - Peshawar Medical College

4 Neurology
QUESTIONS
28 Dizziness and vertigo
A
B
C
D
E
F
G
vertebrobasilar ischaemia
benign positional vertigo
vestibular schwannoma
lateral medullary syndrome
multiple sclerosis
Menière’s disease
auditory eczema
H
I
J
K
L
M
acoustic neuroma
vestibular neuronitis
Ramsay Hunt syndrome
migraine
perilymph fistula
hyperventilation
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 45-year-old woman presents with a left-sided facial palsy and vertigo. She
has impaired hearing on her left side and a vesicular rash is noted around her
external auditory meatus.
2 A 55-year-old man presents with a history of recurrent spontaneous attacks of
vertigo, hearing loss and tinnitus. These attacks last up to 2 h and are sometimes
associated with vomiting.
3 A 65-year-old woman presents with vertigo, vomiting and dysphagia. On
examination there is a left-sided Horner’s syndrome, and loss of pain and
temperature on the right side of the face.
4 A 50-year-old man presents with vertigo when rolling over quickly in bed,
getting out of bed and bending over. His hearing is normal.
5 A 20-year-old man presents with vertigo having suffered with symptoms of flu
for several days.
Answers: see page 88.