________________________________________________________________________ Dizziness and Vertigo
11. Which of the following statements regarding anxiety, balance, and vestibular interactions is TRUE? A) Anxiety can impair ocular motor reflexes. B) Anxiety reduces gaze stability, which may underlie dizziness. C) Anxious states can amplify a normative gaze bias toward potentially threatening stimuli. D) All of the above 12. Post-concussion syndrome persists beyond three months in up to what percentage of patients following concussion? A) 1%
17. Almost all patients with vertigo feel worse with A) exertion. B) head movements. C) exposure to visual stimuli. D) extended time in a supine position. 18. HINTS is an acronym for three ocular motor tests. Which of the following is NOT one of these tests? A) Head impulse tests B) Gaze testing for nystagmus
C) MRI with diffusion-weighted imaging D) Alternative cover test for skew deviation
B) 20% C) 50% D) 90%
19. Within the first 48 hours of onset, posterior circulation stroke is most accurately differentiated from a peripheral dizziness cause by A) HINTS exam. B) computed tomography. C) magnetic resonance imaging. D) MRI with diffusion-weighted imaging. 20. In central paroxysmal positional vertigo, all of the following are true, EXCEPT: A) It always has a dangerous etiology. B) Downbeat or vertical nystagmus can distinguish it from BPPV. C) It can have a relatively benign etiology, such as acute alcohol intoxication. D) It is the primary serious cause of triggered episodic vestibular syndrome and mimic of BPPV. 21. The vestibular suppressant of choice in pregnancy is A) diazepam. B) meclizine.
13. Which of the following is the most vestibulotoxic of all medications? A) Vancomycin B) Loop diuretics C) Aminoglycoside D) Antiepileptic drugs 14. Which of the following contributes to misdiagnosis of posterior circulation TIA or stroke as benign dizziness? A) Failing to consider stroke in younger patients B) Over-reliance on the symptom quality approach C) Overweighting traditional stroke risk factors for patient screening D) All of the above 15. In the “timing and triggers” diagnostic workup, major medical and other obvious non-vestibular dizziness etiologies are identified or ruled out during
C) metoclopramide. D) diphenhydramine.
A) triage. B) timing. C) testing. D) triggers.
22. Which of the following drugs reduces sensory mismatch and is one of the most effective agents for preventing motion sickness?
A) Ondansetron B) Scopolamine C) Amitriptyline D) Promethazine
16. To detect and localize the underlying dizziness/ vertigo pathology, targeted examinations emphasize
A) brain imaging. B) blood workups. C) neurologic exams. D) eye movement assessments.
Self-Assessment questions continue on next page
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Book Code: ANCCTX2027
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