Objectives
By the end of Family Medicine Clerkship, students will be able to:
1. Given a patient with “dizziness”, conduct a history so as to distinguish true vertigo from other types of dizziness.
2. Identify which medications are likely causes of vertigo and other types of dizziness.
3. Conduct a relevant physical exam so as to rule out serious causes of dizziness, including assessment of orthostatic blood pressure, cerebellar & cranial nerve function, precordium, and cardiac rhythm.
4. Identify patients with BPPV and be able to demonstrate the Epley maneuver for these patients.
Clinical Cards
Microcases
https://cards.ucalgary.ca/deck/360
References
Recommended Resources Addressing the Objectives
Dizziness: A Diagnostic Approach (7 pages – does NOT cover medications causing vertigo, and does NOT discuss nystagmus)
Objectives covered: almost all
http://www.aafp.org/afp/2010/0815/p361.pdf
Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician 2010 Aug 15;82(4):361-8, 369.
PMID:20704166
Dizziness: Inner Ear Disorders (8 pages: discusses more details on history-taking for vestibular disorders, peripheral vs central vertigo, and how to interpret nystagmus)
Objectives covered: 2,3,4 are covered in more detail
http://www.ncbi.nlm.nih.gov/pubmed/23648600
Smouha E. Inner ear disorders. NeuroRehabilitation 2013;32(3):455-462.
PMID:23648600
Foundational Knowledge
Pages 1-3 of the above article (Inner Ear Disorders) provides an excellent summary of the physiology and pathophysiology behind vestibular disorders.
Additional Resources
Top 10 causes of dizziness in family medicine, plus clinical pearls (1 page)
Objectives covered: 1
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231493
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Vertigo and dizziness. Can Fam Physician 2007 Nov;53(11):1959.
PMID:18000275
Initial Evaluation of Vertigo
Patient Information
Good patient information is located on the last page of the above recommended article “Dizziness: A Diagnostic Approach”