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.
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
Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician 2010 Aug 15;82(4):361-8, 369.
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
Smouha E. Inner ear disorders. NeuroRehabilitation 2013;32(3):455-462.
Pages 1-3 of the above article (Inner Ear Disorders) provides an excellent summary of the physiology and pathophysiology behind vestibular disorders.
Top 10 causes of dizziness in family medicine, plus clinical pearls (1 page)
Objectives covered: 1
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Vertigo and dizziness. Can Fam Physician 2007 Nov;53(11):1959.
Initial Evaluation of Vertigo
Good patient information is located on the last page of the above recommended article “Dizziness: A Diagnostic Approach”