Bppv

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Take this quiz on BPPV. Before attempting kindly read up the topic from here.

Questions and Answers

1.

BPPV is commonly caused due to
- A.
  
  Dysfunction involving utricle
- B.
  
  Dysfunction involving saccule
- C.
  
  Dysfunction involving posterior semicircular canal
- D.
  
  Dysfunction involving endolymphatic sac
Correct Answer
C. Dysfunction involving posterior semicircular canal

Explanation
BPPV is commonly caused by dysfunction involving posterior semicircular canal. On rare occasions superior and lateral canals too can be involved

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2.

BPPV was first described by:
- A.
  
  Barany
- B.
  
  Neffson
- C.
  
  Paperella
- D.
  
  Portmann
Correct Answer
A. Barany

Explanation
This disorder was first described by Barany in 1921. He documented the various components of this disorder as 1. Nystagmus, 2. Fatiguability of the nystagmus and 3. Vertigo. He failed to correlate the onset of nystagmus with specific positions of the head.

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3.

Unique features of Nystagmus of BPPV are
- A.
  
  Very short latency
- B.
  
  Directional features
- C.
  
  Brief duration
- D.
  
  Prolonged duration
- E.
  
  Reversibility on coming out of provoking position
- F.
  
  Irreversible
Correct Answer(s)
A. Very short latency
B. Directional features
C. Brief duration
E. Reversibility on coming out of provoking position

Explanation
Dix & Hallpike 1952 described the Dix Hallpike maneuver for eliciting the nystagmus. They also described the unique features of nystagmus accompanying this disorder. These features were 1. Very short latency, 2. Directional features, 3. Brief duration, and 4. Reversibility on returning the patient to a seated position.

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4.

Describe Schuknecht's theory for BPPV.
5.

Hall and Ruby described two types of BPPV: BPPV with __________ Nystagmus BPPV with ____________ Nystagmus

Correct Answer(s)
Fatiguable and Non fatiguable nystagmus
6.

Canal lithiasis theory was proposed to account for BPPV by
- A.
  
  Schuknecht
- B.
  
  Hall and Ruby
- C.
  
  Dix Hallpike
- D.
  
  Paperella
Correct Answer
B. Hall and Ruby
7.

Describe the typical features of BPPV.
8.

In Dix Hallpike maneuver the patient is placed
- A.
  
  In supine position
- B.
  
  In prone position
- C.
  
  In sitting position
- D.
  
  In supine position with head hanging down from the edge of the couch
Correct Answer
D. In supine position with head hanging down from the edge of the couch
9.

Describe in detail Dix Hallpike maneuver
10.

Lateral canal BPPV can be identified by
- A.
  
  Dix Hallpike maneuver
- B.
  
  Doll's eye movement
- C.
  
  Lack of righting reflex
- D.
  
  Variation of Dix Hallpike maneuver
Correct Answer
D. Variation of Dix Hallpike maneuver
11.

Frenzel's glasses should be used by
- A.
  
  Observer
- B.
  
  Patient
- C.
  
  Patient and observer
- D.
  
  By everyone present in the examination room
Correct Answer
B. Patient
12.

Describe in detail Epley's maneuver
13.

In Epley Maneuver the patient is placed in
- A.
  
  Dix Hallpike position
- B.
  
  Prone position
- C.
  
  Supine position with head raised by 30 degrees
- D.
  
  Prone position with head hanging out from the edge of the couch
Correct Answer
A. Dix Hallpike position
14.

In Dix Hallpike position
- A.
  
  The posterior canal is horizontal to earth's vertical plane
- B.
  
  The lateral canal is vertical to the earth's axis
- C.
  
  The posterior canal is in the earth's vertical plane
- D.
  
  The superior canal is in the earth's vertical plane
Correct Answer
C. The posterior canal is in the earth's vertical plane
15.

Vibrator therapy for BPPV is contraindicated in patients with
- A.
  
  COPD
- B.
  
  Retinal detachment
- C.
  
  Ear discharge
- D.
  
  Meniere's disease
Correct Answer
B. Retinal detachment
16.

After repositioning maneuvers patient is asked to
- A.
  
  Sleep without a pillow for 2 days
- B.
  
  Sleep with head turned to one side (affected) for 2 days
- C.
  
  Sleep with head elevated to 45 degrees for 2 days
Correct Answer
C. Sleep with head elevated to 45 degrees for 2 days
17.

Which repositioning maneuver can be perfromed by the patient himself?
- A.
  
  Dix Hallpike Maneuver
- B.
  
  Semont's maneuver
- C.
  
  Brandt Droff maneuver
- D.
  
  Ruby maneuver
Correct Answer
C. Brandt Droff maneuver
18.

Describe the maneuver shown above.
19.

Name the surgical procedures used in the management of Intractable BPPV.
- A.
  
  Singular neurectomy
- B.
  
  Posterior semicircular canal plugging procedure
- C.
  
  Modified radical mastoidectomy
- D.
  
  Grommet insertion
Correct Answer(s)
A. Singular neurectomy
B. Posterior semicircular canal plugging procedure
20.

Singular neurectomy is useful in the mangement of intractable BPPV because
- A.
  
  Singular nerve supplies the posterior semicircular canal
- B.
  
  Singular nerve supplies all three semicircular canals
- C.
  
  Singular nerve supplies utricle, saccule and lateral semicircular canals
- D.
  
  Singular nerve supplies the entire labyrinth
Correct Answer
A. Singular nerve supplies the posterior semicircular canal