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Course Examination

1. Dizziness and balance disorders are one of the most frequent complaints to physicians yet are difficult to diagnose. Which of the following would best explain the reason?

    A. Dizziness is commonly a result of a central nervous system lesion.
    B. Dizziness is commonly a result of a peripheral nervous system abnormality.
    C. Dizziness is commonly a vague term.
    D. Both b and c

2. BPPV is a common peripheral vestibular disorder but can vary in type and location. What is the most common type and location of BPPV?

    A. Posterior canalithiasis
    B. Posterior cupulolithiasis
    C. Anterior canalithiasis
    D. Anterior cupulolithiasis

3. Nystagmus is a rapid, alternating eye movement that is defined by the fast phase. The clinician should proceed with caution when the nystagmus is in what direction?

    A. Geotropic
    B. Ageotropic
    C. Torsional
    D. Vertical

4. The semicircular canals detect motion which results in compensatory eye and head movements known as the .

    A. Linear and VOR
    B. Linear and VSR
    C. Angular and VOR
    D. Angular and VSR

5. The cardinal sign of a vestibular disorder is which of the following?

    A. Vertigo
    B. Nystagmus
    C. Nausea
    D. Ear pain

6. An athlete is referred to physical therapy following a sudden onset of dizziness, which she describes as “movement-related” and an unsteady gait. Patient denies vertigo. Which of the following test would be most appropriate?

    A. Dix-Hallpike
    B. Berg’s Balance Scale
    C. Dynamic Visual Acuity (VOR Test)
    D. MMT

7. Which of the following symptom(s) can be associated with BPPV?

    A. Vertigo
    B. Nausea
    C. Postural instability
    D. All the above

8. A patient is referred to physical therapy with complaints of positional vertigo that started about 3 months ago. The patient was previously prescribed Meclizine but reports no significant relief. During your evaluation, you perform a Dix-Hallpike and observe a downbeating, non-fatigable nystagmus in the right Dix-Hallpike. The patient also complains of nausea and visual changes. How would you proceed?

   A. Continue with the Epley Maneuver for right anterior canalithiasis
   B. Continue with the Epley Maneuver for right posterior cupulolithiasis
   C. Bring the patient out of the testing position and notify the physician
   D. Check the patient’s blood pressure

9. BPPV is often considered idiopathic although the research shows it most commonly occurs in which of the following patient populations?

    A. Elderly
    B. s/p labyrinthitis
    C. head trauma
    D. both a and c

10. An elderly patient with significant kyphosis and forward head posture is referred to your clinic. She has c/o positional vertigo, especially when bending over to feed her cat and sometimes when rolling over in bed. She is very apprehensive about receiving the Dix-Hallpike after you explain it might provoke her symptoms. You are most concerned with which of the following?

    A. The risk of vertebral artery insufficiency
    B. Falls if she returns home untreated
    C. Horizontal canal involvement
    D. That her cat will not be fed

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