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Benign Paroxysmal Positional Vertigo (BPPV) (PG)
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1. What is the most common cause of Benign Paroxysmal Positional Vertigo (BPPV)?
*
Viral labyrinthitis
Otoconia dislodged into semicircular canals
Migraine
Acoustic neuroma
2. Which manoeuvre is commonly used to diagnose BPPV?
*
Valsalva manoeuvre
Dix-Hallpike manoeuvre
Romberg test
Tandem gait test
3. What symptom characterises BPPV?
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Continuous dizziness
Episodic vertigo triggered by head movements
Sudden hearing loss
Visual aura
4. What duration is typical for a vertigo episode in BPPV?
*
A few seconds to a minute
Several hours
All day
Overnight
5. What type of nystagmus is seen during a positive Dix-Hallpike test?
*
Torsional and up-beating
Down-beating
Vertical
Bilateral horizontal
6. What is the initial management for BPPV?
*
Surgery
Vestibular suppressants
CT scan
Epley manoeuvre
7. Which semicircular canal is most commonly affected in BPPV?
*
Anterior
Horizontal
Posterior
Superior
8. What is the most common age group affected by BPPV?
*
Under 10
Teenagers
Middle-aged to elderly adults
Pregnant women
9. Which of the following features would suggest an alternative diagnosis to BPPV?
*
Episodes last <1 minute
Nausea and vomiting
Ongoing vertigo at rest
Triggered by rolling in bed
10. What is the recurrence rate of BPPV after successful treatment?
*
Rare
20–30%
50–70%
Almost 100%
11. Which condition must be excluded before diagnosing BPPV?
*
Multiple sclerosis
Vestibular neuritis
Stroke
All of the above
12. What is the role of MRI in BPPV management?
*
Not required
First-line diagnostic test
Used routinely
Only used to exclude central causes of vertigo
13. What advice is given after performing the Epley manoeuvre?
*
Avoid sleeping for 24 hours
Avoid bending forward or lying flat for 48 hours
Take antiemetics
Start antibiotics
14. Which medication is sometimes used short-term for symptom relief in BPPV?
*
Prochlorperazine
Loratadine
Loperamide
Amitriptyline
15. What role do antihistamines play in BPPV?
*
First-line treatment
Diagnostic aid
Short-term symptomatic relief only
Not effective at all
16. How is the diagnosis of BPPV confirmed?
*
Otoscopy
Response to vestibular suppressants
Positive Dix-Hallpike
MRI
17. What is the typical prognosis of BPPV with treatment?
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Chronic condition
Spontaneous resolution uncommon
Rapid improvement with repositioning
Requires lifelong therapy
18. How long does it usually take for symptoms to resolve after Epley manoeuvre?
*
Several months
Immediately or within days
Never resolves
Over a year
19. What is a less common but alternative repositioning manoeuvre for BPPV?
*
Brandt-Daroff exercises
Valsalva manoeuvre
Modified Heimlich
Romberg therapy
20. Which of the following is NOT a characteristic of BPPV?
*
Symptoms worsen with time
Associated with specific head movement
Vertigo with rolling over in bed
Brief, self-limiting episodes