A 60-year-old man presents to his primary care physician complaining that he often feels as if the room is spinning when he gets up from a recumbent position or turns his head. He has not lost consciousness and has had no chest pain. He has no cardiac history, and a recent treadmill test showed no abnormalities. On examination, the sensation can be produced by rapidly turning the head. It can be reproduced many times, but it eventually ceases. Nystagmus is elicited. Hearing is normal. Which of the following is the MOST likely mechanism for this patient's symptoms?
AInsufficient cerebral perfusion
BInsufficient cardiac output
CAberrant stimulation of hair cells
DHair cell death in the semicircular canals
A 65-year-old woman complains of recurrent episodes of sudden-onset dizziness and nausea. She notices an abrupt onset of a spinning sensation when rolling over or sitting up in bed. The symptoms last for 30 seconds and then completely resolve. She has no hearing change or other neurologic symptoms, and her physical examination is completely normal. A Dix-Hallpike maneuver reproduces her symptoms. Which of the following findings on vestibular testing favors the diagnosis of benign paroxysmal positional vertigo (BPPV) over central positional vertigo?
Ahabituation occurs
Babsence of a latency period
Cmoderate vertigo
Dabsence of fatigability
Which of the following will occur in a girl who suddenly stops spinning after several seconds of spinning to the left?
AHer eyes will move slowly to the right
BThe hair cells in the right semicircular canal will depolarize
CWhen asked to point to a target, the girl will point to the right of the target
DThe cupula in the right semicircular canal will move away from the utricle
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