Inner Ear Disorders: The Daily PANCE Blueprint

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Inner Ear Disorders: The Daily PANCE Blueprint

A 20-year-old male presents with acute nausea, dizziness, and left-sided hearing loss over the past 4 hours. She denies a precipitating factor. She denies headaches, fevers, or abdominal pain. She tells you that a week ago, she went to her PCP and was diagnosed with a “cold.” Which of the following is the most likely diagnosis?

A. Viral meningitis
B. Vertebrobasilar insufficiency
C. Benign positional vertigo
D. Acute labyrinthitis
E. Ménière's

Answer and topic summary

The answer is D. Acute labyrinthitis

Acute labyrinthitis is thought to be due to a virus affecting the vestibular portion of the 8th cranial nerve. It usually presents as acute, rapid onset of severe vertigo with nausea, vomiting, imbalance, and unilateral healing loss or tinnitus. On physical exam, you may see vestibular nystagmus. Treatment includes a trial of a course of glucocorticoids and symptomatic treatment (antihistamines, antiemetics, and benzodiazepines).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Ear Disorders ⇒ Inner ear => Labyrinthitis

Also covered as part of the Family Medicine EOR and Emergency Medicine EOR topic lists

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