Age:                46

Gender:          Female

The patient presents with hearing loss and dizziness.  The hearing loss began about 3 years ago and is in the left ear. She has had aural fullness “on and off” for the past six months. She had one episode of “ear infection” about at the time when the aural fullness started, which caused otalgia, but otherwise she is not reporting aural pain.  She reports that the dizziness also started about 6 months ago, coincident with the “flu”. She says the dizziness was moderate to severe, then slowly went away over about 6 weeks.  She got the “flu” again 3 months ago and the dizziness recurred.

□   Differentiate between “flu” and “a bad cold”.  Is it probable that someone gets the flu twice in the same “flu season”?  What is the peak flu season?  What does onset of dizziness along with viral infection suggest as a potential cause of the dizziness?  If the problems are from the virus, what symptoms would you expect?

The patient describes her dizziness on the date of the evaluation as being off balance – she does not describe it as a spinning sensation nor lightheadedness, and it’s not related to changes in position.  She reports that currently her problems are “very mild.” She says she has nausea when it is at its worst, and headache.

The only other significant history item is that she says the left side of her face is “tingly”. She has no vision or swallowing problems.  She does have allergies and is about to begin allergy testing.

She is a non-smoking social drinker, she denies use of illegal drugs.  She says she is trying to limit her caffeine intake by switching to decaf coffee.

• Below is a list of her medications and their dosing.  For each, describe the condition it is typically used to treat (its “indication”) and list alternate names for the drug.
• Indicate what the frequency medical abbrevations mean.

• Advil has one other brand name, what is it?
• What are the brand names for these generics:
• Salicylic acid
• Acetminophen
• Naproxen sodium

 

• What is in Excedrine?
• What does qd, bid, qid, hs and prn mean?

Case Credits: Tish Gaffney, AuD, Nova Southeastern University, aided with case analysis.