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dizziness

Practice targeted AMC-style multiple-choice questions on dizziness.

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A 62-year-old man presents to the emergency department with a history of palpitations and dizziness that started suddenly 2 hours ago. He has a history of hypertension and is on lisinopril. He denies chest pain, shortness of breath, or syncope. On examination, his blood pressure is 110/70 mmHg, heart rate is 150 bpm (irregular), respiratory rate is 18 breaths per minute, and temperature is 36.7°C. An ECG is performed, showing an irregularly irregular rhythm with no distinct P waves and a narrow QRS complex. Which of the following is the most appropriate initial management step?

A. Initiation of anticoagulation therapy
B. Rate control with a beta-blocker
C. Immediate electrical cardioversion
D. Administration of adenosine
E. Rate control with digoxin
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A patient reports dizziness with neck extension. Which manoeuvre is most appropriate to assess for vertebrobasilar insufficiency?

A. Dix-Hallpike manoeuvre
B. Carotid duplex ultrasound
C. Valsalva manoeuvre
D. Vertebrobasilar insufficiency test
E. Romberg test
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A 70-year-old man with a history of hypertension and heart failure is being managed with an ACE inhibitor. He presents to the emergency department complaining of dizziness, especially when standing up. His blood pressure is 90/60 mmHg, and his other vital signs are stable. Which of the following is the most appropriate initial step in managing this patient?

A. Order an ECG to rule out cardiac arrhythmia
B. Prescribe compression stockings
C. Review and potentially reduce the dose of the ACE inhibitor
D. Administer an intravenous bolus of normal saline
E. Start fludrocortisone
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