WBR0130
| Author | PageAuthor::Sapan Patel, M.B.B.S. |
|---|---|
| Exam Type | ExamType::USMLE Step 3 |
| Main Category | |
| Sub Category | SubCategory::Head and Neck, SubCategory::Neurology |
| Prompt | [[Prompt::A 67-year-old man presents with a 2-day history of severe dizziness. The symptoms are exacerbated by turning his head and relieved by lying still. He reports nausea and vomiting for the first 2 days of his illness, but successfully eats breakfast on the day he is seen in clinic. He denies hearing loss and tinnitus. His past medical and surgical histories are unremarkable. He has no previous exposure to ototoxic drugs and denies further neurologic symptoms. Physical examination reveals an obviously uncomfortable white male in a wheelchair.Otologic examination is without abnormality. Weber testing with a 512 Hz tuning fork is to midline. Romberg testing indicates right-sided pathology. Cranial nerve examination is normal except left beating nystagmus. Vertigo is experienced after the Dix-Hallpike maneuver. Nystagmus is observed after a few seconds of lying down during the maneuver.The patient is treated with diazepam, which, on follow up, has relieved his symptoms.
What is the most likely diagnosis?]] |
| Answer A | AnswerA::Meniere's disease |
| Answer A Explanation | AnswerAExp:: |
| Answer B | AnswerB::Acoustic neuroma |
| Answer B Explanation | AnswerBExp:: |
| Answer C | AnswerC::Benign positional vertigo |
| Answer C Explanation | AnswerCExp:: |
| Answer D | AnswerD::Viral labyrinthitis |
| Answer D Explanation | AnswerDExp:: |
| Answer E | AnswerE::Vestibular neuronitis |
| Answer E Explanation | AnswerEExp:: |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation:: Educational Objective: |
| Approved | Approved::Yes |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |