Step 2

Primary 1

A 40-year-old man presents to the clinic for dizziness which began this morning. After waking up, he has been experiencing a spinning sensation not lasting more than a minute at a time, associated with nausea. He has had some lightheadedness during the day but denies hearing loss or tinnitus. He recently recovered from an upper tract illness three weeks ago. Past medical history is unremarkable, and he does not take any medications. Vital signs are normal.

Which of the following is the next best step in management of this patient?

  • A) CT scan of the brain
  • B) Dix-Hallpike test and Epley maneuver
  • C) Meclizine
  • D) MRI of the brain
  • E) Vestibular and balance rehabilitation therapy


Marina Tawadrous


Dr. Raj Dasgupta

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