Benign paroxysmal positional vertigo — MCCQE Part 1 MCQ

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EasyDizziness/VertigoBenign paroxysmal positional vertigoMCCQE Part 1

A 54-year-old woman has brief spinning vertigo triggered by rolling over in bed; Dix-Hallpike reproduces symptoms with torsional nystagmus. Which of the following is the most appropriate next step?

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Correct answer: D — Perform a canalith repositioning manoeuvre

Perform a canalith repositioning manoeuvre is the single best answer because the age, timing, examination findings and investigations in the vignette fit Benign paroxysmal positional vertigo better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian otolaryngology guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian otolaryngology guidance