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Syncope with fall — DGM MCQ

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ModerateFallsSyncope with fallDGM

An 83-year-old man collapses without warning while standing in a queue. He is briefly unconscious and recovers quickly. There is no vertigo or trip; pulse is 48 beats/min. Current medicines include bisoprolol and donepezil. What is the most appropriate assessment?

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Correct answer: D — ECG and cardiovascular assessment for syncope

A fall with transient loss of consciousness and bradycardia should be assessed as syncope with ECG and cardiovascular review. Environmental assessment alone misses arrhythmia, Dix-Hallpike is for positional vertigo, dementia screening is not the immediate issue, and stool culture is irrelevant. Not every fall is mechanical; loss of consciousness changes the pathway.

Reference: NICE NG249; NICE transient loss of consciousness guidance