skip to main content

Low-value testing in syncope — RCPSC IM MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral IM, Ethics, CanMEDSLow-value testing in syncopeRCPSC IM

A patient had vasovagal syncope after diuresis. Neurologic examination and ECG are normal, orthostatic hypotension resolves with medication adjustment and there was no head injury. Which plan is appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Avoid routine CT head, carotid ultrasound and EEG; treat the identified orthostatic cause

The best answer is “Avoid routine CT head, carotid ultrasound and EEG; treat the identified orthostatic cause”. Routine neurologic imaging, carotid studies and EEG have low yield in uncomplicated syncope without focal findings or seizure features. Addressing the demonstrated cause avoids false positives, radiation and delayed discharge.

Reference: Choosing Wisely Canada, Internal Medicine recommendations: https://choosingwiselycanada.org/recommendation/internal-medicine/