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Recurrent falls and deprescribing — ABIM Board MCQ

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ModerateGeneral Internal MedicineRecurrent falls and deprescribingABIM Board

An 86-year-old woman has 3 falls in 2 months. Medications include diphenhydramine nightly, glyburide, hydrochlorothiazide, and lorazepam. Orthostatic blood pressure falls from 142/76 to 106/60 mm Hg. Gait is slow but neurologic examination is nonfocal. Which of the following is the most appropriate management?

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Correct answer: D — Review and deprescribe fall-risk medications and address orthostatic hypotension

Falls in older adults require multifactorial assessment. Anticholinergics, benzodiazepines, sulfonylureas, and diuretics can contribute through sedation, hypoglycemia, and orthostasis; deprescribing and balance/strength interventions reduce risk.

Reference: AGS Beers Criteria; CDC STEADI Falls Guidance