skip to main content

Medication-associated orthostatic hypotension causing falls — SCE Acute Medicine MCQ

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

ModerateMedicine in the ElderlyMedication-associated orthostatic hypotension causing fallsSCE Acute Medicine

An 84-year-old woman is admitted after three falls in a week. Lying BP is 138/76 mmHg and standing BP at three minutes is 102/64 mmHg with dizziness. She takes bendroflumethiazide, amitriptyline and tamsulosin. ECG shows sinus rhythm and haemoglobin is normal. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: D — Medication-associated orthostatic hypotension

The reproducible postural BP drop with symptoms and multiple vasoactive or anticholinergic drugs supports medication-associated orthostatic hypotension. BPPV causes positional vertigo without a sustained BP fall. Complete heart block would be suggested by bradycardia or ECG abnormality. In older adults, falls assessment should include lying-standing BP and medication review.

Reference: NICE CG161, NICE NG56, BNF