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Benign paroxysmal positional vertigo — USMLE Step 3 MCQ

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HardInternal Medicine (chronic management)Benign paroxysmal positional vertigoUSMLE Step 3

A 52-year-old woman has episodic vertigo lasting less than 1 minute when rolling over in bed. She has no hearing loss, tinnitus, weakness, dysarthria, or headache. Dix-Hallpike maneuver produces vertigo and torsional nystagmus after a brief latency. Which of the following is the most likely diagnosis?

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Correct answer: A — Benign paroxysmal positional vertigo

Brief positional vertigo with latency and fatigable torsional nystagmus on Dix-Hallpike testing is typical of BPPV. Canalith repositioning is treatment.

Reference: AAO-HNS benign paroxysmal positional vertigo guideline