skip to main content

Orthostatic hypotension in Parkinson disease — SCE Geriatric Medicine MCQ

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

HardMovement disordersOrthostatic hypotension in Parkinson diseaseSCE Geriatric Medicine

An 84-year-old man with Parkinson disease has increasing falls and light-headedness. BP is 154/82 mmHg lying and 102/60 mmHg standing after three minutes. He takes co-careldopa, rotigotine, amlodipine, bendroflumethiazide and tamsulosin; ECG is normal and Hb is 125 g/L. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: B — Review hypotensive medicines and dopaminergic therapy, then implement non-pharmacological orthostatic measures

The marked postural hypotension is likely multifactorial, involving autonomic Parkinson disease, dopaminergic treatment and hypotensive medicines. Management begins with medication review, hydration, compression and postural strategies; specialist advice may be needed if Parkinson therapy changes are considered. Treating the supine BP without considering standing symptoms may worsen falls. The pearl is to measure lying and standing BP in Parkinson-related falls.

Reference: NICE NG71; NICE CG161; BNF