MKSAP has been trusted by internists since 1967 as the best resource for updating knowledge. MKSAP 18, available in Complete, Digital, and Print packages, consists of 11 comprehensive text chapters with related multiple-choice questions. You'll find 1,200 completely new questions to help you identify learning gaps, stay current, and gain the knowledge you need to provide the best possible patient care. MKSAP 18's original and high-quality questions evolve out of case studies and patient scenarios based on the latest evidence.
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MKSAP 18 Q & A
A 55-year-old man is evaluated in the emergency department for a 2-day history of dizziness accompanied by nausea and vomiting. He works as an electrician, and his symptoms started suddenly while installing an overhead light fixture with his head tilted back for a prolonged period. He describes the dizziness as a constant whirling sensation that is unaffected by changes in position. He also reports symptoms of a recent upper respiratory tract infection but no fever. He has no other medical problems and takes no medications.
On physical examination, temperature is normal, blood pressure is 155/84 mm Hg, pulse rate is 99/min, and respiration rate is normal. Hearing is diminished on the left side. Spontaneous combined horizontal and torsional nystagmus is noted but lessens with a fixed gaze. The patient declines further examination because of severe nausea.
Which of the following is the most likely diagnosis?
A: Benign paroxysmal positional vertigo
C: Meniere disease
D: Posterior circulation stroke
E: Vestibular neuronitis