Título Em Otorrinolaringologia Practice Questions - Título De Especialista Em Otorrinolaringologia E Cirurgia Cérvico-Facial (ABORL-CCF AMB) Exam

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A 52-year-old woman presents to the emergency room with severe episodic vertigo lasting 30 to 45 seconds triggered whenever she turns her head to the right while in bed or looks up to reach a high shelf. There is no associated tinnitus, hearing loss, or spontaneous nystagmus. A right Dix-Hallpike maneuver induces a 5-second latent onset of mixed torsional (counterclockwise, top pole beating toward the down ear) and upbeating nystagmus with intense vertigo lasting 25 seconds, which fatigues upon repeated testing. What is the most appropriate next step in management?

Prescribe oral betahistine 24 mg twice daily and recommend strict bed rest for 5 days Perform an immediate right-sided Epley canalith repositioning maneuver Administer intravenous methylprednisolone 1 g for acute vestibular neuritis Perform a Lempert (360-degree barbecue roll) repositioning maneuver

Correct Answer:

Perform an immediate right-sided Epley canalith repositioning maneuver

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