Geriatrics Ham's EXAM 2025–2026 Accurate
Real Exam Questions and Verified Correct
Answers
Which of the following types of dizziness is most commonly reported by older persons?
a. Vertigo
b. Feeling of being about to pass out
c. Disequilibrium
d. Combination of two or more types of dizziness - answer>>>d. Combination of two or
more types of dizziness
Which of the following is the least common cause of dizziness in primary care geriatrics?
a. Anxiety
b. Vertebrobasilar transient ischemic attacks
c. An acoustic nerve tumor
d. Cervical spine disease
e. Cerumen against the tympanic membrane - answer>>>c. An acoustic nerve tumor
Which of the following historical or physical examination details would most effectively
argue against benign paroxysmal positional vertigo as a cause of dizziness?
a. Brief episodes of dizziness accompanied by nausea
b. A negative result on Romberg's test
c. Failure to reproduce the dizziness with Dix-Hallpike maneuver
,d. Episodes lasting 4 to 6 hours, with progressive unilateral hearing loss
e. Multiple similar episodes over many years - answer>>>d. Episodes lasting 4 to 6
hours, with progressive unilateral hearing loss
Ms. Smith is a 60-year-old woman who visited your office with complaints of sudden
onset dizziness, and a feeling of spinning and wooziness for the last 1 to 2 weeks. She
also complains of a feeling of ear fullness, tinnitus in her left ear, and fluctuating hearing
loss. Dizziness spells usually last for a few hours. On examination, her vital signs are
within normal limits. She has horizontal nystagmus. Her cardiac, respiratory, and
neurologic examination is normal except she is not able to do a tandem walk and one-
leg stand. Which of the following tests should be ordered next?
a. Magnetic resonance imaging of the head
b. Audiometery
c. Computerized tomography of the head
d. Electroencephalogram - answer>>>b. Audiometery
You are asked to evaluate an 80-year-old nursing home resident with past medical
history of mild Alzheimer's disease, hypertension, and reflux esophagitis, who complains
of feeling dizzy, a sensation of being about to pass out on the dining table after eating
his breakfast. He had similar episodes in the past after finishing his meals. He denies any
chest pain or shortness of breath. On examination, he is alert, awake, oriented to
person and place. Vital signs show heart rate of 74 per minute and blood pressure of
110/70. His vital signs in the morning at 7 am were heart rate 70 per minute and blood
pressure 130/80. Other system examination was unremarkable. No recent medication
changes were made. What is the most likely diagnosis?
a. Cerebrovascular stroke
b. Recurrent vestibulopathy
c. Postprandial hypotension
d. Benign paroxysmal positional vertigo - answer>>>c. Postprandial hypotension
,Mr. K. is a 68-year-old retired insurance salesman with a 2-day history of dizziness. He
describes a light-headed sensation as though he is about to pass out, that occurs
whenever he is standing or walking. He has a milder sensation in the sitting position and
is completely relieved when he lies down. There is no sense of spinning accompanying
this sensation. What is the likely physiologic mechanism underlying Mr. K.'s dizziness?
a. Depression or anxiety
b. Diminished oxygenation of the cerebral cortex
c. Cardiac dysrhythmia
d. Stimulation of the vestibular system when he stands
e. Irritation of neck proprioceptive fibers - answer>>>b. Diminished oxygenation of the
cerebral cortex
A 74-year-old man is brought to your office by his concerned wife. At about 2:30 this
morning he got up to go to the bathroom, feeling a little light-headed. He sat on the
toilet, but even as he did so he could feel himself blacking out. His wife heard a thud and
found him unconscious. He became conscious in about 10 to 15 seconds. He did not feel
chest pain or palpitations before or after the episode, and he was not incontinent. On
further questioning, he states that he has had a cold for the past 4 days, for which he
has taken a combination medication containing pseudoephedrine and
chlorpheniramine. Rarely an alcohol drinker, he admits to having a few beers last
evening while watching Monday night football with his son, who is visiting. He does not
have a history of seizures. Four months ago, he had a normal cardiac treadmill test
performed by his cardiologist as part of a routine evaluation. Other than the cold pr -
answer>>>E. all of the above
A 71-year-old woman with hypertension, diabetes, and ischemic cardiomyopathy visits
your office after a witnessed episode of syncope at a church gathering. She does not
remember the event, but her daughter describes her suddenly appearing pale while
sitting and then slumping over and hitting her head on the side of a table. After about
30 seconds she came to on her own. She has a normal physical examination except for
an abrasion on her forehead and her only ECG abnormalities are the changes from her
previous myocardial infarction. What type of syncope is most likely in your differential
diagnosis?
, a. Neurologic
b. Neurally mediated
c. Cardiac
d. Orthostatic
e. Psychiatric - answer>>>c. Cardiac
All of the following evaluation methods are part of the routine workup for a first episode
of syncope except :
a. Electrocardiogram
b. Complete history and physical examination
c. CT scan of the brain
d. Review of medication use - answer>>>c. CT scan of the brain
A positive response to carotid sinus massage indicates a high likelihood of which one of
the following types of syncope?
a. Neurally mediated
b. Cardiac
c. Neurologic
d. Orthostatic
e. Psychiatric - answer>>>a. Neurally mediated
A 65-year-old female patient who is new to your practice presents after one episode of
syncope that was sudden and without prodromal symptoms. She has hypertension,
hypothyroidism, and depression, all controlled on medication per her report. Her
physical examination reveals an obese woman with 2+ pretibial edema and a normal
cardiovascular and neurologic exam. Her ECG shows left ventricular hypertrophy. Which
Real Exam Questions and Verified Correct
Answers
Which of the following types of dizziness is most commonly reported by older persons?
a. Vertigo
b. Feeling of being about to pass out
c. Disequilibrium
d. Combination of two or more types of dizziness - answer>>>d. Combination of two or
more types of dizziness
Which of the following is the least common cause of dizziness in primary care geriatrics?
a. Anxiety
b. Vertebrobasilar transient ischemic attacks
c. An acoustic nerve tumor
d. Cervical spine disease
e. Cerumen against the tympanic membrane - answer>>>c. An acoustic nerve tumor
Which of the following historical or physical examination details would most effectively
argue against benign paroxysmal positional vertigo as a cause of dizziness?
a. Brief episodes of dizziness accompanied by nausea
b. A negative result on Romberg's test
c. Failure to reproduce the dizziness with Dix-Hallpike maneuver
,d. Episodes lasting 4 to 6 hours, with progressive unilateral hearing loss
e. Multiple similar episodes over many years - answer>>>d. Episodes lasting 4 to 6
hours, with progressive unilateral hearing loss
Ms. Smith is a 60-year-old woman who visited your office with complaints of sudden
onset dizziness, and a feeling of spinning and wooziness for the last 1 to 2 weeks. She
also complains of a feeling of ear fullness, tinnitus in her left ear, and fluctuating hearing
loss. Dizziness spells usually last for a few hours. On examination, her vital signs are
within normal limits. She has horizontal nystagmus. Her cardiac, respiratory, and
neurologic examination is normal except she is not able to do a tandem walk and one-
leg stand. Which of the following tests should be ordered next?
a. Magnetic resonance imaging of the head
b. Audiometery
c. Computerized tomography of the head
d. Electroencephalogram - answer>>>b. Audiometery
You are asked to evaluate an 80-year-old nursing home resident with past medical
history of mild Alzheimer's disease, hypertension, and reflux esophagitis, who complains
of feeling dizzy, a sensation of being about to pass out on the dining table after eating
his breakfast. He had similar episodes in the past after finishing his meals. He denies any
chest pain or shortness of breath. On examination, he is alert, awake, oriented to
person and place. Vital signs show heart rate of 74 per minute and blood pressure of
110/70. His vital signs in the morning at 7 am were heart rate 70 per minute and blood
pressure 130/80. Other system examination was unremarkable. No recent medication
changes were made. What is the most likely diagnosis?
a. Cerebrovascular stroke
b. Recurrent vestibulopathy
c. Postprandial hypotension
d. Benign paroxysmal positional vertigo - answer>>>c. Postprandial hypotension
,Mr. K. is a 68-year-old retired insurance salesman with a 2-day history of dizziness. He
describes a light-headed sensation as though he is about to pass out, that occurs
whenever he is standing or walking. He has a milder sensation in the sitting position and
is completely relieved when he lies down. There is no sense of spinning accompanying
this sensation. What is the likely physiologic mechanism underlying Mr. K.'s dizziness?
a. Depression or anxiety
b. Diminished oxygenation of the cerebral cortex
c. Cardiac dysrhythmia
d. Stimulation of the vestibular system when he stands
e. Irritation of neck proprioceptive fibers - answer>>>b. Diminished oxygenation of the
cerebral cortex
A 74-year-old man is brought to your office by his concerned wife. At about 2:30 this
morning he got up to go to the bathroom, feeling a little light-headed. He sat on the
toilet, but even as he did so he could feel himself blacking out. His wife heard a thud and
found him unconscious. He became conscious in about 10 to 15 seconds. He did not feel
chest pain or palpitations before or after the episode, and he was not incontinent. On
further questioning, he states that he has had a cold for the past 4 days, for which he
has taken a combination medication containing pseudoephedrine and
chlorpheniramine. Rarely an alcohol drinker, he admits to having a few beers last
evening while watching Monday night football with his son, who is visiting. He does not
have a history of seizures. Four months ago, he had a normal cardiac treadmill test
performed by his cardiologist as part of a routine evaluation. Other than the cold pr -
answer>>>E. all of the above
A 71-year-old woman with hypertension, diabetes, and ischemic cardiomyopathy visits
your office after a witnessed episode of syncope at a church gathering. She does not
remember the event, but her daughter describes her suddenly appearing pale while
sitting and then slumping over and hitting her head on the side of a table. After about
30 seconds she came to on her own. She has a normal physical examination except for
an abrasion on her forehead and her only ECG abnormalities are the changes from her
previous myocardial infarction. What type of syncope is most likely in your differential
diagnosis?
, a. Neurologic
b. Neurally mediated
c. Cardiac
d. Orthostatic
e. Psychiatric - answer>>>c. Cardiac
All of the following evaluation methods are part of the routine workup for a first episode
of syncope except :
a. Electrocardiogram
b. Complete history and physical examination
c. CT scan of the brain
d. Review of medication use - answer>>>c. CT scan of the brain
A positive response to carotid sinus massage indicates a high likelihood of which one of
the following types of syncope?
a. Neurally mediated
b. Cardiac
c. Neurologic
d. Orthostatic
e. Psychiatric - answer>>>a. Neurally mediated
A 65-year-old female patient who is new to your practice presents after one episode of
syncope that was sudden and without prodromal symptoms. She has hypertension,
hypothyroidism, and depression, all controlled on medication per her report. Her
physical examination reveals an obese woman with 2+ pretibial edema and a normal
cardiovascular and neurologic exam. Her ECG shows left ventricular hypertrophy. Which
