A 68-Year-Old Man Comes to the Office Due to Recurrent

question 285

Multiple Choice

A 68-year-old man comes to the office due to recurrent episodes of dizziness.  His medical problems include hypertension, coronary artery disease, asthma, type 2 diabetes mellitus, and hypercholesterolemia.  He is retired and lives alone.  He does not use tobacco, alcohol, or drugs.  Medications include aspirin, enalapril, isosorbide mononitrate, simvastatin, glyburide, and metformin.  Temperature is 36.7 C (98 F) , blood pressure is 125/80 mm Hg in the decubitus position and 100/70 mm Hg in the standing position, pulse is 86/min in the decubitus position and 92/min in the standing position, and respirations are 14/min.  Examination shows no abnormalities.  Which of the following is the most effective strategy to manage this patient's symptoms?

• A)Stop enalapril
• B)Stop isosorbide
• C)Stop simvastatin
• D)Order a CT scan of the head
• E)Start meclizine

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