Family Nurse Practitioner Exam

A 73-year-old patient presents with episodic vertigo and weakness. What does this suggest?

1. Benign paroxysmal positional vertigo

2. Ménière's disease

3. TIA (transient ischemic attack)

4. CVA (cerebrovascular accident)

The correct answer is: TIA (transient ischemic attack)

The presentation of episodic vertigo and weakness in a 73-year-old patient suggests a transient ischemic attack (TIA). This is due to the nature of TIAs, which often manifest with neurological symptoms that can include dizziness or vertigo, along with other signs of temporary impairment such as weakness or sensory loss. The key characteristics of a TIA include the sudden onset of symptoms that resolve within a short period, typically within 24 hours. The occurrence of vertigo in conjunction with weakness is significant; it points to a possible transient disruption in blood flow to the areas of the brain responsible for balance and motor control, which is typical in TIAs. In contrast, benign paroxysmal positional vertigo (BPPV) tends to be triggered by specific positioning and generally does not include additional neurological weaknesses. Ménière's disease typically presents with recurrent episodes of vertigo, hearing loss, tinnitus, and a sensation of fullness in the ear, rather than generalized weakness. A cerebrovascular accident (CVA) would indicate a more permanent neurological deficit, which typically does not resolve rapidly as seen in the TIA. This context reinforces the notion that episodic vertigo accompanied by weakness in older patients should raise suspicion for TIA