A 52-year-old woman is seen in the family practice clinic for 6 months of recurrent spontaneous episodes of vertigo. She has had 5 episodes, each lasting 2 to 3 hours with nausea and vomiting, accompanied by a low-pitched roaring sound and a feeling of fullness in the left ear. She says her left-sided hearing seems worse around the attacks. She has hypertension controlled with ramipril and takes no other medications. She has no history of gout or kidney disease and no known drug allergies. Neurological examination is normal between attacks, and audiometry shows a left low-frequency sensorineural hearing loss. Sodium is 140 mmol/L (135-145), potassium 4.2 mmol/L (3.5-5.0), and creatinine 68 µmol/L (45-90).
| Heart rate | 74/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 128/78 mm Hg |
Question 1 of 21
Referral to otolaryngology is placed. Which of the following are the most appropriate initial measures to reduce the frequency of her attacks?
Select 2. (0 / 2 selected)
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