Vestibular Disorders — Written Clinical Reasoning · Phys Written Answers

Prompt

DCE-style written reasoning for Vestibular Disorders.

SAQ 1 — Integrated plan (12 marks)

Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]

Model Answer

1. Frame and red flags (3 marks) [1]

State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]

2. Discriminating assessment (3 marks) [2]

List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]

3. Treatment sequence (4 marks) [1] [3]

Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]

4. Follow-up and communication (2 marks) [2]

Disposition, safety-net advice, and who owns follow-up. [1] [2]

SAQ 2 — Exam trap defence (8 marks)

Prompt: Name two high-yield traps in Vestibular Disorders and how you avoid them. [1] [2]

Model Answer

Trap one: delayed escalation of a high-risk feature — avoid by explicit red-flag checklist. [1]

Trap two: therapy mismatched to mechanism — avoid by confirming the discriminating test before escalating treatment. [2] [3]

References

[1]Maas BDPJ, van Leeuwen RB, Spies PE, Schermer TR, et al. The importance of screening for benign paroxysmal positional vertigo in older patients presenting to falls clinics BMC Geriatr, 2026.PMID 42449246
[2]Büntzel J, Kisters K, Büntzel J, Micke O The role of magnesium in otology - A narrative review Magnes Res, 2026.PMID 42439044
[3]Surano S, Lindell E, Mathé J, Davidsson H, et al. Internet-based vestibular rehabilitation versus written instructions after acute vertigo: A randomised controlled trial PLoS One, 2026.PMID 42284306
[4]Magri A, Moise A, Ajit-Roger E, Orishchak O, et al. ChatGPT and patient education in benign paroxysmal positional vertigo, in French and in English Eur Ann Otorhinolaryngol Head Neck Dis, 2026.PMID 41945085
[5]Fushiki H, Ogihara H, Kamo T, Shiozaki T, et al. Vestibular rehabilitation strategies of the Japan Society for Equilibrium Research Auris Nasus Larynx, 2026.PMID 41850198
[6]Xi Y, Yao T, Zhang C, Zhuang T Effectiveness of safety care and clinical nursing pathway in patients undergoing cardiovascular intervention: a randomized controlled trial Perioper Med (Lond), 2026.PMID 42469924
[7]Marks FJ, Walters SJ, Sutton L, Jacques RM What statistical methods are more appropriate for predicting recruitment at the design stage of a randomised controlled trial? Trials, 2026.PMID 42469922
[8]Hajiaqaei M, Mohammadi A Transcranial random noise stimulation (tRNS) over the left dorsolateral prefrontal cortex ameliorates emotion dysregulation and executive function: a single-blind, randomized, sham-controlled clinical trial BMC Psychol, 2026.PMID 42469906

SAQ 1 — Integrated plan (12 marks)

Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]

Model Answer

1. Frame and red flags (3 marks) [1]

State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]

2. Discriminating assessment (3 marks) [2]

List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]

3. Treatment sequence (4 marks) [1] [3]

Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]

4. Follow-up and communication (2 marks) [2]

Disposition, safety-net advice, and who owns follow-up. [1] [2]

SAQ 2 — Exam trap defence (8 marks)

Prompt: Name two high-yield traps in Vestibular Disorders and how you avoid them. [1] [2]

Model Answer

Trap one: delayed escalation of a high-risk feature — avoid by explicit red-flag checklist. [1]

Trap two: therapy mismatched to mechanism — avoid by confirming the discriminating test before escalating treatment. [2] [3]

References

[1]Maas BDPJ, van Leeuwen RB, Spies PE, Schermer TR, et al. The importance of screening for benign paroxysmal positional vertigo in older patients presenting to falls clinics BMC Geriatr, 2026.PMID 42449246
[2]Büntzel J, Kisters K, Büntzel J, Micke O The role of magnesium in otology - A narrative review Magnes Res, 2026.PMID 42439044
[3]Surano S, Lindell E, Mathé J, Davidsson H, et al. Internet-based vestibular rehabilitation versus written instructions after acute vertigo: A randomised controlled trial PLoS One, 2026.PMID 42284306
[4]Magri A, Moise A, Ajit-Roger E, Orishchak O, et al. ChatGPT and patient education in benign paroxysmal positional vertigo, in French and in English Eur Ann Otorhinolaryngol Head Neck Dis, 2026.PMID 41945085
[5]Fushiki H, Ogihara H, Kamo T, Shiozaki T, et al. Vestibular rehabilitation strategies of the Japan Society for Equilibrium Research Auris Nasus Larynx, 2026.PMID 41850198
[6]Xi Y, Yao T, Zhang C, Zhuang T Effectiveness of safety care and clinical nursing pathway in patients undergoing cardiovascular intervention: a randomized controlled trial Perioper Med (Lond), 2026.PMID 42469924
[7]Marks FJ, Walters SJ, Sutton L, Jacques RM What statistical methods are more appropriate for predicting recruitment at the design stage of a randomised controlled trial? Trials, 2026.PMID 42469922
[8]Hajiaqaei M, Mohammadi A Transcranial random noise stimulation (tRNS) over the left dorsolateral prefrontal cortex ameliorates emotion dysregulation and executive function: a single-blind, randomized, sham-controlled clinical trial BMC Psychol, 2026.PMID 42469906