American Board of Internal Medicine (ABIM) Certification Practice Exam

For an older patient experiencing disequilibrium, which is a recommended management strategy?

1. Immediate surgery to correct impairment

2. Physical therapy and mobility aids

3. Extensive imaging and testing to identify causes

4. Medication to relieve dizziness

The correct answer is: Physical therapy and mobility aids

For an older patient experiencing disequilibrium, physical therapy and mobility aids are essential components of management. The primary goal is to improve balance, strength, and coordination, which can significantly reduce the risk of falls—a common concern in the elderly population. Physical therapy provides tailored exercises designed to address specific balance issues, and may include vestibular rehabilitation if the imbalance is related to inner ear problems. Additionally, mobility aids such as canes or walkers can enhance stability and confidence when moving, further decreasing the likelihood of injuries associated with falls. In contrast, options such as immediate surgery may not be appropriate without understanding the underlying cause of the disequilibrium, as surgical interventions carry risks, particularly in older patients who may have multiple comorbidities. Extensive imaging and testing could delay necessary treatment and impose unnecessary stress on the patient. Medication may help relieve symptoms such as dizziness, but it does not address the root causes of disequilibrium or improve overall functionality and safety. Therefore, physical therapy combined with mobility aids is a practical and beneficial approach to managing disequilibrium in older adults.