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A 72-year-old woman on chronic prednisone for polymyalgia rheumatica presents after a witnessed syncopal episode that occurred approximately 10 minutes after standing up from a recliner. Her husband reports she briefly lost consciousness and slumped to the floor without convulsive movements, recovering spontaneously within 30 seconds. She endorses several weeks of increasing fatigue, mild nausea, and a 5-pound unintentional weight loss, and notes she recently tapered her prednisone dose per her rheumatologist's instruction.
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