06-19-2007, 05:41 PM
9. A previously healthy 72-year-old man comes to
the physician
because of a 2-year history of hand tremors and
progressive difficulty
walking. He lives alone and has no close relatives.
He is alert and
oriented. Physical examination shows a decreased rate
of eye blinking.
Neurologic examination shows masked facies and a
pill-rolling resting
tremor of both hands. There is cogwheel rigidity of
the upper extremities
and generalized bradykinesia. His handwriting has
become small and
illegible. He has a slow, shuffling, festinating gait
with a tendency to
lean forward. Postural reflexes are impaired. This
patient is at
greatest risk for injury due to which of the
following?
A
) Bradykinesia
B
) Cogwheel rigidity
C
) Decreased rate of eye blinking
D
) Postural reflex impairment
E
) Tremor
10. A 47-year-old woman comes for a routine health
maintenance
examination. She has a 10-year history of type 2
diabetes mellitus that is
well controlled with an oral hypoglycemic agent. Her
mother died of a
myocardial infarction at the age of 38 years. The
patient weighs 82 kg
(180 lb) and is 163 cm (64 in) tall. Her blood
pressure is 150/95 mm
Hg. Examination shows multiple small skin tags below
the eyebrows and
on the nose and eyelids. Which of the following is
the most appropriate
next step in diagnosis?
A
) Measurement of serum follicle-stimulating hormone
level
B
) Serum lipid studies
C
) 24-Hour urine collection for measurement of
creatinine clearance
D
) X-ray film of the chest
E
) ECG
F
) No further studies indicated
the physician
because of a 2-year history of hand tremors and
progressive difficulty
walking. He lives alone and has no close relatives.
He is alert and
oriented. Physical examination shows a decreased rate
of eye blinking.
Neurologic examination shows masked facies and a
pill-rolling resting
tremor of both hands. There is cogwheel rigidity of
the upper extremities
and generalized bradykinesia. His handwriting has
become small and
illegible. He has a slow, shuffling, festinating gait
with a tendency to
lean forward. Postural reflexes are impaired. This
patient is at
greatest risk for injury due to which of the
following?
A
) Bradykinesia
B
) Cogwheel rigidity
C
) Decreased rate of eye blinking
D
) Postural reflex impairment
E
) Tremor
10. A 47-year-old woman comes for a routine health
maintenance
examination. She has a 10-year history of type 2
diabetes mellitus that is
well controlled with an oral hypoglycemic agent. Her
mother died of a
myocardial infarction at the age of 38 years. The
patient weighs 82 kg
(180 lb) and is 163 cm (64 in) tall. Her blood
pressure is 150/95 mm
Hg. Examination shows multiple small skin tags below
the eyebrows and
on the nose and eyelids. Which of the following is
the most appropriate
next step in diagnosis?
A
) Measurement of serum follicle-stimulating hormone
level
B
) Serum lipid studies
C
) 24-Hour urine collection for measurement of
creatinine clearance
D
) X-ray film of the chest
E
) ECG
F
) No further studies indicated
)))))))