Neurology PreTest Self-Assessment And Review, Eighth Edition (PreTest Clinical Medicine) by Anschel David

Author:Anschel, David [Anschel, David]
Language: eng
Format: mobi, epub
Publisher: McGraw-Hill
Published: 2012-03-19T14:00:00+00:00

Questions 261 to 264

For each clinical scenario, select the most likely condition. Each lettered option may be used once, more than once, or not at all.

a. Meige syndrome

b. Dopa-responsive dystonia

c. Parkinson disease

d. Olivopontocerebellar atrophy

e. Tardive dyskinesia

f. Spasmodic torticollis

g. Whipple disease

h. Hemifacial spasm

i. Essential tremor

261. A 53-year-old woman is unable to stop blinking forcefully and has frequent grimacing movements of the face. At times, she protrudes her tongue against her will. She has never taken any medications.

262. A 42-year-old woman has a long history of twisting movements of her head to the left. These are painful and have resulted over the years in muscular hypertrophy affecting the sternocleidomastoid and trapezius muscles. There is no family history. The remainder of her examination is normal.

263. A 40-year-old literary agent has had worsening tremor of the hands. This has been present for 2 years, but has increasingly impaired her work ability because she is frequently required to take her clients to lunch, and she is embarrassed by her inability to eat and drink normally. A glass of wine with the meal typically helps somewhat. On examination, there is a mild head tremor, but no rest tremor of the hands. When she holds a pen by the tip at arm’s length, however, a coarse tremor is readily apparent. Examination is otherwise normal.

264. A 64-year-old man has noticed dragging of the right leg and tremor and stiffness of the right hand. On examination, he has a tremor of the right hand, which disappears when he reaches to grab a pen. Movements are slower on the right than the left. He has cogwheel rigidity of the right arm.

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