06-01-2015, 05:42 AM
A 59 y/o F present to you for evaluation of fainting episodes. She feels lightheaded when she stands, and she has fainted 3 times within the past 60 days. She has imbalance and shuffling gait that developed slowly over the past 2 years. She is sleepy during the day, and her husband describes snoring as “screeching” while she sleeps. She has urinary incontinence. Her medical history is otherwise unremarkable. She no med. Her older sister has a gait disorder. PE; BP 120/80 while sitting & 80/50 standing; pulse 80/min in both positions. Eye movements are norm. Finger to nose and heel to shin movement are uncoordinated, but there is no tremor. Movements are slow and there is limb rigidity. Deep tendon reflexes are brisk, and Babinski's sign pos.
Most likely Dx?
a)Progressive supranuclear palsy
b)Spinocerebellar degeneration
c)CJ disease
d)Multiple system atrophy
e)Parkinson’s disease
Most likely Dx?
a)Progressive supranuclear palsy
b)Spinocerebellar degeneration
c)CJ disease
d)Multiple system atrophy
e)Parkinson’s disease