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NBME - Parkinson's - resident07
#1
I don't understand this one.

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
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#2
bradikinesia
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#3
D
) Postural reflex impairment
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#4
decreaed rate of eye blinking with risk of corneal dryness n infection
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#5
what about D, doesnt this increases the chances of pt falling and hurtin himself and plus this is an old pt with increase risk for fractures..the question reads ''greatest risk for injury ''..
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#6
i really think it's D although I do understand the eye thing
Reply
#7
D) Postural reflex impairment -- Sure
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