A 70-Year-Old Man Comes to the Office Due to Trouble

question 687

Multiple Choice

A 70-year-old man comes to the office due to trouble sleeping.  He has experienced a progressively worsening urge to move his legs when he watches television at night; the urge persists when he goes to bed and often prevents him from getting to sleep.  The sensation to move his legs is not present during the day and disappears when he gets up and walks.  There is no associated lower extremity numbness, tingling, or weakness.  Medical history is notable only for mild hypertension treated with lisinopril.
Physical examination, including neurologic examination, is unremarkable.
Which of the following is the most appropriate next step in management of this patient?

• A)Fasting glucose
• B)Pramipexole at bedtime
• C)Selective serotonin reuptake inhibitor
• D)Serum ferritin level
• E)Sleep study

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Definitions:

Observational Learning

A learning process that occurs through observing the behavior of others and the outcomes of those behaviors.

Reinforced Learning

A type of machine learning where an agent learns to make decisions by receiving feedback through rewards or penalties.

Social Media

Digital platforms that enable users to create and share content or to participate in social networking.

Punished Behavior

Actions or responses that are decreased in frequency or likelihood due to the application of an adverse stimulus or punishment.