Solved

A 64-Year-Old Man Comes to the Physician Because of a Tremor

question 746

Multiple Choice

A 64-year-old man comes to the physician because of a tremor. He first began experiencing a tremor in his right hand two years ago that gradually has involved his left hand. The tremor worsens when he drinks from a glass of water or tries to tie his shoes. His other medical problems include hypertension treated with lisinopril. He does not smoke cigarettes, but drinks occasionally and mentions that his tremor improves with a glass of wine. His father died of old age and had a "movement problem" in his later years. His mother died of breast cancer. He currently lives alone.
His blood pressure is 120/70 mm Hg, pulse is 84/min, and respirations are 12/min. At rest, he appears comfortable sitting on the examination table. His heart and lung examinations are within normal limits. He is alert and oriented to person, place, and time. He has 5/5 muscle strength in all extremities and has no obvious resting tremor. When asked to touch his finger to his nose, a tremor is present that increases when his finger touches his nose. His head also appears to have a mild tremor as he stands up that decreases once he sits down. His gait appears to be normal.
Which of the following is the most likely diagnosis?

Definitions:

Managing Emphasis

The process of directing attention or highlighting importance in written or spoken communication.

Sentences

An assembly of words which stands on its own as a complete thought, characteristically including a subject and predicate, delivering a statement, posing a question, making an exclamation, or issuing a command.

Topic Sentence

A sentence that expresses the main idea of the paragraph in which it occurs, often serving as an introduction to the content that follows.

Paragraph Arrangement

The organized and logical sequencing of paragraphs in a piece of writing to ensure coherent flow of ideas and information.