A 24-Year-Old Man Is Brought to the Office by His

question 583

Multiple Choice

A 24-year-old man is brought to the office by his parents due to hand shaking and involuntary movements, which have progressively worsened over the last 6 months.  A year ago, he was diagnosed with depression and treated with fluoxetine for 5 months but stopped the medication and did not follow up with his psychiatrist.  His medical history is otherwise unremarkable.  The patient has smoked cigarettes intermittently in the past but does not drink alcohol or use illicit drugs.  He dropped out of college and has worked as a delivery man for the last several years.  Blood pressure is 122/82 mm Hg supine and 120/84 mm Hg standing.  Physical examination reveals clear breath sounds and no cardiac murmurs.  The liver is enlarged, firm, and nontender, and the spleen is not palpable.  There is tremor of both hands that increases with activity.  Occasional rapid, jerky contractions of the distal extremities are also seen.  Laboratory results are as follows: Viral hepatitis panel is negative.  Which of the following is the most likely diagnosis?

• A)Alpha-1-antitrypsin deficiency
• B)Hemochromatosis
• C)Huntington disease
• D)Multiple system atrophy
• E)Serotonin-reuptake inhibitor toxicity
• F)Wilson disease

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Definitions:

Current Liability

Financial obligations due by a company within a year, including loans, accounts payable, and other short-term debts.

Current Asset

Assets that are expected to be converted into cash, sold, or consumed within one year or within the normal operating cycle of the business, whichever is longer.

Asset Turnover Ratio

A financial metric that measures the efficiency of a company in generating sales revenue from its investments in assets.

Perpetual Inventory System

A system for inventory accounting that immediately records inventory transactions, whether it's a sale or purchase, through computerized point-of-sale systems and software for managing enterprise assets.