A 52-Year-Old Man Is Evaluated for Ongoing Cognitive Difficulties

question 33

Multiple Choice

A 52-year-old man is evaluated for ongoing cognitive difficulties.  For the past 2 months, he has been sleeping 12-16 hours daily, much more than he usually does.  When he is awake, he is withdrawn and less socially engaged than normal.  During this time, the patient has had trouble driving, sideswiping cars on the right side of the road more than once.  He also has had several falls, which he attributes to feeling off-balance.  Vital signs are normal.  The patient scores 22/30 (normal: ≥26) on the Montreal Cognitive Assessment.  A partial right homonymous hemianopsia is noted.  Motor and reflex examinations are normal with intact vibratory sensation.  He exhibits dysdiadochokinesia and dysmetria on testing of his upper and lower extremities along with a wide-based gait.  CT scan of the head is normal.  Real-time quaking-induced conversion testing of his cerebrospinal fluid is positive.  This patient will most likely develop which of the following?

• A)Cogwheel rigidity
• B)Flaccid paralysis
• C)Multiple cranial neuropathies
• D)Myoclonus
• E)Peripheral neuropathy

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Definitions:

Income Tax Method

When plant assets are exchanged, tax law says the gain or loss must be absorbed into the cost of the new asset.

Capital Expenditures

Funds used by a company to acquire or upgrade physical assets such as property, industrial buildings, or equipment, intended to improve long-term operational efficiency.

Revenue Expenditures

Costs that are charged to expense as incurred and are primarily associated with the maintenance and repair of fixed assets or for benefits within the current period.

Intangible Asset

An asset that lacks physical substance, such as patents, trademarks, and copyrights, holding value for a business.