A 55-Year-Old Man Comes to the Office Because of Numerous

question 317

Multiple Choice

A 55-year-old man comes to the office because of numerous falls for the past few weeks.  Yesterday, he felt so dizzy that he fell on the ground and hurt his knees.  He has also noticed dry mouth, dry skin, and erectile dysfunction over this period.  His medical history is significant for the recent onset of resting tremors.  He was diagnosed with diabetes 6 months ago, which is controlled with diet.  Blood pressure is 121/84 mm Hg supine, and 92/61 mm Hg standing.  Physical examination reveals rigidity and bradykinesia.  What is the most likely diagnosis of this patient?

• A)Idiopathic orthostatic hypotension
• B)Horner syndrome
• C)Familial dysautonomia (Riley-Day syndrome)
• D)Diabetic neuropathy
• E)Multiple system atrophy

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Definitions:

Sensory Deprivation

A condition in which one is deprived of normal sensory input, which can lead to various cognitive and psychological effects.

Meditation

A practice where an individual uses a technique – such as mindfulness or focusing their mind on a particular thought, object, or activity – to achieve mental clarity and emotional calmness.

Alpha Brain Waves

A type of brainwave detectable by EEG, associated with a state of wakeful relaxation.

Blood Lactate

A substance produced by the body during intense physical activity, serving as a marker for anaerobic metabolism and physical exertion levels.