cbenitesch
Forum Senior
Topics: 10
Posts: 141
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this is a 60 y.o man he comes into your office with his wife. His main worry is that when he is lying on bed he canīt turn around, ge got some problems to get into a stand up position and his wife said that he needs help to get out of the car when heīs driving. His past medical history is unremarkable. On physical exam, you noticed that he has some problem to get any objet from the desk and when you perform a nose-firger tip test he reduced the distance from the initial position and is kind of slow. When he returns to sit down he made it roughly sitting down very strong on the chair. What is the most likely diagnosis?
a) Alzheimerīs Disease
b) Miastenia Gravis
c) Thyroid hormone deficit
d) Parkinsonīs disease
e) N/A
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| Sea_gull
Forum Elite
Topics: 32
Posts: 179
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Most probably it is AKINESIA which is characteristic of Parkinson's disease .So answer d
Just a guess.
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| frank100
Forum Guru
Topics: 48
Posts: 586
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not sure if a shy-drager syndrome, or parkinsonīs itself. but yes (d) sounds good.
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| study_ing
Forum Fanatic
Topics: 180
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d...no autonomic problems mentioned so i guess no shy dragger
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| som
Forum Guru
Topics: 59
Posts: 308
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of the choices given d looks close, but not a typical case
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| cbenitesch
Forum Senior
Topics: 10
Posts: 141
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yup this is a case of Parkinsonīs Disease, is not as typical but there are several signs and symptoms. Iīm agree with you study_ing, it could not be shy drager, this disease has some parkinsonian features, but is not parkinsonīs, this can lead to postural hypotension, sphincter control disturbances, anhidrosis etc.... This is a beatutiful hint!... patients with parkinsonīs disease, they make rough movements to sit down and if you want to clear a diagnose, so give ém a little push, when you give a push to a park diz pat. they will do a retropultion (I donīt know if its the right way to spell!) but they will give some steps backward in a roughly way!!!... another hint just make ém walk backward they will do the same as retropultion, they will walk backward in a dumb way... hope this can help! 
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| robin082006
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