docnikki
Forum Guru
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A 77-year-old woman is brought to the physician by her son for a routine health maintenance examination. She says that she feels well. Her son reports that 1 month ago, she got lost while driving home from the local supermarket. Two weeks ago, she forgot to turn off the stove after cooking dinner. She has been wearing bilateral hearing aids since audiometry 2 years ago showed bilateral high-frequency hearing loss. Her visual acuity corrected with glasses is 20/25 in both eyes. Neurologic examination shows mild fine tremors of the hands when the arms are outstretched; the tremor is not present at rest. Muscle strength is 5/5 in all extremities. Deep tendon reflexes are decreased at the ankles and 2+ elsewhere. Her gait is normal. Sensation to vibration is mildly decreased over the toes. On mental status examination, she is awake, alert, and conversant. Her language function is normal. She is oriented to person, place, and time and recalls one out of three objects after 10 minutes. Which of the following findings in this patient warrants further evaluation?
A) Decreased deep tendon reflexes at the ankles
B) Decreased sensation to vibration over the toes
C) High-frequency hearing loss
D) Memory loss
E) Tremor of the outstretched hands
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| nadiabarati
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B
decreased deep tendon reflexes happen with normal aging? or..?
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| yasmeen
Forum Guru
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B REST R NORMAL AGING
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| robin082006
Forum Hero
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D) Memory loss
Edited by robin082006 on 03/24/07 - 08:04 PM
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| 92306
Forum Senior
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B) Decreased sensation to vibration over the toes
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| ALS
Forum Senior
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Posts: 190
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B)
Resting tremor is more worrisome.
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| rn
Forum Senior
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memory loss.she got lost while driving n forgot to off stove.is it normal??????no.so memory loss is worrisome
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| damngood
Forum Newbie
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D memory loss she didnt turn off the stove
that really needs attention
i mean the fastest attention
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| Ivonne
Forum Guru
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D sounds more like alzheimer than normal aging
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| Korotkoff
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Is decreased sensation to vibration normal?
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| Ivonne
Forum Guru
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@korotkoff
This is what i found:
"With normal aging there is a decline in the vibration sensation in the distal extremities, usually up to the ankles, ocurring in up to half of the patients over age 75 years"
Source: Vascular cognitive impairment by Timo Erkinjuntti, Serge Gauthier
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| Korotkoff
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Thanks Ivonne.
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