DrVirgo
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A 62 year old woman with a history of depression and hypertension presents complaining of recurrent falls over the past 6 months. She had been having difficulty with complex tasks at work and was recently asked to leave. On exam, her mental status is unremarkable. Her Cranial nerve exam is notable for limited downward gaze. She has prominent, symmetric bradykinesia with more axial than limb rigidity. There is no resting tremor. Her gain is stiff with "en bloc" turning. Reflexes are normal with downgoing toes. An MRI of the brain is read as showing a small lacunar infarct in the left putamen. She has recently been started on L-dopa/carbidopa but has had little to no improvement in her symptoms. Which of hte following is the most likely diagnosis?
A. Basal ganglia stroke
B. Carbon monoxide poisoning
C. Cervical stenosis
D. Parkinson disease
E. Progressive supranuclear palsy
and why?
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Our greatest glory is not in never falling, but in rising every time we fall.
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| yasmeen
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progressive supranuclear palsy --parkinsons + vertical gaze palsy
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| yasmeen
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E
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| doc_clotaire
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E 
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The elevator to succes is broke ,you must take the stairs
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| DrVirgo
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E is right! 
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Our greatest glory is not in never falling, but in rising every time we fall.
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| ssrpk
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hey dr.vrigo wht is source of these questions, really nice qs, thanks for posting them here
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life is guud
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| krsna
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E
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