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History & Physical/Neurology A 73 year-old male presents to the clinic with his wife. His wife has noticed that he has developed a resting tremor in his right hand and a shuffling gait over the last year. What finding on physical examination would support your suspected diagnosis? A. Chorea B. Dystonia C. Masked facies D. Hyperreflexia Explanation The patient symptoms are consistent with Parkinsonism. Physical exam findings include masked facies, micrographia, decreased arm swing, and monotonous speech. History & Physical/Neurology A patient with an upper motor neuron lesion would exhibit which of the following findings? A. Fasciculations B. Areflexia C. Muscular atrophy D. Spasticity Explanation A. Fasciculations, areflexia and muscle atrophy are consistent with lower motor neuron lesions. D. Spasticity is an upper motor neuron lesion finding. Diagnostic Studies/Neurology What test is the single most useful test in establishing the diagnosis of multiple sclerosis? A. Cerebral spinal fluid cell count and protein level B. Cerebral spinal fluid immunoglobulin studies C. Evoked potentials D. Magnetic Resonance Imaging
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