Knowmedge Family Medicine Board Exam Practice Question

A 53-year-old woman presents because her husband noticed that she has been having increasing trouble with walking and writing. The patient had been healthy previously. She denies any pain, and she has not suffered from any major illnesses or injuries.

Physical examination reveals a well-dressed, pleasant woman who has a slight tremor of her right hand and difficulty moving from a seated to a standing position. Her movements are very slow, and it appears that she must be very careful in order to keep from loosing her balance once she stands. Her gait is somewhat guarded; however, she does not use any walking aids. Her vital signs are normal, and lab work is unremarkable. A CT and MRI of the head both appear to be within normal limits, and a neurological workup shows that she has decreased strength in her right hand and the inability to perform tandem walking and heel-to-toe walking. Based on the patient’s characteristic symptoms, her physician makes a diagnosis.


Regarding the natural history of and treatment for this disease, what statement is most accurate?

A. Medications usually provide good control of symptoms for approximately 10-15 years
B. Levodopa, used in conjunction with a peripheral decarboxylase inhibitor, is the standard treatment for this disease
C. Memory impairment is an early finding in most patients
D. The average age of onset is 45 years
E. The onset of this disease is typically symmetrical, with upper and lower extremities being affected

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