Which neurologic finding would be considered abnormal in an 88-year-old patient?
Dizziness and problems with balance
Slow papillary response to light
Jerky eye movements
Absence of the Achilles tendon jerk
The Correct Answer is D
A. Dizziness and problems with balance
While dizziness and problems with balance can occur more frequently in older adults due to age-related changes in the vestibular system and other factors, persistent or severe dizziness or balance issues should be evaluated further as they could indicate underlying neurological or medical conditions.
B. Slow papillary response to light
This finding may be considered abnormal, especially if it represents a significant change from the individual's baseline. While age-related changes in pupil function can occur, a slow or sluggish pupillary response to light may indicate dysfunction of the oculomotor nerve or other neurological issues and should be investigated further.
C. Jerky eye movements
Jerky eye movements, such as nystagmus, can be abnormal and may indicate dysfunction of the vestibular system or other neurological conditions. While some degree of nystagmus can occur with age, persistent or severe jerky eye movements should be evaluated further.
D. Absence of the Achilles tendon jerk
This finding may also be considered abnormal. The Achilles tendon reflex, tested using the deep tendon reflex (DTR) examination, can diminish with age but should not be completely absent in the absence of specific medical conditions affecting the reflex arc or spinal cord function.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Increased blinking
Increased blinking is not a typical manifestation of bradykinesia. In fact, individuals with Parkinson's disease may experience reduced blinking (hypokinesia of blinking) rather than increased blinking.
B. States of euphoria
Euphoria is not typically associated with bradykinesia. Instead, individuals with Parkinson's disease may experience a range of mood changes, including depression, anxiety, or apathy, but euphoria is not a common finding.
C. Slurred speech
This is the correct answer. Slurred speech, or dysarthria, can occur in individuals with Parkinson's disease as a result of bradykinesia affecting the muscles involved in speech production. Bradykinesia can cause a reduction in the speed and coordination of movements necessary for clear speech, resulting in slurred or mumbled speech patterns.
D. Decreased respiratory rate
Decreased respiratory rate is not typically associated with bradykinesia. Bradykinesia primarily affects voluntary movements rather than involuntary processes such as respiration. While respiratory muscle weakness can occur in advanced stages of Parkinson's disease, it is not directly related to bradykinesia.
Correct Answer is B
Explanation
A. "Have you had an MMR immunization?"
This question is not directly relevant to the assessment of Guillain-Barré syndrome. MMR immunization history may be pertinent to other health assessments, such as immunity to measles, mumps, and rubella.
B. "Have you had a recent upper respiratory infection?"
This is the correct answer. GBS often occurs after a recent upper respiratory or gastrointestinal infection, so asking about recent illnesses can provide valuable information for diagnosis.
C. "Have you traveled overseas recently?"
While travel history may be relevant to certain infectious diseases, it is not typically associated with the development of Guillain-Barré syndrome. Therefore, this question is less pertinent in this context.
D. "Are you taking a multivitamin?"
The use of multivitamins is unlikely to be directly related to the development of Guillain-Barré syndrome. While nutritional status is important for overall health, it is not a primary focus when assessing for GBS.
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