In mid-January, a 24-year-old man who is brought to the ER b…

In mid-January, a 24-year-old man who is brought to the ER by ambulance after suffering what co-workers described as a seizure like activity. The patient has been working in an enclosed house, using space heaters to keep him warm. He is drowsy on admission without further seizure-like activity. Further questioning of the family reveals no prior history of seizures in the patient and no family history of seizures. Initial evaluation should include all but one. Select the evaluation item not done in the initial workup.

Mr. Avery, 75-year-old male, is brought to your office by hi…

Mr. Avery, 75-year-old male, is brought to your office by his wife. She states that he has just been ‘staring into space’ for the past 2 months. He has been unable to move around the house without falling over and his movements seemed slowed. He has been depressed, drooling, has difficulty swallowing and is losing weight. On exam, he has a slow, shuffling gait and walks in a ‘stooped over’ position. His BP when lying is 140/90 and his standing blood pressure is 100/70. He has marked rigidity of his upper extremities. He has also a tremor that appears to be present only at rest. What is the most likely diagnosis in this patient?