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Old 10-24-2011
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Question Parkinsonism + Postural hypotension?

Previously healthy 60 years old female patient presented with bradykinesia, postural instability and increased rigidity of both upper and lower limbs for 2 years and was diagnosed as Parkinsonism for last years. Later on she developed features of autonomic dysfunction including postural hypotension, hyperhydrosis and urinary incontinence. She was treated with fludrocortisone and nefidipine for the management of postural hypotension. The patient died 4 years later. What would be the most common cause of death in this patient?

A) Myocardial infarction
B) Respiratory system dysfunction
C) Brain tumor
D) Infection
E) Thromboembolic events
F) Biliary cirrhosis
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i think this is shy-Drager syndrome but i dont know the answer
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I guess it is B. Postural, hyperhydrosis and urinary - is cholinergic symptoms , pulmonary problems may be part of that.
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Multiple system atrophy with orthostatic hypotension is the current classification for a neurological disorder that was once called Shy-Drager syndrome. A progressive disorder of the central and autonomic nervous systems, it is characterized by orthostatic hypotension (an excessive drop in blood pressure when standing up) which causes dizziness or fainting. Multiple system atrophy can occur without orthostatic hypotension, but instead have urinary involvement (urgency/incontinence). Doctors classify the disorder into 3 types: the Parkinsonian-type includes symptoms of Parkinson's disease such as slow movement, stiff muscles, and tremor; the cerebellar-type, which causes problems with coordination and speech; and the combined-type, which includes symptoms of both parkinsonism and cerebellar failure. Problems with urinary incontinence, constipation, and sexual impotence in men happen early in the course of the disease. Other symptoms include generalized weakness, double vision or other vision disturbances, difficulty breathing and swallowing, sleep disturbances, and decreased sweating. Because the disease resembles others, a correct diagnosis may take years
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Quote:
Originally Posted by ricko335 View Post
Multiple system atrophy with orthostatic hypotension is the current classification for a neurological disorder that was once called Shy-Drager syndrome. A progressive disorder of the central and autonomic nervous systems, it is characterized by orthostatic hypotension (an excessive drop in blood pressure when standing up) which causes dizziness or fainting. Multiple system atrophy can occur without orthostatic hypotension, but instead have urinary involvement (urgency/incontinence). Doctors classify the disorder into 3 types: the Parkinsonian-type includes symptoms of Parkinson's disease such as slow movement, stiff muscles, and tremor; the cerebellar-type, which causes problems with coordination and speech; and the combined-type, which includes symptoms of both parkinsonism and cerebellar failure. Problems with urinary incontinence, constipation, and sexual impotence in men happen early in the course of the disease. Other symptoms include generalized weakness, double vision or other vision disturbances, difficulty breathing and swallowing, sleep disturbances, and decreased sweating. Because the disease resembles others, a correct diagnosis may take years

So what's the answer?
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E) Thromboembolic events
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Quote:
Originally Posted by Evergreen View Post
So what's the answer?
i dunno i saw everywhere , dats 4 u 2 tell
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Old 10-25-2011
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Correct Answer Answer

Quote:
Originally Posted by ricko335 View Post
i dunno i saw everywhere , dats 4 u 2 tell
I found in the NINDS website the following statement:

What is the prognosis?


Most individuals with multiple system atrophy with orthostatic hypotension die within 7 to 10 years after the onset of symptoms. A problem with the respiratory system is the most common cause of death.

So the answer is B.

http://www.ninds.nih.gov/disorders/m...ypotension.htm
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