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Discussion Starter · #1 ·
A 46 year old man visited your office because he noticed that his hands started shaking too much for the last couple of months. His wife also noticed that his face and body are sometimes shaky. He recently got promoted in his work and has no other problems to report. Patient mentioned that his father developed similar problem at the same age. On examination several scalds noticed on the back of the patients hands and on questioning he said that recently he has been spilling coffee. You also noticed that there's no shaking evident only when you asked the patient to grab a pen. The rest of physical was normal.
What is the next appropriate step in the management?
A- MRI spine
B- Further questioning about domestic violance
C- Start the patient on propranalol
D- Start the patient on carbidopa/levodopa
E- MRI brain
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