FrontalCortex, Inc. is a non-profit corporation dedicated to neurology education.

Neuro-Medicine...

Topic: Adult

Created on Monday, October 27 2008 by rednucleus

Last modified on Monday, October 27 2008.

A 19-year-old man presents with bilateral resting tremor. He has blue lunulae and sun-flower cataract. Which one of the following is not an expected finding in this man?

 
        A) Bilateral extensor planters
 
        B) Recurrent acute hepatitis
 
        C) Normal corneal examination
 
        D) Positive urine sugar with blood sugar of 82 mg/dl
 
        E) Jaundice
 

 


Back to the question = Go back to the top of the page.
See another question like this one = Reload a different version of this question ().
Click here for a random question = Load a random question from the database.
Clone this question = Use this question as a template to create a totally NEW question.
Rate this question = Enter detailed rating for this question!
Average user rating for this question = 1.5 = How users like you have rated this question.
This question was created on October 27, 2008 by rednucleus.
This question was last modified on October 27, 2008.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Bilateral extensor planters

This answer is correct.


The presence of solid upper motor neuron signs in Wilson's disease should strongly question this provisional diagnosis.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 1.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




B) Recurrent acute hepatitis

This answer is incorrect.


The presence of recurrent unexplained acute hepatitis in young individuals should prompt the physician search for Wilson's disease.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 1.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




C) Normal corneal examination

This answer is incorrect.


Around 2% of Wilson's patients with neurological involvement have no Kayser-Fleischer (KF) ring, while this figure drops down to 60% in those with hepatic involvement only. Note that the commonest cause of negative KF ring in those with clear-cut Wilson's is "examination by an inexperienced ophthalmologist!"  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 1.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




D) Positive urine sugar with blood sugar of 82 mg/dl

This answer is incorrect.


Wilson's disease is one of the recognized causes of proximal renal tubular acidosis.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 1.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




E) Jaundice

This answer is incorrect.


From hepatic involvement or from Coomb's negative hemolytic anemia. Note that Wilson's can result in recurrent Coomb's negative hemolytic anemia.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 1.5
Please log in if you want to rate questions.

 

 

 

 

References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York. (ISBN:0070674973)Advertising:
Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 1.5
Please log in if you want to rate questions.

 

FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
adult
Neuro-Medicine...
Question ID: 102708232
Question written by rednucleus. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 10/27/2008
Modified: 10/27/2008
Estimated Permutations: 120

User Comments About This Question:

0 user entries
Please log in if you'd like to add a comment.