Mehl. Bullet - parkinson/parkinson like

Question 1

M. 42F + 3-month Hx of insomnia + discomfort while lying in bed; next best step in management?

Answer 1

Check serum iron.
Dx = restless leg syndrome i

Question 2

M. 42F + 3-month Hx of insomnia + discomfort while lying in bed + serum iron and ferritin are normal; next best step in management?

Answer 2

D2 agonist – i.e., pramipexole or ropinirole, etc.

Question 3

M. Patient with restless leg syndrome is at increased risk for what disease later in life??

Answer 3

answer on USMLE = Parkinson disease (if D2 agonist can Tx, then lack of dopamine transmission may be etiology in some patients).

Question 4

M. 64M + Parkinson disease + 2-month Hx of paranoid behavior; Dx + Tx?

Answer 4

Dx is Parkinson disease
psychosis (PDP);

Tx on shelf = quetiapine (can Tx with quetiapine or clonidine).