Tremor in a 63-year-old man
Outpatient ClinicLarry Sanosyan · 63yo male · CC: Tremor
History
0/7 key findingsAsk the questions your differential demands — not just the ones the case volunteers. Every diagnosis you intend to list owes you one discriminating question.
CASE SETTING: OUTPATIENT CLINIC
Larry Sanosyan, a 63-year-old man with a progressive right hand tremor
Vitals
Opening
Larry Sanosyan, a 63-year-old retired carpenter, comes to the Outpatient Clinic because of a shaking right hand that his wife first noticed about eight months ago. He says it has gradually become more noticeable and is starting to frustrate him when he buttons his shirts or writes checks. He sits calmly on the edge of the exam table with his hands resting in his lap; his right thumb and index finger oscillate steadily while he listens to you.
Reason for visit
63-year-old right-handed man presenting for evaluation of an 8-month history of progressive right hand tremor and stiffness.
Opening statement
"My wife made the appointment because my right hand shakes whenever I'm watching TV. I thought it was just getting older, but now my handwriting is tiny and it takes me twice as long to get dressed."
Larry Sanosyan · 63yo male
Sitting quietly on the exam table with reduced facial expression and a rhythmic right-hand resting tremor