A 65-year-old woman is accompanied by her daughter for a physical examination. She has mild heart failure and takes digitalis and an ACE inhibitor. As you examine the patient, you note flat affect, hand tremor, and slowed movements. The tremor is worsened at rest. There are no neurological deficits. Hand grip, sensation of face and extremities, and lower extremity muscle strength are within normal limits and bilaterally equal. Deep tendon reflexes are equal bilaterally. Cranial nerves II to XII are intact. The mental status examination is normal. These are key signs of:

Question

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The symptoms described, such as flat affect, hand tremor, and slowed movements with the tremor worsening at rest, are classic signs of Parkinson's disease. These features align with the cardinal signs of Parkinsonism, which include tremor, bradykinesia (slowed movement), rigidity, and postural instability.

A 65-Year-Old Woman Is Accompanied by Her Daughter for a Physical