Welcome to your Gp neelima neuro muscular 6-02-17

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Which of the following is a polygenic disorder?

A 23-year-old female is admitted with acute onset headache and is drowsy. She is opening her eyes spontaneously, is disoriented but is localizing to painful stimuli. Which of the following is the investigation of choice for this woman?

A 20-year-old male is admitted with a history of diarrhoea and vomiting associated with weakness of first the lower limbs, and progressing upwards along difficult swallowing. FVC is 1.5 L.Which of the following is the most appropriate immediate treatment for this condition?

A 58-year-old male with severe brain damage is apnoeic, unsedated, and temperature 36.9°C. He is intubated and ventilated. His biochemistry is normal.

A 59-year-old woman presents with polysymptomatology. On examination she has prominent fasciculations. Which of the following conditions is she unlikely to suffer from?

A 45-year-old male presents passing 4-5 litres of urine per day, after commencing a new drug.
Serum sodium            142 mmol/l
Plasma osmolality           295 mosmol/l
Urine osmolality           280 mosmol/l
What drug was prescribed?

A 51-year-old has a 12 month history of deteriorating memory. He has otherwise been well and takes no medication. Which of the following is most typical of frontal lobe dysfunction?

A 70 year old man is recently diagnosed with small cell cancer of the lung. He presents to the emergency room following a witnessed, single, tonic-clonic seizure. His serum sodium is 106mmol/L. The best approach to the management of his electrolyte disturbance is

A 75 year old, right handed person has a history of hypertension and dyslipidaemia for 30 years. He is a retired banker who recently has had trouble calculating his restaurant bill. He also notices that his writing has deteriorated. On physical exam, he has difficulty naming his fingers and is confused with distinguishing left from right. In which part of the brain is the lesion present?

Which has shown to reduce the risk of falls in the elderly?

A 65 year old woman is brought to the emergency department by her family due to development of sudden aphasia and right sided hemiparesis. Her symptoms resolve a few hours later in the hospital. The most likely cause of this woman´s condition is

A 62 year old man presents with the symptoms of ophthalmoplegia, pseudobulbar palsy, axial dystonia and bradykinesia. He is diagnosed as progressive supranuclear palsy. What brain finding would most likely be present in this patient?

Most common cause of dementia in the elderly in developed countries is which of the following?

All of the following are clinical manifestations of neurosyphilis, EXCEPT

A 76 year old Asian woman presents to you with a history of gradual onset of localized low back pain for 6 weeks. The pain is increased with walking or standing and relieved by sitting and lying. Pushing a shopping cart dramatically relieves the pain. Which one of the following is the most likely diagnosis based on the history?

A 70 year old male nursing home resident for three years presents with symptoms of increasing nervousness, anxiety, and worsening of his upper extremity tremors. Which of the following is NOT a cause of his symptoms?

A 26 year old woman presents with a severe headache, concomitant with confusion and somnolence. She progresses to seizures and focal neurologic deficits are noted. The defects are associated with a tear in the vessels of the dural sinus. The most likely diagnosis is

An 86 year old woman complains of right temporal headaches of throbbing by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198780&Page=18#48711647">NATURE associated with malaise and fatigue. Brain CT scan and neurological exam were normal. She experienced sudden blindness in her right eye a week later. Her ESR was 120 mm/hr and a hematocrit of 28%. The most likely diagnosis is

A woman with somnambulism has fallen asleep. She passes from light sleep into a deeper sleep. Just before she experience an episode of somnambulism, her EEG is likely to show which of the following?

A 64-year-old man has lower back pain that radiates to the back of his buttocks, thighs, and lower legs for past several months. It starts when he is walking and improves on stopping and stooping forward. He also has numbness and weakness in both his lower extremities. The pain can be elicited by extension of the spine. Significant muscular wasting is noted in the lower limbs. CT scan confirms the suspected diagnosis. On his previous visit 2 weeks ago, the patient was referred for physical therapy. He was also prescribed a high dose of NSAIDs. Which of the following should be the next step in management?

A 50-year-old woman with a history of partial epilepsy and alcohol abuse has been sober for 2 months. Her seizures had previously been well controlled with phenytoin. She again had a seizure with rhythmic jerking of her left arm, then fell to the ground, and then she proceeded to have a generalized tonic-clonic seizure lasting 2 minutes, during which she urinated. 20 minutes after the seizure, her mental status returned. Examination is nonfocal. Which of the following diagnostic studies would be the most useful in determining the etiology of her breakthrough seizure?

A 22-year-old man has a 3-day history of weakness and tingling in his legs, which has worsened to involve his upper body. He is now having difficult breathing. He has HIV with the last CD4 T-cell count being 750 cells/mm3. He is vitally stable except that respiratory rate is 30/mm. There is profound weakness in his lower extremities and torso, with normal cranial nerves and moderately reduced strength in his upper extremities. Deep tendons reflexes are absent in his lower extremities and reduced in his upper extremities. What will the CSF show?

A 50-year-old male feels he is about to pass out when he gets up from seated or lying position. He drinks 14 by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198780&Page=23#93387709">GLASSES of water daily. His BP is 120/80 on sitting that changes to 70/50 upon standing along with dizziness and loss of balance. Mucous membranes are moist. What would be the best diagnostic study to confirm the diagnosis?

A 75-year-old man has gradually worsening forgetfulness and disorientation for past 2 years. Last week twice he left the house and was found in the street. He misplaces things, gets confused dressing and often insists that he has taken a bath when he has not. He can no longer manage his money. No by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198780&Page=24#14894889">IMPORTANT past history. Evaluation rules out thyroid disease, metabolic and endocrine disorders, depression, drug effects, vitamin deficiencies, vascular disease, infectious disease, and normal pressure hydrocephalus. Mental status examination reveals cognitive deficits. Which neurotransmitter abnormality is most common in this disease?

A 39-year-old diabetic (poorly controlled) has diplopia and occasionally blurred vision when hyperglycemic. She is unable to keep her right eye open since 1 day. She also has migraine headaches, particularly severe for the past 2 days. Family medical history is significant for diabetes, renal failure, and heart disease. Examination reveals a droopy right eyelid and an inability to elevate, adduct, and depress the right eye. The right pupil also appears dilated. Vision is 20/30 OD and 20/25 OS. Which of the following is the most likely cause of her visual complaints?

A 59-year-old man with a history of squamous cell carcinoma of the lung diagnosed 2 months ago has seizures and decreased mentation. He is drowsy, is moving all four extremities but does not follow verbal commands. A CT scan of the head shows multiple brain metastases with cerebral edema. The patient is started on intravenous steroids and phenytoin. From which additional therapy would this patient benefit?

Investigation that best supports a diagnosis of new variant CJD is which one of the following?

A 24 year old man is admitted after an altercation in which he is stabbed in the thigh by a bottle. Which feature suggests injury to the femoral nerve?

A 44 year old type 1 diabetic has a 2 month history of deteriorating pain and stiffness of the right shoulder. Exam shows painful limitation of internal rotation and can abduct the right arm to only 90 degrees. Flexion is unimpaired. There is weakness of movement of that shoulder with slight wasting of shoulder muscles. Reduced vibration sensation is present in both hands. The diagnosis is

A 66 year old man presents with unsteadiness, rigidity of movement and tremor of the right hand. The feature that most strongly suggest Idiopathic Parkinson Disease is which one of the following?

A 55-year-old man has features of a paraspinal abscess affecting C4-C6 along a soft systolic murmur and clear chest. What investigation is useful?

A 78 year old man becomes "senile" over a period of 3 or 4 weeks. He used to be active. Now, he stares at the wall, barely talks, and sleeps most of the day. His son recalls that he fell from the stairs about a week before the mental changes began. Which of the following would a CT scan of his head most likely show?

A 37 year old intoxicated man is brought to the Emergency Department with a deep laceration to his right distal forearm after putting his hand through a window. On examination, he has no sensation to his little finger and the ulnar aspect of his ring finger. He is unable to flex the distal joint of his little finger. Power on abduction and adduction of all fingers is markedly decreased. When he flexes his wrist, his hand deviates radially. What structure(s) have been damaged?

A 57-year-old man presents with night time sweats, nocturia, poor concentration and day time somnolence. To which of the following conditions does this diagnosis predispose?

Which of the following is not included in the initial management of any patient with coma of undetermined cause?

A 51 year old female with a history of hypertension and non-insulin-dependent diabetes mellitus presents to the emergency department with diplopia. She felt numbness in the right side of the face and sensation of weakness in the right arm earlier that day. Within 2 to 4 hours she had developed complete ptosis of the left eye. Which of the following arteries is occluded in this patient?

A 50 year old man with a long history of alcohol use comes to the emergency room of a general hospital. He is confused and on examination is noted to have palsies of conjugate gaze, horizontal nystagmus, and ataxia. The most likely diagnosis is

A 22 year old woman is brought to the Emergency Department with a history of acetaminophen overdose 4 hours ago. She is drowsy with a respiratory rate of 24/minute. All of the following are included in her treatment, except

A patient is on carbamazepine for his new onset seizures. He has now had 3 attacks in last 2 weeks. His serum level of carbamazepine is normal. The most appropriate next step is

A gunshot wound to the upper arm causing shock wave damage to the median nerve may leave the patient with

A 32 year old has been on life supports systems for the past 48 hours following blunt head trauma. Brain death cannot be established in his patient if there is the presence of

A 73-year-old lady has four months of memory loss, urinary incontinence and falls. On examination she has mild memory loss and a broad-based, slow gait. Muscle tone is normal and both plantars are down going. Diagnose:

An elderly patient suffers from a head trauma and is brought to the ER for its treatment. He develops changes in behavior with frequent vomiting and headache. Which of the following is not indicated in the initial management?

A 70 year old man on physical examination is found to have expressive dysphasia and mild right arm weakness. The most probable location of his lesion is which of the following?

A mother tells the pediatrician that her brother died of Duchenne muscular dystrophy at age 18. She is worried about her 4 year old son that may have the condition. Muscles near which of the following joints are affected earliest in this condition, and therefore should be the target of examination?

A mentally retarded child presents with seizures. His head CT scan demonstrates multiple hamartomas of the brain. The child also has adenoma sebaceum (perivascular angiofibromata) on his face. The lesion that is associated with this patient´s disease is

The cut surface of the brain photograph shows well circumscribed regions of gray discoloration of various brain regions. The patient was a 63 year old woman who had a 20 year long history of a neurologic disease characterized by a relapsing recurring course and various neurologic deficits. The most likely underlying mechanism of this condition is

Which would not be present in a right sided Brown-Sequard syndrome?

A patient was involved in an automobile accident. CT scan fails to show a pituitary gland. Endocrine evaluation demonstrates serum hormones are all within normal limits. The most likely diagnosis is

All of the following conditions are associated with neuropathic arthropathy, EXCEPT

A 56 year old alcoholic male is brought to the ER in a state of global confusion, psychosis, and ataxia. Examination demonstrates ophthalmoplegia and polyneuropathy. What is the most appropriate treatment for this patient?

A 69-year-old man has weakness, headaches, and an inability to perform simple activities of daily living. He no longer knows how to dress himself or brush his hair, and worries that he has lost the ability to use his left hand. His memory that has been declining for the last few years is much worse than it used to be. He has had CAD, TIA 2 years ago, and AF. His AF has been treated with warfarin for the past year, although he has not taken any medications over the last week. Vital signs are normal. Neurologic examination reveals a left-sided hemiparesis that is worse in the arms, left-sided neglect and a left-sided homonymous hemianopsia. Sensation is intact, although reflexes are brisk. Localize the lesion:

A 60-year-old man has been very forgetful for the last few weeks. He is unable to find things at home, has difficulty remembering names, and occasionally did not recognize his daughter. He developed urinary incontinence 3 weeks ago. He is confused but is not in any distress. He is noticed to have a short-stepped, shuffling gait with postural instability. He walks normally when offered support. Which of the following is associated with this patient´s condition?

A 30-year-old female has headaches for past 2 years relieved by high doses of aspirin or ibuprofen. Coughing and sneezing aggravates the headaches and there are moments of blurring of vision. She takes OCPs and tetracycline for acne. She has prominent papilledema on eye exam. Next step in her management is:

A 56-year-old smoker has persistent headache bilaterally on the temporal and occipito-nuchal areas, squeezing and band like, for past 2 months. He had a sudden severe headache this morning, crashed to the ground, and started having a seizure. There is decreased sensation and power in the right half of the body. A ring like zone of contrast enhancement extending into the right hemisphere with hemorrhage inside is seen on T1-weighted MRI images, surrounded by extensive edema appreciated on T2-weighted images. Laboratory investigations are within normal, including negative antibodies to HIV. Which of the following is the most likely diagnosis?

A 50-year-old man over the past couple of months has periods in which his body shakes. These are limited to his face, arms, and legs. He had recent promotion at work. On grabbing a pen, his hands begin to shake. He has healed first-degree burns on his hands, due to spilling coffee all over himself. His father had something similar to this as a middle-aged man. What is the next step in the management of this patient?

A boy aged 18 years has a history of a sudden onset of a frontal headache and photophobia. He had neck stiffness and a temperature of 38°C.

Following binge drinking, a 42-year-old female develops protracted vomiting, aspiration and right lower lobe pneumonia. Her Na is 123mEq/L. She is placed on antibiotics and receives an IV drip of 5% normal saline. Next morning she is oriented but unable to speak or move her extremities. Her Na is 141mEq/L. What would head MRI show?

A 30-year-old woman with progressive weakness of the left side of her body (especially lower limb) over the past 2 weeks gets a grand mal seizure. There is extension of the left great toe with left-sided plantar stimulation. CBC = Normal, CSF = mild lymphocytosis, elevated protein, and a moderate amount of eosinophils. Gram stain shows no organisms. MRI is as follows:

What is the most appropriate treatment?

A 33 year old woman has bilateral hand numbness and tingling. The symptoms began approximately 9 months ago. The symptoms are worse at night and when she is working and are affecting her work as a by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198814&Page=30#50279420">COMPUTER programmer. On examination, there is tingling of the fingers when the base of the wrists are tapped. There is mild weakness of right thumb abduction. No atrophy is seen. Deep tendon reflex are normal. Following X-ray, which one is next step in management?

Which of the following would be expected following distal occlusion of the posterior cerebral artery?

A 72-year-old female with a prior history of chronic anxiety has 3 day old severe left temporal headache radiating from the eye to the scalp and also feels discomfort during eating. Which one of the following drugs should be given to this patient while awaiting the results of diagnostic tests?

A 25-year-old lady is diagnosed with left eye optic neuritis. An MRI scan of her brain is normal. What is the chance of her subsequently developing Multiple Sclerosis?

An 82 year old female suffers cervical spinal soft-tissue injury in a motor vehicle accident. No neurologic or skeletal damage is reported at the time. Three months later, she presents with sudden onset of homonymous right upper quadrantanopia. CT scan reveals a non-hemorrhagic lesion in the left lower occipital lobe. Which imaging study would provide the most useful information?

A 56 year old man complains of extremely severe, sharp, shooting pain in his face. He describes the episodes as being "like a bolt of electricity" that are brought about by touching a specific area, last about 60 seconds, and occur many times during the day. Neurologic examination is normal, but it is noted that part of his face is unshaven because he fears to touch that area. Gadolinium-enhanced MRI shows no abnormalities of the trigeminal nerve. The most appropriate initial treatment is

A 54 year old woman presents with ptosis and diplopia. On examination of the eye, the pupil is widely dilated and non reactive to by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198834&Page=6#67357984">LIGHT. Which nerve is likely injured?

Which of the following is not seen in alcohol withdrawal?

A 34 year old man was driving his car when he was struck from behind by another car. He experienced immediate neck and shoulder pain and was seen and examined by you in the emergency department. Physical examination showed slight cervical muscle spasm. Cervical spine and shoulder X-ray films at that time were normal. You reassured him that no structural damage was evident on the studies. He was treated with a return visit in the office in 2 week. Today, at the 4 week return visit, he insists he is not improved and demands everything be done to "find out why I still hurt." Physical examination including neurologic examination is normal. Repeat X-ray films of the cervical spine are normal. At this time it is most normal. What is appropriate to tell the patient at this time?

All of the following hematologic conditions may produce stroke EXCEPT

A 36 year old businessman who works out of his home and does most of his work on his personal by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198834&Page=10#42048660">COMPUTER has noticed that he is waking up during the night with numbness and tingling in his fingers. A definitive diagnostic test in this individual is

A 65 year old man begins to develop behavioral changes and irritability, and is found wandering in the park near his home. Neurological examination shows the presence of mind aphasia and cognitive dysfunction, but motor function is preserved. CT scan of the head demonstrates selective atrophy of the cortex of the frontal lobes. The most likely diagnosis is

A 3 year old child with a history of an ependymoma is examined by CT scan of the head. Although the mass is seen to impinge on a tract of the CSF circulation, the ventricles all appear completely normal in size. Obliteration of which of the following structures is most likely to allow the patient to avoid the development of hydrocephalus?

A 55 year old man presents to the emergency department after an episode of bizarre behavior. The patient dies in sepsis one day later, despite medical therapy. The brain at autopsy is shown in the photograph below. The most likely cause the observed process is

A 4 year old girl is brought to the emergency room by her parents. According to them the girl has been complaining of severe headache and has two episodes of vomiting. There is bilateral papilledema and an impaired level of consciousness on physical examination. Emergency contrast CT scan reveals displacement of the ventricular system by a multilocular mass with well defined white high attenuation by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198834&Page=14#30633272">RINGS around black low attenuation centers. The lesion involves the cerebellum. This lesion most likely related to which of the following?

A 52 year old female presents with a 5 year history of headaches, generalized tonic clonic seizures, and bilateral leg weakness. Radiographic imaging of skull reveals hyperostosis of the calvarium. Biopsy of the responsible lesion shows a Whorling pattern of the cells. The most likely diagnosis is which one of the following?

A 22 year old boy is brought to the ER after a bicycling accident. A car door suddenly opened in front of him. He smashed into it and was thrown 15 feet away. On examination, he is drowsy and confused. He opens his eyes when his name is called. He mumbles words that you understand but the sentences do not make sense. He moves all four limbs but does not respond to any commands. He is able to pull both hands away when pinched and squirms when his sternum is rubbed, making no effort to stop you. The Glasgow COMA Scale of this patient is

Test that would be LEAST useful in the diagnosis of myasthenia gravis is which one of the following?

Which of the following does NOT play a role in the management of increased intracranial pressure?

A 62 year old type 2 diabetic presents because of falls and postural instability. He has a mild resting tremor in his right hand. His condition improves when an anticholinergic agent is started. He returns a month later because his symptoms returned by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198834&Page=19#86836811">SHORTLY after he started a new "stomach" medication. Which medication was most likely prescribed?

A 42-year-old man has an intermittent and severe headache for 2-weeks. It occurs in the evening and awakens him from sleep. It is severe, grade 9/10, and ibuprofen does not benefit. It never lasts more than 2 hours. It is behind the left eye radiating to the neck and shoulders along watery discharge from his nose and a droopy eyelid during the attacks. Yesterday, he had "the worst headache of my life", which having intercourse. He often takes cheese and chocolate. Examination is normal. Which of the following is the most likely diagnosis?

A 59-year-old woman has suffered lancinating facial pain in the distribution of the second and third branches of her trigeminal nerve for the past year. Occasionally, it is associated with facial spasms and often is precipitated by brushing her teeth or a particularly vigorous yawn. Carbamazepine provided minimal relief. She has tried multiple antiepileptic medications and baclofen but the pain still continues. She denies any aura, visual changes, or nausea. Which is the next best step?

A 16-year-old girl complains of being unable to taste foods the way she used to. She also has difficulty chewing and swallowing. She has a burning sensation in her mouth whenever she eats spicy foods or drinks carbonated beverages. She also has complaints of dry eyes. She noticed these symptoms 4 weeks ago initially. She has dry, red eyes and dry mucosal surface in the oral cavity, along with dental caries. She keeps clearing her throat, and there is an increase in the hoarseness of her voice. Which of the following is the most likely cause of this patient´s symptoms?

A 10-month old infant had a seizure an hour ago. He has not been able to feed all day and has been unusually somnolent and vomited twice by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198834&Page=23#22071470">SHORTLY. The mother is constantly frustrated with him and has to discipline him regularly. No trauma history exists. He had chickenpox 3 months ago that recovered within 3 week. He was born at 34 weeks´ gestation and is up to date on his immunizations and normally developing. He responds minimally to voice, palpation, or toys. All examination is normal. Which of the following is the appropriate next step?

A 55-year-old man (a 40-pack-year smoker) has weakness and blurry vision for the past month. Primarily, he has had difficulty raising his arms above his head and getting up out of a by DealXplorer" href="http://www.interface.edu.pk/medical-exams/test.php?u=33509&t=198834&Page=24#36695407">CHAIR. His eyes appear more "droopy" than before. He is afebrile and normotensive. He has ptosis, which improves with repetitive blinking. He has 4/5 strength is his proximal shoulders and legs, and 5/5 strength in the rest of the muscle groups. Remaining all examination is normal. Which of the following is the next step in management?

A 56-year-old diabetic and hypertensive is having steadily deteriorating gait and incontinence, has difficulty walking without assistance and is unsteady. He has had multiple falls and has truncal ataxia. Otherwise he is normal. One week ago, he fell against the wall and broke a left rib. He has had pneumonia. He takes insulin, lisinopril, and aspirin and has no known drug allergies. CT scan of the head show enlarges ventricles. MMSE shows slightly diminished performance. Which of the following is the most appropriate management?

A 59-year-old man has extremely severe, sharp, shooting pain on the right side of his face; as being like a bolt of electricity brought about by touching a specific area. This lasts about 60 seconds and occurs many times during the day. No nighttime episodes of pain exist. Examination and MRI scan are normal. Which is the most appropriate next step?

A 23-year-old woman has a severe headache that began early in the morning. It is located mainly on the right side, worsened by rapid head motion or sneezing. The face and scalp are extremely tender on the right side. She has had similar attacks in the past and finds some relief by lying down in a dark, quiet room. She denies any visual auras but does report hearing a ringing in her left ear. Photophobia exists. Which neurotransmitter requires modulation here?

A 65-year-old man has watery nasal discharge and mild headache for the last several days in the absence of upper respiratory infection. He has a family history of asthma, allergic rhinitis, and atopic dermatitis. He takes hydrochlorothiazide and omeprazole for HTN and GERD. No other findings exist. Evaluation of the nasal discharge with glucose testing suggests a CSF leak. Which of the following is the next best step in management?

A 24 year old woman has a 2 day history of diplopia and unsteadiness. 2 weeks ago she suffered an upper respiratory tract infection. On physical exam there is complete opthalmoplegia, areflexia and gait ataxia. The blood tests that is most likely to confirm the underling diagnosis is which one of the following?

A 63 year old smoker has a tremor mostly affecting the right hand but also latterly the left hand which hand gradually deteriorated over five years. He drinks 15 units of alcohol weekly, noting an improvement in his tremor following alcohol. Exam shows some mild titubation and a postural tremor in both arms with no worsening during finger-nose testing. The most likely diagnosis is

After being increasingly confused, unsteady and unable to look after herself over the last two to three weeks, an 80-year-old female is admitted following a seizure. She was drowsy and had a temperature of 37.5°C, and a blood pressure of 190/110 mmHg. She had a mixed aphasia and mild right hemiparesis. What is the most likely diagnosis?

Regarding benign essential tremor which of the following is true?

A 30-year-old man has a previous history of acute intermittent porphyria. He has been violent with acute psychosis. Which of the following sedatives would be the most beneficial and safest for him?

A 75 year old woman presents with a 6 month history of pain in thighs, deteriorating gait and low back discomfort, exacerbated by walking. Examination reveals hypoactive muscle stretch reflexes in the legs. X-rays of the lumbosacral area shows the expected degenerative changes associated with a woman of her age. The most likely diagnosis is

Frontal lobe brain damage is associated with which of the following?

Which finding of physical examination is usually not associated with increasing intracranial pressure?

A 73 year old male sees a physician with advanced Parkinson´s disease. What would be the best initial treatment?

A 50 year old man comes to the emergency room with a 20 year history of alcohol abuse. He is agitated and floridly psychotic, with visual hallucinations and persecutory delusions. On examination his blood pressure, heart rate and respiratory rate are all increased. He is disoriented, sweaty, and has abdominal cramps. The most likely diagnosis is which of the following?

Which of the following presentations will be present in a radial nerve injury?