Repeated USMLE Questions Step 1- 191

A 36-year-old man comes to the office for evaluation of involuntary movements of his hands and feet. These movements developed gradually over the past 3 years. He is otherwise in a good health and takes no medication. He does not smoke or drink alcohol. He does not drink any caffeinated beverages or use any recreational drugs. His family noticed recent personality changes over the same period. On examination, there are abnormal involuntary movements of his hands with no certain pattern. He walks in dancing like-movements that make him almost losing his balance. Mental status examination shows abnormal low score.

What is the most likely diagnosis of this patient?

A- Parkinson's disease

B- Creutzfeldt-Jakob disease

C- Tourette's syndrome

D- Drug-induced tremors

E- Huntington's disease

Answer







Dancing-like involuntary movements with no pattern are characteristic of chorea. The patient age, gradual development of symptoms and abnormal mental status suggest Huntington’s disease.

The correct answer is E