Shaky hands and slurred speech

Instructions

You are a medical student on placement in general practice. Your next patient is Beatriz Cardoso, 17, who has had shaky hands for four months and, more recently, slurred speech. Her father has brought her in.

1. 1

   Take a focused history

2. 2

   Perform a focused examination

3. 3

   Outline to the examiner:

   • Your most likely diagnosis and differentials
   • Next steps in management, including relevant investigations

• Please verbalise your examination; findings will be provided on request
• You do not need to summarise your findings