T.K. is a 62-year-old woman with a past medical history

T.K. is a 62-year-old woman with a past medical history of bipolar disease, hypertension, and diabetes, for which she takes lithium, valproic acid, lisinopril, and metformin. She states that she was diagnosed a week ago with dyslipidemia but is currently trying to control it with a strict diet. She presents to the clinic with feeling much weaker and has noticed increased arm tremors while she is resting after performing household duties for the past few months. Upon examination, it is found that she can walk with a normal gait, which she describes as “slow” for her, and has a slight tremor in her arms at rest, which persists with movement. She states her friend was recently diagnosed with Parkinson’s disease and thinks she may have it as well. 1. What is the most appropriate first step in evaluating T.K. for Parkinson’s disease? 2. What is the most appropriate recommendation for T.K.? 3. What is the most appropriate initial therapy for T.K.?

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