A shuffling gait is typically associated with a patient who has?

Appeared in: HPSSC - 2015

Explanation

A shuffling gait is a classic and distinctive feature of Parkinson's disease, as confirmed by the visual evidence in the image.
This gait results from bradykinesia (slowness of movement) and rigidity, which are core motor symptoms of the condition.
Other accompanying signs include a stooped posture, reduced arm swing, and a tendency to take rapid, small steps (festination), all of which are caused by the loss of dopamine-producing neurons in the brain.

Option A: This is a vascular disorder causing vasospasm in fingers and toes in response to cold or stress; it does not affect gait.
Option B: This autoimmune disorder causes fatigable muscle weakness. While severe proximal weakness can lead to a waddling gait, it does not typically cause a shuffling gait.
Option D: This demyelinating disease of the central nervous system typically causes a spastic gait (stiff-legged, scissoring) or an ataxic gait (unsteady, wide-based) due to upper motor neuron damage or cerebellar involvement.

Clinical Relevance

Nursing practice connection: Use the key finding related to Gait assessment and its association with neurological disorders to guide bedside assessment, documentation, and the next nursing action.
Observing a patient's gait is a fundamental nursing assessment skill that provides crucial clues to underlying neurological conditions and helps in evaluating fall risk.
Early recognition of a shuffling gait allows for timely referral and management, which can improve the patient's quality of life and safety.
What if? If the patient had a wide-based, unsteady, 'drunken' gait, the most likely cause would be a cerebellar disorder (ataxic gait), not Parkinson's disease.

How to Approach the Question

First, identify the key clinical sign presented in the question: 'shuffling gait'.
Second, analyze the accompanying image, noting the stooped posture and short steps, which are classic features that complement the description of a shuffling gait.
Third, systematically review the options and recall the typical presentation of each disease.
Match the shuffling gait to Parkinson's disease, which is known for its characteristic motor symptoms of bradykinesia and rigidity.
Eliminate the other options by recalling their distinct presentations: Raynaud's (vascular), Myasthenia gravis (fatigable weakness/waddling), and Multiple sclerosis (spastic/ataxic gait).

Concept Tested & Keywords

Concept Tested: Gait assessment and its association with neurological disorders.
Stem keywords: shuffling gait
Lead-in keywords: typically associated with
Clinical cues: The image shows a classic parkinsonian posture, which reinforces the diagnosis associated with a shuffling gait.

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E6 Medicine Harrison 22e Part 1 p. 219-221

Practise the full HPSSC - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.