Findings come first and conclusions after in this closing MN552 presentation: one composite man's tremor exam, then four candidate explanations, each citing lines for and against. Searches like "mn 552 unit 10 assignment example", "mn552 unit 10 sample" and "mn552 unit 10 example" land here.
Bilateral Hand Tremor in a Retired Letter Carrier: An Assessment Case Presentation
[Student Name]
Purdue University Global
MN552: Advanced Health Assessment
Unit 10 Assignment (slides with speaker notes)
[Instructor Name]
[Date]
Composite patient written as a model document. No real patient or clinician is described.
Slide 1: Chief Complaint
Slide text: 66-year-old retired letter carrier. "My hands shake. I spill my coffee and my signature looks like a kid wrote it."
Speaker notes: I open with his own words because they describe the problem in terms of what he can no longer do. Both examples involve holding or using something, which frames every slide that follows: this is a tremor that matters when his hands are working. He carried mail for 34 years, retired two years ago, and now volunteers at a food pantry, where he stacks cans and signs delivery forms; both tasks have become harder. He came in because his wife noticed him using two hands to lift a mug and asked him to get it checked. He has no other neurologic complaints. The audience should hold two questions while I present the data: in which positions does the tremor appear, and what else would be present if it were something other than a tremor alone?
Slides 2 to 5: History, With Numbered Findings
Slide 2 text: Onset 8 months ago. Both hands. Gradual. Speaker notes: Finding 1, onset about eight months ago, gradual, with no sudden start. Finding 2, both hands from the beginning, which he says are about equally affected.
Slide 3 text: Worse holding a cup or a pen. Better after wine at dinner. Speaker notes: Finding 3, worse when holding a cup, writing or using a screwdriver. Finding 4, not noticed when his hands rest in his lap watching television. Finding 5, noticeably less for about an hour after a glass of wine with dinner.
Slide 4 text: Mother "had shaky hands." Five cups of coffee daily. Albuterol inhaler twice a month. Speaker notes: Finding 6, his mother, who died at 88, had shaky hands for many years; no diagnosis he knows of. Finding 7, five cups of coffee a day for decades, unchanged recently. Finding 8, albuterol inhaler for mild asthma, used about twice a month, last used three weeks ago.
Slide 5 text: No weight loss, no heat intolerance, no falls, no change in walking, no change in smell. Speaker notes: Finding 9, he reports no weight loss, palpitations or heat intolerance. Finding 10, no falls, no shuffling, no change in handwriting size, no loss of smell and no acting out dreams, according to his wife.
Slides 6 to 8: Examination, Described by Position
Slide 6 text: Tremor by position. Speaker notes: Finding 11, no tremor with hands resting in his lap during a 60-second observation, including while counting backward from 20. Finding 12, a fine, rapid tremor of both hands with arms held outstretched, roughly symmetric. Finding 13, tremor present throughout finger-to-nose testing in both arms, without increasing sharply as the finger nears the target.
Slide 7 text: No head or voice tremor. Normal tone, tapping and arm swing. Speaker notes: Finding 14, no head tremor and no voice tremor while reading a paragraph aloud. Finding 15, tone normal in both arms with passive movement at wrists and elbows, including with a contralateral activation maneuver. Finding 16, finger taps maintain speed and amplitude over 10 repetitions in both hands. Finding 17, arm swing equal while walking, gait normal, turns in three steps.
Slide 8 text: Thyroid not enlarged. Pulse 72. No other neurologic findings. Speaker notes: Finding 18, thyroid not enlarged and without nodules, no eyelid lag. Finding 19, pulse 72 and regular, blood pressure 132/78 mm Hg. Finding 20, remainder of the neurologic examination, including cranial nerves, strength, reflexes and sensation, without abnormality.
Slides 9 and 10: Differential, Each Entry Cited
Slide 9 text: Essential tremor; enhanced physiologic tremor. Speaker notes: Rule for this list: no entry appears without a supporting finding. Essential tremor. For: bilateral action and postural tremor (2, 3, 12, 13), absent at rest (4, 11), gradual onset over months (1), a likely family history (6) and improvement with alcohol (5), which is often reported in this condition. Against: no head or voice tremor (14), though these are not required. Enhanced physiologic tremor. For: fine postural tremor (12), five cups of coffee daily (7) and a beta-agonist inhaler (8). Against: inhaler use is infrequent and was not recent (8), coffee intake is long-standing while the tremor is new (1, 7), and the family history (6) is not explained.
Slide 10 text: Thyroid-related tremor; parkinsonism. Speaker notes: Thyroid-related tremor. For: fine postural tremor (12). Against: no weight loss, palpitations or heat intolerance (9), a normal pulse (19) and a thyroid gland that is not enlarged (18). Parkinsonism. For: tremor at age 66 raises the question, so it belongs on the list. Against: no rest tremor (4, 11), normal tone (15), no slowing or decrement in finger taps (16), normal arm swing and gait (17), and no loss of smell or dream enactment (10). Current clinical criteria for Parkinson disease require slowed movement plus rest tremor or rigidity, and none are recorded here (Postuma et al., 2015).
Slides 11 and 12: What Would Sharpen the Picture, and References
Slide 11 text: Observations still to gather. Speaker notes: Two observations would sharpen this picture without starting a workup: a handwriting sample, looking at size and tremor in the strokes, and an Archimedes spiral drawn with each hand. Both are simple bedside records that show tremor amplitude and can be repeated at future visits to track change. A third observation is functional: asking him to pour water from one cup to another and to drink from a full cup, which reproduces his chief complaint in the room and gives a baseline he and his clinician can both see. His own goal, which he stated at the end of the visit, is to sign his name clearly on the pantry forms again, and any future record should measure progress against that goal as well as against the spiral. None of these observations is a diagnostic test, and none commits him to a plan; they make the next description more precise than this one. The consensus classification of tremor by the International Parkinson and Movement Disorder Society emphasizes describing the activation condition, distribution and associated signs before naming a syndrome, which is the order this presentation follows (Bhatia et al., 2018). A practical review for primary care makes the same point about separating rest from action tremor at the first visit (Crawford & Zimmerman, 2018).
Slide 12 text: References. Speaker notes: Three sources are cited, all accessible in full through the library, and each one is used on a specific slide: the tremor classification and the primary care review on slide 11, and the Parkinson disease criteria on slide 10.
References
Bhatia, K. P., Bain, P., Bajaj, N., Elble, R. J., Hallett, M., Louis, E. D., Raethjen, J., Stamelou, M., Testa, C. M., & Deuschl, G. (2018). Consensus statement on the classification of tremors from the task force on tremor of the International Parkinson and Movement Disorder Society. Movement Disorders, 33(1), 75-87. https://doi.org/10.1002/mds.27121
Crawford, P., & Zimmerman, E. E. (2018). Tremor: Sorting through the differential diagnosis. American Family Physician, 97(3), 180-186. https://www.aafp.org/pubs/afp/issues/2018/0201/p180.html
Postuma, R. B., Berg, D., Stern, M., Poewe, W., Olanow, C. W., Oertel, W., Obeso, J., Marek, K., Litvan, I., Lang, A. E., Halliday, G., Goetz, C. G., Gasser, T., Dubois, B., Chan, P., Bloem, B. R., Adler, C. H., & Deuschl, G. (2015). MDS clinical diagnostic criteria for Parkinson's disease. Movement Disorders, 30(12), 1591-1601. https://doi.org/10.1002/mds.26424
How this MN552 Unit 10 example is structured
The presentation keeps a strict wall between data and interpretation, which is how this course typically wants a case built. Every finding appears first in neutral clinical language, numbered in the speaker notes so the differential can cite it. The differential is short on purpose: essential tremor, enhanced physiologic tremor from caffeine and an inhaler, a thyroid cause, and parkinsonism. Each entry has two lines, findings for and findings against, with numbers pointing back. Parkinsonism is listed and argued down rather than left out, since tremor at this age raises it, and the recorded absence of rest tremor, rigidity and slowed tapping is the evidence against. Nothing on the list lacks a supporting finding. The closing slide names further observations, a handwriting sample and a spiral drawing, that would sharpen the picture, without prescribing a workup.
Get an MN552 Unit 10 example written to your instructions
Whatever your MN552 Unit 10 presentation calls for, slides, a recorded talk or a written paper, attach the case or your own composite outline and the rubric. Written to your instructions, a first presentation costs nothing and arrives within 24-48h, findings set out before any interpretation and a short differential that cites every finding it uses. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN552 Unit 10 questions, answered
How many conditions belong in the differential?
Usually three to five for a presentation this length. The count matters less than the rule behind it: each entry needs at least one recorded finding supporting it, and any condition the findings obviously raise should appear even if the evidence argues against it. The sample keeps four and explains why each earned its place.
Should the presentation include a treatment plan?
Only if your prompt asks. Many assessment course presentations stop at findings and a differential, leaving management to later courses. The sample closes with the observations that would sharpen the picture, a handwriting sample and a spiral drawing, because they extend the assessment rather than move beyond it.
Can the presentation be based on a patient I saw?
Only in composite, de-identified form, and only where your section permits it. The sample's patient is invented. The real visit behind your version, the clinical time logged for it and anything your preceptor signs belong to you alone; the sample shows how a finished presentation arranges findings and a differential, nothing more.