American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is characterized by extensive unsteadiness during standing or walking in older patients?

1. Osteoporosis

2. Disequilibrium

3. Parkinson’s disease

4. Vertigo

The correct answer is: Disequilibrium

The condition characterized by extensive unsteadiness during standing or walking in older patients is disequilibrium. Disequilibrium refers to a feeling of imbalance or instability, particularly when the individual is in an upright position. This sensation commonly occurs in the elderly due to various factors, including changes in sensory input, vestibular dysfunction, or musculoskeletal issues. Older adults may experience a decline in proprioception and balance, leading to difficulty with equilibrium, especially during ambulation. This condition can result from a combination of age-related physiological changes, neurological conditions, and other health factors, making it a prevalent concern in geriatric patients. In contrast, osteoporosis primarily concerns bone density and strength rather than balance and instability during movements. Parkinson's disease may involve gait disturbances, such as shuffling or freezing, but it also includes other motor and non-motor symptoms, which can be more complex than mere unsteadiness. Vertigo typically involves a sensation of spinning or movement, which is different from the imbalance experienced in disequilibrium. Thus, the defining characteristic of extensive unsteadiness points specifically to disequilibrium in this context.