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Essential tremor — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareEssential tremorUSMLE Step 3

A 62-year-old has gradual bilateral hand tremor while writing and holding a cup. His father had similar tremor, and one alcoholic drink transiently improves it. There is no rigidity, bradykinesia, or gait disturbance. Which diagnosis is most likely?

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Correct answer: D — Essential tremor

An action tremor with a family history and temporary alcohol responsiveness supports essential tremor. Parkinson disease usually features resting tremor and bradykinesia; cerebellar tremor is intention-predominant with other signs.

Reference: American Academy of Neurology, Essential Tremor Guideline: https://www.aan.com/Guidelines/home/GuidelineDetail/491