MRCP2-3584

MRCP2-3584

A 55-year-old man presents to the Neurology Outpatient Clinic with complaints of memory loss and ataxia. He has lost 10 kg of weight over the past six months and is experiencing fatigue, watery diarrhoea, and abdominal pain. He has a medical history of osteoarthritis and hypertension. On examination, he appears tanned and is wearing loose clothing. A systolic murmur is heard over the left fifth intercostal space during cardiovascular examination. His abdomen is distended, and there is palpable pelvic lymphadenopathy. Neurological examination reveals clonus in the ankles bilaterally, and he has a broad-based stance and sways while walking. Cognitive testing shows an Abbreviated Mental Test Score (AMTS) of 8 out of 10. What is the most likely diagnosis?