Review Question - QID 215160

A 59-year-old man is brought to the primary care clinic by his wife for recent behavioral changes. In the past 2 months, his wife has caught him stimulating his genitals in public on at least 5 separate occasions. Over the same time frame, he has also taken up online gambling and has lost a large sum of money. He denies any recent cognitive changes. His medical history includes hypertension for which he takes amlodipine. He was diagnosed with Parkinson disease 3 months ago and started on pramipexole. The patient’s temperature is 98.2°F (36.8°C), blood pressure is 124/80 mmHg, pulse is 64/min, and respirations are 16/min. Physical exam reveals an irate-appearing man who loudly proclaims his annoyance at the long wait. His fingers exhibit a slow tremor at rest. What is the most likely diagnosis?