12-01-2010, 09:23 PM
A 60-year-old white woman comes to the office because of a 6- to 12-month history of weakness. She initially noted the weakness in her right hand, and it has now become generalized and is associated with muscle cramps. She is not taking any medications. Past medical history is unremarkable. On physical examination there is marked muscle wasting of the hands and arms bilaterally (left greater than right). There is less muscle wasting in the legs. Sensation to touch remains intact. Muscle fasciculation of the arms and hands is noted and deep tendon reflexes are decreased. Speech and mentation are intact. Which of the following studies is most likely to be abnormal in this patient?
A) Edrophonium chloride test
B) Electromyography
C) Serum protein electrophoresis
D) Urine lead levels
E) Urine mercury levels
A) Edrophonium chloride test
B) Electromyography
C) Serum protein electrophoresis
D) Urine lead levels
E) Urine mercury levels