09-06-2011, 05:26 PM
A previous healthy 54 year old woman is evaluated in the emergency department for worsening shortness of breath and an inability to swallow over the past 2 days. She also had generalized fatigue, difficulty climbing stairs, diificulty holding her eyelids open, and intermittent double vision for the past month. Physical examination reveals nasal speech, bilateral ptosis, mild proximal weakness, and normal reflexes. Body mass index is 20, and forced vital capacity is 1.5 L.
Which of the following is the most appropriate initial treatment for this patient
a) High dose prednisone
b) Plamapheresis
c) Pyridostigmine
d) Azathioprine
e) Riluzole
Which of the following is the most appropriate initial treatment for this patient
a) High dose prednisone
b) Plamapheresis
c) Pyridostigmine
d) Azathioprine
e) Riluzole