12-15-2008, 06:19 PM
A 32-year-old woman comes to the physician because of weakness of the lower
extremities for 2 days. Three years ago, she had pain and partial loss of vision of
the right eye; the vision returned to normal after 6 weeks. There is mild pallor of
the right optic disc. She has impaired tandem gait. Babinski's sign is present
bilaterally. There is mild spasticity of the lower extremities and mild weakness of
the iliopsoas and hamstring muscles. Serum creatine kinase activity is 50 U/L.
Which of the following is the most likely diagnosis?
A) Amyotrophic lateral sclerosis
B) Becker's muscular dystrophy
C) Diffuse sensorimotor peripheral neuropathy
D) Duchenne's muscular dystrophy
E) Hyperkalemic periodic paralysis
F) Hypokalemic periodic paralysis
G) Multiple sclerosis
H) Myasthenia gravis
I) Myasthenic (Lambert-Eaton) syndrome
J) Myotonic muscular dystrophy
K) Polymyositis
L) Pontine astrocytoma
M) Pontine infarction
N) Spinal cord tumor
O) Transverse myelitis
31.) A healthy 42-year-old man comes to the physician for a life insurance evaluation.
He smoked one-half pack of cigarettes daily for 20 years but quit 10 years ago. His
father died of a myocardial infarction at the age of 65 years. The patient weighs 93
kg (205lb) and is 178 cm (70 in) tall. His blood pressure is 160/110 mm Hg,
pulse is 96/min, and respirations are 16/min. Physical examination, ECG, and an x-
ray film of the chest show no abnormalities. Laboratory studies are within normal
limits except for a serum cholesterol level of 206 mg/dL. Which of the following is
the greatest risk factor for cerebral infarction in this patient?
A) Genetic profile
B) History of smoking
C) Hypercholesterolemia
D) Hypertension
E) Obesity
extremities for 2 days. Three years ago, she had pain and partial loss of vision of
the right eye; the vision returned to normal after 6 weeks. There is mild pallor of
the right optic disc. She has impaired tandem gait. Babinski's sign is present
bilaterally. There is mild spasticity of the lower extremities and mild weakness of
the iliopsoas and hamstring muscles. Serum creatine kinase activity is 50 U/L.
Which of the following is the most likely diagnosis?
A) Amyotrophic lateral sclerosis
B) Becker's muscular dystrophy
C) Diffuse sensorimotor peripheral neuropathy
D) Duchenne's muscular dystrophy
E) Hyperkalemic periodic paralysis
F) Hypokalemic periodic paralysis
G) Multiple sclerosis
H) Myasthenia gravis
I) Myasthenic (Lambert-Eaton) syndrome
J) Myotonic muscular dystrophy
K) Polymyositis
L) Pontine astrocytoma
M) Pontine infarction
N) Spinal cord tumor
O) Transverse myelitis
31.) A healthy 42-year-old man comes to the physician for a life insurance evaluation.
He smoked one-half pack of cigarettes daily for 20 years but quit 10 years ago. His
father died of a myocardial infarction at the age of 65 years. The patient weighs 93
kg (205lb) and is 178 cm (70 in) tall. His blood pressure is 160/110 mm Hg,
pulse is 96/min, and respirations are 16/min. Physical examination, ECG, and an x-
ray film of the chest show no abnormalities. Laboratory studies are within normal
limits except for a serum cholesterol level of 206 mg/dL. Which of the following is
the greatest risk factor for cerebral infarction in this patient?
A) Genetic profile
B) History of smoking
C) Hypercholesterolemia
D) Hypertension
E) Obesity