Items 341–345A 32-year-old man develops weakness in his hands over the course of 3 months. Further questioning reveals that he is also having trouble with swallowing. He occasionally slurs his words and has noticed progressive weakness in his cough over the preceding 4 weeks. The weakness is not substantially worse later in the day. He has no sensory complaints associated with his weakness. Sexual function, bladder and bowel control, hearing, vision, and balance are all alleged to be unchanged. The examining physician discovers marked atrophy of the interosseous muscles of both hands. Deep tendon reflexes are hyperactive in the arms and the legs. Extensor plantar responses are present bilaterally. Rectal sphincter tone is normal.341. This patient’s illness characteristically produces electromyographic changes that includea. Fibrillationsb. Markedly slowed nerve conduction velocitiesc. Impaired sensory nerve action potentialsd. H reflexese. No abnormalities…………
342. A biopsy is performed to obtain tissue from the first dorsal interosseous muscle. The pathologist reports that there are numerous abnormally small musclefibers intermingled with hypertrophied muscle fibers. The normal mosaic of muscle fiber types is disrupted. There is no significant inflammatory infiltrate. This pathologic description is most consistent with……….343. The patient develops progressive difficulty breathing. His cough becomes totally ineffective for clearing his airway, and he requires a tracheostomy. Facial muscle weakness and fasciculations are obvious at the time the tracheostomy is performed. The most appropriate treatment for this patient is.....344. The patient dies within 9 months of his initial evaluation. An autopsy is performed, but only the central nervous system (CNS) can be examined. Examination of the spinal cord would be expected to reveal degeneration of the
.....345. The shortest life expectancy is associated with which clinical sign in amyotrophic lateral sclerosis?a. Atrophy of the interosseib. Atrophy of the gastrocnemiusc. Fasciculations in the lumbrical musclesd. Atrophy of the pectoralis musclese. Fasciculations in the tongue<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<Part4: Disorders of myelinationItems 266–269A 21-year-old right-handed female student was working in the photography lab 1 week ago, which required standing all day. After that, she experienced a cold sensation in the left foot and her entire left leg fell asleep. The feeling lasted 4 to 5days and then slowly went away. Her right lower extremity was fine. Coughing, sneezing, and the Valsalva maneuver did not worsen her symptoms. She had a
You've reached the end of your free preview.
Want to read all 66 pages?
- Spring '11
- Macroeconomics, Internal carotid artery, Parietal lobe, Anterior cerebral artery, Circle of Willis