MKSAP: 30-year-old woman is evaluated for a 1-year history of fatigue

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for a 1-year history of fatigue, headaches, poor sleep, depression, intermittently blurred vision, and weakness when climbing stairs. She takes no medication. Following a physical exam and lab studies, what diagnostic tests should be performed next? On physical examination, vital signs are normal. Bilateral ptosis and diplopia are noted, but funduscopy findings are normal. Strength testing reveals mild weakness of the hip flexors. Tendon stretch reflexes are normal, as are results of a sensory examination. Results of laboratory studies are positive for autoantibodies directed against muscle-specific tyrosine kinase receptors but are negative for antibodies against the acetylcholine receptor. Which of the following diagnostic tests should be performed next? A: CT of the chest B: Edrophonium test C: Lumbar puncture D: MRI of the brain Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Cancer Source Type: blogs