Access Medicine'sCase of the Week: Neurology

From: Graber and Wilbur’s Family Medicine Examination and Board Review, 4th Edition
Access Medicine'sCase of the Week: Neurology


A 43-year-old woman with a history of myasthenia gravis presents to the ED while on vacation. She reports she is feeling tired and rundown and endorses flu-like symptoms in addition to some worsening of her proximal lower extremity weakness. On examination, she is afebrile with a respiratory rate of 18. She has mild diplopia with lateral gaze. Her strength is 4/5 proximally and 4+/5 distally bilaterally. Her sensory examination is normal. Plantar responses are down-going bilaterally.

Question 1 of 6:

In determining this patient's further disposition, what is the most important test?

  A - Arterial blood gas

  B - CXR

  C - Head CT

  D - Spirometry (forced vital capacity [FVC] and negative inspiratory force [NIF])

  E – CBC

Click HERE to answer all 6 questions and complete the case!

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