determine
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A 25-year-old woman has intermittent diplopia. She says she chokes on her food and regurgitates it, sometimes through her nose. Physical examination reveals drooping eyelids and bilateral facial muscle weakness without atrophy; deep tendon reflexes are normal. Which one of the following is the most likely diagnosis?<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
1) familial periodic paralysis
2) muscular dystrophy
3) polymyositis
4) myasthenia gravis
5) multiple sclerosis
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| babli
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4) myasthenia gravis
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| achilles
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4-myasthenia gravis
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| yasmeen
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4 IS RIGHT
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| Rasul
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myastenia gravis
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| determine
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why not 5? I choosed 4 before, but now thinking about 5 as well?
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| AAAAA
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Please review MS
MS affects one eye and the symptoms are totally different
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| AAAAA
Forum Fanatic
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Please review MS
MS affects one eye and the symptoms are totally different
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seeking study partner in USMLE, Canadian MCC OSCE examination
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| determine
Forum Guru
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ok,thanks. i will
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| babli
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The first symptoms of multiple sclerosis are often visual changes. A large number of people with multiple sclerosis develop optic neuritis, which is described as painful vision loss. If you are diagnosed with optic neuritis early, treatment could change the course of the disease. Before actual loss of vision, you may have visual changes described by many people as blurred or hazy vision, flashing lights, or alterations in color. The tissues around your eye and moving your eye may be painful. Most people recover over several months. Others are left with permanent visual defects. Double vision occurs when eyes move different directions and is another common symptom of multiple sclerosis.
Double vision or eye tremor (nystagmus) may result from involvement of the nerve pathways controlling movement of the eye muscles. Visual disturbances result from involvement of the optic nerves (optic neutritis) and may include development of blind spots in one or both eyes, changes in color vision, or blindness. Optic neuritis usually involves only one eye at a time and is often associated with movement of the effected eye.
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| babli
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Symptoms
The symptoms of multiple sclerosis may occur in one of three patterns:
* The most common pattern is the "relapsing-remitting" pattern, in which there are clearly defined symptomatic attacks lasting 24 hours or more, followed by complete or almost complete improvement. The period between attacks may be a year or more at the beginning of the disease, but may shrink to several months later on. This pattern is especially common in younger people who develop MS.
* In the "primary progressive" pattern, the disease progresses without remission or with occasional plateaus or slight improvements. This pattern is more common in older people.
* In the "secondary progressive" pattern, the person with MS begins with relapses and remissions, followed by more steady progression of symptoms.
Between 10-20% of people have a benign type of MS, meaning their symptoms progress very little over the course of their lives.
Because plaques may form in any part of the central nervous system, the symptoms of MS vary widely from person-to-person and from stage-to-stage of the disease. Initial symptoms often include:
* Muscle weakness, causing difficulty walking
* Loss of coordination or balance
* Numbness, "pins and needles," or other abnormal sensations
* Visual disturbances, including blurred or double vision.
Later symptoms may include:
* Fatigue
# Muscle spasticity and stiffness
# Tremors
# Paralysis
# Pain
# Vertigo
# Speech or swallowing difficulty
# Loss of bowel and bladder control
# Incontinence, constipation
# Sexual dysfunction
# Cognitive changes.
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| determine
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Oooh, thanks babli! That`s great
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| Jinx
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so whats the answer?
is it MS?
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