new_n_lost
Politically InCorrect
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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?
1) Familial periodic paralysis
2) Muscular dystrophy
3) Polymyositis
4) Myasthenia gravis
5) Multiple sclerosis
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| monam84
Forum Senior
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Ill say myasthenia gravis, ptosis --> diplopia, if they say that it gets progressively worse over the day then that would nail the diagnosis. MG commonly affects the face--> weakness (not atrophy).
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| monam84
Forum Senior
Topics: 35
Posts: 135
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MG also affects striated muscles like the upper one third of esophagus which may be why shes regurg food (possible a zenkers diverticulum)..
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| keepgoing
Forum Guru
Topics: 63
Posts: 1,676
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4.MG
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| usmle4me
Forum Elite
Topics: 6
Posts: 283
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MG
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| new_n_lost
Politically InCorrect
Topics: 653
Posts: 6,085
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___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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