A 55-Year-Old Man Comes to the Clinic Due to Gradual

question 328

Multiple Choice

A 55-year-old man comes to the clinic due to gradual, progressive weakness of the right upper extremity over the past 6 months.  Over the last month, he has also noticed weakness in the left upper extremity.  Vital signs are normal.  Physical examination shows fasciculations and atrophy of the intrinsic muscles of the right hand and the muscles of the forearm.  Reflexes are brisk in the upper extremities, and the plantar responses are extensor.  Mild gait ataxia is present.  Over the course of his illness, this patient will most likely develop which of the following?

• A)Decreased left ventricular compliance
• B)Decreased lung vital capacity
• C)Degeneration of the cardiac conduction system
• D)Inability to feel sensations below the neck
• E)Refractory generalized tonic-clonic seizures

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