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A 54-Year-Old Previously Healthy Man Comes to the Office Due

question 437

Multiple Choice

A 54-year-old previously healthy man comes to the office due to progressive fatigue and weakness for the past 2 months. His weakness predominantly involves the lower extremities, causing him to have difficulty rising from a chair. The patient also has a persistent cough and unintentional 7-kg (15.4-lb) weight loss during the same period. He has a 30-pack-year smoking history and drinks alcohol occasionally. Physical examination shows bilaterally decreased strength in the proximal muscles of the lower extremities with normal bulk and tone. Quadriceps tendon reflexes are diminished bilaterally. Chest x-ray reveals a hilar mass, biopsy of which demonstrates small cells that stain positive for chromogranin and synaptophysin. Which of the following is the most likely cause of this patient's muscle weakness?

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Definitions:

Missing Units

Units, items, or elements that are lost or absent, which may affect outcomes or analyses.

Perception

The process by which individuals organize and interpret their sensory impressions to give meaning to their environment.

Synthesize

To combine various elements or ideas into a coherent and unified whole, often generating new insight or understanding.

Perceptual Selection

The psychological process by which individuals screen and select various stimuli that vie for their attention, filtering out some data while allowing other data to enter perception.