A 32-Year-Old Man Is Brought to the Emergency Department Due

question 721

Multiple Choice

A 32-year-old man is brought to the emergency department due to weakness and tingling that started in his feet and is now at his knees.  A week ago, the patient noticed that his legs felt weak while climbing stairs.  Since then, the weakness has progressively worsened every day.  Today, he fell twice when attempting to walk.  Medical history is insignificant, except for a mild respiratory infection 2 weeks ago that resolved spontaneously.  The patient does not use tobacco, alcohol, or illicit drugs.  He takes no medications.  Vital signs are within normal limits.  Physical examination shows marked weakness in the distal muscles and moderate weakness in the proximal muscles in both legs.  Deep tendon reflexes are absent at the knees.  This patient's condition is most likely associated with which of the following?

• A)Endomysial inflammatory infiltration
• B)Endoneurial arteriole hyalinization
• C)Endoneurial inflammatory infiltration
• D)Mutations of a muscle structural protein gene
• E)Toxin penetration through the blood-nerve barrier

---

Definitions:

Axillary Artery

A major blood vessel that carries oxygenated blood to the lateral aspect of the torso, armpit, and upper limb.

Median Cubital Artery

The median cubital artery is a superficial blood vessel in the elbow region that connects the cephalic and basilic veins and is often used for venipuncture.

Ulnar Artery

The artery that runs along the side of the forearm that is closest to the body when in an anatomical position, supplying blood to the forearm and hand.

Major Arterial Vessel

A major arterial vessel is a large artery that carries oxygen-rich blood away from the heart to various parts of the body.