A 65-Year-Old Man Is Evaluated for Right Lower Extremity Weakness

question 119

Multiple Choice

A 65-year-old man is evaluated for right lower extremity weakness and difficulty walking.  The patient has a history of hypertension, type 2 diabetes mellitus, and osteoarthritis.  He has smoked a pack of cigarettes daily for 30 years.  During physical examination, the lateral border of his right sole is stroked using the blunt tip of a reflex hammer.  The maneuver, starting near the heel and proceeding to the base of the fifth toe, elicits extension of the great toe and fanning out of the other toes.  Which of the following additional findings is most likely to be observed in this patient's right lower extremity?

• A)Decreased muscle girth compared to the left side
• B)Increased briskness of deep tendon reflexes
• C)Increased muscle rigidity with rhythmic interruptions
• D)Pronounced weakness of extensor muscles compared to flexors
• E)Spontaneous, intermittent contractions of muscle fibers

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