A 70-Year-Old Man Comes to the Physician with Muscle Pains

question 346

Multiple Choice

A 70-year-old man comes to the physician with muscle pains and weakness over the last several weeks.  He now has difficulty getting up from a chair and climbing stairs.  He has no fever, weight loss, vision changes, or shortness of breath.
The patient's other medical problems include hyperlipidemia, gout, hypertension, chronic kidney disease, and degenerative joint disease of the hips and knees.  His medications include lisinopril, allopurinol, colchicine, atorvastatin, and acetaminophen.
Vital signs are within normal limits.  Examination shows some tenderness to palpation of his thighs and weakness of both thighs to extension and flexion.  Deep-tendon reflexes are symmetrically diminished at the patellar tendons and absent at the Achilles tendons.  Peripheral pulses are normal.
Laboratory results are as follows:

Electromyogram shows slowed sensory and motor nerve conduction velocities and small-amplitude, short-duration polyphasic waves.
A quadriceps muscle biopsy demonstrates widespread cytoplasmic vacuolization but no inflammation.
What is the most likely explanation for this patient's symptoms?

• A)Atorvastatin
• B)Colchicine
• C)Diabetic amyotrophy
• D)Hypothyroidism
• E)Polymyositis

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Definitions:

Abnormal Spoilage

Waste or spoilage that exceeds the normal or expected levels during the manufacturing process.

Weighted Average Method

An inventory valuation method that assigns a weighted average cost to each unit of inventory, taking into account both the cost of goods available for sale and the number of units available.

Unit Costs

The cost incurred to produce, store, and sell one unit of a product or service.

Process Costing

An accounting methodology used to allocate costs to units of production in continuous or repetitive processes.