A 65-Year-Old Man Comes to the Office for Evaluation of Slowly

question 1192

Multiple Choice

A 65-year-old man comes to the office for evaluation of slowly progressive right-hand weakness for the past 3 months.  The patient has no pain or numbness.  Medical history is significant for degenerative joint disease in both his hips and hypertension.  Vital signs are normal.  Physical examination shows atrophy of right thenar eminence and first and second web spaces.  Muscle strength testing reveals decreased right grip strength and moderate weakness of the finger abduction.  Tendon reflexes are 3+ in the right arm and 1+ in the left arm and lower limbs.  Sensory examination shows no abnormalities.  Electrophysiologic studies reveal widespread fibrillations and positive sharp waves in bilateral upper and lower extremity muscle groups.  The underlying mechanism of this patient's disease most likely involves an abnormality in which of the following?

• A)Anterior horn cell
• B)Dorsal spinal root
• C)Neuromuscular junction
• D)Peripheral nerve
• E)Skeletal muscle

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Definitions:

Risk Averse

A description of an individual's or entity's preference to avoid risk, favoring certainty in investment or economic decisions.

Expected Utility

A concept in economics that calculates the utility expected from different outcomes, taking into account their probabilities.

Total Utility

The complete contentment derived from the consumption of a specific amount of a product or service.