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A 34-Year-Old Man Comes to the Emergency Department Due to Progressive

question 574

Multiple Choice

A 34-year-old man comes to the emergency department due to progressive leg weakness for the past several days. He also reports a tingling sensation in the toes and mild low back pain. Three weeks ago, the patient was evaluated for flulike illness, oral ulcer, and lymphadenopathy and was diagnosed with HIV infection. He has not started antiretroviral therapy yet while waiting for drug resistance testing results. Temperature is 37 C (98.6 F) , blood pressure is 120/70 mm Hg, and pulse is 72/min. Lower extremity examination shows marked muscle weakness and loss of deep tendon reflexes bilaterally. Touch, pain, and vibration sensations are intact. Upper extremity examination shows no abnormality. There is no focal back tenderness and no signs of meningeal irritation are present. Which of the following would be most helpful in revealing the cause of this patient's weakness?

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Definitions:

Chesapeake Planters

Wealthy landowners in the Chesapeake Bay region during the colonial period, primarily involved in the cultivation of tobacco using slave labor.

Shipbuilding Industry

A sector of the economy that designs, constructs, and repairs ships, crucial for transportation, military, and trade purposes.

Task System

A labor system used on plantations, particularly in the cultivation of rice and cotton, where enslaved people were assigned specific tasks to complete each day, as opposed to working from sunrise to sunset.