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pt undergoes evaaluation for fatigability. He denies any chest pain, dyspnea, lower extremity edema or palpitations. He has no other medical problems, but his lab values significant for elevated CPK. which of the follwing is the best next step management in this pt?
a.oral glucose tolerance test
b.24 hr urinary cortisol excretion
c.Serum TSH
d.Serum prolactin
e.EKG
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thats a good q ,i couldnt figure out actually,fatigability with elevated cpk,some muscle origin(no chest pain)low thyroid may be ??
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c is the correct answer.
Hypothyroidism is a common cause of elevated CPK b'cos of hypothyroid myopathy. Sometimes it can be the first manifestation of hypothyroidism.
The other causes of elevated CPK are :
1.HMG-coAreductase inhibitors(statins)
2.Autoimmune dz(dermato-/polymyositis)
3.muscular dystrophies(DMD).
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thanks krish07,your qs are good!
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u all r welcome.
i learn a lot from this forum as well, but except d/ sometimes when ppl forget or delay to post the answers.
