NBME 2 Block 2 No. 15..plz answer and explain. - christine09

[ArchivalUser]

15. A previously healthy 67-year-old man comes to
the physician
because of a 4-month history of hand weakness,
intermittent tingling of the
small fingers of his hands, and mild neck pain.
Examination shows
wasting, weakness, and fasciculations of the
interossei muscles. Sensation
is decreased to pinprick and vibration in the small
fingers of each
hand. Triceps tendon reflexes are decreased. Which
of the following is
the most likely diagnosis?

A
) Amyotrophic lateral sclerosis

B
) Cervical spondylosis

C
) Multiple sclerosis

D
) Myasthenia gravis

E
) Myasthenic (Lambert-Eaton) syndrome

F
) Myotonic muscular dystrophy

G
) Polymyalgia rheumatica

H
) Polymyositis

I
) Progressive neuropathic (peroneal) muscular

atrophY

[ArchivalUser]

A 42-year-old woman comes for a follow-up examination.
Two weeks ago,
her blood pressure was 152/94 mm Hg during a routine
visit. Her blood
pressure today is 150/94 mm Hg, pulse is 76/min, and
respirations are
14/min. Examination shows no other abnormalities.
Serum studies show:


Na+ 142 mEq/L
Cl“ 105 mEq/L
K+ 4 mEq/L
HCO3“ 26 mEq/L
Urea nitrogen (BUN) 12 mg/dL
Glucose 101 mg/dL
Creatinine 0.8 mg/dL

An ECG shows no abnormalities. Which of the following
is the most
appropriate next step in management?

A
) Measurement of plasma renin activity

B
) Serum lipid studies

C
) 24-Hour urine collection for measurement of
metanephrine level

D
) Echocardiography

E
) Captopril renal scan

[ArchivalUser]

B

[ArchivalUser]

the 2nd one is A.

[ArchivalUser]

I agree with B & A

[ArchivalUser]

Thank you piglet and beethoven
can you plz DDX among answers A B and E??im kinda confused with diff answers from my friends..