12-03-2009, 03:17 AM
A 60-year-old left-handed man comes in with complaint
of numbness and tingling in his lower extremities
for about 10 months. He notes no weakness. He
has had type II diabetes mellitus for 6 years and has a
30-pack per year smoking history. There is no family
history of similar problems. Examination reveals
decreased sensation to light touch, pinprick, and
vibratory sensation in the feet extending to 7 centimeters
below the knees symmetrically. Chest, abdomen,
and upper extremities have normal sensation. His
reflexes are 1/4 in the upper extremities and quadriceps
with absent Achilles reflexes bilaterally. The
remainder of his neurological and general medical
examination is unremarkable.
Which of the following would NOT be useful in
helping to determine a particular cause of this
patient™s condition?
A) Serum immunofluorescence electrophoresis.
B) TSH/free T4.
C) Hemoglobin A1C.
D) Electrolytes (Na, K, Cl, CO2).
E) Vitamin B12.
of numbness and tingling in his lower extremities
for about 10 months. He notes no weakness. He
has had type II diabetes mellitus for 6 years and has a
30-pack per year smoking history. There is no family
history of similar problems. Examination reveals
decreased sensation to light touch, pinprick, and
vibratory sensation in the feet extending to 7 centimeters
below the knees symmetrically. Chest, abdomen,
and upper extremities have normal sensation. His
reflexes are 1/4 in the upper extremities and quadriceps
with absent Achilles reflexes bilaterally. The
remainder of his neurological and general medical
examination is unremarkable.
Which of the following would NOT be useful in
helping to determine a particular cause of this
patient™s condition?
A) Serum immunofluorescence electrophoresis.
B) TSH/free T4.
C) Hemoglobin A1C.
D) Electrolytes (Na, K, Cl, CO2).
E) Vitamin B12.