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MMLU / A 40-year-old female secretary comes to the office because of a 2-month history…

Problem

Answer published by the source. Consult the official source to check your work against its answer.

question

A 40-year-old female secretary comes to the office because of a 2-month history of fatigue, and generalized aching and weakness of the proximal muscles of all four extremities. The patient initially noticed the weakness only while she was getting in and out of her car, but during the past 2 weeks, the weakness has progressed, so that she now has difficulty combing her hair. Since the symptoms began, she also has had aching of the joints in her hands that has responded partially to ibuprofen. She was adopted and family history is unknown. She has two teenaged children who are well. She appears uncomfortable. She is 170 cm (5 ft 7 in) tall and weighs 68 kg(150 lb); BMI is 24 kg/m2 . Vital signs are temperature 37.7°C (99.8°F), pulse 90/min, respirations 20/min, and blood pressure 110/70 mm Hg. The patient is alert and fully oriented. Physical examination discloses cracking of the skin of both hands that involves the tips and lateral sides of several fingers. The muscles of the upper arms and legs are somewhat tender to pressure. Results of serum laboratory studies show a creatine kinase concentration of 600 U/L and a lactate dehydrogenase concentration of 800 U/L. Results of complete blood count are within the reference ranges. Which of the following is the most likely diagnosis?

choices

  1. Fibromyalgia
  2. Myasthenia gravis
  3. Polymyositis
  4. Scleroderma

subject

professional_medicine

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Source and history

task_id
15bbaf3b-c43e-5b07-926c-ca05a70c43e7
task_key
all--test--15bbaf3b-c43e-5b07-926c-ca05a70c43e7
task_revision_id
1
config / split
all / test

Official source

initial import