Weakness and Paralysis (Assessment & Diagnosis) — 58yo Man | Neurology | MCCQE1 Q#13439
MCCQE1 Question #13439
Dimension of Care
Chronic Care
Activity
Assessment & Diagnosis
Objective
Weakness and Paralysis
Section
Medicine / Family Medicine
Subject
Neurology
Last updated: February 2026
A 58-year-old man presents with 6 months of progressive difficulty climbing stairs, rising from a chair, and lifting objects overhead. He reports intermittent muscle aching but no sensory symptoms, back pain, or bowel/bladder dysfunction. There is no history of falls, diplopia, dysphagia, or fluctuating symptoms. Medications include atorvastatin, started 8 months ago, and hydrochlorothiazide. On examination, he has symmetric proximal muscle weakness with normal distal strength, normal reflexes, intact sensation, and no muscle tenderness, rash, or cranial nerve deficits. Which additional finding would most strongly support an inflammatory myopathy rather than a neuropathic cause of weakness?
Full answer analysis and choices are available inside the practice session.
Related questions
- #13444 — A 24-year-old woman presents with 18 hours of persistent vomiting and a new seve...
- #13426 — A 19-year-old woman presents to a university health clinic 24 hours after an elb...
- #13425 — A 52-year-old man presents with 6 months of “weakness.” He no longer mows the la...
- #13417 — A 58-year-old man presents with 6 months of persistent right-sided, high-pitched...
- #13395 — A 52-year-old man is assessed in a neuromuscular clinic for 8 months of progress...
- #13319 — A 58-year-old man presents with 3 months of progressive difficulty climbing stai...