Re: Q2, 3

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Posted by Veronica from IP on October 21, 2013 at 23:01:40:

In Reply to: Q2, 3 posted by Veronica on October 09, 2013 at 16:22:24:

C, F

Q2 a nerve conduction study should confirm that this woman has a peripheral neuropathy, that is a disturbance of sensory and motor nerve function in the limbs. Given her social condition, she is at high risk for a
nutritional neuropathy. a glove-and-stocking pattern of sensory disturbance is usually seen with lesions involving peripheral nerves. With severe neuropathy of the hands or the feet, ulcerations and pressure sores
will develop over the skin that is innervated by the damaged nerves. Metabolic or nutritional problems are the usual causes of a glove-and-stocking sensory disturbance. DM, thiamine deficiency and neurotoxine
damage(insecticides) are the commonest causes of the sensory disturbances. affected persons usually report the sens. of pins and needles in the hands and feet, but with some neuropathies severe pain may develop
along with the loss of sensory acuity.

This patient has a myopathy, elevated ESR and periungual telangiectasias suggest an inflammatory myopathy and specifically dermatomyositis. CPK will help to confirm that this is a primary muscle disease Additional
tests would include EMG and muscle biopsy, neither of which is offered as choices

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