Hy 2262

[tommyk]

Hy 2262
A 60-year-old woman complains of increasing weakness and fatigue over the past several months. She reports some muscle discomfort. She reports that any physical activity leads to fatigue, and he is unable to find any comfortable position at rest. She has lost 5 pounds over the past 5 months. Prior to this, she has always been healthy and is not on any medications. Physical examination is unremarkable. Chem 7 is normal. Which of the following is the most likely diagnosis?
1-Age Dependent Depression
2-Hypokalemia
3-Polymyalgia rheumatica
4-Polymyositis
5-Temporal arteritis
6-Hypothyroidism
7-Dementia































































a) #3 Polymyalgia rheumatica (PMR) is characterized by muscle discomfort and patients often have vague symptoms. The neuromuscular examination is normal. Depression can cause fatigue and diminished activity but discomfort is less frequently a complaint. Hypokalemia can cause muscle weakness but discomfort is not a typical feature. Polymyositis can cause muscle discomfort but there should be accompanying weakness on examination. The serum creatine kinase (CK) is often elevated. Temporal arteritis can occur with PMR, but this patient is not complaining of headache or vision change. I said Chem 7 was normal and made no mention of TSH.