Approach to differentiating lesions (muscle) Quiz: Ace Your Exams
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A 54-year-old man has been hospitalized in the medical intensive care unit for the past 45 days due to complications related to sepsis. For the past week, he has had trouble moving in bed as well as symmetric proximal muscle weakness. His past medical history is notable for type 2 diabetes mellitus complicated by neuropathy, hypertension, and gastroesophageal reflux disease. He is currently receiving cefepime, insulin lispro, gabapentin, lisinopril, and omeprazole. The patient’s temperature is 37.0°C (98.6°F), pulse is 98/min, respirations are 8/min and labored, blood pressure is 150/90 mmHg, and oxygen saturation is 87% on room air. On examination, the patient appears drowsy but awakens easily. Lungs are clear to auscultation. There is significant weakness with neck flexion and bilateral shoulder abduction. What is the most appropriate next step in management?
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