Approach to differentiating lesions (muscle) Quiz: Ace Your Exams

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A 21-year-old man presents to the primary care clinic for evaluation of weakness. For the past year, he has experienced episodes of generalized weakness in his arms and legs after exercise, lasting for hours to days at a time. In between episodes, he experiences no weakness. There are no associated sensory changes. His past medical history is noncontributory, and he takes no medications. The patient’s biological mother and maternal grandmother have experienced similar symptoms, and they have noted that alcohol use can trigger these episodes of weakness. The patient’s temperature is 37.0°C (98.6°F), pulse is 66/min, respirations are 12/min, and blood pressure is 118/78 mmHg. General and neurological examinations are normal. Which of the following additional pieces of information regarding this patient’s history or examination is most appropriate to obtain at this time?

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Relation of symptoms to food intake

Shortness of breath or chest pain with exercise

Use of a statin

Difficulty loosening grip

Presence of facial rash