Topic 8 — Muscle Weakness, Myopathies and Childhood Muscular Dystrophies

20 A-Type Single Best Answer Questions • Final Year MBBS

AIM-generated KMU Past Paper Practice questions designed to resemble professional-examination reasoning style; these are not claimed to be verbatim previous KMU questions. :chatgpt-content-reference{index=”0″}

Question:
A 38-year-old woman presents with gradually progressive weakness of the shoulder and pelvic muscles. Sensation is normal. Serum creatine kinase is elevated. Thyroid testing is normal and there is no family history of muscle disease. Which investigation would most directly help determine whether active inflammatory muscle disease is present?

Question:
A woman with progressive proximal weakness has a heliotrope-type eyelid discoloration and papules over the extensor surfaces of her finger joints. Which finding would best distinguish her condition from polymyositis?

Question:
A 40-year-old patient with inflammatory myopathy initially improves with treatment but later develops increasing difficulty swallowing. Which clinical action is most appropriate?

Question:
A patient presents with proximal muscle weakness, but examination also demonstrates sensory loss in a stocking distribution and absent ankle reflexes. Which interpretation is most appropriate?

Question:
A boy with a dystrophinopathy has an abnormal gait but remains ambulant considerably longer than his cousin, who became weak in early childhood. Which diagnosis best fits the boy’s relatively milder course?

Question:
A 6-year-old boy with progressive muscle weakness has difficulty keeping up with classmates. His parents report frequent falls. Which additional history is most useful for assessing functional progression?

Question:
During examination of a child with suspected muscular dystrophy, the clinician notes lumbar lordosis and a waddling gait. What is the most appropriate next bedside maneuver to further assess proximal lower-limb function?

Question:
A child with established muscular dystrophy develops progressive limitation of ankle dorsiflexion. Which intervention is most appropriate before a severe fixed deformity develops?

Question:
Parents of a boy with Duchenne muscular dystrophy ask why apparently unaffected female family members may still need counselling. Which principle best explains this concern?

Question:
A 23-year-old man with an inherited muscle disorder reports weakness together with difficulty immediately opening his hand after making a tight fist. Which additional feature would best support myotonic dystrophy rather than Duchenne muscular dystrophy?

Question:
A teenager presents with shoulder-girdle weakness and prominent scapular winging. The clinician also notes difficulty smiling and closing the eyes tightly. Which pattern of muscle involvement is most characteristic?

Question:
A 21-year-old patient has weakness centered on the shoulder and pelvic girdles without facial weakness or myotonia. Which diagnostic category best matches this clinical distribution?

Question:
A child with Duchenne muscular dystrophy is reviewed for increasing fatigue. Which finding would represent disease involvement beyond the limb muscles and therefore require additional specialist assessment?

Question:
A mother of a child with progressive muscular dystrophy says, “If treatment cannot cure the genetic problem, there is no benefit in continued follow-up.” Which response best reflects appropriate counselling?

Question:
A man with remote paralytic poliomyelitis has weakness around the ankle but no fixed deformity. Which intervention is most appropriate to improve alignment and walking while minimizing progression of deformity?

Question:
A patient with childhood poliomyelitis develops scoliosis and progressive gait difficulty. Which assessment is most useful for determining the mechanical basis and functional severity of his disability?

Question:
A patient with previous poliomyelitis has a lower-limb deformity that remains passively correctable. What is the most appropriate interpretation?

Question:
A woman with suspected inflammatory myopathy has raised creatine kinase and proximal weakness. Muscle imaging demonstrates areas of active muscle inflammation. What is an additional practical value of imaging in this setting?

Question:
A child with progressive weakness is being evaluated for an inherited muscular dystrophy. Which test most directly establishes the underlying molecular diagnosis when a specific dystrophy is suspected?

Question:
A child has progressive muscle weakness. The family asks whether enlarged muscles necessarily indicate preserved function. Which explanation best reflects the pathology of muscular dystrophy?