A 55-Year-Old Man Comes to the Physician Because of Progressive

A 55-year-old man comes to the physician because of progressive weakness of his arms over the past 8 months. His temperature is 37.1°C (98.8°F) , pulse is 88/min, and blood pressure is 118/70 mm Hg. Examination shows dysarthria. There is mild atrophy and twitching of the tongue. Muscle strength is decreased in all extremities. Muscle tone is decreased in the right lower extremity and increased in the other extremities. Deep tendon reflexes are absent in the right lower extremity and 4+ in the other extremities. Plantar reflex shows an extensor response on the left.  Over the course of his illness, this patient will most likely develop which of the following?

A) Decreased left ventricular compliance
B) Decreased lung vital capacity
C) Degeneration of the cardiac conduction system
D) Inability to feel sensations below the neck
E) Refractory generalized tonic-clonic seizures

Correct Answer:

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