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63F presents with a two week history of progressive weakness and dysphagia. There is no diurnal variation. On examination she has a violaceous rash over the eyelids and papules over the knuckles. Tone is normal. There is a proximal pattern of weakness bilaterally. Reflexes are normal. Which of the following investigations would give you a definitive diagnosis?
63F presents with a two week history of progressive weakness and dysphagia. There is no diurnal variation. On examination she has a violaceous rash over the eyelids and papules over the knuckles. Tone is normal. There is a proximal pattern of weakness bilaterally. Reflexes are normal. A muscle biopsy has been sent off, with your working diagnosis of dermatomyositis. What additional investigation should you consider at this stage?
A 76 year old man attends clinic with reduced mobility for the last 3 months. As he walks into the clinic room, you see he has a shuffling gait with reduced arm swing. On examination, there is rigidity, more so in the left upper limb than the right. There is no tremor but you think there is bradykinesia. He is on a long list of medication and you are not sure if they might be causing some of the symptoms. Which of the following investigations could you use to support the likely diagnosis?
A 75-year-old right handed lady presents having woken at 7am with new onset speech disturbance and right-sided weakness. She was last seen well before going to bed at 10pm the night before. She has a past medical history of hypertension and hypothyroidism. You complete an ABCDE assessment and an ECG shows an irregularly irregular rhythm at a rate of 75bpm. On examination, right upper and lower limb power is 3/5 and she is unable to name objects. The rest of the examination is unremarkable. Following your assessment, which initial investigation should be carried out?
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