USMLE step 2 Mcq 97:A 55 year old woman complains to her general practitioner of a progressive difficulty of holding objects with her left hand

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Question:
A 55 year old woman complains to her general practitioner of a progressive difficulty of holding objects with her left hand. She also admitted to swallowing difficulties over the past 6 months. On examination the physician noted signs of lower motor neurone involvement . An initial diagnostic test in the work up of this patient should include

a) barium swallow
b) Electromyography
c) CT scan of the spine
d) MRI of the spine
e) MRI of the brain


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