A 55 year old woman complains to her general practitioner of a progressive difficulty of holding objects with her left hand.

Question Number 0191
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. Examination demonstrates widespread lower motor neuron involvement. The most appropriate diagnostic test is
a) lumbar puncture
b) Cardiolipin antibody titer
c) Antinuclear antibody titer
d) electromyography
e) Congo red staining of carpal tissue biopsy


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