How good at neurology are you?

Image courtesy of Dr John Thorpe 2. Please read the following passage. You receive a telephone call regarding a 30 year-old man about to undergo incision and drainage of a pilonidal abscess under general anaesthetic. His father had died unexpectedly following an appendicectomy. This led the anaesthetist to ask him some questions about his muscles. He said he had never been great at sport and he was the one who always dropped the ball in his family. The anaesthetist asks you whether this is relevant: (a) What would be the best way to confi rm the diagnosis ? (i) EMG (ii) Muscle biopsy (iii) Genetic test (iv) Plasma creatine kinase level (v) Other (b) What would you advise the anaesthetist? (i) Reassure (ii) Proceed with operation, but be prepared for prolonged post-operative recovery (iii) Proceed with operation but do not administer curare-like agents (iv) Proceed with operation but do not administer non-depolarizing blockers (v) Cancel operation AUGUST 2003 251