SESAP Question
==============


**I****tem** **482**

A 32-year-old woman has muscle weakness. The chest com puted tomogram (CT) shown is obtained. Which of the fol lowing statements about her condition is NOT true?

1.  Her weakness is likely to improve after treatment with neostigmine, azathioprine, or corticosteroids

2.  It is most likely to be malignant

3.  It may be associated with Cushing’s syndrome, RBC aplasia, hypoproteinemia, and collagen vascular disease

4.  Operation is indicated in this patient

5.  The condition is associated with antibodies to acetyl choline receptors in the muscle

![Figure1](http://canjsurg.ca/https://www.canjsurg.ca/content/cjs/41/4/271/F1.medium.gif)

[Figure1](http://canjsurg.ca/content/41/4/271/F1)

For the critique of item 482 see page 282.

## Footnotes

*   (Reproduced by permission from *SESAP ****’****96–****’****98 Syllabus Surgical Education and Self-Assessment Program*, Volume 2, 9th edition. For enrolment in the Surgical Education and Self-Assessment Program, please apply to the American College of Surgeons, 55 East Erie St., Chicago, IL 60611, USA.)