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This 20-year-old man has noted increasing drooping of his lids over the past several years.  He holds his chin up to see.  Several male members of his family have been similarly affected.

1.	When confronted with a patient like this, the most important test to obtain among the following is:
	a. electrocardiogram b. urinalysis c. stool sample for parasites d.  protein electrophoresis
2.	The patient on further examination demonstrates a severe limitation of ocular movements in all directions.  He reports double vision on direct questioning, but does not complain spontaneously. The signs do not improve when testing is done with Tensilon.  The most likely diagnosis is:
	a. myasthenia gravis b. Botulism c. orbital psuedotumor d.  chronic progressive external ophthalmoplegia
3.	Ocular treatment for this condition could include the following:
	a. topical lubricants b. ptosis repair c. eye muscle surgery d.  all of the above

For answers to the above, click here on or after October 4, 2005.