A 28-year-old woman comes to the office due to weakness. The p | Surgery collections Videos and quizez 2021

A 28-year-old woman comes to the office due to weakness. The patient, who is 8 weeks postpartum, reports intermittent weakness of the upper and lower extremities. She says, "11/ly arms feel weak after carrying the baby for a few minutes, and I can't lift him until I rest for some time. Yesterday evening, I couldn't even get off of the toilet, but today, I feel fine." The patient has also had episodes of blurry vision. Her pregnancy was complicated by gestational diabetes, but she has no chronic medical conditions. The patient's only medication is a daily multivitamin. She does not use tobacco, alcohol, or illicit drugs. Blood pressure is 120/68 mm Hg and pulse is 74/min. Physical examination shows normal pupils and extraocular movements. Jugular venous pressure is not elevated, and chest auscultation reveals no abnormalities. There is no extremity edema. Deep tendon reflexes and muscle strength of the bilateral upper and lower extremities are normal.