A patient in the intensive care unit is being assessed for critical illness myelopathy. Which of the following would contribute to the onset of this disorder?
1. type 1 diabetes mellitus
2. diagnosis of chronic bronchitis
3. presence of renal calculi
4. anesthesia with neuromuscular blocking agents
4
Rationale: Critical illness myelopathy is a spectrum of muscle disorders that present with diffuse weakness, depressed deep tendon reflexes, and mildly elevated creatine kinase levels. It has been associated with high dose corticosteroid therapy and neuromuscular blocking agent use. Elevated glucose levels have been associated with critical illness polyneuropathy. Chronic bronchitis and renal calculi are not associated with the onset of critical illness myelopathy.
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