nbme what is your diagnosis here?

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nbme what is your diagnosis here?

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8 Posts

nadiabarati

05/29/07 - 04:33 AM

29. A previously healthy 27-year-old woman is brought to the emergency department because of a 2-day history of weakness of her arms and legs and numbness of her hands and feet and a 4-hour history of mild shortness of breath while supine. The weakness began in her feet and has progressed to involve the hands. She describes a sensation of "electrical shocks" extending from the buttocks to the feet. Today, she tripped and fell several times and was unable to button clothes or hold utensils. Three weeks ago, she had a mild upper gastrointestinal illness that resolved within 5 days. Her respirations are 20/min and shallow. There is mild facial weakness; cranial nerves are otherwise intact. Muscle strength in the upper and lower extremities is 4/5 proximally and 2/5 distally. There is areflexia. Babinski's sign is absent bilaterally. Sensation to vibration is slightly decreased at the fingers and toes.

mano
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05/29/07 - 04:47 AM

GBS?

doc_clotaire
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05/29/07 - 09:51 AM

Motor ( ascending weakness ) and sensory ( numbness ) involvement in a young female after a GI illnesst ( Campylobacter Jenuni ) is :

Guillan Barre Sd until proven otherwise

NSIM ----------------Airway ( Vital capacity )

DX -------------------Clinical + CSF (high protein )+ Nerve conduction velocity ( slowed )

TX ------------------IVIG + Plasmaferesis (Never give steroids please, you may make the px worse

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ram3
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06/04/07 - 10:25 AM

Ascending paralysis following infection is gbs BIG TIME diagnosis is CSF protein>55mg/dl and management is Plasmapharesis

sailing boat
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06/04/07 - 11:02 AM

yep gbs

Justice
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06/04/07 - 03:09 PM

GBS

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prathapdoctor
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06/04/07 - 03:17 PM

GBS obviously.

khorshid
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06/04/07 - 03:27 PM

GBS

, Dx: Albumino-cytologic dissociation of CSF (which means the amount of increase in protein is not correlated with cells)
also have loss of DTR. cause of death: resp failure.

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