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NBME 18 Answers

nbme18/Block 3/Question#41

24 yo man, 3 days of progressive numbness of both feet

Myelinated primary afferents

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Guillain Barre is T-cell mediated destruction of myelinated axons. Generally presents with a rapid onset following a viral / bacterial illness with ascending paralysis.

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submitted by tamey(2),

i think this is vitamin B12 deficiency as it causes demyelination of spinocerebellar tract (ataxic gait),corticospinal tract(weakness),DC/ML(loss of vibration and propreoception)

Is this Guillain barre though? I felt it was Acute inflammatory demyelinating polyradiculopathy, discussed on page 512 FA 2019.

There is no relation to C jejuni here nor does the patient have any other relations to infection such as eating something or etc.