Well done to those who answered correctly, and comisserations tho those who got caught out… the correct answer to this question was:
g. Guillain Barre Syndrome
See why it was Guillain Barre Syndrome below. Check your hypothesis against the clinical signs:
|Tone||any sign of UMN lesion or hypotonia (cerebellar?) NO
but there is some reduced tone in the left arm:
|Power||He is weak and its come on over the past few days: this is classical of GBS: an ascending peripheral motor and sensory poylneuropathy.|
|Coordination||Normal: as expected|
|Sensation||Normal: So can it still be GBS???
YES! The sensory signs are often vary vague: there may be only back pain as the presenting feature.
|Reflexes||Clinical tip: no reflexes suggests a lower motor neurone problem. Could it me MND? Very unlikely: there’s only LMN signs and the onset of the illness is too acute.|
|Other things||GBS: measure the Forced Vital Capacity:
If this is low: the patient may need ventilation.
Also remember: cardiac conduction deficits (monitor the patient on a cardiac monitor)
Remember FVC monitoring in GBS.
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