تصفح
دخول
تسجيل
نسيتها؟

ضعف عضلي


ضعف عضلي


حالة سريرية

كتابة حرة وطرح موضوع النقاش!

A 14-year-old boy is brought to the emergency department because of soreness, and
weakness in his legs for the past day that has slowly spread from his calves to his thighs. He
now complains of weakness in his trunk and arms. On examination he appears tired and lays
on the examining table. His temperature is 37 C (98.6 F), pulse is 48/min, and respirations are
22/min. Both of his legs are diffusely tender. Deep tendon reflexes are absent in the lower
extremities, and sensation is greatly diminished. Which of the following studies is essential for
this patient's diagnosis?
A. Creatinine phosphokinase levels
B. Stool culture for Campylobacter jejuni
C. Motor nerve conduction test
D. Cerebrospinal fluid studies
E. Muscle biopsy

by

Quote:
D. Cerebrospinal fluid studies
the best's picture
the best
طالب دراسات عليا


طيب بشو شكيت ؟

qusei


أنا شكيت بغيلان باريه

the best's picture
the best
طالب دراسات عليا

right
The correct answer is D. Guillain-Barré syndrome (GBS) is a postinfectious
polyneuropathy that causes demyelination of BOTH motor and occasionally, sensory
nerves. It is classically an ascending paralysis. CSF studies are essential for diagnosis
and reveal a protein level usually twice normal values but with normal amounts of white
blood cells, normal glucose level and an absence of pleocytosis (elevated lymphocytes).
Autonomic nervous system involvement can produce the bradycardia seen in this
vignette.
Creatinine phosphokinase levels (choice A) may be mildly elevated and sometimes are
normal, but are not essential for diagnosis.
Stool culture for Campylobacter jejuni (choice B), a well recognized infection associated
with GBS, is again not essential for diagnosis. By the time the disease presents stool
cultures are often negative.
Motor nerve conduction tests (choice C) would show decreased velocities, but are not
specific for GBS
.
A muscle biopsy (choice E) is not indicated and can be normal in early stages. Late
disease reveals denervation atrophy
.
qusei
ابق على تواصل مع حكيم!
Google+