The Anatomy of a Question
A 39-year-old woman presents with a ten-day history of progressive weakness. She is having more difficulty walking today. She has noted increased weakness in her arms and face. She states I feel like I cant breathe very deeply. but denies vision changes or headache. She denies fever now, but did have fever accompanied by diarrhea and abdominal pain three weeks ago. There is notable extremity muscle weakness to resistance and she is unable to walk without assistance. Achilles and patellar reflexes are absent. Which of the following is the most likely cause for these findings?
Answer choice options
- A. Diabetic neuropathy
- B. Guillain-Barré syndrome
- C. Huntington’s disease
- D. Multiple sclerosis
The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:
B.Guillain-Barré syndrome Presents with progressive weakness and loss of DTRs.
D.Multiple sclerosis May have acute exacerbations of weakness.
C.Huntington’s disease A progressive neurologic disorder but develops over years.
A.Diabetic neuropathy Chronic and typically involves sensory deficits.
The Anatomy of an Explanation
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