A 34-year-old man presents to the Emergency Department with progressive bilateral lower-limb weakness, blurred vision, numbness in both legs, and difficulty walking over the past 3 days. On examination, he appears distressed and is struggling to breathe. He is taking shallow breaths, has a respiratory rate of 32 breaths/min, and an oxygen saturation of 86% on room air What is the most appropriate next step in management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: B. Admit the patient to the ICU for continuous respiratory monitoring and assessment for ventilatory support.
This patient is in impending respiratory failure: shallow breathing, RR 32 and SpO₂ 86% after rapidly progressive ascending weakness (a GBS-like picture). Airway and breathing come first, so admit to ICU for respiratory monitoring and assess for ventilation/intubation. Specific therapy (IVIG or plasma exchange) follows.
- IV methylprednisolone (A) treats an MS relapse, and steroids are not helpful in GBS. The old bank key (A) is wrong.
- Observing on the ward (C) or waiting for MRI (D) is unsafe.
ليش كل خيار صح أو غلط
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A
ليش غلط
Steroids are not helpful in Guillain-Barre syndrome, and this patient is in respiratory distress, so airway and breathing come first.
✓ Step_Up_To_Medicine_6th_Edition_2024_GUILLIAN_BARRE_SYNDROME.pdf · p. 2 -
B
ليش صح
In GBS, respiratory function must be monitored, and ICU treatment and intubation may be indicated; this patient has a respiratory rate of 32 and SpO2 of 86%.
✓ Guillain Barre Syndrome + mysthenia gravis.pdf · p. 4 -
C
ليش غلط
GBS can progress to respiratory failure within hours, so a patient struggling to breathe needs hospital monitoring, not observation on a medical ward.
✓ Step_Up_To_Medicine_6th_Edition_2024_GUILLIAN_BARRE_SYNDROME.pdf · p. 2 -
D
ليش غلط
Respiratory failure in GBS can develop with little warning, so waiting for MRI results before acting is unsafe; respiratory function needs regular monitoring.
✓ GBS and MG D.pdf · p. 1
- المصدر
- Guillain Barre Syndrome + mysthenia gravis.pdf · p. 4
9. Demyelination Syndromes.pdf · p. 2
Step_Up_To_Medicine_6th_Edition_2024_GUILLIAN_BARRE_SYNDROME.pdf · p. 2 - المحاضرة
- GBS & Myasthenia Gravis · Neurology · Module C
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- MED43 ♀ Compre