Guillain-Barre syndrome — MCCQE Part 1 MCQ

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ModerateWeaknessGuillain-Barre syndromeMCCQE Part 1

A 35-year-old man develops progressive ascending weakness 10 days after diarrhoeal illness, absent reflexes and falling forced vital capacity. Which of the following is the most appropriate next step?

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Correct answer: A — Admit for respiratory monitoring and consider IVIG or plasma exchange

Admit for respiratory monitoring and consider IVIG or plasma exchange is the single best answer because the age, timing, examination findings and investigations in the vignette fit Guillain-Barre syndrome better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Neurological Sciences Federation guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Neurological Sciences Federation guidance