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Guillain-Barré syndrome — MCCQE Part 1 MCQ

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HardWeaknessGuillain-Barré syndromeMCCQE Part 1

A 24-year-old man presents with 4 days of ascending leg weakness after diarrhoeal illness. Reflexes are absent, sensation is mildly reduced in the feet, and forced vital capacity is 18 mL/kg. Blood pressure fluctuates between 90/60 and 170/100 mmHg. What is the most appropriate investigation?

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Correct answer: B — Urgent respiratory function monitoring with neurology assessment

Ascending weakness with areflexia and autonomic instability suggests Guillain-Barré syndrome; the immediate investigation is serial respiratory assessment, including vital capacity, because respiratory failure can develop rapidly. Nerve conduction studies and CSF can support diagnosis but should not delay admission and monitoring. CT head does not fit the peripheral pattern.

Reference: Canadian Neurological Sciences Federation resources; MCC Objectives—Weakness