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Guillain-Barré syndrome with respiratory risk — RCPSC EM MCQ

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HardNeurological emergenciesGuillain-Barré syndrome with respiratory riskRCPSC EM

A 58-year-old man presents with ascending weakness and paraesthesias after a diarrhoeal illness. RR is 26, single-breath count is 12, FVC is 14 mL/kg, and he has areflexia with normal sensation. BP fluctuates between 90 and 180 systolic. What is the most appropriate initial management?

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Correct answer: D — Admit to ICU-level monitoring and arrange IVIG or plasma exchange with neurology

Guillain-Barré syndrome with declining respiratory mechanics and autonomic instability requires ICU monitoring and disease-modifying therapy.

Reference: Royal College Emergency Medicine exam format and training experiences