A 21-year-old male medical student is taken to the ER by his roommates complaining of progressive weakness. The history reveals that this student had an intestinal virus with diarrhea and vomiting that resolve over 2 days. About 10 days later, he noticed tingling sensations and numbness in his feet, followed by progressive weakness. Over the last 8 days it has gotten so bad that he is having trouble standing, and walking. His physical examination shows normal cranial nerves, distal weakness of the lower extremities (about 3+/5), absent reflexes over the lower extremities, and mild decreased vibration and position sense loss. 1. What is your differential diagnosis? 2. Where is the lesion? 3. Which diagnostic test would you perform first and why? 4. What is the most likely diagnosis and why?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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A 21-year-old male medical student is taken to the ER by his roommates complaining of progressive weakness. The history reveals that this student had an intestinal virus with diarrhea and vomiting that resolve over 2 days. About 10 days later, he noticed tingling sensations and numbness in his feet, followed by progressive weakness. Over the last 8 days it has gotten so bad that he is having trouble standing, and walking. His physical examination shows normal cranial nerves, distal weakness of the lower extremities (about 3+/5), absent reflexes over the lower extremities, and mild decreased vibration and position sense loss. 1. What is your differential diagnosis? 2. Where is the lesion? 3. Which diagnostic test would you perform first and why? 4. What is the most likely diagnosis and why?
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