Demyelinating Diseases USMLE Step 1 Practice Question
A 26-year-old woman with no prior neurological disease presents with acute bilateral leg weakness and numbness. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Spine MRI reveals central cord T2 hyperintensity at C4-C6. CSF analysis shows mildly elevated protein (52 mg/dL) with normal glucose. Formal testing demonstrates weakness and sensory loss in all limbs with preserved deep tendon reflexes. Bladder function remains intact. Which diagnosis best explains these findings?
Answer choices
- AAcute lumbosacral radiculopathy
- BAcute transverse myelitisCorrect answer
- CMultiple sclerosis with myelitis
- DGuillain-Barré syndrome
- ESpinal cord compression from disc herniation
- FPosterior cord syndrome from vertebral artery dissection
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