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Pathology · Neuropathology: Guillain-Barre syndrome
Sample itemA 28-year-old man develops symmetrical ascending weakness with absent reflexes two weeks after an episode of diarrhoea. Which cerebrospinal fluid result is expected?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Protein 120 mg/dL with 3 cells per microlitre
Guillain-Barre syndrome is an acute demyelinating polyneuropathy often following Campylobacter jejuni infection, through molecular mimicry between bacterial lipo-oligosaccharide and nerve gangliosides. Inflammation at nerve roots raises CSF protein while cell count stays normal, termed albuminocytological dissociation. The protein may be normal in the first week.
Option by option
A. Neutrophils 1500 per microlitre with low glucose
Neutrophilic pleocytosis with low glucose indicates bacterial meningitis.
B. Lymphocytes 200 per microlitre with normal protein
A lymphocytic pleocytosis with normal protein suggests viral meningitis.
C. Oligoclonal IgG bands with mildly raised cells
Oligoclonal bands are typical of multiple sclerosis, a central demyelinating disease.
D. Protein 120 mg/dL with 3 cells per microlitre (correct)
Correct. High protein with a normal cell count is characteristic.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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