Neurology: chronic inflammatory demyelinating polyneuropathy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: chronic inflammatory demyelinating polyneuropathy

Sample item

A 45-year-old man has symmetrical proximal and distal limb weakness with areflexia that has progressed over 4 months. CSF protein is 180 mg/dL with 2 cells per mm3, and nerve conduction studies show demyelination. Which diagnosis and treatment are correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. CIDP, treated with IV immunoglobulin, corticosteroids or plasma exchange

Chronic inflammatory demyelinating polyneuropathy is an immune-mediated neuropathy that progresses for more than 8 weeks, in contrast to Guillain-Barre syndrome which peaks within 4 weeks. It shows albuminocytological dissociation and demyelinating conduction block. Unlike GBS it responds to corticosteroids, as well as to IV immunoglobulin and plasma exchange.

Option by option

  • A. Charcot-Marie-Tooth disease, treated with physiotherapy alone

    Charcot-Marie-Tooth disease is hereditary with a slow course from childhood and has no inflammatory CSF changes.

  • B. CIDP, treated with IV immunoglobulin, corticosteroids or plasma exchange (correct)

    Correct. Progression beyond 8 weeks with demyelination defines CIDP and it is treatable.

  • C. Diabetic amyotrophy, treated with glycaemic control alone

    Diabetic amyotrophy is a painful asymmetric proximal neuropathy in diabetes, not a symmetric demyelinating illness.

  • D. Guillain-Barre syndrome, treated with plasma exchange only

    GBS reaches its nadir within 4 weeks, and a 4-month course excludes it.

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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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, CIDP, treated with IV immunoglobulin, corticosteroids or plasma exchange. Chronic inflammatory demyelinating polyneuropathy is an immune-mediated neuropathy that progresses for more than 8 weeks, in contrast to Guillain-Barre syndrome which peaks within 4 weeks.

Why is "Charcot-Marie-Tooth disease, treated with physiotherapy alone" not the answer?

Charcot-Marie-Tooth disease is hereditary with a slow course from childhood and has no inflammatory CSF changes.

Why is "Diabetic amyotrophy, treated with glycaemic control alone" not the answer?

Diabetic amyotrophy is a painful asymmetric proximal neuropathy in diabetes, not a symmetric demyelinating illness.

Why is "Guillain-Barre syndrome, treated with plasma exchange only" not the answer?

GBS reaches its nadir within 4 weeks, and a 4-month course excludes it.

What concept does this question test?

It tests Neurology: chronic inflammatory demyelinating polyneuropathy in General Medicine. It shows albuminocytological dissociation and demyelinating conduction block. Unlike GBS it responds to corticosteroids, as well as to IV immunoglobulin and plasma exchange.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: chronic inflammatory demyelinating polyneuropathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.