question - nini2020

[ArchivalUser]

Follwing information is from MKSAP (very much reliable):

* Transverse myelitis is an acute or subacute demyelinative or inflammatory disorder of the spinal cord that causes motor, sensory, and autonomic dysfunction below a spinal cord level.
* High-dose intravenous corticosteroids are indicated for INITIAL treatment of acute transverse myelitis.

I think this depend on patient presentation also---> in question if pt present as emergency ------> go for steroids ---> followed by investigation

[ArchivalUser]

http://www.usmleforum.com/showthread.php?tid=489248

[ArchivalUser]

a 30 y old male with 2 day h/o progressive leg weakness, ascending pasesthesia and dull back pain had urinary retension today. phy exam show decreased reflexes and sensations up to the level of umbilicus. bladder cath shows 500 cc of urine. wat is next best step?
1.LP
2.X ray spine
3.high dose steroids
4. CT spine and brain
5. MRI spine

In this question ---> go for MRI --->
because:-
It can be GBS also. and steroids are not effective in GBS

question is very tricky.

[ArchivalUser]

steroids

[ArchivalUser]

@ harry
that Q cant be GBS as bladder involvement is there.... its a case of trans myelitis, but they say MRI 1st.

[ArchivalUser]

@ successor:

Urinary retention can be observed in GBS. Although Bowel and bladder dysfunction rarely presents as an early symptom or persists for a significant period of time.