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Old 11-18-2012
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Arrow Billy Step 1 Questions # 86

A 22-year-old college student presents to the school health service complaining of worsening weakness in his arms and legs. He says that over the past day he has also begun to feel weakness in his chest and back. He mentions that he thinks he had food poisoning earlier in the week, which caused stomach pain and bloody diarrhea. Physical examination reveals that the deep tendon reflexes in his lower extremities are absent. His physician sends his stool to be cultured. The results show infection with Campylobacter jejuni. Which one of the following statements is most consistent with the disease process connecting the patient’s gastrointestinal infection and his neurological symptoms?

(A) An excessive immune response to a gastrointestinal Campylobacter jejuni infection led to an autoimmune inflammation of peripheral nerves

(B) Dissemination of Campylobacter jejuni gastrointestinal infection led to infiltration of peripheral nerves with C. jejuni

(C) Dissemination of Campylobacter jejuni gastrointestinal infection led to infiltration of peripheral muscle cells with C. jejuni

(D) Toxins secreted by Campylobacter jejuni infiltrated into peripheral nerves, causing their destruction

(E) Toxins secreted by Campylobacter jejuni infiltrated into peripheral muscle cells

Last edited by billy; 11-18-2012 at 05:43 AM.
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Old 11-18-2012
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Default my answer :)

(A) An excessive immune response to a gastrointestinal Campylobacter jejuni infection led to an autoimmune infl ammation of peripheral nerves
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Default A

Think it's A coz the other choices don't make sense to me
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Default A

it is Guillain Barre syndrome.
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Old 11-19-2012
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Default Guillan Barre

A) An excessive immune response to a gastrointestinal Campylobacter jejuni infection led to an autoimmune inflammation of peripheral nerves
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Old 11-19-2012
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Correct Answer A is correct

This patient has Guillain-Barré as a result of his gastroenteritis.The important message here is that Guillain- Barré syndrome is thought to be primarily an
autoimmune disorder against peripheral nerves and the cells that myelinate them (Schwann cells). Thus, it makes sense that an excessive immune response to an infection (such as from a pathogen like Campylobacter jejuni) can lead to an autoimmune process. Histologically, this disease is characterized by perivenular and endoneurial infiltration with lymphocytes, macrophages, and plasma cells.
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