A 38-Year-Old Man with Ascending Weakness and Breathlessness
A branching clinical case simulation for a patient presenting with two days of progressive ascending weakness and breathlessness on lying flat. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 5hard20 min6 stages
- Patient
- 38 years, male
- Presenting complaint
- Two days of progressive ascending weakness and breathlessness on lying flat.
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are in the emergency department of a district general hospital. Mr. Ashworth, a 38-year-old man, presents with two days of progressive weakness starting in his feet and moving upwards. He also reports difficulty breathing when lying flat. He had a diarrhoeal illness two weeks ago. Triage observations are shown. You need to assess and manage him.
What this case teaches
Recognise Guillain-Barré syndrome; monitor forced vital capacity as the key measure; anticipate respiratory failure and autonomic instability; start immunotherapy.
How the case unfolds
- 1HistoryHistory
- 2ExaminationExamination
- 3InvestigationsInvestigations
- 4DiagnosisDiagnosis
- 5TreatmentTreatment
- 6MonitoringMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
Log in to run "A 38-Year-Old Man with Ascending Weakness and Breathlessness"
A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
More like this
- A 6-week-old with fever and bulging fontanelle: a case of bacterial meningitis
- A 62-year-old man with tearing interscapular pain and hypertension
- A 63-year-old man with haematemesis and melaena
- A 70-Year-Old Woman with Atrial Fibrillation and a Cold, Pale, Painful Leg
- A Warfarinised Elderly Man with a Fall: A Case of Fractured Neck of Femur
- Acute Asthma Exacerbation in a Child: A Case in Emergency Medicine
Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.