Brisk Knee in Medicine / Internal Medicine — 43yo Man | Neurology | SMLE Q#12426

SMLE Question #12426

Medicine / Internal Medicine Neurology

Objective: OBJ-307

Last updated: February 2026
A 43-year-old man has 2 days of rapidly progressive bilateral leg weakness and new urinary incontinence. Over 24 hours, numbness ascended to a clear sensory level around the umbilicus. One week earlier, he had a febrile upper respiratory illness. Examination shows flaccid 2/5 power in both legs with brisk knee and ankle reflexes, reduced pinprick sensation below about T10, and decreased anal sphincter tone. Upper limb examination is normal. What is the most likely diagnosis?

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