Close
22nd May 2023
A 52-year-old plumber is in the Acute Medical Unit
A 52-year-old plumber is in the Acute Medical Unit after presenting with new bilateral lower limb weakness. He reports this has come on over the past week but today caused two falls. On further questioning, he also reports a couple of months’ history of abdominal pain and constipation, as well as trouble sleeping.
He has no other past medical history and takes no regular medication. On examination, he has bilateral weakness of ankle dorsiflexion and plantarflexion, but normal sensation.
His blood results show:
| Hb | 108 g/L | Male (130-180 g/L) |
| WBC | 8.4 x 10⁹/L | (4.0-11.0 x 10⁹/L) |
| Platelets | 205 x 10⁹/L | (150-500 x 10⁹/L) |
| MCV | 76 fL | (82-100 fL) |
| MCH | 22 pg | (27-32 pg) |
| Blood film | Basophilic stippling |
What is the most likely diagnosis?
Complete Guide to Clinical Genetics ST3 Application and Recruitment (2027)
Written by Medibuddy. Last updated: October 2026. Clinical Genetics is
Complete Guide to Clinical Radiology ST3 Application and Recruitment (2027)
Recruitment paused: NHS England is not running Clinical Radiology ST3+ recru
Complete Guide to Paediatric Surgery ST3 Application and Recruitment in United Kingdom (2026)
Written by Medibuddy. Last updated: October 2026. If you’re planning
Take your subscriptions with you
Our mobile app allows you to access your interview and exam question banks wherever you are.
