Which of these diseases cause predominately sensory loss?

Appeared in: OSSSC Nursing Officer-2023

Explanation

Diabetes mellitus is the most common cause of peripheral neuropathy, which typically manifests as a predominantly sensory deficit.
The classic presentation is a distal, symmetric polyneuropathy, often described as a "stocking-glove" distribution of sensory loss.
Symptoms include numbness, tingling (paresthesia), and burning pain, which usually precede motor weakness.
Hyperglycemia leads to metabolic and vascular changes that damage both the nerve fibers (axons) and their protective myelin sheath.

Why Other Options Were Wrong

Option A: Guillain-Barre syndrome (GBS) is characterized by predominantly motor symptoms.
Option B: Diphtheritic neuropathy is primarily a motor neuropathy.
Option C: Lead poisoning classically causes a pure motor neuropathy.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differential diagnosis of peripheral neuropathies based on sensory versus motor predominance as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in managing diabetic neuropathy by educating patients on meticulous foot care to prevent ulcers and infections, which can lead to amputation.
Regular sensory testing using a monofilament is a key nursing assessment to detect the loss of protective sensation in diabetic patients.
Pain management for neuropathic pain is complex and often involves non-opioid medications like gabapentin or pregabalin, requiring careful patient monitoring for efficacy and side effects.

How to Approach the Question

First, identify the core of the question, which is to find the disease with 'predominantly sensory loss'.
Analyze each option by recalling the classic presentation of its associated neuropathy.
For Guillain-Barre syndrome, recall 'ascending paralysis' (motor).
For Diphtheria, recall 'bulbar palsy' and muscle weakness (motor).
For Lead poisoning, recall the classic 'wrist drop' or 'foot drop' (motor).
For Diabetes, recall the 'stocking-glove' pattern of numbness and tingling (sensory).

Concept Tested & Keywords

Concept Tested: Differential diagnosis of peripheral neuropathies based on sensory versus motor predominance.
Stem keywords: diseases, predominately sensory loss, neuropathy
Lead-in keywords: Which

Question ID

Q5e0aBN6ec96J8Gv0tIJ39

Reference Book

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1220-1222

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 2153-2155

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