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542 > ALS & GB > Flashcards

ALS & GB Flashcards

1
Q

Factors possibl leading to ALS

A

veterans in Iraq war
exposure to lead, pestisides, env contacts
use of tobacco/alcohol
extreme physical exertion

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2
Q

What are the two types of ALS

A

sporadic

familial

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3
Q

What is sporadic ALS

A

most common

can affect anyone anywhere

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4
Q

What is familial ALS

A

Inherited

50% chance each offspring will inherit the gene and dev ALS

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5
Q

How to DX als

A

process of elimination
tests vary b symptoms vary
e.g. nerve conduction, spinal tap, electromyography, scle/n biopsy

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6
Q

Clinical subtypes of als

A

UMN
LMN
Bulbar

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7
Q

UMN onset

A

general mm weakness
spasticity
hyperreflexia

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8
Q

LMN onset

A 
weakness 
mm atrophy of extremities 
cervical extensor weakness
fasiculations 
muscle cramps
loss of reflexes
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9
Q

Bulbar involvement

A

problems w/ speech/swalowing

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10
Q

What other system is affected inALS

A

cognition: mild mod

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11
Q

What systems are spared in ALS

A

Visual
Sensory
GI/Urinary

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12
Q

Phase I ALS(stages1-3)

A

Independent
I: mild weakness, clumsy, ambuatory, I in ADL
II: mod selective weakness slight decerase I in ADL
III: severe selective weakness in ankles/wrists/hands, mod decrease I in ADL, easily fatigued, slight increase in respiratory effort

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13
Q

Phase II (stage IV-V)

A

Partially I
IV: hangin arm syndrome w/ shoulder pain and edema in hands, WC dependent, severe LE weakness, able to perfrom some ADL but easily fatigued

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14
Q

Phase III (Stage VI)

A

Dependent

VI: dependednt w/ all positioning, complete dependence in ADL, extreme fatigue

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15
Q

Scial/emotional /economic consequences

A

depression: fast progression and external locus of control
psychosocial adjustment: little time to adjust
economic problems: decreased income

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16
Q

Wht symptoms can you treat with meds

A 
muscle cramps
excessive saliva
depression
insomnia
anxiety
spasticity
swallowing
17
Q

What is rilutek

A

anticoagulant.

prolongs survival inhibiting glutamate release from n endings and blocking amino acid receptors on cell bodies

18
Q

What should eval be based on in ALS

A

phases and lvl of function

19
Q

What to eval in ALS

A 
ADL
IADL
Dysphagia
Balance/falls
Cultrual/social/psychosocial/spiritual
20
Q

What to focus on in ALS

A

Compensation and adaptation

21
Q

What is GB

A

acute inflammatory demyelinating polyradiculoneuropathy

22
Q

Wha does GB affect

A

n roots

peripheral n leading to mm

23
Q

What does GB cause

A

motor neuropathy

flaccid paralysis

24
Q

wha does GB usually follow

A

viral infection

25
Q

GB Symptoms

A

Rapid symmetrical ascending paralysis (distal to proximal)
Sensory involvement (stocking glove)
pain (aching mm, symmetrical and hypersensitive) (pins/needles, larger muscles:dull aching)
ANS (decreased cardiac output, BP fluctuations, cardiac arrhthmia)

26
Q

Onset of GB

A

Sudden
may progress quickly w/in days
May result in respiratory failure
most reach max paralysis in 2 weeks

27
Q

What happens after max paralysis in GB

A

plateau

remyelination and axonal regeneration begins

28
Q

TX for GB

A

plasmophoresis (transfusion of plasma)

immunoglobin therpay

29
Q

Prognosis of GB

A

good
50% recover well
15% have sig decrease in funcition secondary to paralysis( usually distl)

30
Q

OT in GB

A

can’t do much while plateaued need to be recovering
ROM-early stages:PROM then AAROM and AROM to prevent contractures
MMT - dont do all at once for fatigue
Dyshphagia Eval
dev exercise program

31
Q

things to address

A 
Sensory/pain
postitioning
ROM/Strength
Dysphagia
Fatigue
EC/WS
ADL IADL
Stress mgnt 
AE Home
32
Q

What do people with ALS sually die from

A

respiratory failure

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