GB Flashcards

1
Q

definitions

A

acute/rapid 2-3 wks demyelinating dz of the peripheral nervous system

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2
Q

what happens

A

the immune system attacks the myelin so the nerves can’t communicate. the dendrites collect signal sends down axon passes signal down myelin to the neuromuscular junction then to muscle fibers

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3
Q

etiology

A

no clear, might be autoimmune

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4
Q

triggered by

A

infection from campylobacter, mycoplasma pna, h influ (gram -), or viral cytomegalovirus or Epstein Barr. dt they have antigens that look like myelin

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5
Q

affects which systems

A

nervous endocrine, metabolic

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6
Q

age and sex?

A

all ages and men more freq

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7
Q

hallmark sign

A

ascending paralysis/weakness

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8
Q

S&S

A

based on nerves affected, starts low extrem and ascends
nerves convey vibrations/sensation: paraesthesia
motor nerves: muscle weak, slow refelx, cant stand
cranial nerve: dbl vision/ diff speaking (7 & 12) eyes/swallowing,
resp muscles= death
autonomic nerves: constipation, B&B incont, ortho hypotension
symmetric: rapid progressive distal muscle weakness and paresthesia, deep tendon reflex
hypesthesia
bilat facial and oropharyngeal paresis
diff swallowing
*resp paralysis: poor inspiratory drive and effect, hypoxemia 2nd to resp failure
*burning toes
weakness/paralysis will stabilize in 2 wks: will gradually improve over months to years

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9
Q

diag

A

LP: increased proteins/albumin with normal wbc. normal protein 18-58 with GB protein will be in the 100’s
nerve cond/EMG: slower cond >50 normal is 20
pulmonary function test: and check abg
cbc: early leukocytosis w/ l shift

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10
Q

tx

A
02, suction, cough assist, postural drainage, trach, aimed at reducing symptoms:
meds suppress the immune system
IVIG or plasmapheresis: 1st line (pick 1, combo doesn't help)
prevent thomboembolytic events
pain: gabapentin, nsaids, opioids
stress ulcer prevention
encourage intake
pt for rom
maintain skin
nutritional support
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11
Q

severe polyneuropathy is a

A

medical emergency

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12
Q

tx severe polyneuropathy

A

admit to icu
obtain abg and vital capacity
intubate if vc <12-15, Pa02 <70 diff clear secretions, concern for aspiration
anticipate vent support
monitor brady/tachy arrhythmia, ortho hypotension, systemic htn,

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