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Pathophysiology > GBS > Flashcards

GBS Flashcards

1
Q

What is GBS?

A

acute inflammatory demyelinating polyneuropathy

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2
Q

What do 66% of GBS pts report prior to onset of symptoms?

A

viral infection

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3
Q

What is the cause of the initial myelin destruction?

A

inflammation due to an autoimmune reaction

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4
Q

What is the pathogenesis of GBS?

A

antibodies penetrate and bind to the antigen on the surface of the myelin
antibody dependent macrophages are activated
macrophages respond to inflammation
attack and destroy myelin between nodes of ranvier
blocks conduction of nerve impulses, schwann cell is primary target of attack

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5
Q

What happens after acute polyneuropathy?

A

after initial demyelination, body initiates repair process
schwann cells divide and remyelinate nerves
recovery is possible because no destruction of cell body or axon
reproduce myelin sheath with a shorter internodal distance

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6
Q

What is the secondary process that may happen?

A

some axons are damaged due to the inflammatory effect
free radicals excreted by macrophages
longer time to heal
possible residual damage - more severe cases

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7
Q

How does GBS present in a pt?

A

varying degree of rapidly ascending, symmetrical muscle weakness, tingling, numbness and pain

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8
Q

What is typically the first neurological symptom of GBS?

A

paresthesia in toes or hands

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9
Q

What do reflexes look like in a person with GBS?

A

severely diminished or absent

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10
Q

What are associated ANS issues with GBS?

A

tachycardia
abnormal cardiac rhythm
BP changes

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11
Q

In what pattern does recovery occur in GBS?

A

proximal to distal

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12
Q

What does the acute phase of GBS look like?

A

onset of symptoms is rapid and progressive and worsens over 24 to 72 hours and continues to progress for days or weeks

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13
Q

What is the plateau phase of GBS look like?

A

symptoms remain for days or a few weeks

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14
Q

Describe recovery of GBS.

A

remyelination and axonal regeneration occurs

can take months to 2 years

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15
Q

What is the static phase of GBS?

A

lasts 2-4 weeks and occurs after progression ceases but before recovery

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16
Q

In most cases progression ceases in within ______ weeks.

A

4

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17
Q

What is the most common form of GBS?

A

Acute inflammatory demyelinating polyneuropathy (AIDP)

18
Q

What is AIDP?

A

rapid progression with one attack and then a complete recovery

recovery often begins within 3 weeks

19
Q

What is Acute Motor Axonal Neuropathy (AMAN)?

A

primarily attacks motor nerves

most severe form of GBS

20
Q

What is a possible complication of AMAN?

A

respiratory failure

21
Q

What is the prognosis for AMAN?

A

good, but takes longer than AIDP and can have residual deficits

22
Q

What is Acute motor and sensory axonal neuropathy (AMSAN)?

A

attacks motor and sensory nerves

results in an incomplete recovery

23
Q

What is the hallmark of GBS?

A

symmetrical loss

24
Q

When must most treatments be given in order to be effective for GBS?

A

within 1-2 weeks of initial attack

25
Q

____________ are not effective in treating GBS.

A

oral steroids

26
Q

What is plasmapheresis and what is the PT implication.

A

removes the damaged antibodies

can’t treat when the patient is going through this–lasts about a week

27
Q

What treatment blocks the damaged antibodies and has a dose given over 2-5 days?

A

High Dose Immunoglobulin Therapy - IVIG

28
Q

When would immunosuppressive therapy be indicated?

A

if pt stays in acute phase too long

last resort

29
Q

What are poor prognostic indicators for GBS?

A

older age at onset
protracted time before recovery begins
need for ventilation

30
Q

What is myasthenia gravis?

A

most common disorder of the neuromuscular junction

characterized by fluctuating weakness and fatiguability of skeletal muscles

31
Q

What are risk factors for MG?

A

hx of thymic disorders
DM, RA, Lupus
chronic infections

32
Q

What is the pathology of MG?

A

reduction of acetylcholine receptors
receptors that remain are flattened
results in decreased efficiency of neuromuscular transmission

33
Q

What are early signs of MG?

A

diplopia (double vision)
ptosis

34
Q

What is hallmark of MG?

A

ptosis

35
Q

What drug is used to diagnose MG?

A

tensilon - if symptoms improve + diagnosis

36
Q

What is the most reliable and objective diagnostic measure for MG?

A

EMG testing

37
Q

What are treatments of MG?

A

ACHe inhibitor medication
surgical removal of thymus
immmunosuppression

38
Q

How is MG similar to MS?

A

there are periods of remission/exacerbation but not as noticeable or severe

39
Q

What is Polio?

A

viral infection that specifically attacks the motor cell bodies

40
Q

What impairments are caused by polio?

A

asymmetric motor impairments

NO sensory loss or change
Intact reflexes

41
Q

What is post polio syndrome?

A

new neuromuscular symptoms that occur decades after recovery from acute paralytic episode

this only occurs in muscles that were effected initally

Pathophysiology (10 decks)

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