Guillain Bare Syndrome

Question 1

what type of disease is GBS?

-2

Answer 1

autoimmune

polyneuropathy

Question 2

what structure is damaged in GBS?

Answer 2

peripheral nerves

Question 3

what happens to muscle?

Answer 3

flaccis paralysis

Question 4

what happens to muscle tone?

Answer 4

↓tone

Question 5

what happens to muscle strength?

Answer 5

weakness

Question 6

patient’s antibodies attack what molecule in which system?

what are these antibodies caleld?

Answer 6

gangliosides
PNS

anti-ganglioside antibody

Question 7

anti-GM1 antibody stands for what?

how many pt is it present in?
-% wise

Answer 7

anti-ganglioside antibody

25%

Question 8

is inflammation acute or chronic?

Answer 8

acute

Question 9

what are the 2 main subtypes of GBS?

Answer 9

Acute inflammatory demyelinating polyneuropathy

Acute motor axonal neuropathy

Question 10

which subtype involved myelin destruction?

what cell destroys the myelin?

which cell activates the above cell?

Answer 10

Acute inflammatory demyelinating polyneuropathy

macrophages

T cell

Question 11

which subtype involved a specific antibody attacking axons?

which immunoglobulin is it?

Answer 11

Acute motor axonal neuropathy

IgG

Question 12

the pathophysiology of GBS has been given what term?

explain this pathophysiology?

Answer 12

molecular mimicry

infection –> some viruses have similar antigens to gangliosides –> antibodies confused and attack gangliosides

Question 13

where on the neurones are gangliosides located?

Answer 13

axolemma

Question 14

which bacteria has antigens similar to gangliosides?

Answer 14

campylobacter

Question 15

which muscles groups become weak first?

Answer 15

legs

Question 16

are the proximal or distal muscles affected first?

Answer 16

proximal first

Question 17

is the muscle weakness progressive or not?

Answer 17

progressive

Question 18

due to extraocular muscle weakness what symptoms can occur?

Answer 18

15%

Question 19

due to oropharyngeal weakness what symptoms can occur?

Answer 19

speech problems

Question 20

what happens to reflexes?

Answer 20

Hyporeflexia

Question 21

what happens to muscle tone?

Answer 21

hypotonia

Question 22

where can paraesthesia occur?

is the paraesthesia mild or sever?

Answer 22

hands and feet

usually mild

Question 23

1st line Ix?
-2

result for each?

Answer 23

LP - ↑protein with normal WBC count

Nerve conduction study - slower

Question 24

what is the result on spirometry?

Answer 24

↓vital capacity

Question 25

what is the result on LP? explain this result? how long would it take for these results to be seen on a CSF?

Answer 25

↑protein because of inflammation 3 days for protein to elevate in CSF

Question 26

1st line Mx? -2 combining the above two Mx gives a synergistic effect. true or false?

Answer 26

Plasma exchange high dose IV immunoglobulin false (no synergistic effect)

Question 27

what is prognosis? | good or bad

Answer 27

good recovery

Question 28

2-5% of GBS patients die from what complication?

Answer 28

resp failure

Question 29

Plasma exchange is oft abbreviated to what term? how does this procedure work?

Answer 29

PLEX remove their blood, centrifuge to separate, give back their rbc & wbc. give healthy donated FFP

Question 30

which blood product contains the antibodies?

Answer 30

FFP

Question 31

why do you not do IV immunoglobulin in IgA deficient patients ?

Answer 31

SE = anaphylaxis

Question 32

list all symptoms of GBS? | -8

Answer 32

``` Progressive muscle weakness Leg/back pain 65% speech problems facial weakness diplopia hypotonia Hyporeflexia Paraesthesia hand & feet (80%) ```

Question 33

complication of leg muscle weakness?

Answer 33

DVT

Question 34

list complications?

Answer 34

Resp muscle weakness Cranial nerve involvement- diplopia Autonomic nerves effected DVT

Question 35

if autonomic nerves are effected. what features will you see? -4

Answer 35

urinary retention, diarrhoea, BP or HR changes

Question 36

how any GBS pts require ventilation at some point? %wise and why?

Answer 36

30% resp muscle weakness

Question 37

what is typical history?

Answer 37

rapid acute onset of symptoms, lots of muscle weakness.

Question 38

what does GBS stand for?

Answer 38

Guillain Barre Syndrome