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Neurology > Guillain Bare Syndrome > Flashcards

Guillain Bare Syndrome Flashcards

1
Q

what type of disease is GBS?

-2

A

autoimmune

polyneuropathy

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2
Q

what structure is damaged in GBS?

A

peripheral nerves

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3
Q

what happens to muscle?

A

flaccis paralysis

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4
Q

what happens to muscle tone?

A

↓tone

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5
Q

what happens to muscle strength?

A

weakness

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6
Q

patient’s antibodies attack what molecule in which system?

what are these antibodies caleld?

A

gangliosides
PNS

anti-ganglioside antibody

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7
Q

anti-GM1 antibody stands for what?

how many pt is it present in?
-% wise

A

anti-ganglioside antibody

25%

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8
Q

is inflammation acute or chronic?

A

acute

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9
Q

what are the 2 main subtypes of GBS?

A

Acute inflammatory demyelinating polyneuropathy

Acute motor axonal neuropathy

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10
Q

which subtype involved myelin destruction?

what cell destroys the myelin?

which cell activates the above cell?

A

Acute inflammatory demyelinating polyneuropathy

macrophages

T cell

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11
Q

which subtype involved a specific antibody attacking axons?

which immunoglobulin is it?

A

Acute motor axonal neuropathy

IgG

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12
Q

the pathophysiology of GBS has been given what term?

explain this pathophysiology?

A

molecular mimicry

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

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13
Q

where on the neurones are gangliosides located?

A

axolemma

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14
Q

which bacteria has antigens similar to gangliosides?

A

campylobacter

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15
Q

which muscles groups become weak first?

A

legs

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16
Q

are the proximal or distal muscles affected first?

A

proximal first

17
Q

is the muscle weakness progressive or not?

A

progressive

18
Q

due to extraocular muscle weakness what symptoms can occur?

A

15%

19
Q

due to oropharyngeal weakness what symptoms can occur?

A

speech problems

20
Q

what happens to reflexes?

A

Hyporeflexia

21
Q

what happens to muscle tone?

A

hypotonia

22
Q

where can paraesthesia occur?

is the paraesthesia mild or sever?

A

hands and feet

usually mild

23
Q

1st line Ix?
-2

result for each?

A

LP - ↑protein with normal WBC count

Nerve conduction study - slower

24
Q

what is the result on spirometry?

A

↓vital capacity

25
Q

what is the result on LP?

explain this result?

how long would it take for these results to be seen on a CSF?

A

↑protein

because of inflammation

3 days for protein to elevate in CSF

26
Q

1st line Mx?
-2

combining the above two Mx gives a synergistic effect. true or false?

A

Plasma exchange

high dose IV immunoglobulin

false (no synergistic effect)

27
Q

what is prognosis?

good or bad

A

good recovery

28
Q

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

A

resp failure

29
Q

Plasma exchange
is oft abbreviated to what term?

how does this procedure work?

A

PLEX

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

30
Q

which blood product contains the antibodies?

A

FFP

31
Q

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

A

SE = anaphylaxis

32
Q

list all symptoms of GBS?

-8

A 
Progressive muscle weakness 
Leg/back pain 65% 
speech problems 
facial weakness 
diplopia 
hypotonia 
Hyporeflexia 
Paraesthesia hand & feet (80%)
33
Q

complication of leg muscle weakness?

A

DVT

34
Q

list complications?

A

Resp muscle weakness

Cranial nerve involvement- diplopia

Autonomic nerves effected

DVT

35
Q

if autonomic nerves are effected.

what features will you see?
-4

A

urinary retention, diarrhoea, BP or HR changes

36
Q

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

and why?

A

30%

resp muscle weakness

37
Q

what is typical history?

A

rapid acute onset of symptoms, lots of muscle weakness.

38
Q

what does GBS stand for?

A

Guillain Barre Syndrome

Neurology (40 decks)

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