Guillain-Barre Syndrome Flashcards
Guillain-Barre syndrome is caused by
auto immune disorder- generally after a viral or bacterial infection of the respiratory or GI system
The major pathologic or structural changes of the lungs associated with ventilatory failure accompanying Guillain-Barré syndrome include:
- bronchospasm
- airway obstruction
- mucous accumulation
- alveolar dilation
2 and 3 are correct
Your patient has an infection caused by Campylobacter jejuni. Her physician is concerned about the possible development of Guillain-Barré syndrome. If this disease were to occur, when would it appear after this current infection?
in 1 to 4 weeks
. A patient with Guillain-Barré syndrome has been placed in the intensive care unit. Initial treatment should include:
- assessment of breathing
- mechanical ventilation
- supportive care
- stabilizing vital signs
1, 3, 4 are correct
It is initially important to support the patient, assess his/her breathing, and stabilize the vital signs. Mechanical ventilation would only be instituted if the patient was in respiratory failure.
The most important thing to assess in the Guillain-Barré patient to determine acute ventilatory failure is: 1 VC measurement 2 maximum voluntary ventilation 3 forced expiratory volume in one second 4 tidal volume measurement
1- correct VC measurement
A VC (vital capacity) of
Management of the patient with Guillain-Barré Syndrome includes all of the following, EXCEPT: 1 Correct giving corticosteroids 2 mechanical ventilation 3 high-dose immunoglobulin therapy 4 plasmapheresis
A- corticosteroids
corticosteroids are not effective in treating the Guillain-Barré patient and may actually prolong recovery time
Your patient has a severe case of Guillain-Barré syndrome. It is most important that he be monitored for: 1. tachycardia 2 apnea 3 hypertension 4 fever
- apnea
Your Guillain-Barré syndrome patient was placed on mechanical ventilation when respiratory failure appeared imminent. She is now stable. Her chest radiograph will most likely show: 1. enlarged heart 2 pleural effusion 3 normal lung fields 4 pneumonia
C normal lung fields
unless there is a complicating cardiopulmonary problem. None is mentioned
In Guillain Barre, which of the following pathologic changes develop in the peripheral nerves? 1. inflammatoin 2 increased ability to transmit nerve impulses 3 demyelination 4 edema a. 2 and 3 b 3 and 4 c 2, 3, and 4 d 1, 3, 4
D: 1, 3, 4
Which of the following is associated with Guillan Barre syndrome? 1. alveolar consolidation 2 mucous consolidation 3. alveolar hyperinflation 4 atelectasis a 1 and 2 b 3 and 4 c 1, 2, and 4 d 2, 3, and 4
C: 1, 2 and 4
Guillain-Barre syndrome is move common in 1. people older than 45 years of age 2 blacks 3 males 4 early childhood
1 and 3
Which of the following are possible precursors to Guillan-Barre? 1. mumps 2 swine flu vaccine 3 infectious mononucleosis 4 measles a 1 and 4 b 2 and 3 c 2 only d 2, 3, and 4 e 1, 2, 3, and 4
answer is all- 1, 2, 3 and 4 (e)
Full recovery from Guillan Barre occurs in approximately what % of cases? 10% 30% 60% 90%
90%
Which of the following are indicators for intubation and mechanical ventilation in patients with Guillain Barre? 1. pH < 7.40 2. Paco2 > 45 3 FVC < 20 ml/kg 4 NIF < -25 cmH2O
2, 3 and 4
Pathologic changes of the peripheral nerves include:
demyelinatoin
inflammation
edema
decreased nerve impulse transmission (leading to paralysis)
T/F Patients with GB have high serum antibody titers and elevated levels of IgM during the recovery phase
FALSE
antibodies are greatly reduced during the recovery phase
Infectious mononucleosis is associated with as many as ___% of cases
25%
Early signs of GB:
fever, malaise, nausea, prostration, tingling/numbness in the extremities
skeletal muscle paralysis & loss of deep tendon reflexes
Progressive symptems include
ascending paralysis
cranial nerves 9 & 10 are effected (glossopharyngeal and vagus)
gag reflex is decreased or absent
swallowing is difficult (dysphagia)
aspiration likely unless airway is protected
Paralysis generally peaks in less than ____ days
ten
T/F Recovery from GB can take several weeks and in some cases several months
true
The diagnosis of GB syndrome is based on:
clinical history
significant signs including paralysis
examination of CSF
T/F Plasmapheresis has been shown to be an effective treatment in severe cases of GB
true
The RV/TLC ratio in GB is:
increased
Decreased
Normal
normal
ABG findings in GB
acute ventilatory failure with hypoxemia (acute respiratory acidosis) pH decrease Paco2 increased HCO3 increased PaO2 decreased
