Guillain Barré Syndrome Flashcards

1
Q

Guillain-Barre syndrome (GBS) describes an immune mediated demyelination of the peripheral nervous. What is the incidence of GBS?

1 - 1000 / 100,000
2 - 100 / 100,000
3 - 10 / 100,000
4 - 1 / 100,000

A

4 - 1 / 100,000

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2
Q

Guillain-Barre syndrome (GBS) describes an immune mediated demyelination of the peripheral nervous. Typically, what age does GBS typically peak?

1 - 5-10
2 - 20-30
3 - 40-50
4 - 70-80

A

2 - 20-30

BUT can occur at any age
Rare in children

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3
Q

Guillain-Barre syndrome (GBS) describes an immune mediated demyelination of the peripheral nervous. Is GBS more common in men or women?

A
  • men

3:2 ratio

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4
Q

Guillain-Barre syndrome (GBS) describes an immune mediated demyelination of the peripheral nervous. Is GBS typically an acute or chronic conditoon?

A
  • acute

Also called Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP)

Polyradiculoneuropathy = Diseases characterised by injury or dysfunction involving multiple peripheral nerves and nerve roots

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5
Q

Infection often precedes Guillain-Barre syndrome (GBS) (although not always), but what infection is most common associated with causing GBS?

1 - Cytomegalovirus
2 - Epstein Barr Virus
3 - Campylobacter jejuni
4 - Influenza
5 - HIV

A

3 - Campylobacter jejuni

Can also occur following vaccination

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6
Q

Infection often precedes Guillain-Barre syndrome (GBS) (although not always), with Campylobacter jejuni being the most associated with GBS. Typically GBS occurs within how long post infection?

1 - <12 weeks
2 - <6 weeks
3 - <4 weeks
4 - <1 week

A

3 - <4 weeks

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7
Q

Which 2 of the following are the typical signs of Guillain-Barre syndrome (GBS)?

1 - worsening ascending weakness
2 - rigidity and hypertonia
3 - areflexia
4 - hypereflexia

A

1 - worsening ascending weakness

3 - areflexia (lack of reflexes)

Both of these are LMN presentations

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8
Q

Is Guillain-Barre syndrome (GBS) a UMN or LMN demyelinating condition?

A
  • LMN

Attacks Schwann cells

The most common flaccid paralysis causing condition and increasing for some reason

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9
Q

Guillain-Barre syndrome (GBS) typically presents with an ascending weakness (legs 1st then arms) and a lack of reflexes, common in LMN conditions. Are there major sensory symptoms?

A
  • no

If present these symptoms are mild and can present like glove and stockings

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10
Q

In addition to the ascending weakness (legs 1st then arms) and areflexia (lack of reflexes), which of the following do patients NOT typically present with in Guillain-Barre syndrome (GBS)?

1 - back pain
2 - history of gastroenteritis or URTI
3 - cranial nerve involvement e.g. diplopia
4 - babinski sign
5 - autonomic involvement: e.g. urinary retention, diarrhoea

A

4 - babinski sign

Present in UMN lesions

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11
Q

Guillain-Barre syndrome (GBS) is though to be due to molecular mimicry, where pathogens imitate host antigens. Which of the following antibodies are most commonly associated with GBS?

1 - Anti-schwann antibodies
2 - Anti-ganglioside antibodies
3 - Anti-oligodeendroctes
4 - Anti-macularcytes

A

2 - Anti-ganglioside antibodies

Written as GM-1 and typically present in 25% of patients with GBS

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12
Q

Guillain-Barre syndrome (GBS) is though to be due to molecular mimicry, where pathogens imitate host antigens. Anti-ganglioside antibodies are most commonly associated with GBS. Are these useful in diagnosing patients?

A
  • no

Typically present following the condition

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13
Q

Guillain-Barre syndrome (GBS) is typically a clinical diagnosis, with patients presenting with ascending weakness (legs 1st then arms) and areflexia (lack of reflexes) and mild sensory symptoms. A lumbar puncture could be performed to aid with diagnosis, but which of the following would be observed in GBS?

1 - high protein and high WBC
2 - high glucose and high WBC
3 - high protein and normal WBC
4 - low protein and high WBC

A

3 - high protein and normal WBC

May also be normal in early disease course

Nerve conduction studies (show demyelinating pattern) and imaging can be supportive

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14
Q

Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome (GBS). Although the following can present in a similar way to GBC, what is typically affected first in MFS compared to GBS?

1 - sensory affects
2 - upper limbs
3 - bulbar symptoms
4 - eye muscles

A

4 - eye muscles

MFS typically presents as a descending paralysis

Anti-GQ1b antibodies are present in 90% of cases

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15
Q

As patients with Guillain-Barre syndrome (GBS) experience neuropathic pain, which 2 of the following are most likely to be given to help with the pain?

1 - gabapentin
2 - amitriptyline
3 - sertraline
4 - carbamazepine

A

1 - gabapentin
4 - carbamazepine

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16
Q

Are steroids effective in Guillain-Barre syndrome (GBS)?

A
  • no
17
Q

Steroid are ineffective in Guillain-Barre syndrome (GBS). What can patients with GBS be given instead?

1 - IV immunoglobulins
2 - Methotrexate
3 - Mycophenolate mofetil
4 - Ciclosporin

A

1 - IV immunoglobulins

Plasmapheresis can also be used to remove the auto-antibodies from the blood

18
Q

Cardiac and respiratory function need to be monitored in patients with Guillain-Barre syndrome (GBS). Which of the following is the most effective at monitoring respiratory function?

1 - O2 saturations
2 - forced vital capacity
3 - ABG
4 - FBC

A

2 - forced vital capacity

19
Q

If treated appropriately patients with Guillain-Barre syndrome (GBS) have a good prognosis and recover in what time frame?

1 - <1-2 weeks
2 - <3-4 weeks
3 - <8-12 weeks
4 - <3-6 months

A

3 - <8-12 weeks

Can be longer though and 15 % may be unable to walk unaided at 6 months

20
Q

What is the mortality rate in Guillain-Barre syndrome (GBS)?

1 - 50%
2 - 35%
3 - 15%
4 - 5%

A

4 - 5%