Guillain Barre Syndrome

Question 1

Guillain barre syndrome is autoimmune and inflammation to what?

Answer 1

The PNS

Question 2

What is occuring to the PNS in Guillain Barre syndrome?

Answer 2

autoimmune and infammation

Question 3

Guillain barre syndrome is an acute onset of what?

Answer 3

generalized paralysis

Question 4

What is the Et of GBS?

Answer 4

Idiopathic

Question 5

The Patho of Guillain Barre Syndrome is preceeded by what? Over how long?

Answer 5

A Upper respiratory tract infection or a Gastrointestinal infection (1-4 weeks)

Question 6

This preceeding infecting for Guillain Barre Syndrome can be one of two things. Say what each is, and the name of it.

Answer 6

1. Bacteria: Campylobacter jejuni

2. Virus: EBV

Question 7

What is the genous and species name of the bacteria that can lead to GBS?

Answer 7

Campylobacter jejuni

Question 8

What are resevoirs were Campylobacter jejuni can be? (3)

Answer 8

1. Poultry
2. Unpasterized milk
3. Contaminated water

Question 9

The Patho for Guillain Barre Syndrome involves Abs and T cells targgeting what? where?

Answer 9

Myselin sheath in the PNS

Question 10

D/t the Abs and T cells targetting the myelin sheath, there is inflammation. What cells would then be present?

Answer 10

Lymphocytes, macrophages, neutrophils

Question 11

What are the cells that produce the myelin in the PNS? Will they be damaged?

Answer 11

The Schwann cells. Yes, they will be damaged.

Question 12

There can be evidenceo to support autoimmunity is occuring because of what being bound to the Schwan cells?

Answer 12

Abs

Question 13

The mnfts for the infection for Guillain Barre syndrome may or may not be present.. why?

Answer 13

Because the symptoms of the infection may not be present (recovered from the infection) you woulnd’t associate the symptoms of GBS together (can come 1-4 weeks later)

Question 14

What is the first mnfts you will see in GBS?

Answer 14

Paresthesias (abnormal sensations such as numbness or tingling)

Question 15

Where do the mnfts typicalling begin?

Answer 15

Peripherals: hands / feet

Question 16

What wil progressively happen after the paresthesias?

Answer 16

progressive ascending muscle weeaknes, which then progresses to…

Question 17

What will progress after the muscle weakness?

Answer 17

Paralysis

Question 18

What manifestation will be felt once the hip or should has been reached?

Answer 18

Deep muscle pain

Question 19

If no intervention is provided to the patient, what will occur to them?

Answer 19

They will become completely paralyzed

Question 20

What would most people die from from GBS? What percentage?

Answer 20

Respiratory failure (~30%)

Question 21

What is used in the Dx of Guillain Barre Syndrome? (4)

Answer 21

1. Hx
2. Physical Exam
3. Decreased Nerve conduction
4. CSF

Question 22

What are you assessing for in the physical exam?

Answer 22

Weakness and tendon reflexes

Question 23

Why are you assessing the CSF?

Answer 23

The peripheral nerves originate in the spinal chord, therefore they may be an increase of proteins in the CSF. ALSO. Trying to rule out other disorders such as MS where you are assessing the CSF.

Question 24

What does protein in the CSF indicate? (1 of 3 things)

Answer 24

1. Compromised BBB
2. Autoimmune Brain or Spinal Chord
3. Inflammation

Question 25

What does the treatment involve for GBS? (4)

Answer 25

1. Maintail vital fx 2. Plasmapheresis 3. IV IgG 4. Pain control

Question 26

Explain the plasmapheresis

Answer 26

Is a process in which the liquid in the blood, or plasma, is separated from the cells. In sick people, plasma can contain antibodies that attack the immune system. A machine removes the affected plasma and replaces it with good plasma, or a plasma substitute

Question 27

Why the IV IgG?

Answer 27

D/T patient having Abs removed, pt. has low immunity therefore replacement Abs is required.

Question 28

Most people with Guillain Barre Syndrome will recover fully or partially? In how long?

Answer 28

Fully in 6-12 months

Question 29

Do patients recovering from Guillain Barre Syndrome typically have any long term impediments?

Answer 29

Typically, no, but sometimes yes.

Question 30

The Etiology of Guillain Barre Syndrome involves autoimmunity that are self targeting based on the MHC/HLA. This means a person would be more at risk if they had genetically defected MHC or HLA proteins on the surface of their cells. What do the Abs then do to the defected MHC or HLA proteins on the surface of the cells?

Answer 30

Abs would be binding to them.