Guillian Barre

Question 1

a group of predominately demyelinating diseases of the peripheral nerves causing acute progressive weakness, usually ascending paralysis, divided into 2 forms: demyelinaing and miller fisher

Answer 1

guillian barre

Question 2

demyelinating form:

acute inflammatroy demyelinating polyradiculoneuropathy, 30% of pts have elevated what?

Answer 2

anti GM I antibodies

Question 3

Miller FIsher:

Answer 3

ophthalmoplegia, areflexia, ataxia of limbs with relatively preserved muscle strength, 90% of pts have elevated anti GQ1b abs

Question 4

RFs?

Answer 4

DM
recent surgery 
organ transplant 
hodgkins lymphoma 
swine flu vaccine 
rabies

Question 5

what kind of destruction to myelin/axon?

Answer 5

autoimmune

Question 6

earliest symptoms?

Answer 6

dysesthesias, paresthesias of feet and hands

Question 7

other symptoms besides dysesthesias, paraesthesias?

Answer 7

pain in back and legs

autonomic neuropathy (labile body pressure, arrhythmias, ilues, urinary retention)

respiratory muscle paralysis

cranial nerve involvement, facial weakness, occulomotor weakness

Question 8

history we could find what?

Answer 8

upper respiratory or diarrheal infx within 1-3 weeks, campylobacter jejuni, CMV, EBV, m. penumoniae, HIV

Question 9

Serum anti GM1 antibody in what?

Answer 9

axonal variant

Question 10

CSF:

Answer 10

elevated protein and normal WBC (except in HIV aseptic meningitis)

Question 11

most sensitive test?

Answer 11

nerve conduction studies

Question 12

this is common in GB and characteristic of acquired demyelinatig neuropathy?

Answer 12

conduction block

Question 13

what conforms dx?

Answer 13

prolonged distal latency and slowing of conduction velocity in two nerves each in arms or legs

Question 14

tx?

Answer 14

plasmaphoresis and IV Ig

mechanical ventilation, intubation for swallowing

Question 15

CI for GB?

Answer 15

STEROIDS!!!!!

Question 16

precautions in who and what?

Answer 16

ARF in elderly

diabetics, preexisting renal dx, hep C

Question 17

3 phases of illness?

Answer 17

initial
plateau
recovery

Question 18

highest risk of death and comps when?

Answer 18

initial phase (1 day - 3 weeks)

Question 19

during the recovery phase, there is no discernible recovery in adults after how long?

Answer 19

2 years

Question 20

mortality most often from?

Answer 20

dysautonomia or complications

Question 21

comps: there is a ton, just main ones

Answer 21

paralysis, permanent weakness, respiratory failure, hypo/hyper tension, cardiac arrhythmias, urinary retention sepsis, penumonia, DVT PE depression