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Residência Pediatria > Neuro > Flashcards

Neuro Flashcards

GBS

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1
Q

GBS is a postinfectious ___

A

Polyneuropathy

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2
Q

In GBS; Involves only motor nerves T/F

A

False; sensory and sometimes autonomic nerves can be affected

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3
Q

In GBS; the onset usually starts __ days after a GI or respiratory infection

A

Aprox 10 days

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4
Q

In GBS; Cite 3 main sources of GI infection

A

Undercooked poultry; unpasteurized milk; contaminated water

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5
Q

In GBS; West Nile virus can mimic GBS but more often causes ___

A

Motor neuron disease similar to poliomyelitis

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6
Q

In GBS; Cite 3 vaccines related to GBS

A

Rabies; influenza; Menigo C

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7
Q

In GBS; Initial symptoms include… 3

A

Numbness and paresthesia; followed by weakness

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8
Q

In GBS; Radicular back pain and myalgia are common in the initial stage T/F

A

True; children can be very irritable

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9
Q

In GBS; Weakness starts from __ to __

A

Lower limbs; uppper limbs and finally bulbar muscles

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10
Q

In GBS; weakness is usually (Asymmetric/Symmetric)

A

Symmetric

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11
Q

In GBS Weakness progresses over ___ to ___; reaching a nadir at ___

A

days to weeks; 4wks

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12
Q

In GBS; percentage of children that lose the ability to walk:

A

60%; small proportion progress to flaccid tetraplegia

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13
Q

In GBS; What percentage pressents bulbar involvement?

A

50%; can result in respiratory insufficiency

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14
Q

In GBS; Signs of impending respiratoy failure (3)

A

Dysphagia and facial weakness; hoarse voice

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15
Q

In GBS; Autonomic involvement can present as… (4)

A

BP labylity; HR lability; post hypotension; asystole

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16
Q

In GBS; Tendon reflexes are lost latter in the clinical presentation

A

False; usually occurs early; may be only hyporeflexia; 10% retain reflexes

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17
Q

In GBS; CIDP symptoms develop over __; recur intermittently and can progress over…

A

4-6wk; months to years

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18
Q

In GBS; CIDP weakness is both ___ and ___ and ___ severe

Chronic inflammatory demyelinating polyradiculopathy

A

distal; proximal; variably

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19
Q

In GBS; CIDP hypo or areflexia is

Chronic inflammatory demyelinating polyradiculoneuropathy

A

Almost universal

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20
Q

In GBS; Classic weakness includes…

A

Tetraparesis with or without motor involvement

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21
Q

In GBS; Paraparetic weakness includes…

A

Lower limbs

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22
Q

In GBS; Pharyngeal-cervical-brachial weakness includes…

A

Bulbar; neck; upper limbs

23
Q

In GBS; Bifacial weakness with paresthesias includes…

A

facial involvement

24
Q

In GBS; MFS includes…

Miller-fisher syndrome

A

External ophthalmoplegia; ataxia

25
Q

In GBS; Bickerstaff’s brainstem encephalitis includes…

A

External ophthalmoplegia; ataxia; hyppersomnolence

26
Q

In GBS; DDx should include (5)

A

Spinal cord lesions; peripheral neuropathies; Junction disorders; Myophaties; Others

27
Q

In GBS; CSF PTN is elevated/reduced

A

Elevated; usually more than 2x upper limit

28
Q

In GBS; CSF glicose and celullarity are…

A

normal and no pleocytosis; there should be less than 10 wbc

29
Q

In GBS; Cytoalbuminologic dissociation can take up to ___ to show up

A

A week from the onset of symptoms

30
Q

In GBS; Typical findings of MRI include…

A

Thickening of the cauda equina and intrathecal nerve roots with “gadolinium” enhancement

31
Q

In GBS; Electromyography shows…

A

Motor and sensory nerve cond velocity reduction; reflecting patchy nature of nerve involvement

32
Q

In GBS; CPK levels are…

A

Mildly elevated or normal

33
Q

In GBS; Serum antiganglioside antibodies against ___ and ___ are sometimes elevated

A

GM1; GD1

34
Q

In GBS; Sural nerve biopsy shows… (3)

A

Segmental demyelination; focal inflammation; “Wallerian degeneration”

35
Q

In GBS; Respiratory effort must be monitored by…

A

Bedside testing or spirometry

36
Q

In GBS; Mild cases may be treated expectantly T/F

A

True; most present spontaneous remission

37
Q

In GBS; IV immunoglobulin should be used in…

A

Severe or rapidly progressive muscle weakness; 0.4g/kg/day for 5 days or 1g/kg/day for 2

38
Q

In GBS; Alternatives to ImunoG (2)

A

Plasmapheresis and/or immunosuppressive drugs

39
Q

In GBS; Steroids can be used as an alternative to ImunoG T/F

A

False; not effective for weakness; may help with pain

40
Q

In GBS; Supportive care includes (6)

A

Respiratory sup; Nutricional sup; Prev bed sores; prev trombosis; Tx secondary inf; pain management

41
Q

In GBS; Neuropathic pain can be treated with (2)

A

Narcotics; “Gabapentin”

42
Q

In GBS; CIDP can be treated with… (3)

Chronic inflammatory demyelinating polyradiculopathy

A

Steroids; IVIG; refractory cases may need immunossuppressants

43
Q

In GBS; the course is ___phasic

A

Mono

44
Q

In GBS; recovery begins within…

A

2-3wks; can take months

45
Q

In GBS; IVIG ___ recovery

A

Hastens; “doesn’t” alter long-term outcome

46
Q

In GBS; Severity is an indicator of long and possibly incomplete recovery T/F

A

TRUE

IOT, progression rate of symptoms

47
Q

In GBS; (Demyelinating/axonal) forms predict faster recover than(Demyelinating/axonal) forms

A

Demyelinating;axonal

48
Q

In GBS; Tendon reflexes are recovered early T/F

A

False; usually last to recover

49
Q

In GBS; recovery follows a ___ pattern

A

Head to lower limbs; opposite of presentation

50
Q

In GBS; Cite 2 mains symptoms required for DX

A

Progressive weakness in legs and arms; Areflexia

51
Q

In GBS; Cite 3 common complications

A

Venous thrombosis; pressure ulcer; Pulmonary inf

52
Q

In GBS; EGRIS score meassures…

A

Risk of respiratory failure

53
Q

In GBS; IVIG is indicated by using wich score?

A

GBS disability score; >/=3

Residência Pediatria (12 decks)

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