Neurodegenerative Disorders Flashcards
How long does Guillain-Barre take to recover from?
6 months-1 year
What is the most common bacterial trigger for Guillain Barre?
Campylobacter jejuni
What kind of weakness does Guillain-Barre cause?
Symmetric and ascending (feet up)
What kind of sensory loss happens in Gullain Barre?
Distal sensory loss
What happens to reflexes in Guillain Barre?
Hypoactive or absent
How is Guillain Barre diagnosed?
History and physical
Is weakness in Guillain Barre acute or progressive?
Progressive
What is BP goal in Gullain Barre?
Up to 200 systolic
A negative inspiratory force of less than what is concerning?
Less than -30
A forced vital capacity below what is concerning?
Below 20
Should a pt with bulbar weakness be put on BiPaP?
No
Which agent shouild be avoided during RSI in Gullain Barre?
Succinylcholine
After how long on a vent should a Guillain Barre pt be trached?
After 2 weeks
What kind of weakness does myasthenia gravis cuase?
Fluctuating and symmetric weakness
Does weakness get worse or better with activity in myasthenia gravis?
Worse
What is the first line medication class for myasthenia gravis?
Cholinesterase inhibitors
Besides cholinesterase inhibitors, what other class of meds are myasthenia gravis pts on?
Steroids
Does MS have symmetric or asymmetric weakness?
Asymmetric
What happens to reflexes in MS?
Hyperreflexive
What medication is used to manage acute flares of MS?
Steroids
What is the etiology of Gullain Barre?
Post infectious
What is the most common viral trigger for Guillain Barre?
Cytomegalovirus
Is weakness more proximal or distal in Guillain Barre?
Proximal
Do you have pain with Guillain Barre?
Yes
Do autonomic changes happen in Guillain Barre?
Yes
What will you see on CSF in Guillain Barre?
Elevated protein
What would MRI show in Guillain Barre?
Nerve root enhancement
What is a normal negative inspiratory force?
-100
What is forced vital capacity?
Maximum amount of air a person can expel from the lungs
What is a normal forced vital capacity?
40-70
Are secretions a contraindication to BiPaP?
Yes
Which paralytic should be used during RSI for Guillain Barre?
Rocuronium
What is the decision to extubate a Guillain Barre pt based on?
Muscle strength and serial PFTs
What two immunotherapies can be given for Guillain Barre?
IVIG and PLEX
MG causes what to happen to the thymus?
Thymic hyperplasia
Which disease causes “fatigueable weakness”?
Myasthenia gravis
What type of weakness does myasthenia gravis cause?
Fluctuating, proximal
What happens to reflexes in MG?
Normal
Are there sensory changes in MG?
No
What two antibodies do you test for in MG?
AChR and MuSK
What is the tensilon test used to diagnose?
MG
What happens if you give tensilon and the pt has MG?
Ocular sx will resolve
What will happen in the ice test if the pt has MG?
Ptosis will resolve
What happens if you overdose an MG pt on cholinesterase inhibitors?
Cholinergic crisis
What kind of immunomodulating therapy will MG pts be on?
Corticosteroids
What is used in the treatment of myasthenic crisis?
IVIG and PLEX
Thymectomy can be done for treatment of which disease?
MG
What is the number one trigger of myasthenic crisis?
Infection
What is a cholinergic crisis caused by?
Overdose of MG drugs
Which type of MG crisis causes excess secretions?
Cholinergic
Which type of MG crisis causes respiratory weakness?
Myasthenic
Is MS a problem with the CNS or PNS?
CNS
Does MS cause symmetric or asymmetric weakness?
Could be asymmetric
What happens to reflexes in MS?
Will be high
Fatigue is worse with what in MS?
Heat and activity
What kind of clinical course do pts with MS have?
Relapsing remitting
What will you see on brain MRI in MS?
Nonenhancing white matter lesions
What is acute transverse myelitis?
Spinal cord inflammation
What will happen to reflexes below the lesion in acute transverse myelitis?
Hypoactive or absent
Dymelinating optic neuritis is is dymelination of which cranial nerve?
CNII
What is the first line treatment for MS flares?
Steroids
What is the second line treatment for MS flares?
PLEX
Does immunomodulatory therapy reduce current MS lesions?
No, just slows development of future ones