Neurologic/Neuromuscular Diseases (1 or 2)

Question 1

Myasthenia Gravis (Treatment/Management)

Answer 1

1) Closely monitor VT, VC, MIP
-Intubate and institute mechanical ventilation when indicated
DO NOT WAIT FOR PT. TO CRASH

2) Bedrest restriction & soft diet to reduce symptoms
3) Oxygen therapy for hypoxemia
4) Hyperinflation therapy
5) Pulmonary hygeine

6) Other treatment modalities
- corticosteroids in servere cases
- adrenocorticotropic hormone
- thymectomy
- plasmapheresis

Question 2

Guillain-Barre Syndrome (Treatment/Management)

Answer 2

1) Directed at stabilization of vital signs & supportive care

2) Initially pt. should be managed in ICU
- bedside monitoring
* urinary catheterization
* ECG & BP monitoring

3) Closely monitor VT, VC, MIP
- intubate & institute mechanical ventilation when indicated

4) Oxygen therapy for hypoxemia
5) Hyperinflation therapy (IS/SMI, IPPB)
6) Pulmonary hygiene
7) Plasmapheresis - severe cases only

8) Other treatment modalities
- anti-coagulant therapy
- physical therapy
- corticosteroids

Question 3

Drug Overdose (Treatment/Management)

Answer 3

1) Placement of an artificial airway is first priority
2) Mechanical ventilation for ventilatory failure
3) Naloxone (Narcan) can be used to reverse a narcotic overdose

Question 4

Stroke/Cerebral Infarction/Cerebrovascular Accident (CVA)/Transient Ischemic Attack (TIA)

Answer 4

1) Treatment initiated within 6 hours of symptom onset

2) Drug therapy
- anticoagulation therapy
- vasodilators
- thrombolytic therapy (for acute ischemic stroke)

Question 5

Poliomyelitis/Tetanus/Botulism/Muscular Dystrophy

Answer 5

1) Closely monitor VT, VC, MIP
- intubate & institute mechanical ventilation as indicated

2) Drug therapy
- paralyzing agents to relax jaw for intubation
- ventilation (for tetanus/botulism)