Pathology Review: Neuromuscular Diseases Flashcards
Myasthenia Gravis: In the primary assessment, what will an RT find in the past medical history?
GRADUAL onset of weakness, may have previous admissions for Myasthenia Gravis
Neuromuscular Diseases: what should be monitored for any patient with a neuromuscular disease? And how should it be treated?
Tidal Volume, Vital Capacity, Maximum Inspiratory Pressure.
If values fall below acceptable levels, institute mechanical ventilation.
Myasthenia Gravis: what are the symptoms of physical appearance?
General weakness that improves with rest, ptosis, diplopia, dysphagia.
(Drooping eyelids, double vision, difficulty swallowing)
Myasthenia Gravis: What is a special test for this disease process?
Tensilon Challenge Test
Myasthenia Gravis: If VT, VC, MIP and weakness IMPROVE with Tensilon, what should be done?
Maintenance drug therapy (anticholinesterase therapy, cholinesterase inhibitors)
- Prostigmine (Neostigmine)
- Pyridostigmine (Mestinon, Regonol)
Myasthenia Gravis: If VT, VC, MIP and weakness WORSEN with Tensilon, what should be done?
Administer atropine to reverse Tensilon
Myasthenia Gravis: What are the treatment/management for this disease process?
- Closer monitor VT, VC, MIP
- Bedrest restriction and soft diet to reduce symptoms
- oxygen therapy
- hyperinflation therapy
- pulmonary hygiene
Myasthenia Gravis: what are some other treatment modalities?
Corticosteroids in severe cases, adrenocorticotropic hormone, thymectomy, plasmapheresis
Guillain-Barre Syndrome: What is the time of onset for this disease process?
1-4 weeks
Guillain-Barre Syndrome: what is the past medical history?
Febrile illness, often VIRAL in nature
Guillain-Barre Syndrome: what might an RT find with the physical appearance?
Acute weakness, especially in the legs
Guillain-Barre Syndrome: what is a special test for this disease process?
Lumbar puncture- high protein level in CSF, abnormal electromyograph
Guillain-Barre Syndrome: initially, where should patients be managed?
Initially patients should be managed in the ICU
- urinary catheterization
- ECG & BP monitoring
Guillain-Barre Syndrome: what are the treatment/management options?
- Closely monitor VT, VC, and MIP
- oxygen therapy
- hyperinflation therapy
- pulmonary hygiene
- plasmapheresis - severe cases only
Guillain-Barre Syndrome: what are other treatment modalities?
Anti-coagulant therapy, physical therapy, corticosteroids
Drug Overdose: what is the first priority of treatment/management?
Placement of an artificial airway is the FIRST priority
Drug Overdose: what are the treatment/management?
Mechanical ventilation for ventilatory failure
Naloxone (Narcan) can be used to reverse a narcotic overdose
Stroke: Upon primary assessment, what is the past medical history?
Cerebral thrombi or emboli (most common), atherosclerosis, hypertension
Stroke: what is a special test for this disease process?
CT/MRI of the brain
Stroke: when should treatment be initiated?
Treatment should be initiated within 6 hours of symptom onset
Stroke: what are the treatment/management?
Drug therapy:
- anticoagulation therapy
- vasodilators
- thrombolytic therapy (for acute ischemic stroke)
