Pathology Review: Neuromuscular Diseases

Question 0

Myasthenia Gravis: In the primary assessment, what will an RT find in the past medical history?

Answer 0

GRADUAL onset of weakness, may have previous admissions for Myasthenia Gravis

Question 1

Neuromuscular Diseases: what should be monitored for any patient with a neuromuscular disease? And how should it be treated?

Answer 1

Tidal Volume, Vital Capacity, Maximum Inspiratory Pressure.

If values fall below acceptable levels, institute mechanical ventilation.

Question 2

Myasthenia Gravis: what are the symptoms of physical appearance?

Answer 2

General weakness that improves with rest, ptosis, diplopia, dysphagia.

(Drooping eyelids, double vision, difficulty swallowing)

Question 3

Myasthenia Gravis: What is a special test for this disease process?

Answer 3

Tensilon Challenge Test

Question 4

Myasthenia Gravis: If VT, VC, MIP and weakness IMPROVE with Tensilon, what should be done?

Answer 4

Maintenance drug therapy (anticholinesterase therapy, cholinesterase inhibitors)

1. Prostigmine (Neostigmine)
2. Pyridostigmine (Mestinon, Regonol)

Question 5

Myasthenia Gravis: If VT, VC, MIP and weakness WORSEN with Tensilon, what should be done?

Answer 5

Administer atropine to reverse Tensilon

Question 6

Myasthenia Gravis: What are the treatment/management for this disease process?

Answer 6

• Closer monitor VT, VC, MIP
• Bedrest restriction and soft diet to reduce symptoms
• oxygen therapy
• hyperinflation therapy
• pulmonary hygiene

Question 7

Myasthenia Gravis: what are some other treatment modalities?

Answer 7

Corticosteroids in severe cases, adrenocorticotropic hormone, thymectomy, plasmapheresis

Question 8

Guillain-Barre Syndrome: What is the time of onset for this disease process?

Answer 8

1-4 weeks

Question 9

Guillain-Barre Syndrome: what is the past medical history?

Answer 9

Febrile illness, often VIRAL in nature

Question 10

Guillain-Barre Syndrome: what might an RT find with the physical appearance?

Answer 10

Acute weakness, especially in the legs

Question 11

Guillain-Barre Syndrome: what is a special test for this disease process?

Answer 11

Lumbar puncture- high protein level in CSF, abnormal electromyograph

Question 12

Guillain-Barre Syndrome: initially, where should patients be managed?

Answer 12

Initially patients should be managed in the ICU

• urinary catheterization
• ECG & BP monitoring

Question 13

Guillain-Barre Syndrome: what are the treatment/management options?

Answer 13

• Closely monitor VT, VC, and MIP
• oxygen therapy
• hyperinflation therapy
• pulmonary hygiene
• plasmapheresis - severe cases only

Question 14

Guillain-Barre Syndrome: what are other treatment modalities?

Answer 14

Anti-coagulant therapy, physical therapy, corticosteroids

Question 15

Drug Overdose: what is the first priority of treatment/management?

Answer 15

Placement of an artificial airway is the FIRST priority

Question 16

Drug Overdose: what are the treatment/management?

Answer 16

Mechanical ventilation for ventilatory failure

Naloxone (Narcan) can be used to reverse a narcotic overdose

Question 17

Stroke: Upon primary assessment, what is the past medical history?

Answer 17

Cerebral thrombi or emboli (most common), atherosclerosis, hypertension

Question 18

Stroke: what is a special test for this disease process?

Answer 18

CT/MRI of the brain

Question 19

Stroke: when should treatment be initiated?

Answer 19

Treatment should be initiated within 6 hours of symptom onset

Question 20

Stroke: what are the treatment/management?

Answer 20

Drug therapy:

• anticoagulation therapy
• vasodilators
• thrombolytic therapy (for acute ischemic stroke)