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Med Surg 2 > PRELIMS: GBS, MS, Bell's Palsy > Flashcards

PRELIMS: GBS, MS, Bell's Palsy Flashcards

1
Q

What is Guillain-Barré Syndrome?

A

Acquired symmetrical polyneuropathy, often beginning in the lower extremities and progressing to total body paresis.

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2
Q

What are common initial symptoms of Guillain-Barré Syndrome?

A

Paresthesias in toes and fingertips, ascending weakness.

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3
Q

Which muscles are typically involved in Guillain-Barré Syndrome?

A

Facial and oropharyngeal muscles.

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4
Q

Which muscles are typically spared in Guillain-Barré Syndrome?

A

Extraocular muscles and sphincters.

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4
Q

What type of reflexes are usually affected in Guillain-Barré Syndrome?

A

Muscle stretch reflexes are absent or severely decreased.

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5
Q

What is a common pain symptom in Guillain-Barré Syndrome?

A

Deep aching pain in the back, buttocks, and posterior thighs

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6
Q

What are some common etiological factors for Guillain-Barré Syndrome?

A

Viral or bacterial infections, immunization, or surgery.

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7
Q

What is the common agent associated with Guillain-Barré Syndrome?

A

Campylobacter jejuni.

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8
Q

What are some disorders included in Motor Neuron Disease?

A

Spinal muscular atrophy (SMA), Amyotrophic lateral sclerosis (ALS), Primary lateral sclerosis (PLS), Progressive muscular atrophy (PMA), Progressive bulbar palsy (PBP).

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9
Q

Where do upper motor neurons (UMNs) originate?

A

Motor cortex, premotor areas, temporal cortex, and sensory cortex.

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10
Q

What do upper motor neurons (UMNs) synapse with?

A

Cells in the brainstem nuclei and the ventral horn of the spinal cord, which are lower motor neurons (LMNs).

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11
Q

What are the clinical features of Primary Lateral Sclerosis (PLS)?

A

Spasticity usually starting in the lower extremities, urinary incontinence, spastic dysphagia.

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12
Q

What is the common onset age for Primary Lateral Sclerosis (PLS)?

A

Between 20 to 60 years old.

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13
Q

What is Lathyrism and what causes it?

A

A condition caused by excessive consumption of chickling pea (Lathyrus sativus), leading to neurotoxic effects.

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14
Q

What does “amyotrophy” refer to in ALS?

A

Atrophy of muscle fibers.

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14
Q

What is the gender prevalence for ALS?

A

Males are affected more than females, with a ratio of approximately 2:1.

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14
Q

What are the clinical features of Classic Amyotrophic Lateral Sclerosis (ALS)?

A

Weakness, atrophy, fasciculations, spasticity, spastic dysarthria, and typically sparing of bowel, bladder, and sensation.

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14
Q

What is another name for Amyotrophic Lateral Sclerosis (ALS)?

A

Lou Gehrig’s Disease or Charcot’s Disease.

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15
Q

What is a common cause of death in ALS patients?

A

Respiratory failure and aspiration.

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15
Q

What are some common features of Pseudobulbar Affect in ALS?

A

Emotional lability, inappropriate laughter or crying, and emotional outbursts.

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15
Q

What chromosomal defect is commonly associated with ALS?

A

A 15% defect in Chromosome 21q12.1.

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15
Q

What are the survival rates for ALS based on age of onset?

A

2.5 years survival for onset at 62 years, vs. 8 years for early onset.

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15
Q

Describe the typical progression of weakness in ALS.

A

Starts as dysfunction or weakness in one part of the body and gradually spreads to other parts.

15
Q

What is a key diagnostic criterion for ALS?

A

The presence of both upper motor neuron (UMN) and lower motor neuron (LMN) signs in more than two regions.

15
Q

What cognitive impairments are associated with ALS?

A

: Issues with executive function, visual attention, working memory, cognitive flexibility, problem-solving, and verbal fluency.

15
Q

What are typical treatment strategies for spasticity in ALS?

A

Stretching, positioning, Baclofen, Tizanidine.

15
Q

What diagnostic tests are used for ALS?

A

EMG-NCV (fibrillation and fasciculation potentials), CT scan/MRI (degeneration of tracts).

15
Q

How is Bell’s Palsy diagnosed?

A

iagnosis is mainly by exclusion, ruling out other causes of facial paralysis.

16
Q

What are the typical findings in electromyography (EMG) for ALS?

A

Fibrillations, fasciculations, unstable motor units, increased duration/amplitudes in slowly progressing ALS, low-amplitude polyphasic motor unit potentials.

16
Q

What is a common issue with muscle biopsy in ALS?

A

Denervation atrophy.

16
Q

What are some commonly affected muscles in ALS?

A

Weakest: wrist extensor, finger extensor, hand intrinsics. Spared: wrist & finger flexor, elbow extensors.

17
Q

Name a medication used to decrease glutamate and extend life in ALS patients.

A

Rilutek (Riluzole).

17
Q

What are some adaptive strategies for feeding in ALS?

A

Soft solids > liquids, using adaptive utensils, and feeding tubes if necessary.

17
Q

What are the levels of injury in Bell’s Palsy and their effects?

A

Stylomastoid Foramen: Facial Muscles
Chorda Tympani: Salivation & taste loss
Stapedius: Hyperacusis
Geniculate Ganglion: Lacrimation
Internal Auditory Meatus: Deafness, tinnitus, balance loss
Pons: Marcus Gunn phenomenon, marin Amat, and CN V, VI, IX, X involvement

17
Q

What are some special considerations for communication in ALS?

A

Dysarthria, sialorrhea, and the use of communication aids or devices.

17
Q

What are some common medications used to manage ALS symptoms?

A

What are some common medications used to manage ALS symptoms?

17
Q

What is Bell’s Palsy?

A

Bell’s Palsy is a common neurologic disorder characterized by abrupt, unilateral, peripheral facial paresis or paralysis without a detectable cause.

17
Q

What is Ramsay Hunt Syndrome?

A

It is a type of facial paralysis associated with herpes zoster virus infection, presenting with severe otalgia, facial paralysis, and vesicular eruption.

17
Q

What are some common physical therapy interventions for ALS?

A

Maintenance of range of motion, prevention of contractures, low-impact aerobic exercise, use of splints & gait aids.

17
Q

What are the main symptoms of Bell’s Palsy?

A

Sudden onset facial weakness, hyperacusis, decreased tear production, altered taste, facial or retro-auricular pain, and potential hearing loss.

17
Q

What are common risk factors for Bell’s Palsy?

A

Increased risk in pregnancy, diabetes, and a history of upper respiratory infections.

17
Q

What is the typical age of onset for Multiple Sclerosis?

A

The mean age of onset is 32 to 34 years old.

18
Q

What are the main treatments for Bell’s Palsy?

A

Treatments include corticosteroids, antiviral medications, eye care, physical therapy, and psychological support.

18
Q

What is Multiple Sclerosis (MS)?

A

MS is an inflammatory disease of the CNS characterized by areas of demyelination leading to functional and cognitive impairments.

18
Q

What factors are associated with poor prognosis in MS?

A

Progressive course of onset, male gender, onset before age 40, cerebellar involvement at onset, and multiple system involvement.

18
Q

What are some bad prognosis factors for Bell’s Palsy?

A

Complete facial palsy, no recovery by three weeks, age over 60 years, severe pain, Ramsay Hunt syndrome, and severe facial nerve degeneration.

18
Q

What are common clinical presentations of MS?

A

Weakness, paresthesias, gait difficulty, visual disturbances, diplopia, ataxia, vertigo, and urinary bladder dysfunction.

18
Q

What are the types of MS?

A

Relapsing-Remitting MS
Secondary Progressive MS
Primary Progressive MS
Plateaued MS
Benign MS
Malignant MS

18
Q

What are the primary diagnostic tools for MS?

A

Cerebrospinal Fluid Examination, Magnetic Resonance Imaging (MRI), and Evoked Potential Recordings.

18
Q

What are the major types of MS treatment?

A

Steroids
Immunosuppressive drugs
Disease-modifying treatments (e.g., Interferon, Copaxone)
4-Aminopyridine

18
Q

What is the role of 4-Aminopyridine in MS treatment?

A

It blocks K+ channels, prolonging nerve action potentials and restoring conduction in demyelinated fibers.

18
Q

What are some emerging therapies for MS?

A

Alemtuzumab, Cladribine, Fingolimod, and Teriflunomide.

18
Q

What are some common problems and challenges faced by MS patients?

A

Cognitive and psychiatric problems, neurogenic bladder and bowel, spasticity, ataxia, sexual dysfunction, and difficulties with ADLs.

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Med Surg 2 (16 decks)

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