Guillian Barre Flashcards

(37 cards)

1
Q

what is GB also known as

A

acute inflammatory demyelinating polyneuropathy

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2
Q

pathology of GBS

A

autoimmune disorder that destroys myelin sheath surrounding peripheral nerves

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3
Q

what typically precedes GBS

A

2/3 cases have an infection 2 weeks prior to GBS onset

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4
Q

what infections typically precede GBS

A

upper respiratory or GI

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5
Q

what percentage of cases have idiopathic origins

A

27

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6
Q

what are the 4 distinct phases of GBS

A

latency
progression
plateau
recovery

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7
Q

latency phase definition

A

between onset of preceding illness and neuropathic symptoms

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8
Q

progression phase definition

A

onset of symptoms until nadir
- point in which symptoms are most severe

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9
Q

plateau phase definition

A

period of weakness

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10
Q

clinical motor manifestations of GBS

A

symmetrical ascending loss of motor function

reduced deep tendon reflexes

can involve respiratory / oral muscles

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11
Q

in _____% of cases, mechanical ventilation may be indicated due to _____

A

20-30%

paresiss/paralysis of diaphragm and intercostal musculature

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12
Q

sensory clinical manifestations of GBS

A

distal hyperesthesias, paresthesias, numbness

decreased proprioception

stocking-glove

cramping pain

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13
Q

explain stocking and glove pattern

A

not a dermatomal pattern, more global
– ie entire foot and hand

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14
Q

autonomic clinical manifestation of GBS

A

low cardiac output
arrythmias
BP fluctuations
peripheral pooling of fluid
urinary retention

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15
Q

which gender is GBS seen more in

A

males

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16
Q

what percentage of patients reach symptom nadir in 1-3 weeks from onset

17
Q

explain recovery rate of GBS

A

gradual recovery of strength 2-4 wks after plateau

about 80% are ambulatory within 6 months of symptom onset

18
Q

explain % of cardiac event death in those with GBS

19
Q

what are the most common residual deficits seen in GBS

A

foot drop
facial weakness
hand atrophy
sensory ataxia
dyesthesia

20
Q

what is dyesthesia

A

abnormal sensation that is unpleasant and can be pain-like

21
Q

how is the diagnosis of GBS completed

A

clinical presentations
CSF sampling
EMG
nerve conduction velocity testing

22
Q

when one is diagnosed with GBS, what immediately occurs? why?

A

hospitilization due to risk of respiratory compromise

23
Q

what are the options for medical management of GBS

A

Plasmapheresis
IV immunoglobulin

24
Q

what is plasmapheresis

A

removal of plasma from blood to remove antibodies from blood stream

25
what is IV immunoglobulin treatment
injection of proteins that interrupt myelin destruction
26
during evaluation, what major system should be focused on? when should this be checked?
cardiopulm system review before, during and after exercise
27
motor exam during GBS eval should include
oculomotor facial muscles cranial nerve grip strength
28
what areas are at risk of pressure breakdown in those with GBS
feet - bottom specifically hands
29
what phases of GBS are considered to be "acute"
latency and progression
30
what "hat" do we wear during acute phase
preventative
31
what interventions applicable during acute GBS
respiratory pain control positioning / splinting monitor decline of muscle function PROM/AAROM in pain-free ranges
32
what setting is the acute phase of GBS treated in
acute care
33
contraindications during acute phase GBS
strengthening (not even AROM) fatiguing patient
34
during all phases of GBS, what should be focused on
monitoring of prolonged postexercise weakness and DOMS
35
what interventions are indicated during plateau phase GBS
all the same from acute, may begin to incorporate AROM upright positioning bed mobility light functional skills
36
what is contraindicated during plateau phase GBS
strengthening fatiguing patient
37
what interventions are indicated during recovery phase GBS
low rep, sub max non-resisted ex multi joint functional activities aerobic training with monitoring