lecture 4: guillain barre syndrome and CNS tumors

Question 1

what is another name for guillain barre syndrome

Answer 1

Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP)

Question 2

guillain barre syndrome is an immune mediated ____ that affects ____ ___ and ____ nerves , leading to ____ neuropathy and flaccid paralysis with possible sensory and ANS effects

Answer 2

polyneuropathy
nerve roots
peripheral
motor

Question 3

guillain barre syndrome usually follows an ____

Answer 3

infection

Question 4

what kind of onset is** guillain barre syndrome**

Answer 4

rapid

Question 5

is Guillain-Barré Syndrome/ a UMN or LMN disorder

Answer 5

lower
schwann cells make up the myelin

Question 6

what age and sex does Guillain-Barré Syndrome/ usually affect

Answer 6

males
any ages but usually > 50

Question 7

what is usually the first symptoms of someone with Guillain-Barré Syndrome/

Answer 7

weakness and tingling/loss of sensation in the hands and feet , ascending the limbs

Question 8

how are the motor symptoms in Guillain-Barré Syndrome/

Answer 8

goes distal to proximal (ascending paralysis)
rapid and progressive
relative symmetrical motor involvement

Question 9

how is the sensory loss in Guillain-Barré Syndrome/

Answer 9

glove adn stocking

Question 10

how are the relaxes in Guillain-Barré Syndrome/

Answer 10

decreased (bc it is a LMN disorder)

Question 11

what cranial nerve involvement is in Guillain-Barré Syndrome/

Answer 11

CN 7,9, 10 , 11 , 12

Question 12

what is present in up to 50% if pts with Guillain-Barré Syndrome/

Answer 12

dysautonomia

Question 13

1/3 patients required assisted ___ due to paralysis and weakness in diaphragm, intercostals , accessory inspiratory musculature

Answer 13

ventilation

Question 14

if the single breath count test is < ___ then they might require mechanical ventilation for Guillain-Barré Syndrome/

Answer 14

19

Question 15

The Guillain-Barré Syndrome disability scale is used as a outcome measure for function/acitvity, what score is it if that patient is

able to walk without support of a stick bu incaoable of manual work
confined to bed or chair
requiring assisted ventilation
dead
able to walk with a AD

Answer 15

2, 4,5,6, 3

Question 16

when is the acute stage of GBS

Answer 16

1-10 days

Question 17

when is the peak of motor sysmtoms for GBS

Answer 17

2-8 weeks post onset

Question 18

when is the plateau periods for GBS

Answer 18

2-8 weeks

Question 19

when can improvement begin for GBS

Answer 19

2-3 months post onset

Question 20

what does it mean when most patients have a fulminating course of GBS

Answer 20

disease develops rapidly and severely

Question 21

when is max paralysis for GBS

Answer 21

1-2 days of onset

Question 22

most GBS patients will reach their peak at how many weeks

Answer 22

3 weeks

Question 23

what factor of GBS are associated with poor prognosis

Answer 23

Severity of muscle weakness (especially tetraplegia)
• If respiratory support required
• Cranial nerve involvement associated with loss of eye movement, swallowing
• Rapid rate of progression from onset
• Length of time to nadir
• Older age at onset
• History of GI illness
• Recent cytomegalovirus

Question 24

what kind of deficit do GBS patients have and what is the primary movement dysfucntion

Answer 24

force production and weakness

Question 25

during the **ascending** phase of GBS is PT invovled

Answer 25

maybe or maybe not education is important durign this stage and gentle PROM , AAROM and AROM

Question 26

what kind of ROM is being done during the **plateau** stage of GBS

Answer 26

AAROM and AROM

Question 27

when do u Encourage multi-joint and cross-plane work without forgetting need for single joint and/or gravity minimized positions for GBS patients

Answer 27

during the plateau stage

Question 28

what considerations should u have during the **descending** phase of GBS

Answer 28

* Eccentric contractions * Fast-twitch fibers * Pain * Fatigue * Vitals

Question 29

when should u avoid exercise for GBS patients

Answer 29

in acute and progressive stages , limited to ROM (AROM or AAROM)

Question 30

when can u do **Limited repetition low resistance activities** can be commenced once strength begins to return

Answer 30

after plateau

Question 31

when should u avoid **eccentric contr4actions** from GBS

Answer 31

if less then or equal to 3/5 strength

Question 32

what are the two distinct groups that CNS tumors are presents in

Answer 32

childeren 0-14 and adults 40-70 white , male

Question 33

what is teh difference between primary and secondary tumor presentation

Answer 33

primary: originate in the CNS secondary: metastatic tumors that spring to the CNS from systemic cancer sits out of the brain

Question 34

what is the **Most common** cause of cancer death in **children and adolescent 0-19 years**

Answer 34

primary CNS tumors

Question 35

how does **secondary** tumors usually **spread**

Answer 35

through arterial circulation

Question 36

what determines the **impairment** the patient with a **tumor** will have

Answer 36

location

Question 37

what is the **most common** type of **non malignant brain tumor**

Answer 37

meningioma

Question 38

what is the **most** **common** type of **malignant brain tumor**

Answer 38

glioblastoma

Question 39

what **sign and symptoms** is present in **50**% of patients with **CNS tumor**

Answer 39

headache

Question 40

what are the signs and symptoms of a CNS tumor

Answer 40

headache seizures altered mental status papilledema

Question 41

what are **focal neurological signs** of CNS tumor

Answer 41

* weakness, * numbness, loss of coordination, vision * problems, speech difficulties, seizures, * altered mental state (memory loss, confusion, change in personality)

Question 42

what is the **frontal** and **parietal** lobe responsible for

Answer 42

frontal: personality , movement , sense of smell parietal lobe: identification of objects , sense of pain and touch , spatial position

Question 43

what is the **temporal** and **occipital** lobe responsible for

Answer 43

temp: mem, speech, musical rhythm occ: vision

Question 44

what does the **pons** and **medulla** control

Answer 44

pons: eye and face movement medulla: heart and lungs

Question 45

when is a headache a red flag

Answer 45

- interrupts sleep or is worse on waking and improves thru the day - elicited by postural changes, coughing , or exercise - recent onset is more severe -new onset of headaches in older poeple - associated with nausea, commit , papilledema or focal neurological sings

Question 46

has exercise been found to provide positive benefits to cancer survivors

Answer 46

yes