Neuro

Question 1

GBS is a postinfectious ___

Answer 1

Polyneuropathy

Question 2

In GBS; Involves only motor nerves T/F

Answer 2

False; sensory and sometimes autonomic nerves can be affected

Question 3

In GBS; the onset usually starts __ days after a GI or respiratory infection

Answer 3

Aprox 10 days

Question 4

In GBS; Cite 3 main sources of GI infection

Answer 4

Undercooked poultry; unpasteurized milk; contaminated water

Question 5

In GBS; West Nile virus can mimic GBS but more often causes ___

Answer 5

Motor neuron disease similar to poliomyelitis

Question 6

In GBS; Cite 3 vaccines related to GBS

Answer 6

Rabies; influenza; Menigo C

Question 7

In GBS; Initial symptoms include… 3

Answer 7

Numbness and paresthesia; followed by weakness

Question 8

In GBS; Radicular back pain and myalgia are common in the initial stage T/F

Answer 8

True; children can be very irritable

Question 9

In GBS; Weakness starts from __ to __

Answer 9

Lower limbs; uppper limbs and finally bulbar muscles

Question 10

In GBS; weakness is usually (Asymmetric/Symmetric)

Answer 10

Symmetric

Question 11

In GBS Weakness progresses over ___ to ___; reaching a nadir at ___

Answer 11

days to weeks; 4wks

Question 12

In GBS; percentage of children that lose the ability to walk:

Answer 12

60%; small proportion progress to flaccid tetraplegia

Question 13

In GBS; What percentage pressents bulbar involvement?

Answer 13

50%; can result in respiratory insufficiency

Question 14

In GBS; Signs of impending respiratoy failure (3)

Answer 14

Dysphagia and facial weakness; hoarse voice

Question 15

In GBS; Autonomic involvement can present as… (4)

Answer 15

BP labylity; HR lability; post hypotension; asystole

Question 16

In GBS; Tendon reflexes are lost latter in the clinical presentation

Answer 16

False; usually occurs early; may be only hyporeflexia; 10% retain reflexes

Question 17

In GBS; CIDP symptoms develop over __; recur intermittently and can progress over…

Answer 17

4-6wk; months to years

Question 18

In GBS; CIDP weakness is both ___ and ___ and ___ severe

Chronic inflammatory demyelinating polyradiculopathy

Answer 18

distal; proximal; variably

Question 19

In GBS; CIDP hypo or areflexia is

Chronic inflammatory demyelinating polyradiculoneuropathy

Answer 19

Almost universal

Question 20

In GBS; Classic weakness includes…

Answer 20

Tetraparesis with or without motor involvement

Question 21

In GBS; Paraparetic weakness includes…

Answer 21

Lower limbs

Question 22

In GBS; Pharyngeal-cervical-brachial weakness includes…

Answer 22

Bulbar; neck; upper limbs

Question 23

In GBS; Bifacial weakness with paresthesias includes…

Answer 23

facial involvement

Question 24

In GBS; MFS includes…

Miller-fisher syndrome

Answer 24

External ophthalmoplegia; ataxia

Question 25

In GBS; Bickerstaff's brainstem encephalitis includes…

Answer 25

External ophthalmoplegia; ataxia; hyppersomnolence

Question 26

In GBS; DDx should include (5)

Answer 26

Spinal cord lesions; peripheral neuropathies; Junction disorders; Myophaties; Others

Question 27

In GBS; CSF PTN is elevated/reduced

Answer 27

Elevated; usually more than 2x upper limit

Question 28

In GBS; CSF glicose and celullarity are…

Answer 28

normal and no pleocytosis; there should be less than 10 wbc

Question 29

In GBS; Cytoalbuminologic dissociation can take up to ___ to show up

Answer 29

A week from the onset of symptoms

Question 30

In GBS; Typical findings of MRI include…

Answer 30

Thickening of the cauda equina and intrathecal nerve roots with "gadolinium" enhancement

Question 31

In GBS; Electromyography shows…

Answer 31

Motor and sensory nerve cond velocity reduction; reflecting patchy nature of nerve involvement

Question 32

In GBS; CPK levels are…

Answer 32

Mildly elevated or normal

Question 33

In GBS; Serum antiganglioside antibodies against ___ and ___ are sometimes elevated

Answer 33

GM1; GD1

Question 34

In GBS; Sural nerve biopsy shows… (3)

Answer 34

Segmental demyelination; focal inflammation; "Wallerian degeneration"

Question 35

In GBS; Respiratory effort must be monitored by…

Answer 35

Bedside testing or spirometry

Question 36

In GBS; Mild cases may be treated expectantly T/F

Answer 36

True; most present spontaneous remission

Question 37

In GBS; IV immunoglobulin should be used in…

Answer 37

Severe or rapidly progressive muscle weakness; 0.4g/kg/day for 5 days or 1g/kg/day for 2

Question 38

In GBS; Alternatives to ImunoG (2)

Answer 38

Plasmapheresis and/or immunosuppressive drugs

Question 39

In GBS; Steroids can be used as an alternative to ImunoG T/F

Answer 39

False; not effective for weakness; may help with pain

Question 40

In GBS; Supportive care includes (6)

Answer 40

Respiratory sup; Nutricional sup; Prev bed sores; prev trombosis; Tx secondary inf; pain management

Question 41

In GBS; Neuropathic pain can be treated with (2)

Answer 41

Narcotics; "Gabapentin"

Question 42

In GBS; CIDP can be treated with… (3) | Chronic inflammatory demyelinating polyradiculopathy

Answer 42

Steroids; IVIG; refractory cases may need immunossuppressants

Question 43

In GBS; the course is ___phasic

Answer 43

Mono

Question 44

In GBS; recovery begins within…

Answer 44

2-3wks; can take months

Question 45

In GBS; IVIG ___ recovery

Answer 45

Hastens; "doesn’t" alter long-term outcome

Question 46

In GBS; Severity is an indicator of long and possibly incomplete recovery T/F

Answer 46

TRUE ## Footnote IOT, progression rate of symptoms

Question 47

In GBS; (Demyelinating/axonal) forms predict faster recover than(Demyelinating/axonal) forms

Answer 47

Demyelinating;axonal

Question 48

In GBS; Tendon reflexes are recovered early T/F

Answer 48

False; usually last to recover

Question 49

In GBS; recovery follows a ___ pattern

Answer 49

Head to lower limbs; opposite of presentation

Question 50

In GBS; Cite 2 mains symptoms required for DX

Answer 50

Progressive weakness in legs and arms; Areflexia

Question 51

In GBS; Cite 3 common complications

Answer 51

Venous thrombosis; pressure ulcer; Pulmonary inf

Question 52

In GBS; EGRIS score meassures…

Answer 52

Risk of respiratory failure

Question 53

In GBS; IVIG is indicated by using wich score?

Answer 53

GBS disability score; >/=3