Neurodegenerative Disorders

Question 1

How long does Guillain-Barre take to recover from?

Answer 1

6 months-1 year

Question 2

What is the most common bacterial trigger for Guillain Barre?

Answer 2

Campylobacter jejuni

Question 3

What kind of weakness does Guillain-Barre cause?

Answer 3

Symmetric and ascending (feet up)

Question 4

What kind of sensory loss happens in Gullain Barre?

Answer 4

Distal sensory loss

Question 5

What happens to reflexes in Guillain Barre?

Answer 5

Hypoactive or absent

Question 6

How is Guillain Barre diagnosed?

Answer 6

History and physical

Question 7

Is weakness in Guillain Barre acute or progressive?

Answer 7

Progressive

Question 8

What is BP goal in Gullain Barre?

Answer 8

Up to 200 systolic

Question 9

A negative inspiratory force of less than what is concerning?

Answer 9

Less than -30

Question 10

A forced vital capacity below what is concerning?

Answer 10

Below 20

Question 11

Should a pt with bulbar weakness be put on BiPaP?

Answer 11

No

Question 12

Which agent shouild be avoided during RSI in Gullain Barre?

Answer 12

Succinylcholine

Question 13

After how long on a vent should a Guillain Barre pt be trached?

Answer 13

After 2 weeks

Question 14

What kind of weakness does myasthenia gravis cuase?

Answer 14

Fluctuating and symmetric weakness

Question 15

Does weakness get worse or better with activity in myasthenia gravis?

Answer 15

Worse

Question 16

What is the first line medication class for myasthenia gravis?

Answer 16

Cholinesterase inhibitors

Question 17

Besides cholinesterase inhibitors, what other class of meds are myasthenia gravis pts on?

Answer 17

Steroids

Question 18

Does MS have symmetric or asymmetric weakness?

Answer 18

Asymmetric

Question 19

What happens to reflexes in MS?

Answer 19

Hyperreflexive

Question 20

What medication is used to manage acute flares of MS?

Answer 20

Steroids

Question 21

What is the etiology of Gullain Barre?

Answer 21

Post infectious

Question 22

What is the most common viral trigger for Guillain Barre?

Answer 22

Cytomegalovirus

Question 23

Is weakness more proximal or distal in Guillain Barre?

Answer 23

Proximal

Question 24

Do you have pain with Guillain Barre?

Answer 24

Yes

Question 25

Do autonomic changes happen in Guillain Barre?

Answer 25

Yes

Question 26

What will you see on CSF in Guillain Barre?

Answer 26

Elevated protein

Question 27

What would MRI show in Guillain Barre?

Answer 27

Nerve root enhancement

Question 28

What is a normal negative inspiratory force?

Answer 28

-100

Question 29

What is forced vital capacity?

Answer 29

Maximum amount of air a person can expel from the lungs

Question 30

What is a normal forced vital capacity?

Answer 30

40-70

Question 31

Are secretions a contraindication to BiPaP?

Answer 31

Yes

Question 32

Which paralytic should be used during RSI for Guillain Barre?

Answer 32

Rocuronium

Question 33

What is the decision to extubate a Guillain Barre pt based on?

Answer 33

Muscle strength and serial PFTs

Question 34

What two immunotherapies can be given for Guillain Barre?

Answer 34

IVIG and PLEX

Question 35

MG causes what to happen to the thymus?

Answer 35

Thymic hyperplasia

Question 36

Which disease causes "fatigueable weakness"?

Answer 36

Myasthenia gravis

Question 37

What type of weakness does myasthenia gravis cause?

Answer 37

Fluctuating, proximal

Question 38

What happens to reflexes in MG?

Answer 38

Normal

Question 39

Are there sensory changes in MG?

Answer 39

No

Question 40

What two antibodies do you test for in MG?

Answer 40

AChR and MuSK

Question 41

What is the tensilon test used to diagnose?

Answer 41

MG

Question 42

What happens if you give tensilon and the pt has MG?

Answer 42

Ocular sx will resolve

Question 43

What will happen in the ice test if the pt has MG?

Answer 43

Ptosis will resolve

Question 44

What happens if you overdose an MG pt on cholinesterase inhibitors?

Answer 44

Cholinergic crisis

Question 45

What kind of immunomodulating therapy will MG pts be on?

Answer 45

Corticosteroids

Question 46

What is used in the treatment of myasthenic crisis?

Answer 46

IVIG and PLEX

Question 47

Thymectomy can be done for treatment of which disease?

Answer 47

MG

Question 48

What is the number one trigger of myasthenic crisis?

Answer 48

Infection

Question 49

What is a cholinergic crisis caused by?

Answer 49

Overdose of MG drugs

Question 50

Which type of MG crisis causes excess secretions?

Answer 50

Cholinergic

Question 51

Which type of MG crisis causes respiratory weakness?

Answer 51

Myasthenic

Question 52

Is MS a problem with the CNS or PNS?

Answer 52

CNS

Question 53

Does MS cause symmetric or asymmetric weakness?

Answer 53

Could be asymmetric

Question 54

What happens to reflexes in MS?

Answer 54

Will be high

Question 55

Fatigue is worse with what in MS?

Answer 55

Heat and activity

Question 56

What kind of clinical course do pts with MS have?

Answer 56

Relapsing remitting

Question 57

What will you see on brain MRI in MS?

Answer 57

Nonenhancing white matter lesions

Question 58

What is acute transverse myelitis?

Answer 58

Spinal cord inflammation

Question 59

What will happen to reflexes below the lesion in acute transverse myelitis?

Answer 59

Hypoactive or absent

Question 60

Dymelinating optic neuritis is is dymelination of which cranial nerve?

Answer 60

CNII

Question 61

What is the first line treatment for MS flares?

Answer 61

Steroids

Question 62

What is the second line treatment for MS flares?

Answer 62

PLEX

Question 63

Does immunomodulatory therapy reduce current MS lesions?

Answer 63

No, just slows development of future ones