Guillain-Barre Syndrome Flashcards Preview

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Flashcards in Guillain-Barre Syndrome Deck (25)
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1
Q

Guillain-Barre syndrome is caused by

A

auto immune disorder- generally after a viral or bacterial infection of the respiratory or GI system

2
Q

The major pathologic or structural changes of the lungs associated with ventilatory failure accompanying Guillain-Barré syndrome include:

  1. bronchospasm
  2. airway obstruction
  3. mucous accumulation
  4. alveolar dilation
A

2 and 3 are correct

3
Q

Your patient has an infection caused by Campylobacter jejuni. Her physician is concerned about the possible development of Guillain-Barré syndrome. If this disease were to occur, when would it appear after this current infection?

A

in 1 to 4 weeks

4
Q

. A patient with Guillain-Barré syndrome has been placed in the intensive care unit. Initial treatment should include:

  1. assessment of breathing
  2. mechanical ventilation
  3. supportive care
  4. stabilizing vital signs
A

1, 3, 4 are correct
It is initially important to support the patient, assess his/her breathing, and stabilize the vital signs. Mechanical ventilation would only be instituted if the patient was in respiratory failure.

5
Q
The most important thing to assess in the Guillain-Barré patient to determine acute ventilatory failure is:
1 VC measurement
2 maximum voluntary ventilation
3 forced expiratory volume in one second
4 tidal volume measurement
A

1- correct VC measurement

A VC (vital capacity) of

6
Q
Management of the patient with Guillain-Barré Syndrome includes all of the following, EXCEPT:
1 Correct giving corticosteroids 
2 mechanical ventilation 
3 high-dose immunoglobulin therapy 
4 plasmapheresis
A

A- corticosteroids

corticosteroids are not effective in treating the Guillain-Barré patient and may actually prolong recovery time

7
Q
Your patient has a severe case of Guillain-Barré syndrome. It is most important that he be monitored for:
1. tachycardia
2 apnea
3 hypertension
4 fever
A
  1. apnea
8
Q
Your Guillain-Barré syndrome patient was placed on mechanical ventilation when respiratory failure appeared imminent. She is now stable. Her chest radiograph will most likely show:
1. enlarged heart
2 pleural effusion
3 normal lung fields
4 pneumonia
A

C normal lung fields

unless there is a complicating cardiopulmonary problem. None is mentioned

9
Q
In Guillain Barre, which of the following pathologic changes develop in the peripheral nerves?
1. inflammatoin
2 increased ability to transmit nerve impulses
3 demyelination
4 edema
a. 2 and 3
b 3 and 4
c  2, 3, and 4
d 1, 3, 4
A

D: 1, 3, 4

10
Q
Which of the following is associated with Guillan Barre syndrome?
1. alveolar consolidation
2 mucous consolidation
3. alveolar hyperinflation
4  atelectasis
a  1 and 2
b  3 and 4
c  1, 2, and 4
d  2, 3, and 4
A

C: 1, 2 and 4

11
Q
Guillain-Barre syndrome is move common in
1.  people older than 45 years of age
2   blacks
3   males
4  early childhood
A

1 and 3

12
Q
Which of the following are possible precursors to Guillan-Barre?
1.  mumps
2  swine flu vaccine
3  infectious mononucleosis
4  measles
a 1 and 4
b  2 and 3
c  2 only
d  2, 3, and 4
e  1, 2, 3, and 4
A

answer is all- 1, 2, 3 and 4 (e)

13
Q
Full recovery from Guillan Barre occurs in approximately what % of cases?
10%
30%
60%
90%
A

90%

14
Q
Which of the following are indicators for intubation and mechanical ventilation in patients with Guillain Barre?
1. pH < 7.40
2. Paco2 > 45
3  FVC < 20 ml/kg
4  NIF <  -25 cmH2O
A

2, 3 and 4

15
Q

Pathologic changes of the peripheral nerves include:

A

demyelinatoin
inflammation
edema
decreased nerve impulse transmission (leading to paralysis)

16
Q

T/F Patients with GB have high serum antibody titers and elevated levels of IgM during the recovery phase

A

FALSE

antibodies are greatly reduced during the recovery phase

17
Q

Infectious mononucleosis is associated with as many as ___% of cases

A

25%

18
Q

Early signs of GB:

A

fever, malaise, nausea, prostration, tingling/numbness in the extremities
skeletal muscle paralysis & loss of deep tendon reflexes

19
Q

Progressive symptems include

A

ascending paralysis
cranial nerves 9 & 10 are effected (glossopharyngeal and vagus)
gag reflex is decreased or absent
swallowing is difficult (dysphagia)
aspiration likely unless airway is protected

20
Q

Paralysis generally peaks in less than ____ days

A

ten

21
Q

T/F Recovery from GB can take several weeks and in some cases several months

A

true

22
Q

The diagnosis of GB syndrome is based on:

A

clinical history
significant signs including paralysis
examination of CSF

23
Q

T/F Plasmapheresis has been shown to be an effective treatment in severe cases of GB

A

true

24
Q

The RV/TLC ratio in GB is:
increased
Decreased
Normal

A

normal

25
Q

ABG findings in GB

A
acute ventilatory failure with hypoxemia (acute respiratory acidosis)
pH decrease
Paco2 increased
HCO3 increased
PaO2 decreased