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26 Cards in this Set
- Front
- Back
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What is AIDP? |
acute inflammatory demyelinating polyneuraopthy
used to be called Guillan Barre syndrome |
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What does it cause? |
autoimmune demyelination of peripheral nerves and ascending weakness/paralysis |
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is there any CNS involved? |
no |
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what infections are associated with development of Guillan Barre? |
Campylobacter and viral URIs |
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weakness starts in the feet and moves up toward the chest |
this is wen GBS becomes dangerous because it results in diaphragmatic weakness and resp failure |
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the most specific dx test for GBS is |
NCS/EMG |
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what does the CSF show? |
increased protein with normal cell count (pretty similar to MS) |
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what causes death in GBS> |
respiratory failure and dysautonomia |
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how do we track whether the patient will devleop respiratory failure or not? |
with repeat FVC's and peak inspiraotry pressures
So PFT's are very important in GBS |
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treatment for GBS is with ... or ... |
plasmapharesis or IVIG
both the same efficacy |
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does prednisone help in GBS? |
NO |
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so the first test you should order urgently is... |
PFTs |
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what is myasthenia gravis? |
autoimmune condition char'd by antibodies against the AChR resulting in fatigable weakness |
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classic symptoms of MG |
difficulty chewing double vision dysphonia weakness worse at the end of the day |
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Why do people notice the EOMs and chewing so much |
because they may be the only muscular activity they're engaging in at the time e..g watching TV, reading |
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what will PE show> |
ptosis, weakness with sustained activity |
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best initial test for MG |
anti-AChR antibodies
up to 90% sensitive |
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what antibody is probably present if they DON'T have anti-Achr? |
anti-MUSK |
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What is the most accurate test for myasthenia>? |
EMG showing decreased strength with repetitive nerve stimulation (fatigability) |
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what is the classic test for MG/ |
edrophonium test showing a clear improvement in motor function that lasts a few moments |
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What imaging test should be done in MG? |
CXR, chest CT etc. to look for a thymoma |
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best initial treatment for MG |
neostigmine and physostigmine |
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what is the most appropriate next step if these meds do not help |
thymectomy if they're under 60 |
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what if they're over 60? |
prednisone
you can also use azathioprine, cyclophos, or mycophenolate at some point as well |
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in a severe, acute crisis what is the treatmnet? |
PLEX or IVIG just like GBS |
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so remember that steroids are helpful in MG but not |
in GBS |
