30 Questions
What is the definitive diagnostic procedure for Myasthenia Gravis?
Electromyography (EMG)
Which muscle weakness manifestation of Myasthenia Gravis involves the eyelid drooping?
Ptosis
What is the purpose of the Tensilon test using Edrophonium Chloride?
To distinguish Myasthenic crisis from Cholinergic crisis
Which difficulty is NOT typically associated with Myasthenia Gravis?
Weight gain
What type of heart condition requires defibrillation as a treatment according to the text?
Atrial Fibrillation
Which test is used to assess muscle strength improvement within a minute in Myasthenia Gravis?
Tensilon test with Edrophonium Chloride
Which viral infection is NOT mentioned as a possible trigger for Auto Immune disease in the text?
Influenza A virus
What is the characteristic histology finding associated with Auto Immune disease mentioned in the text?
Presence of macrophages phagocytosing myelin surrounded by lymphoid cells
What is a common complication that can be prevented by encouraging patients to move around in Auto Immune disease management?
Deep vein thrombosis
In Auto Immune disease management, what is the highest priority for maintaining airway and supporting pulmonary function?
Respiratory care
Which of the following is NOT a component of the pharmacologic management of Auto Immune disease according to the text?
Antibiotics
What type of changes are less prominent in Auto Immune disease compared to ascending muscle weakness and paralysis?
Sensory changes
What is a common cause of death in Guillain-Barre Syndrome?
Respiratory paralysis
Which term describes the Unilateral disability of upper and lower extremities seen in the text?
Paresis
What diagnostic test is used to evaluate skeletal muscle electrical activity?
EMG
Which sign is associated with Upper Motor Neurons in the text?
Spasticity and hyperreflexia
Which term is used to describe the awkwardness of fine finger movements?
Dysarthria
What is a common nursing intervention for Guillain-Barre Syndrome related to nutrition?
Promote adequate fluid and nutritional intake
What is a common symptom of ptosis?
Upper face paralysis
What nursing intervention is essential to protect the eye in a patient with ptosis?
Using protective eye wear
What effect do corticosteroids have in the treatment of multiple sclerosis?
Suppress the immune system
What characterizes the etiology of multiple sclerosis?
Autoimmune response targeting the myelin sheath
What age group is most commonly affected by multiple sclerosis?
Females aged 20-40 years old
What did Jean Marie Charcot describe regarding multiple sclerosis?
Associated it with randomly scattered patches of demyelination
What is the relationship between Vitamin D levels and multiple sclerosis?
Individuals with MS tend to have insufficient vitamin D levels.
What role do T helper cells play in multiple sclerosis?
They are key in the development of lesions.
What is the primary function of the Blood-Brain Barrier?
Preventing immune cell infiltration into the nervous system.
How do macrophages contribute to multiple sclerosis?
Removing degenerating myelin.
What is the manifestation of Corticospinal syndrome in multiple sclerosis?
Symmetric muscular weakness and stiffness.
What does peripheral vasculitis result from in multiple sclerosis?
Recurrence of inflammatory reactions.
Study Notes
Autoimmune Disorders
Guillain-Barré Syndrome
- Follows viral infection (URTI, GIT) or swine flu immunization
- Affects all age groups and sexes
- Causes: Campylobacter jejuni, Cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, Haemophilus influenzae, HIV
- Histology: Nerve infiltrated lymphoid cells with phagocytosis of myelin by macrophages
- Clinical features:
- Ascending muscle weakness and paralysis
- Respiratory failure possible
- Less prominent sensory changes
- Remyelination over 3-4 months
- Diagnostics:
- EMG
- CSF Analysis
- CT scan/MRI
- Management:
- Maintain airway and support pulmonary function
- Prepare patient for Plasmapheresis during acute phase
- Pharmacologic treatment: Steroids, IV IgG, Anti-arrhythmic, Propranolol
- Encourage patient to move around to prevent complications due to immobility
- Prevent Contractures and atrophy
- Prevent DVT
- Provide Nutritional support
- Safe environment to minimize infection
- Emotional support
Multiple Sclerosis
- Chronic, debilitating, progressive disease with periods of remission and exacerbation
- Characterized by randomly scattered patches of demyelination
- Common in females of 20-40 years old
- Etiology:
- Autoimmune response
- Environmental factors (Vitamin D levels)
- Genetics (HLA)
- Infection by a slow latent virus
- Manifestations occur intermittently and depend on CNS involvement
- Blood-Brain Barrier Breakdown: Leaks form in the blood-brain barrier, allowing immune cells to infiltrate
- Pathology:
- Immune response leads to recurrent inflammatory reactions
- Lymphocytes secrete IgG antibodies, which increase during exacerbations
- Macrophages enter the myelin sheath, removing degenerating myelin, forming patchy areas of demyelination
- Areas of Plaque Formation:
- Corticospinal syndrome
- Generalized muscle weakness
- Muscle wasting and atrophy
- Diagnostics:
- Electromyography
- Blood tests (CRH modulator antibodies)
- Chest x-ray/CT Scan
- Edrophonium Chloride (Tensilon test)
Test your knowledge on symptoms and signs associated with generalized muscle weakness, paresis, and paralysis. Learn about upper and lower motor neuron signs, muscle wasting, atrophy, and other related manifestations.
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