Question 1

Which of the following are identified as the causative organisms of the respiratory or gastrointestinal infections that precede the onset of most cases of GBS?

Accepted Answer

A)  Chlamydia psittaci and Campylobacter jejuni 
B)  Cytomegalovirus and mononucleosis 
C)  Campylobacter jejuni and cytomegalovirus 
D)  Mononucleosis and parainfluenza 2 
A)  Chlamydia psittaci and Campylobacter jejuni 
B)  Cytomegalovirus and mononucleosis 
C)  Campylobacter jejuni and cytomegalovirus 
D)  Mononucleosis and parainfluenza 2 C

Question 2

In which of the following persons would Guillain-Barré syndrome most likely occur?

Accepted Answer

A)  African-American female-22 years of age 
B)  Hispanic male-31 years of age 
C)  Asian female-17 years of age 
D)  Caucasian male-53 years of age 
A)  African-American female-22 years of age 
B)  Hispanic male-31 years of age 
C)  Asian female-17 years of age 
D)  Caucasian male-53 years of age D

Question 3

Under microscopic inspection, the skeletal muscle nerves of a Guillain-Barré patient show which of the following?
1) Hypertrophy
2) Edema
3) Inflammation
4) Demyelination

Accepted Answer

A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 C

Question 4

A patient with Guillain-Barré is paralyzed and on mechanical ventilatory support. Which of the following pulmonary complications is most likely to occur as the result of prolonged immobilization?

Accepted Answer

A)  Pneumonia 
B)  Pressure sores 
C)  Thromboembolism 
D)  Atelectasis 
A)  Pneumonia 
B)  Pressure sores 
C)  Thromboembolism 
D)  Atelectasis

Question 5

Typical chest assessment findings in a patient with Guillain-Barré syndrome include:
1) diminished breath sounds.
2) crackles.
3) tracheal deviation.
4) depressed diaphragms.

Accepted Answer

A) 1, 3, 4 
B) 1, 2 
C) 3, 4 
D) 2, 3, 4 
A) 1, 3, 4 
B) 1, 2 
C) 3, 4 
D) 2, 3, 4

Question 6

When a person has Guillain-Barré syndrome, how are peripheral nerves affected?

Accepted Answer

A)  They hypertrophy. 
B)  They fail to reproduce. 
C)  The myelin sheath is removed. 
D)  Schwann cells attack the peripheral nerves. 
A)  They hypertrophy. 
B)  They fail to reproduce. 
C)  The myelin sheath is removed. 
D)  Schwann cells attack the peripheral nerves.

Question 7

The peripheral nervous system problems found with Guillain-Barré syndrome (GBS) include:
1) loss of reflexes.
2) increased reflex reactions.
3) flaccid paralysis of skeletal muscles.
4) tetany of skeletal muscles.

Accepted Answer

A) 2, 3 
B) 1, 4 
C) 1, 3 
D) 2, 4 
A) 2, 3 
B) 1, 4 
C) 1, 3 
D) 2, 4

Question 8

The major pathologic or structural changes of the lungs associated with ventilator failure accompanying Guillain-Barré syndrome include:
1) alveolar consolidation.
2) airway distortion and dilation.
3) mucosal edema.
4) atelectasis.

Accepted Answer

A) 1, 4 
B) 2, 3 
C) 1, 2, 3 
D) 2, 3, 4 
A) 1, 4 
B) 2, 3 
C) 1, 2, 3 
D) 2, 3, 4

Question 9

The diagnosis of Guillain-Barré syndrome is based on:
1) urinalysis, which shows elevated blood urea nitrogen.
2) abnormal electromyography results.
3) cerebrospinal fluid, which shows elevated protein level.
4) clinical history.

Accepted Answer

A) 4 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 4 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3

Question 10

Common noncardiopulmonary manifestations associated with Guillain-Barré are:
1) asymmetric muscle weakness in distal extremities.
2) leg pain.
3) distal paresthesia.
4) muscle paralysis that most often spreads downward from the face to the arms and trunk.

Accepted Answer

A) 1 
B) 2, 3 
C) 1, 2, 4 
D) 2, 3, 4 
A) 1 
B) 2, 3 
C) 1, 2, 4 
D) 2, 3, 4

Question 11

A patient with Guillain-Barré syndrome developed atelectasis. His chest radiograph findings would be expected to show:

Accepted Answer

A)  "ground-glass" appearance. 
B)  "honeycombing." 
C)  increased opacity. 
D)  blunted costophrenic angles. 
A)  "ground-glass" appearance. 
B)  "honeycombing." 
C)  increased opacity. 
D)  blunted costophrenic angles.

Question 12

A 75-kg, 50-year-old male patient has Guillain-Barré syndrome. His most recent assessment indicates his VC is 900 mL and NIF is -16 cm H2O. What plan should the respiratory therapist recommend?

Accepted Answer

A)  Initiate EMG monitoring. 
B)  Initiate continuous positive airway pressure (CPAP). 
C)  Initiate mechanical ventilation. 
D)  Reassess the patient each hour. 
A)  Initiate EMG monitoring. 
B)  Initiate continuous positive airway pressure (CPAP). 
C)  Initiate mechanical ventilation. 
D)  Reassess the patient each hour.

Question 13

Clinical indications that a patient has impending acute ventilatory failure include:
1) pH 2 > 45 mm Hg.
4) MEP > 40 cm H2O.

Accepted Answer

A) 1, 3 
B) 1, 2, 3 
C) 2, 4 
D) 2, 3, 4 
A) 1, 3 
B) 1, 2, 3 
C) 2, 4 
D) 2, 3, 4

Question 14

A Guillain-Barré syndrome patient has autonomic nervous system dysfunction which can result in which of the following?
1) Tachycardia
2) Hypotension
3) Urinary retention
4) Fever

Accepted Answer

A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3

Question 15

Approximately what percentage of patients with GBS develop respiratory muscle paralysis?

Accepted Answer

A)  <5% 
B)  6% to 9% 
C)  10% to 30% 
D)  31% to 50% 
A)  <5% 
B)  6% to 9% 
C)  10% to 30% 
D)  31% to 50%

Question 16

Which of the following has been shown to shorten the course of a severe case of Guillain-Barré syndrome?

Accepted Answer

A)  Renal dialysis 
B)  Plasmapheresis 
C)  Blood transfusion 
D)  NSAIDs 
A)  Renal dialysis 
B)  Plasmapheresis 
C)  Blood transfusion 
D)  NSAIDs

Question 17

In the United States and Europe, what is the most common subtype of GBS?

Accepted Answer

A)  Miller Fisher syndrome (MFS) 
B)  Acute motor axonal neuropathy (AMAN) 
C)  Acute pandysautonomic neuropathy (APN) 
D)  Acute inflammatory demyelinating polyneuropathy (AIDP) 
A)  Miller Fisher syndrome (MFS) 
B)  Acute motor axonal neuropathy (AMAN) 
C)  Acute pandysautonomic neuropathy (APN) 
D)  Acute inflammatory demyelinating polyneuropathy (AIDP)

Exam 29: Guillain-Barré Syndrome

Which of the following are identified as the causative organisms of the respiratory or gastrointestinal infections that precede the onset of most cases of GBS?

In which of the following persons would Guillain-Barré syndrome most likely occur?

Under microscopic inspection, the skeletal muscle nerves of a Guillain-Barré patient show which of the following? 1) Hypertrophy 2) Edema 3) Inflammation 4) Demyelination

A patient with Guillain-Barré is paralyzed and on mechanical ventilatory support. Which of the following pulmonary complications is most likely to occur as the result of prolonged immobilization?

Typical chest assessment findings in a patient with Guillain-Barré syndrome include: 1) diminished breath sounds. 2) crackles. 3) tracheal deviation. 4) depressed diaphragms.

When a person has Guillain-Barré syndrome, how are peripheral nerves affected?

The peripheral nervous system problems found with Guillain-Barré syndrome (GBS) include: 1) loss of reflexes. 2) increased reflex reactions. 3) flaccid paralysis of skeletal muscles. 4) tetany of skeletal muscles.

The major pathologic or structural changes of the lungs associated with ventilator failure accompanying Guillain-Barré syndrome include: 1) alveolar consolidation. 2) airway distortion and dilation. 3) mucosal edema. 4) atelectasis.

The diagnosis of Guillain-Barré syndrome is based on: 1) urinalysis, which shows elevated blood urea nitrogen. 2) abnormal electromyography results. 3) cerebrospinal fluid, which shows elevated protein level. 4) clinical history.

Common noncardiopulmonary manifestations associated with Guillain-Barré are: 1) asymmetric muscle weakness in distal extremities. 2) leg pain. 3) distal paresthesia. 4) muscle paralysis that most often spreads downward from the face to the arms and trunk.

A patient with Guillain-Barré syndrome developed atelectasis. His chest radiograph findings would be expected to show:

A 75-kg, 50-year-old male patient has Guillain-Barré syndrome. His most recent assessment indicates his VC is 900 mL and NIF is -16 cm H2O. What plan should the respiratory therapist recommend?

Clinical indications that a patient has impending acute ventilatory failure include: 1) pH < 7.35. 2) FVC < 20 mL/kg. 3) PaCO2 > 45 mm Hg. 4) MEP > 40 cm H2O.

A Guillain-Barré syndrome patient has autonomic nervous system dysfunction which can result in which of the following? 1) Tachycardia 2) Hypotension 3) Urinary retention 4) Fever

Approximately what percentage of patients with GBS develop respiratory muscle paralysis?

Which of the following has been shown to shorten the course of a severe case of Guillain-Barré syndrome?

In the United States and Europe, what is the most common subtype of GBS?

The Patient Interview

The Physical Examination

The Pathophysiologic Basis for Common Clinical Manifestations

Pulmonary Function Testing

Blood Gas Assessment

Assessment of Oxygenation

Assessment of the Cardiovascular System

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program

Respiratory Insufficiency, Respiratory Failure and Ventilatory Management Protocols

Recording Skills and Intra-Professional Communication

Chronic Obstructive Pulmonary Disease, Chronic Bronchitis and Emphysema

Asthma

Cystic Fibrosis

Bronchiectasis

Atelectasis

Pneumonia, Lung Abscess Formation, and Important Fungal Diseases

Tuberculosis

Pulmonary Edema

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Cancer of the Lung, Prevention and Palliation

Interstitial Lung Diseases

Acute Respiratory Distress Syndrome

Myasthenia Gravis

Cardiopulmonary Assessment and Care of Patients With Neuromuscular Disease

Sleep Apnea

Newborn Assessment and Management

Pediatric Assessment, Protocols, and Pals Management

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndrome

Respiratory Syncytial Virus Infection Bronchiolitis

Chronic Lung Disease of Infancy

Congenital Diaphragmatic Hernia

Congenital Heart Disease

Croup and Croup-Like Syndromes: Laryngotracheobronchitis, Bacterial Tracheitis, and Acute Epiglottitis

Near Drowningwet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Filters

A 75-kg, 50-year-old male patient has Guillain-Barré syndrome. His most recent assessment indicates his VC is 900 mL and NIF is -16 cm H₂O. What plan should the respiratory therapist recommend?

Clinical indications that a patient has impending acute ventilatory failure include: 1) pH < 7.35. 2) FVC < 20 mL/kg. 3) PaCO₂ > 45 mm Hg. 4) MEP > 40 cm H₂O.