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Small Animal Medicine > Disorders of the Peripheral Nervous System > Flashcards

Disorders of the Peripheral Nervous System Flashcards

1
Q

What are the 3 most common diagnostics used for PNS disorders?

A
  1. neurologic exam findings
  2. electrodiagnostics
  3. muscle/nerve biopsies
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2
Q

What are 3 signs of peripheral neuropathies?

A
  1. decreased to absent reflexes
  2. poor muscle tone
  3. neurogenic atrophy
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3
Q

How are most degenerative peripheral neuropathies diagnosed?

A

characteristic features and biopsies

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4
Q

What is thought to cause laryngeal paralysis/polyneuropathy complex? What is the most consistent sign?

A

axonopathy of unknown cause believed to be heritable —> seen in younger dogs!

laryngeal paralysis

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5
Q

What 4 breeds have reported laryngeal paralysis/polyneuropathy complex?

A
  1. Dalmatian
  2. Rottweiler
  3. Leonbergers
  4. Pyrenean Mountain dog
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6
Q

What are the 3 most common clinical signs associated with laryngeal paralysis/polyneuropathy complex? What is prognosis like?

A
  1. limb paresis with hyporeflexia
  2. megaesophagus
  3. laryngeal paralysis

poor —> no treatment

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7
Q

What is dancing Doberman disease? How does it initially present? What happens within months?

A

neuropathy with a wide age range of onset

flexing of one pelvic limb while standing

alternate flexing of pelvic limbs = dancing

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8
Q

How do dogs with dancing Doberman disease commonly act while not ambulating? What are 4 signs? What is prognosis like?

A

prefer to sit

  1. no lameness
  2. no apparent discomfort
  3. no dancing while ambulating
  4. gastrocnemius atrophy

good —> no tx, very slow progression

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9
Q

What is idiopathic facial paralysis? What breed is predisposed?

A

canine analog of human Bell’s Palsy

Cocker Spaniels

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10
Q

What is the most common sign of idiopathic facial paralysis? What must be ruled out to make a diagnosis? What treatment may be indicated?

A

unilateral lip droop with decreased to absent palpebral reflexes +/- VIII deficits

otitis, hypothyroidism

glucocorticoid therapy

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11
Q

What are the 2 forms of laryngeal paralysis? What are the most common signs? What is prognosis like?

A
  1. hereditary = young dogs
  2. acquired = older dogs

inspiratory stridor, respiratory distress, dysphonia

guarded —> surgical treatment required

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12
Q

What are 2 secondary effects of idiopathic megaesophagus? What treatment is recommended?

A
  1. regurgitation
  2. aspiration pneumonia

supportive - motility modifiers

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13
Q

What are the 2 most common metabolic causes of neuropathies?

A
  1. diabetes mellitus
  2. hypothyroidism
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14
Q

What are the 2 most common neoplastic causes of neuropathies?

A
  1. malignant nerve sheath tumors
  2. soft tissue tumor with nerve entrapment
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15
Q

What are the likely causes of paraneoplastic neuropathy?

A
  • neoplastic release of neurotoxic factors
  • innocent bystander effect - cells or tissues are injured by immunologic reactions in response to neoplastic cells
  • axonal or Schwann cell dysfunction
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16
Q

What neoplasm is commonly associated with paraneoplastic neuropathy?

A

insulinomas - not thought to be related to hypoglycemia

(may resolve with successful treatment)

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17
Q

What cranial nerves are commonly affected by paraneoplastic neuropathies? What is it associated with?

A

trigeminal and facial

lymphoma

18
Q

What is indicative of acute idiopathic polyradiculoneuritis? What is an additional sign?

A

coonhound paralysis —> rapidly progressive LMN paresis/plegia that starts at pelvic limbs and progresses to thoracic limbs

voice loss

19
Q

What abilities are commonly left intact with acute idiopathic polyradiculoneuritis? What other signs are possibly seen?

A
  • pain senation, often hyperesthetic
  • urination ability

axonal loss and respiratory compromise

20
Q

What is suspected to cause chronic inflammatory demyelinating polyneuropathy? What is the most common signalment and signs?

A

autoimmune disorder

mature dogs and cats

LMN signs in the pelvic limbs first

21
Q

What treatment is recommended for chronic inflammatory demyelinating polyneuropathy?

A

Prednisone (autoimmune disorder!)

  • relapse and refractoriness occasionally
22
Q

What sign is most commoly associated with trigeminal neuritis?

A

acute onset of dysphagia

  • self-limiting, apparently non-painful
23
Q

What are the 4 most common signs associated with myopathies?

A
  1. weakness with preservation of sensory function
  2. muscle atrophy
  3. myalgia
  4. exercise intolerance
24
Q

What is myotonia congenita? What is the cause? How is it diagnosed?

A

heritable trait in dogs and DSH with failure of muscular relaxation

abnormal sarcolemmal ion conductance

dive bomber waxing and waning EMG - differentiates from muscular disease

(supportive treatment only)

25
Q

What 2 breeds are overrepresented with autoimmune polymyositis?

A
  1. Newfoundland - early age
  2. Boxer - pre-neoplastic condition
26
Q

What are the 5 most common signs associated with autoimmune polymyositis?

A
  1. generalized weakness
  2. stiff gait
  3. muscle atrophy
  4. myalgia
  5. dysphoria
27
Q

What 3 diagnostics are used for autoimmune polymyositis? What do most patients respond to?

A
  1. elevated CK
  2. abnormal EMG
  3. muscle biopsy*

immunosuppression

28
Q

What muscle fiber types are most commonly affected by masticatory myositis? What signalment is most commonly affected?

A

autoimmune disorder of Type IIM fibers of masticatory muscles

young adult large breeds

29
Q

What are the most common signs of masticatory myositis? What is seen in the acute and chronic phases?

A
  • painful swelling of masticatory muscles
  • trismus - lockjaw, sustained tetanic spasms
  • occasional fever

ACUTE = exophthalmos
CHRONIC = enophthalmos, muscle atrophy

30
Q

What treatment is recommended for masticatory myositis? What side effect is commonly seen?

A

immunosuppression

accentuate muscle atrophy —> pred head

31
Q

What are some causes of traumatic myopathies?

A
  • infraspinatus contracture
  • iliopsoas injury
  • quadriceps contracture
  • gastrocnemius avulsion
  • coccygeal muscle injury
32
Q

What is acquired myasthenia gravis?

A

autoimmune NMJ disorder caused by the production of antibodies directed against nicotinic ACh receptors, resulting in muscle weakness

33
Q

What are the clinical forms of acquired myasthenia gravis?

A
  • focal: megaesophagus
  • generalized: obvious appendicular weakness (+/-megaesophagus), facial, pharyngeal, or laryngeal weakness
  • acute fulminating: rapidly progressive, severe form in which generalized weakness occurs over hours to a few days
34
Q

What 4 dog breeds breeds are predisposed to acquired myasthenia gravis? 2 felines?

A
  1. Akitas
  2. Terriers
  3. Retrievers
  4. GSDs

Abyssinian and Somali cats

(bimodal age distribution)

35
Q

What are the most common clinical signs associated with acquired myasthenia gravis?

A
  • swallowing difficulty
  • vomiting, regurgitation
  • hypersalivation
  • coughing
  • labored breathing
  • limb muscle weakness
  • dysphoria
36
Q

What are 3 diagnostics used for acquired myasthenia gravis?

A
  1. radioimmunoassay for serum AChR antibodies**
  2. positive Tensilon test (prevents the breakdown of the chemical acetylcholine)
  3. decremental repetitive nerve stimulation
37
Q

What additional diagnostics are recommended for diagnosing myasthenia gravis?

A
  • basic blood work
  • thyroid levels
  • thoracic radiographs

(megaesophagus!)

38
Q

What medical treatments are recommended for acquired myasthenia gravis? What else may be indicated?

A
  • anticholinesterase - Pyridostigmine
  • immunosuppressive therapy

megaesophagus - feeding tube, pneumonia treatment

39
Q

What causes the variable prognosis of acquired myasthenia gravis?

A
  • persistence of megaesophagus and pneumonia
  • higher spontaneous remission likely in dogs
40
Q

What treatment is recommended if patients with acquired myasthenia gravis do not respond well to Pyridostigmine? What is avoided?

A

immunosuppression

glucocorticoids —> Prednisone can make pneumonia worse

Small Animal Medicine (52 decks)

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