5: Peripheral neuropathy Flashcards Preview

Neurology Week 4 2018/19 > 5: Peripheral neuropathy > Flashcards

Flashcards in 5: Peripheral neuropathy Deck (28)
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1

What is an endocrine disease which causes peripheral neuropathy?

Diabetes

2

What happens to the reflex response when peripheral nerves are damaged?

Reduced/absent reflexes

3

What are some symptoms of autonomic neuropathy?

Sweating

Tachycardia

Gastroparesis

4

What is dyesthesia?

Pain on touching caused by peripheral nerve damage

5

Neuropathy of which nerve causes a high-stepping gait?

Why?

Deep fibular nerve

Responsible for foot dorsiflexion, so patient has to lift foot high to prevent dragging foot

6

What is the most common mononeuropathy?

Carpal tunnel syndrome

7

Mononeuritis multiplex is (symmetrical / asymmetrical).

asymmetrical

8

Peripheral neuropathy tends to be (symmetrical / asymmetrical).

symmetrical

9

What sort of distribution does diabetic peripheral neuropathy often take?

Glove and stocking

10

In which two ways can large diameter nerve fibres be damaged?

Axonal loss (e.g infarction, trauma)

Demyelination

11

What is a common acute-onset demyelinating neuropathy?

Guillain Barre syndrome

12

What are the symptoms of GBS?

Progressive loss of sensation in limbs

Tingling pain

13

When do symptoms peak in GBS?

2 weeks after onset

14

What can be absent in GBS?

Reflexes

15

1 in 4 GBS patients require ___.

ventilation

16

How is Guillain Barre syndrome treated?

Admission to hospital

IV immunoglobulins (to buffer immune system)

Plasmapharesis (filtering of blood to strip out demyelinating substances)

17

What is a less common type of demyelinating neuropathy?

Hereditary motor and sensory neuropathy (HMSN)

18

What are common presentations of HMSN?

Just memorise:

LOWER LIMB MUSCLE WASTING (tibial / fibular nerve)

CLAW HAND (ulnar nerve)

HIGH ARCHED FOOT (imbalance between leg and foot muscles)

 

19

What are some causes of peripheral neuropathy?

Infection

Drugs/Alcohol

Neoplasia

Vasculitis

Diabetes, vitamin deficiencies, porphyria...

20

What are need-to-know causes of autonomic neuropathy?

Diabetes

Amyloidosis

HMSN

GBS

Porphyria

21

A patient presents with an acute abdomen and peripheral neuropathy.

What is the likely diagnosis?

Porphyria

22

A patient has tingling and muscle wasting over their thenar eminence.

What neuropathy do they have?

Carpal tunnel syndrome

Caused by compression of the median nerve within the carpal tunnel

23

Describe two tests which can elicit carpal tunnel symptoms.

Phalen's test: ask patient to do reverse prayer sign

Tinel's test: tap on the carpal tunnel with your finger or a tendon hammer

24

A patient describes a lack of sensation over their "regimental badge patch" area.

Which nerve is involved in this peripheral neuropathy?

Axillary nerve

25

A patient experiences facial weakness.

Which nerve is involved in this neuropathy?

CN V

FOREHEAD SPARING - UMN disease (e.g a stroke)

NO FOREHEAD SPARING - LMN disease (Bell's palsy)

26

A patient presents with wrist drop.

Which nerve is likely involved in this peripheral neuropathy?

Radial nerve

27

A patient presents with a claw hand.

Which nerve is likely involved in this peripheral neuropathy?

Ulnar nerve

28

A patient presents with a hand of benediction.

Which nerve is likely involved in this peripheral neuropathy?

At which point in the upper limb is it damaged?

Median nerve

Forearm or elbow (because it's not a carpal tunnel syndrome)