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neuro 23 Flashcards

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1
Q

Wallerian degeneration

A

disintegration of axons and myelin distal to the site of injury

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2
Q

neuronal (or axonal) degeneration

A

distal dying of the axons and loss of myelin after damage to the cell body of the neurons

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3
Q

small nerve fibers

A

neuropathic pain (aching, shooting, throbbing or burning); distrubance of temp sensation; and autonomic dysfunction (cardiac arrythmias, orthostatic hypotension, impotence)

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4
Q

large nerve fibers

A

loss of vibration and joint position sense, weakness, fasciculations, and loss of DTRs

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5
Q

anti-ENA

A

group of antibodies (like anti-Ro and La) to screen to connective tissue diseases

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6
Q

methylmalonic acid

A

increased means vit B12 def

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7
Q

urine porphobilinogen

A

for acute intermittent porphyria

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8
Q

ANCA

A

Wegener’s granulomatosis

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9
Q

anti-Hu antibody

A

for paraneoplastic syndromes

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10
Q

anti-GM1 MAG antibody

A

for autoimmune neuropathy

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11
Q

symmetric prcimal and distal weakness with sensory loss

A

guillan barre, chronic inflamm demyelination polyradiculopathy

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12
Q

symmetric distal weakness with sensory los

A

drug or toxin-induced; metabolic neuropathy; amyloidosis

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13
Q

asymm distal weakness with sensory loss; multiple nerves

A

vasculitis; hereditary neuropathy with liability to pressure palsies; infections like leprosy, Lyme, sarcoidosis, and HIV

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14
Q

single nerve

A

compressive mononeuropathy and radiculopathy

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15
Q

asymm distal weakness without sensory loss

A

motor neuron disease, multifocal motor neuropathy

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16
Q

asymm proximal and distal weakness with sensory loss

A

polyradiculopathy or plexopahty , meningeal carcinomatosis or lymphomatosis, HNPP, hereditary neuropathies

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17
Q

symm sensory loss without weaknes

A

crytpogenic sensory polyneuropathy; metabolic, drug-induced, or toxic neuropathies; leprosy

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18
Q

asumm proprioceptive sensory loss without weakness

A

sesnory neuronopathies

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19
Q

autonomic symptoms and signs

A

diabetes, amyloidosis, GB, vincristine, porphyria, HIV-related autonomic neuropathy, idiopathic pandysautonomia

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20
Q

the most common infection to precede guillan barre is what?

A

campylobacter jejuni; others include herpes, most freq CMV or EBV

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21
Q

most frequent antibodies found in GBS

A

anti-GM1

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22
Q

clinical presentation of Guillan barre

A

ascending areflexic motor paralysis, witho or without sensory problems, including neuropathic pain

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23
Q

initial sx of GB

A

tingling and pins-and-needles sensations in the feet, sometimes with lower back pain

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24
Q

Miller fisher variant of GB

A

gait ataxia, areflexia, and external opthalmoplegia, usually without limb weakness

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25
Nerve conduction studes in GB Miller fisher variant
normal
26
what antibodies are pos in Miller Fisher variant of GB
anti-GQ1b in 90% of cases
27
albuminocytologic dissociation in CSF
characteristic of GB
28
what do electrodiagnostic studies of GB show?
prolonged distal latencies, possible conduction block, and decreased motor unit recruitment on EMG
29
management of GB
hospitalize patient and monitor forced vital capacity and neg insp pressure; treat with IVIg or plasmapharesis; steroids are not beneficial
30
chronic inflamm demyelinating polyradiculoneuropathy
sometimes called chronic GB
31
clinical presentation of CIDP
slowly evolving weakness beginning in the lefs, with widespread areflexia and loss of vibratory sense (larger fiber); weakness of neck flexors; painful paresthesias can occur
32
treatmen of CIDP
these patients respond to periodic IVIG therapy; most improve with steroids, but half will relapse
33
multifocal motor neuropathy
pure motor multiple mononeuropathy; immune-mediated mechanism
34
clinical manifestations of MMN
slowly progressive asymm, predominantly distal limb weakness that usually begins in the arms
35
sensory problems inmultifocal motor neuropathy?
minor sensory symptoms are common; however, objective sensory deficits, UMN, and CN findings are absent
36
diagnostic eval of multifocal motor neuropathy
electrodiagnostic studes show conduction block in motor nerves in areas not prone to compression. Very high IgM anti-GM1 is found in most patients
37
treatment for MMN
IVIg, rituximab, and immunosuppressants like cyclophosphamide
38
neuropathies assoc with serum monoclonal gammopathies
patients often have multiple myeloma, amyloidosis, macroglobulinemia, cryoglobulinemia, lymphoma, or leukemia
39
clinical manifestations of neuropathies assoc with monoclonal gammopathies
symmetric sensorimotor neuropathies that affect the legs more than the arms; prominent large-fiber sensory loss and sensory ataxia
40
diagnostic eval for neuropathies assoc with monoclonal gammopathies
electrodiagnositc studies show signif demyelination and axonal loss
41
clinical manifestations of diabetic polyneuropathy
neuropathic pain and dyesthesias; distal, symm, slowly progressive sensory loss in the legs (stocking distrib); autonomic insuff; weakness is late feature
42
treatment for diabetic polyneuropathy
glucose control; symptomtic management of pain that may respond to TCAs, duloxetine, or anticonvulsants like gabapentin, pregabalin, lamotrigine, and others
43
uremic neuropathy
symmetric, distally predominant sensorimotor axonal polyneuropathy; foot drop and leg weakness are common
44
poprphyric neuropaty
assoc with acute intermittent porphyria; sensorimotor axonal polyneuropathy manifested by paresthesias and dyesthesias of the extremities, sometimes with weakness or paralysis
45
critical illness neuropathies
axonal sensorimotor polyneuropathy; patients in the ICU; unknown etiology
46
Charcot-Marie-Tooth disease
most common inherited polyneuropathy; symmetric slowly progressive distal muscular atrophy of the legs and feet; in most cases, it eventually involves the hands
47
hammer toes and pes cavus
common in charcot-marie-tooth
48
CMT gene
charcot-marie-tooth
49
neuropathy of leprosy
motor and sensory; predilection for cooler areas like nose, ears, and distal limbs; DTRs preserved; palpable nerve hypertrophy
50
pandysautonomia
acquired disorder usually immune following a viral infection in wich the sump and parasymp systems are affected
51
pathogenesis of acute pandysautonomia
autoantibodies against ganglionic acetylcholine receptor
52
symptoms of median nerve entrapmen
numbness or tingling over one or more of the first 4 digits; weakness of the thenar muscles; decr sensation in the volar aspect of the first three and a half digits
53
Tinel's and Phalen's signs
present in median nerve entrapment; Tinel's- tapping on the nerve produces tingling; Phalen's
54
features of ulnar nerve entrapment
paresthesias and pain in the fifth digit and the medial half of the fourth; difficulty spreading the fingers; weakness and atrophy of the FDI and ADM
55
what cuases unar nerve entrapment
compression of the ulnar nerve in the cubital tunnel in the elbow
56
radial nerve entrapment
wrist drop and sensory loss on dorsal hand; weakness of tricpes, brachioradialis, supinatory, and wrist and finger extensors;
57
cause of radial nerve entrapment
compression of the radial nerve at the level of the axilla (Saturday night palsy), the spiral groove, or in the forearm
58
meralgia paresthetica
burning sensation and variable loss of sensation over the anterior thigh
59
cause of meralgia paresthetica
entrapment of the lateral femoral cutaneous nerve near the inguinal ligament
60
clinical features of femoral neuropathy
leg weakness on attempting to stand or walk; pain in the anterior thigh; weakness of the quads, absent or diminshed patellar reflex, and sensory loss over the anterior thigh
61
cause of femoral neuropathy
usually trauma from surgery, stretch injury (lithotomy position in childbirht), DM, and other inflamm processes
62
clinical features of peroneal neuropathy
foot drop with minimal sensory complaints; weakness of extensor hallucis longus, tibialis anterior, and the peroneal muscles; sens loss over the dorsal part of the foot is mild
63
cause of peroneal neuropathy
entrapment of peroneal nerve between the neck of the fibula and the insertion of the peroneus longus muscle
64
features of C5 root syndrome
pain in lateral shoulder, sensory loss over the deltoid; weakness of deltoid, supraspinatus, and biceps; impairment of biceps reflex
65
features of C6 root syndrome
pain in radial side of the arm to the thumb; weakness of biceps and brachioradials; impairment of biceps reflex
66
features of C7 root syndrome
pain between second and fourth finger; weakness of triceps, wrist extensors and flexors, pectoralis major muscles; impairment or loss of triceps reflex
67
clinical features of L3 root syndrome
often none, sometimes medial thigh and knee sens loss; quads weakness; adductor may be affected; loss of knee jerk reflex and impaired adductor reflex
68
features of L4 root syndrome
loss of sensation in medial leg below knee to medial maleolus; weaknes of quads and anterior tibial muscles; decreased knee jerk
69
features of L5 root syndrome
loss of sensation over dorsm of foot to great toe; weakness of extensor hallucis longus, extensor dig longus, inversion, and eversion of foot
70
features of S1 root syndrome
loss of sensation in lateral foot; weakness in plantar flexion, toe flexion; decreased or absent ankle jerk reflex

Neuro (43 decks)

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