Neuro 3 pt1 Flashcards Preview

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Flashcards in Neuro 3 pt1 Deck (25)
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1
Q

Most common disorder of Neuromuscular transmission
Cardinal features are weakness and fatigability of the skeletal muscles
Weakness increases with activity and improves c rest

A

Myasthenia Gravis

2
Q

Myasthenia Gravis

Peak incidence is what age range in males/females/

A

Peak incidence women in 20s/30s and men in 50s/60s

3
Q
hyperthyroidism
hypokalemic periodic paralysis(HPP)
RA
Sjogren’s syndrome
SLE
DM
these are all associated disorders with:
A

Myasthenia Gravis

4
Q

Acetylcholine Receptors are either __ or __

A

nicotinic or muscarinic

5
Q

The fundamental defect of Myasthenia Gravis is:

A

decrease in available acetylcholine receptors

6
Q

“Myasthenic fatigue” is caused by

A

inefficiency of NM transmission causing increasing weakness c activity

7
Q

– if you do the same thing over and over you will be less and less able to function. this term is called ____; what is this associated with?

A

Presynaptic rundown

associated with Myasthenia Gravis

8
Q

What is MuSK? What does it stand for?

A

Muscle Specific tyrosine Kinase (MuSK) is protein involved in AChR clustering at NM junction mostly bulbar
Reduces the amt. of AChRs
IgG and T-cell mediated

9
Q
Cranial nerve exercise: what's the principle eye function of each of these CN?
Abducens 
Oculomotor 
Facial 
Oculomotor
A

Abducens: LATERAL eye movement
Oculomotor: MEDIAL eye movement
Facial: Lower the eyelid
Oculomotor: Raise the eyelid

10
Q

What two nerves are involved with swallowing?

A

Vagus & Glossopharyngeal

11
Q

Face muscles are tired and you can’t smile correctly. This is called:

A

Myasthenic “snarl” of Myasthenia Gravis

12
Q

MG weakness:
~85% have ______ weakness.
How are their DTR’s? Why?

A

proximal limb weakness
DTRs preserved. Reflexes are fine because it doesn’t involve the spine’s reflex arc. –use this to differentiate between MG and some other disorders.

13
Q

weakness restricted to extraocular muscles for >3yrs

Pupillary function is still good

A

Ocular MG

14
Q

How do you dx Ocular Myathenia Gravis?

A

ice test (your eye will work better with the cool temperature), tensilon test; same as generalized MG PLUS: you have a thymoma

15
Q

What is the most common symptom of Ocular MG?

A

ptosis (whether it is uni or bilateral)

16
Q

MG testing (it’s highly sensitive & specific)

A

Acetylcholine receptor antibodies

17
Q

He showed us a video of a dog that could barely walk, but then after they did some test it could. What was the dog’s conditinon and test?
What did it do?

A

Tensilon Test in a dog with MG

Tensilon test- IV edrophonium inhibits acetylcholinesterase and transiently reverses ptosis & EOM weakness(relatively contraindicated in CAD or bronchiole asthma), need antidote atropine ready

18
Q

Tx of Myasthenia Gravis (2 types)

A

Thymectomy if there’s a thymoma
or
Aceytlchoinesterase, and then try prednisoneW

19
Q

What does ALS stand for? (what is each initial’s definition)?

A

Amyotrophy: muscle atrophy
Lateral(and anterior): white matter corticospinal tracts
Sclerosis: resultant firm gliosis – scarring and damage seen on MRI.

20
Q

Is ALS UMN, LMN, or both?

A

BOTH

21
Q

ALS- cause unknown, other than gene mutation identical in both inherited and sporadic forms.
Name 2 things that increase risk in these genetically susceptible pts

A

smoking

lead exposure

22
Q

Most common presentation of ALS

A

asymmetric distal limb weakness (80%)

23
Q

what is a bulbar symptom?

A

sx relating to the medulla oblongata

24
Q

What is the most common ALS bulbar sx? (2)

A

Dysarthria or dysphagia

25
Q

ALS: Tx

A

riluzole is first and only drug approved by FDA for slowing progression

overall tx is supportive