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Flashcards in neuro- weakness Deck (27)
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1
Q

definitive diagnosis for MS

A

clinical, but at least one lesion in white matter on MRI + oligoclonal bands on MRI

2
Q

INO

A

lesion in MLF gives IPS medial rectus palsy on lateral gaze and horizontal nystagmus of abd eye (contralat side)

3
Q

treatment of MS?

A

IV high dose corticosteroids for ACUTE attacks

disease modifying= interferon, cyclophosphamide if really bad

4
Q

symptomatic therapy for MS:

  • muscle spasticity
  • neuropathic pain
A

baclofen, dantrolene

carbamezapine, gabapentin

5
Q

GBS affect with nerves?

A

motor, not usually sensory

6
Q

treatment of GBS?

A

IVIG!

do NOT give steroids

7
Q

myasethenia gravis:

  • path
  • treatment
A
  • antibodies to postsynaptic Ach(N) receptors in NMJ
  • Symptomatic tx= AchE inhibitors (pyridostigmine)

Definitive: thymectomy

  • IVIG
  • immunosuppressants
8
Q

do you need to intubate MG patients?

A

low threshold, intubate at FVC of 15ml/kg

9
Q

reflex pattern in MG vs lambert eaton?

A

in MG, reflexes are preseved

In LE, patients have hyporeflexia

10
Q

diagnosing MG

A
  • emg
  • CT scan for thymoma (10%)
  • edrophonium (tensilon) test- AchE
11
Q

gowers maneuver

A

patient with DMD pulls himself from floor because of weak proximal lower etremeity muscles

12
Q

character of enlarged calves in DMD

A

hypertrophy at first, becomes pseudohypertrophy as fat replaces muscle

13
Q

polymyositis

A

proximal muscle weakness, elevated CK, ESR, etc

dx with muscle bx showing infravesicular infilatrates

14
Q

shortness of breath in suspected AS?

A

they can develop restrictive lung dz from decreased movement of their spine

15
Q

myalgias, rhabdo, myoglobinuria and “second wind phenomenon”

A

mcardle’s dz= glycogen stroage do 2/2 myphosphorylase deficiency

16
Q

giant cell tumor (aka osteoclastoma):

  • appearance on xray
  • pathology
  • demographic
A
  • soap bubble at distal femur or proximal tibia
  • over active osteoclasts due to over expression of RANK-L
  • boys age 20-40
  • benign!

*consider local excision or tx with dinosumab

17
Q

chondrosarcoma

A

age 50-70
on hip or femur
“moth eaten” appearance on xray + periosteal reaction

18
Q

first line for sx pagets

A

IV zolendronate

*can cause flu like reaction, osteonecrosis of the jaw

19
Q

what should you check after finding a calcaneal fracture from a fall? (think about compression)

A

spinal xray

20
Q

anti-ro, anti-lo

A

sjodrens

SLE

21
Q

empiric against GNR in septic arhtritis?

A

IV ceftriaxone

22
Q

who gets osteosarcoma?

A

bimodal: 10-20, >65
- pain worse at night and with activity
- metaphysis of long bones
- sunburt + codman’s triangle

23
Q

whats at risk in mid/proximal humerus break?

distal humerus break?

A

radial nerve

radial artery

24
Q

differentiate bony lesions in metastatic prostate cancer vs MM

A

prostate= osteoblastic aka sclerotic lesions

MM= punched out

25
Q

morning stiffness as an indicator of OA or RA?

A

OA <30 mins

RA > 30 mins

26
Q

role of entanercept in AS?

A

it helps with spinal mobility but DOES NOT prevent disease progression

27
Q

calcification of hylaine cartilage on XRAY?

A

pseudogout