Neurology 4 limb Weakness Flashcards
(48 cards)
With limb weakness what could a FBC show
Could show evidence of infection or anaemia suggestive of vitamin deficiency eg B12
what electrolytes could be deranged that would cause on contribute to limb weakness
potassium, calcium, phosphate and magnesium
in a patient with reduced mobility and weakness what must you always consider
assessing the risk of a VTE as LMWH may be indicated
If a patient with GBS becomes more breathless what should you consider
Chest infection? fever, night sweats, productive cough
PE? DVT symptoms
Is the GBS affecting his breathing? Need to ask if lying flat worsens his breathing (this commonly occurs in neuromuscular ventilatory failure due to a weak diaphragm), has his limb weakness worsened, does his neck feel weaker?
in a patient with GBS why does lying flat worsen their breathing
neuromuscular ventilatory failure due to a weak diaphragm
GBS becomes chronic if I lasts for how many weeks
8 weeks
what does acute myelopathies mean and what reflexes would they exhibit
involves the spinal cord
could have brisk reflexes
what is botulism
Very rare but life-threatening condition caused by toxins produced by Clostridium botulinum bacteria
Think of a heroin user who has necrotic skin lesions
causes double vision, dysarthria and dysphagia
descends rather than ascends
if there is a very low cell count in the CSF what should you be considering
HIV
what key measurements does a LP measure
Opening pressure White cell count Red cell count Protein Glucose
what percentage of glucose should be in CSF compared to plasma
2/3
in MS there is IgG synthesis in the CNS therefore what should you see in CSF
oligoclonal bands
what does the CSF fluid show if it is bacterial infection
high opening pressure
100-50000 cells mainly neutrophils
proteins greater than 1
glucose less than 40%
what does the CSF fluid show if it is viral infection
opening pressure normal
5-1000 cells mainly lymphocytes
protein between 0.5-1
glucose 50-66%
what does the CSF fluid show if it is an infection with TB
opening pressure is high/very high
5-500 cells mainly lymphocytes
protein greater than 1
glucose less than 33%
what does the CSF fluid show if it is a fungal infection
opening pressure is very high
0-1000 cells mainly lymphocytes
protein between 0.5-2
glucose 30-50%
what kind of infection would show neutrophils predominately in the CSF fluid
bacterial
which kind of infection would show mainly lymphocytes in the CSF
viral or fungal infection
what would you expect to see in the CSF if someone has MS
often normal CSF except OCB would be positive
what would you expect to see in the CSF if someone has GBS
normal cells and glucose however there would be raised protein
what would you expect to see in the CSF if someone has cancer
high WBC and proteins
very low glucose and abnormal cytology
what would you expect to see in the CSF if someone has a subarachnoid haemorrhage
there would be high RBC and xanthochromia which is raised bilirubin and oxyhemoglobin (however will only appear after 12 hours)
what is the most common viral encephalitidies
herpes simplex
what is transverse myelitis (TM)
an inflammation of the spinal cord
