Neuropathy Flashcards
(124 cards)
1
Q
what is polyneuropathy?
A
symmetrical loss of multiple different nerves
2
Q
what is mononeuropathy?
A
single nerve issue
3
Q
do polyneuropathies have more distal or proximal symptoms?
A
more distal
4
Q
is a polyneuropathy symmetrical or asymet?
A
symmetrical
5
Q
is a polyneuropathy a disease of motor or sensory nerves?
A
BOTH..it is a mixed nerve deficit
6
Q
other than motor and sensory deficit, what can polyneuropathy have?
A
autonomic dysfunction
7
Q
will there be lower or upper motor neuron findings on polyneuropathy?
A
LMN
8
Q
what is the most common demyelinating acute polyneuropathy??
A
AIDP or Guillain Barre
9
Q
what does AIDP stand for?
A
acute inflammatory demyelinatiing polyradiculopathy
10
Q
what two nerve types are demyelinated in ADIP?
A
spinal nerve roots and peripheral nerves
11
Q
where does weakness mainly occur in AIDP?
A
distal limbs and advances to proximal muscles
12
Q
what often precedes AIDP?
A
flu like illness
13
Q
what bug is associated with AIDP?
A
campylobacter jejuni
14
Q
what is shown in LP with AiDP?
A
elevated protein only
15
Q
does AIDP preserve deep tendon reflexes?
A
NO…LMN issue
16
Q
what is usual cause of death in AIDP?
A
respiratory failure
17
Q
what is driving factor for AIDP?
A
inflammatory immune mediated
18
Q
what is Rx for AIDP?
A
plasma exchange/IVIG
19
Q
what is a common demyelinating chronic polyneuropathy?
A
Charcot Marie Tooth Disease
20
Q
what happens in Charcot Marie Tooth Disease?
A
chronic demyelination of peripheral nerves
21
Q
what are symptoms of Charcot Marie Tooth Disease?
A
foot pain and dysfunction
calves and ankles thin compared to thigh…but be aware it can be asymptomatic
22
Q
what is foot finding in Charcot Marie Tooth Disease?
A
high arches with hammer toes
23
Q
what is patho finding in Charcot Marie Tooth Disease?
A
onion bulb due to demyel and remyel over time
24
Q
what portions of legs are mainly affected in Charcot Marie Tooth Disease?
A
calves and feet
25
what is mutation in Charcot Marie Tooth Disease?
PMP22 (CMT1)
26
is diabetic neuropathy more proximal or distal?
distal
27
is diabetic neuropathy more sensory or motor?
sensory
28
aside from sensory loss, what else can have issues in diabteic neuropathy?
autonomic dysfxn
29
what are the autonomic dysfxn issues in diabetic neuropathy?
postural hypotension
decreased bladder emptying
nausea
sexual dysfxn
30
what is a vitamin deficiency that can lead to neuropathy?
B12
31
carpal tunnel is due to what nerve entrapment?
median nerve
32
where is weakness in carpal tunnel?
thumb adduction and opposition
| atrophy of thenar eminence
33
what are sx of carpal tunnel?
pain/numbness in hand/wrist...worse at night
34
what is rx for carpal tunnel?
NSAIDs, steroids injection, surgical decompression or splints night
35
where is pain in ulnar nerve palsy?
at elbow
36
what muscles are weak in ulnar nerve palsy?
interosseous muscle
37
what motion is weak with ulnar nerve palsy?
grip strength
38
what canal is compressed in ulnar nerve palsy?
guyons canal
39
what is main sign of radial nerve palsy?
wristdrop
40
what muscles are weak in radial nerve palsy?
finger extensors, wrist extensors, brachioradialis
41
what is another name for radial nerve palsy?
saturday night palsy
42
peroneal nerve palsy is caused by what commonly?
prolonged lying or leg cast
43
what is sign for peroneal nerve palsy?
foot drop
44
what is movement weakness in peroneal nerve palsy?
foot dorsiflexion and eversion
45
what is sensory loss in peroneal nerve palsy?
dorsum of foot and lateral shin
46
what is weakness in sciatic nerve palsy?
leg flexion..hamstrings
47
where is sensory loss in sciatic nerve palsy?
peroneal, tibial and sural
48
what is absent in sciatic nerve palsy?
ankle jerk
49
what is weak in femoral nerv palsy?
quads
50
where is sensory loss in femoral nerve palsy?
anterior/medial thigh to medial shin
51
what reflex is changed in femoral nerve palsy?
knee jerk
52
name three things that inhibit action of ACH esterase?
insecticides
pyridostigmine
nerve gas
53
what is cause of issue in myasthenia gravis?
antibodies against ACh receptor on postsynaptic cell
54
is myasthenia gravis pre or post synapse?
post syanptic issue
55
what can myasthenia gravis be associated with that you should investigate?
thymoma
56
what are symptoms of myasthenia gravis?
```
fatigable weakness
diplopia
ptosis
bulbar weakness
proximal limb weakess
```
57
what is bulbar weakness in myasthenia gravis?
all cranial nerves are weak
58
what is Rx for myasthenia gravis?
pyridostigmine
59
what is MoA of pyridostigmina?
blocks ACh esterase to increase ACh in NMJ
60
what is issue in Lambert Eaton Myasthenic Syndrome?
antibodies against voltage gated Ca channels
61
is Lambert Eaton Myasthenic Syndrome pre or post synaptic issue?
pre
62
what is main feature of Lambert Eaton Myasthenic Syndrome?
symmetric proximal muscle weakness
63
is Lambert Eaton Myasthenic Syndrome an issue with distal or proximal muscles?
PRoximal
64
is Lambert Eaton Myasthenic Syndrome hypo or hyperreflexive?
Hypo
65
what is Lambert Eaton Myasthenic Syndrome associated with?
small cell lung cancer
66
what is issue in botulism?
presynaptic block of Ach release
67
is botulism pre or post synapse?
presynaptic issue
68
where is botulin from?
clostridium bacteria
69
where do babies get botulin from?
honey
70
what is main symptom of botulism?
descanding paralysis
71
what are the four Ds that botulism can lead to?
diplopia, dysarthria
dyspnea
dysphagia
72
what is a myopathy?
neuromuscular disorder where muscle weakness is due to dysfunction of muscle fibers
73
is myopathy inherited or acquired?
can be either
74
what are the three acquired myopathies to know?
polymyositis
dermatomyositis
inclusion body myositis
75
what two drugs can cause acquired myopathy?
steroid or statin
76
what does polymyositis lead to?
proximal muscle weakness
77
is polymyositis proximal or distal muscles?
proximal
78
is polymyositis symmetric or asymmetric?
symmetric
79
what is elevated in polymyositis?
Creatine Kinase
80
what type of pain inpolymyositis?
muscle pain
81
dermatomyositis has what muscle involvement?
proximal muscle weakness
82
what is dermatomyositis associated with?
malignancies
83
other than proximal muscle weakness, what does patient experienc with dermatomyositis ?
skin rash
84
what is issue in inclusion body myositis?
inflammatory myopathy
85
what type of weakness does inclusion body myoitis lead to?
asymmetric weakness
86
what two muscles are mainly affected in inclusion body myositis?
finger flexor and qaudriceps muscle
87
what are CK levels in inclusion body myositis?
normal or mildly elevated
88
what are CK levels in dermatomyositis?
elevated
89
how are muscular dystrophies inherited?
X linked pattern
90
what are the mutations in muscular dystrophy?
deletions
91
name the three muscular dystrophies to know
duchenne and becker
| and myotonic
92
when does duchennes onset?
2-3yo
93
who does duchenne and becker muscular dystrophy affect?
BOYS
94
when does becker start?
5-15 yo
95
what are clinical features of muscular dystrophy?
cardiomyopathy
calf hypertrophy
Gowers sign
96
what is gowers sign in muscular dystrophy?
when patient uses their legs to crawl up on themseleves to get up
97
what is myotonic muscular dystrophy?
features a delayed muscle relaxation after contraction
98
what are signs of myotonic dystrophy?
weakness and muscle wasting
frontal balding
temporal wasting
cataract
99
what is myotonia?
poor muscle relaxation after contraction
100
what is inheritance pattern of myotonic dystrophy?
AD
101
what is issue in ALS?
degeneration and loss of motor neurons
102
where is ALS focused in the SC?
anterior horn cells
103
do LMN or UMN get affected in ALS?
BOTH...clinical hallmark
104
what happens to muscles in ALS?
atrophy
105
what tract is most obviously affected in ALS?
lateral corticospinal
106
what is usual presentation of ALS?
limb weakness
107
does ALS involve cranial nerves?
yes..has bulbar involvement
108
what does bulbar involvement lead to in ALS?
dysphagia, dysarthria, difficulty chewing, dyspnea
109
what is Rx for ALS?
Riluzole
110
what is spinal muscular atrophy?
inherited anterior horn cell degeneration
111
who gets spinal muscular atrophy?
infants
112
what is presentation od spinal muscular atrophy?
floppy baby
113
what cells degenerate in spinal muscular atrophy?
anterior horn cells
114
what causes poliomyelitis?
polio virus
115
what is CNS destruction in poliovirus?
anterior horn of spinal Cord LMN!!
116
what is symptom of poliomyelitis?
LMN weakness
117
is poliomyelitis asym or sym?
symmetric
118
can you recover from polio?
yes
119
other than skeletal muscles what can be affected by poliomyelitis?
bulbar and respiratory muscles
120
are reflexes normal in neuropathy?
no
121
are reflexes normal in myopathy?
yes
122
are sensory changes seen in myopathy?
no
123
is neuropathy more distal or proximal?
more distal
124
is myopathy more distal or poximal?
proximal
