Paralysis

Question 1

botulism caused by what?

Answer 1

exotoxin, old cans, IVDA

Question 2

paralysis in botulism?

Answer 2

descending paralysis

Question 3

paralysis with CN palsy and dilated non reactive pupils?

Answer 3

botulism

Question 4

diagnosis of botulism?

Answer 4

EMG with progressively increased muscle fiber contraction

Question 5

weakness of GBS?

Answer 5

symmetric ascending weakness, loss of DTR

Question 6

other symptoms of GBS?

Answer 6

autonomic and sensory issues

Question 7

weakness with normal nerve conduction velocity? with decremental motor response to nerve stim

Answer 7

MG

Question 8

MG pupillary effects?

Answer 8

none

Question 9

treatment for MG?

Answer 9

pharesis removes the ach receptor ab, high dose steroids, pyridostigmine

Question 10

causes of critical illness myopathy? sx?

Answer 10

steroids/flaccid quadriparesis

Question 11

cause of critical illness polyneuropathy? sx?

Answer 11

sepsis/weakness, absent DTR, loss of distal sensation

Question 12

tx of CIM and CIP?

Answer 12

tight glucose contral, prevent secondary issues

Question 13

PE sign in spinal cord compression?

Answer 13

positive straight leg raise

Question 14

central cord syndrome limbs?

Answer 14

upper limbs worse than lower

Question 15

anterior cord syndrome location of injury

Answer 15

ASA occlusion

Question 16

b/l spastic paralysis with loss of temp and pain distal to lesion?

Answer 16

anterior cord syndrome

Question 17

loss of vibratory sense and proprioception, urinary retention?

Answer 17

posterior spinal cord

Question 18

causes of posterior spinal cord syndrome?

Answer 18

vertebral srtery dissection, MS

Question 19

ipsilateral weakness and loss of proprioception

contralateral loss of temp and pain

Answer 19

brown sequard syndrome- later half of the cord

Question 20

Miller fisher variant of GBS?

Answer 20

oculoparesis, ptosis, ataxia, areflexia

Question 21

tx of GBS?

Answer 21

IVIG or pharesis

Question 22

ticke borne paralysis sx?

Answer 22

tick needs to fed for 7 days first, also ascending paralysis

Question 23

MG sx? diagnosis?

Answer 23

ach receptor ab, proximal muscle weakness

Question 24

anti NMDA encephalitis association?

Answer 24

ovarian and testicular teratoma

Question 25

presentation of anti NMDA encephalitis?

Answer 25

young patient with paranoia or psychosis who deescalates to encephalopathy and seziures

Question 26

ascending paralysis complicated by areflexia and proprioception loss?

Answer 26

AIDP

Question 27

tx for AIDP?

Answer 27

plasmapharesis or IVIG

Question 28

tx for GBS?

Answer 28

IVIG or pharesis

Question 29

complications of IVIG?

Answer 29

anaphylaxis, aseptic meningitis, renal failure, fluid overload

Question 30

central cord syndrome cause? sx?

Answer 30

likely in setting of arthritis in older patients, loss of motor and sensory in arms and legs

Question 31

reversal of nondeploarizing NMB like cisatracurium?

Answer 31

neostigmine

Question 32

combat muscarinic effects of neostigmine?

Answer 32

glycopyrolate

Question 33

how does suggamadex work?

Answer 33

encapsulates NMBA in plasma and then creates a concentration gradiest to pull more out of muslce and eliminated via kidneys

Question 34

nutritional deficiency that can mimic GBS?

Answer 34

thiamine deficiecny- beriberi

Question 35

wernicke encephalopathy presentation?

Answer 35

vomiting, horizontal nystagmus, palsies of eye movement, fever, ataxia

Question 36

MIP and NIF threshold for MG?

Answer 36

>-20 NIF is bad, <40 on MIP bad, VC <15 cc/kg

Question 37

poor indicator for VC on MG assessment?

Answer 37

<20 cc/kg

Question 38

ice pack test for what?

Answer 38

improvement in ocular movement and proptosis, assessing for MG

Question 39

concern for excess pyridostigmine when treating MG?

Answer 39

cholinergic crisis

Question 40

treatment for MG

Answer 40

IVIG or pharesis for 5 days

Question 41

weakness with progressive decrement of action potentials with repetitive motion on electrophysiological studies?

Answer 41

MG

Question 42

weakness that will show electrophysiological with acute inflammatory demyelinating polyneuropathy

Answer 42

GBS

Question 43

cholingergic crisis in which of the weaknesses?

Answer 43

MG

Question 44

sx of cholingergic crisis in MG?

Answer 44

urinary retention, bradycardia, inc oral secretions, SLUDGE

Question 45

tx of cholingergic crisis in MG?

Answer 45

Supportive use atropine

Question 46

syringobulbia?

Answer 46

cysts in brainstem with gradual onset of motor, sensory, and autonomic sx

Question 47

when is it ok to use BIPAP in myasthenia crisis?

Answer 47

before the patient develops hypercapnia