Flashcards in Peripheral neuropathies Deck (23)
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1
What is the MC hereditary disease of the PNS?
Charcot Marie Tooth
2
Presentation of Charcot Marie Tooth
Progressive loss of motor and sensory function of UE/LE
3
Physical exam findings in Charcot Marie Tooth
Pes cavus with:
1. Hammer toes
2. Foot drop
3. Stork leg
4
What is a positive stocking-glove distribution in diabetic neuropathy?
Burning, prickling pain, tingling
5
What is a negative stocking-glove distribution in diabetic neuropathy?
Feelings of numbness or deadness, "stocking glove" pattern
6
What is an early symptom of foot weakness/motor issues in diabetic neuropathy?
Foot slapping and toe scuffling
7
List some autonomic sx's in diabetic neuropathy
1. CV: Orthostatic hypotension
2. GI: Gastoparesis, N/V/D, constipation
3. GU: Incontinence
8
What dos the inability to perceive a tuning fork in a diabetic patient indicate?
increased risk for a foot ulcer
9
DTR physical exam findings in diabetic neuropathy
Hypoactive or absent DTRs
10
Nerve pain treatment in diabetic neuropathy
1. Gabapentin, Pregabalin
2. Tricyclic antidepressant
3. NSAIDs
11
Orthostatic hypotension treatment diabetic neuropathy
Alpha 1 agonist
12
Bladder dysfunction treatment in diabetic neuropathy
Oxybutnin
13
What causes Vitamin B12 deficiency?
1. Inadequate absorption=MC: Celiac dz, IBS
2. Inadequate intake: Vegans
3. Inadequate utilization: Liver d/o, enzyme deficiencies
4. Drugs: Metformin, NO,antacids
14
What is the classic triad of sx's in Vitamin B12 deficiency?
1. Weakness
2. Sore tongue
3. Paresthesia
15
Early stages of Vitamin B12 deficiency PN?
1. Decreased position and vibratory sense in extremities
2. Weakness
3. Hyporeflexia
16
Late stages of Vitamin B12 deficiency PN?
1. Spasticity, ataxia
2. Irritable/depressed
3. Paranoia: "Megaloblastic madness"
17
What is the initial test for diagnostic work-up in Vitamin B12 deficiency
Serum B12 (Cobalamin)
18
CBC findings in Vitamin B12 deficiency
Megaloblastic anemia
19
Why do we want to order folate in Vitamin B12 deficiency?
R/O Folate deficiency as these both cause Megaloblastic anemia
20
Schilling test
Dx intrinsic factor deficiency
21
Define "Wet" Thiamine B1 deficiency
Cardiovascular:
1. Peripheral edema
2. Tachycardia
3. JVD
4. SOB
22
Define "Dry" Thiamine B1 deficiency
Nerves:
1. Paralysis
2. Weakness
3. Confusion
4. Eye movements
5. Pain
23
