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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

Thiamine B1 Deficiency treatment

1. Thiamine Replacement: 50 Imx several days, followed by 2.5-5 mg/day for maintenance
2. Brown rice