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CMT > Polyneuropathies & Mononeuritis Multiplex > Flashcards

Polyneuropathies & Mononeuritis Multiplex Flashcards

1
Q

Peripheral Diabetic Neuropathy

pathophys

A
  • due to late stage DM
  • damage to axons (worse at long nerves)
  • causes motor and sensory loss
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2
Q

Peripheral Diabetic Neuropathy

complication

A

vascular problems

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3
Q

Peripheral Diabetic Neuropathy

signs/sx

2

A
  • sensory: diminished sensation to pain, vibration, temp
  • stocking glove pattern
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4
Q

Peripheral Diabetic Neuropathy

PE findings

3

A
  • Semmes-Weinstein filament test
  • may have toe clawing
  • calluses and ulcerations on plantar skin over MT heads
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5
Q

Peripheral Diabetic Neuropathy

when does Semmes-Weinstein filament test indicate significant risk for injury?

A
  • cannot feel 5.07 size
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6
Q

Peripheral Diabetic Neuropathy

Dx

3 components

A
  • X-rays: show joint subluxation, subtle fractures, bone desctruction
  • monitor glucose
  • consider EMG/NCV to determine tarsal tunnel syndrome/diabetic neuropathy
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7
Q

Peripheral Diabetic Neuropathy

when does charcot arthropathy occur

A

occurs w/ prolonged neuropathy

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8
Q

Peripheral Diabetic Neuropathy

signs/sx of charcot arthropathy

4

A
  • collapse of arch
  • destabilization of midfoot joints
  • pt ends up with “rocker bottom foot” deformity
  • leads to ulcers on bottom of foot
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9
Q

Peripheral Diabetic Neuropathy

tx (non meds)

A
  1. improve glucose control
  2. shoe adjustments
  3. wound care for ulcers
  4. refer to podiatry for prevention
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10
Q

Peripheral Diabetic Neuropathy

medical tx

4

A
  • Nortriptyline and amitriptyline (tx pain & cause drowsiness)
  • gabapentin or pregabalin (tx pain but have abuse potential)
  • SSRIs may help
  • topical steroids may help (capsaicin or lidocaine)
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11
Q

Autonomic Diabetic Neuropathy

pathophys

A
  • damage to autonomic nerves by long term high blood glucose
  • can change BP, pulse, GI activity, bladder function, ED
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12
Q

Autonomic Diabetic Neuropathy

signs /sx

3 groups

A
  1. GI: n/v/d, constipation, gastroparesis, reflux, feel full
  2. GU: incomplete emptying of bladder, ED
  3. Circulatory: orthostatic hypotension
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13
Q

Autonomic Diabetic Neuropathy

tx

A
  • same as peripheral diabetic neuropathy
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14
Q

Carcot-Marie Tooth Disease

pathophys

A
  • inherited motor and sensory losses
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15
Q

Carcot-Marie Tooth Disease

differentiate type 1 vs type 2

A
  1. mutations in myeline protein genes
  2. axonal loss
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16
Q

Carcot-Marie Tooth Disease

signs/sx

4

A
  1. foot deformities causing abnormal gait
  2. muscle wasting in legs
  3. distal sensory loss in LE
  4. slight tremor in LE
17
Q

Carcot-Marie Tooth Disease

PE findings

3

A
  1. diminished or absent DTRs
  2. claw foot/high arch
  3. claw fingers
18
Q

Carcot-Marie Tooth Disease

dx

A

EMG/NCV

19
Q

Carcot-Marie Tooth Disease

tx

3

A
  1. no cure
  2. NSAIDs/acetaminophen for pain
  3. surgeries for deformities
20
Q

Guillain-Barre Syndrome

pathophys

A
  • acute, idiopathic polyneuropathy
  • follows infection, vaccine, surgery
21
Q

Guillain-Barre Syndrome

signs/sx

4 components

A
  • weakness (biggest complaint)
  • no sensory loss
  • bilateral, symmetric
  • begins in proximal legs, spreads to arms, then face
22
Q

Guillain-Barre Syndrome

dx

A
  • LP
  • EMG/NCV
23
Q

Guillain-Barre Syndrome

what will LP show

A

CSF has high protein count w/ normal cell count

24
Q

Guillain-Barre Syndrome

tx

A
  • not much for mild cases
  • plasmapheresis (early on)
  • ICU if problems breathing
  • clot prevention
25
Q

Guillain-Barre Syndrome

prognosis

A
  • life threatening if autonomic invovlement is severe
  • 20% of pts have permanent disabilities
  • 3% have relapses
  • almost all pts recover

CMT (72 decks)

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