Quiz 5 PNS

Question 1

Common causes of PNS neuropathies

Answer 1

vitamin deficiency, medications, systemic disease (diabetes), traumatic injury, alcohol

Question 2

axolemma

Answer 2

cell membrane surrounding the axon and maintains membrane potential of the neuron

Question 3

Wallerian degeneration

Answer 3

process that happens when a nerve fiber is cut or crush and nerve fiber is separated from neuron’s cell body

Question 4

most common cranial nerve neuropathy

Answer 4

Bell’s Palsy

Question 5

Bell’s Palsy

Answer 5

CN 7

• associated with HSV 1
• unilateral paralysis of entire face including mouth
• no loss of speach

Question 6

Difference between Bell’s Palsy and a stroke

Answer 6

Stroke: can move forehead, loss of speach

Bell’s: no loss of speach, can’t move forehead, can’t lift eyelid, can’t puff cheeks

Question 7

trigemminal neuralgia

Answer 7

• superior cerebellar artery compresses trigemminal nerve root.
• severe pain on face where trigemminal nerve runs

Question 8

oculomotor nerve palsy

Answer 8

maintain lateral and down gaze because trochlear and abducens nerves are in tact

Question 9

mononeuropathies of limbs

Answer 9

• carpal tunnel syndrome
• ulnar neuropathy
• brachial plexus neuropathy
• peroneal neuropathy
• meralgia parasthetica

Question 10

Carpal Tunnel

Answer 10

compression/entrapment of median nerve

first three digits and half of 4th (where median nerve runs)

Question 11

what do hypothenar eminence atrophy and thenar eminence atrophy indicate?

Answer 11

hypothenar: median nerve (carpal tunnel)
thenar: ulnar nerve

Question 12

meralgia paresthetica

Answer 12

lateral cutaneous nerve of thigh is compressed by the inguinal ligament

• pain, tingling, numbness
• common in obese patients

Question 13

3 CN mononeuropathies

Answer 13

CN 3 oculomotor nerve palsy
CN 5 trigemminal neuralgia (tic delarux)
CN 7 Bells Palsy

Question 14

mechanism of diabetic neuropathy related to hyperglycemia

Answer 14

hyperglycemia leads to accumulation of sorbitol and depletion of inositol

• decreased inositol Na, K, ATP-ase
• leads to decreased nerve function
• sorbitol holds water in which can affect nerves

Question 15

renal failure is most commonly associated with

Answer 15

axonal degeneration

Question 16

most common cause of immune inflammatory polyneuropathies in US

Answer 16

Guillain barre syndrome

- goes from feet up

Question 17

What polyneuropathy starts from the head and moves downward?

Answer 17

Botulism (descending paralysis)

Question 18

chronic inflammatory demyelinating polyrediculopathy

Answer 18

gradual onset
relapses and remits
macrophage cells strip away myelin
mimicks ascending paralysis of guillain barre
no respiratory involvement

Question 19

ethanol related neuropathy

Answer 19

distal, painful neuropathy

burning, stabbing pain

Question 20

In what population is peripheral neuropathy most common?

Answer 20

in diabetic patients

Question 21

B1/thiamine deficiency

Answer 21

beri beri
alcohol related
wernicke korsikoff syndrome

Question 22

B6 deficiency

Answer 22

toxicity of dorsal root ganglion

Question 23

B12 deficiency

Answer 23

megaloblastic anemia

Question 24

infectious diseases that can cause polyneuropathies

Answer 24

leprosy (Hanson’s disease)
HIV/AIDS
lyme
varicella zoster

Question 25

#1 viral pathology to affect PNS

Answer 25

Herpes Zoster

Question 26

hist leprosy (mycobacterium leprae)

Answer 26

red snapper | acid fast to see (doesn't take up gram stain well)

Question 27

Herpes Zoster

Answer 27

lives in dorsal root ganglion stress can cause it to come on usually unilateral involves 1-3 dermatomes

Question 28

lyme neuropathy vs bells palsy

Answer 28

bilateral facial neuropathy more common in patients with lyme disease

Question 29

Areas most commonly affected by herpes zoster

Answer 29

trigemminal (opthalmic) and thoracic dermatomes

Question 30

hist of herpes zoster

Answer 30

multinucleated giant cell

Question 31

sign that precedes opthalmic herpes zoster

Answer 31

Hutchinson's sign | - skin lesion on tip of nose

Question 32

complication of shingles that involves the eyes

Answer 32

herpes zoster oticus severe otalgia and cutaneous vesicular eruptions corneal ulceration

Question 33

what is herpes zoster oticus called when it is associated with facial paralysis?

Answer 33

Ramsey-Hunt syndrome

Question 34

benign primary intracranial tumor of myelin-forming glial cells of the vestibulocochlear nerve. - sensori-neuro hearling loss - disturbed balance - vertigo - N/V - pressure in ear

Answer 34

schwanomma (acoustic neuroma)

Question 35

common, benign spindle cell tumor of peripheral nerves

Answer 35

neurofibroma

Question 36

schwanomma on CN 8

Answer 36

vestibular schwannoma

Question 37

multiple neurofibromas

Answer 37

neurofibromatosis

Question 38

which type of neurofibromatosis is more common?

Answer 38

type 1 (90%)

Question 39

characteristics of type 1 neurofibromatosis

Answer 39

- usually unilateral | - cafe au lait spots

Question 40

mutation of what causes neurofibromatosis 1?

Answer 40

neurofibromin, a tumor suppressor gene

Question 41

type 2 neurofibromatosis

Answer 41

- bilateral - cause here loss by age 20 - mutation of protein merlin

Question 42

elongated cells in parallel bundles (like bundles of cables) | no atypia

Answer 42

perineuroma

Question 43

tumor that arises from major nerves in neck, forearm, lower leg, buttocks. - associated with neurofibromatosis - increased cells and mitotic figures

Answer 43

malignant peripheral nerve sheath tumor (MPNST)/malignant schwannoma