Skeletal Muscle and Peripheral Nerve Pathology I Flashcards Preview

MSK Exam 1 Spring 2015 > Skeletal Muscle and Peripheral Nerve Pathology I > Flashcards

Flashcards in Skeletal Muscle and Peripheral Nerve Pathology I Deck (56):
1

looking for what in CSF

protein
inflammation

2

types of peripheral nerve injury

1 - axonal - trauma
2 - demyelinating - MS/GB
3 - neuronopathies - kill nerve body - polio

3

MBP

myelin basic protein
-role in myelin compaction

mutant forms - charcot marie tooth disease

demyelinating neuropathy - slow conduction

4

atrophy of leg muscle

polio

5

acute axonal injury

degeneration of distal axon

6

reinnervation of myofibers

myelinated by proliferating schwann cells

new internodes shorter and myelin sheath thinner

7

axonal degeration

loosened myelin layers
lipid droplet vaculoles

8

what does nerve follow to regenerate

myelin

9

mononeuropathy

affect single nerve

trauma, entrapment, infection

10

polyneuropathy

affect multiple nerves

symmetric fashion

stocking and glove distribution

11

mononeuritis multiplex

disease process damaging several nerves in haphazard fashion

vasculitis common cause

12

polyradiculoneuropathy

affect nerve root as well as peripheral nerve
-diffuse symmetric sx prox and distal parts of body

13

acute inflammatory demyelinating polyneuropathy

guillan barre

14

paralysis and areflexia, DTR gone, nerve conduction slow, CSF protein high, preceding acute flu-like illness

guillan barre

15

guillan barre infections

campylobacter jejuni
CMV
EBV
mycoplasma pneumonia
prior vaccination - no evidence

16

nerve biopsy

often lymphocytes

17

chronic guillan barre

2 months or more

doesn't get better

18

onion bulb neuropathy

demyelinzation

19

myelin basic protein

stain for myelin

20

ulnar deviation

rheumatoid arthritis

21

systemic autoimmune diseases with neuropathy

rheumatoid arthritis
sjogren
SLE

22

vasculitis

non-infectious inflammation of blood vessels - can involve and damage peripheral nerves

23

fibrinoid necrosis of vessels

polyarteritis nodosum

24

target lesion

lyme

25

pseudomembrane

diptheria

toxin causes neuropathy

26

most common cause of stocking glove peripheral neuropathy

diabetes

27

thin myelinated nerve, thick endometrial vessel, nodular sclerosis of glomerulus

diabetes

28

numbness, loss of pain sensation, difficulty with balance, paresthesia, dysthesia

distal symmetric diabetic polyneuropathy

leads to foot and ankle fractures, chronic skin ulcers

also - diabetics have autonomic dysfunction

postural hypotension, incomplete bladder emptying, sexual dysfunction

29

peripheral neuropathy in diabetic

has variable presentation

30

distal, symmetric neuropathy, asymptomatic or muscle cramp, distal dysesthesias, diminished DTRs

uremic neuropathy
-with chronic renal failure

axonal degeneration is primary event**

recovery after dialysis

31

compression mononeuropathy with distal symmetric sensory polyneuropathy

thyroid dysfunction - hypothyroid

32

vit B12 deficiency

pernicious anemia
-subacute combined degeneration with damage to long tracts in SC and peripheral nerves

33

peripheral neuropathy deficiency

B1 (thiamine)
B6 (pyridoxine)
folate
vit E
copper
zinc

34

uremic frost

white froth around mouth

with neuropathies

35

wernickes encephalopathy

image of brain lesion
-from thiamine deficiency**

36

toxic neuropathies

alcohol
heavy metals - lead, mercury, arsenic, thallium
medications - vinca alkaloids, taxanes, cisplatin

37

basophilic stippling on RBC

lead poisoning

can cause neuropathy

38

dots on hands with neuropathy

arsenic

39

direct infiltration of tumor to brachial plexus

pancoast tumor

40

paraneoplastic sensorimotor neuropathy

with small cell lung cancer

41

waldenstroms

B cell IgM immunoglobulins
-hyperviscosity an demyelinating peripheral neuropathy

42

periphera nerve injury/entrapment

carpal tunnel

43

2nd and 3rd toes neuropathy with trauma
-dancer

whartons neuroma

44

charcot marie tooth disease

sensory AND motor neuropathy

inherited genetic disorder**

45

distal muscle atrophy, sensory loss, foot deformity

CMT - charcot marie tooth disease

see bruising, cuts, abrasions - no symptoms - no sensation of pain**

46

pes cavus foot

with CMT 1

high arch and prominent metatarsal heads

47

painless weakness

with disorders of NMJ

48

myasthenia gravis

painless weakness**

autoimmune - Abs against AChR

49

associations with myasthenia gravis

thymoma / thymic hyperplasia
anti-AChR Abs

50

weakness that worsens with exertion

myasthenia gravis
also see diplopia and ptosis

51

tx of myasthenia gravis

acetylcholinesterase inhibitors

52

lambert eaton myasthenic syndrome

autoimmune disorder causing Abs that block ACh release by inhibiting presynaptic Ca channel

gets better with exertion**

53

myasthenia gravis vs. lambert eaton

MG - postsynaptic
LE - presynaptic

LE - better with exertion
MG - worse with exertion

54

association with lambert eaton

neuroendocrine carcinoma of lung
-small cell

55

CD8 T cells

polymyositis

56

CD4 T cells

dermatomyositis