3: Neurology - Muscular dystrophies Flashcards

1
Q

What are muscular dystrophies

A

Group of progressive disorders affecting musculoskeletal system

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2
Q

What are the three types of muscular dystrophies

A
  • Duchenne
  • Becker’s
  • Limb-Girdle
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3
Q

In which gender do muscular dystrophies occur and why

A

Males

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4
Q

What is the inheritance pattern of muscular dystrophies

A

X-linked recessive

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5
Q

What causes muscular dystrophy

A

Mutation in dystrophin gene

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6
Q

What type of mutation is present in duchenne muscular dystrophy

A

Frameshift

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7
Q

What type of mutation is present in becker’s muscular dystrophy

A

Point mutation

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8
Q

What age does duchenne muscular dystrophy occur

A

onsets 2-5 years

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9
Q

Where is weakness in duchenne muscular dystrophy

A

Proximal muscles

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10
Q

How will gait present in duchenne muscular dystrophy

A

Waddling

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11
Q

What are two signs seen in duchenne muscular dystrophy

A
  • Calf pseudo hypertrophy

- Gower’s manoeuvre

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12
Q

What is Gower’s manoeuvre

A

Individual uses their hands to walk themselves up their legs to standing

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13
Q

Why does calf pseudo hypertrophy occur

A

Replacement calf-muscle with fat

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14
Q

What is an early sign of duchenne muscular dystrophy

A

Delayed gross motor milestone - difficulty walking

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15
Q

What is duchenne muscular dystrophy associated with

A

Cognitive impairment

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16
Q

What is main cause of death in duchenne muscular dystrophy

A
  • Respiratory failure

- Dilated cardiomyopathy

17
Q

What is Becker’s muscular dystrophy

A

Presents similarly to duchenne muscular dystrophy however onsets after 15-years and is milder

18
Q

Explain progression in Becker’s muscular dystrophy

A

Milder and slower progression

19
Q

What is a more common association with Becker’s muscular dystrophy

A

Heart defects

20
Q

What is the role of the dystrophin protein

A

Holds cytoskeleton to ECM

21
Q

What happens in muscular dystrophy

A

Disruption in dystrophin causes muscle-cell necrosis which results in replacement with fat - causing it to appear large = pseudohypertrophy

22
Q

What is first-line for duchenne muscular dystrophy

A

Creatinine Kinase (CK)

23
Q

What is second-line for DMD

A

Genetic analysis

24
Q

When may a muscle biopsy be performed

A

Genetic analysis inconclusive

25
How will muscle biopsy present in DMD
Absent dystrophin
26
How will muscle biopsy present in BMD
Reduced dystrophin
27
How is DMD managed during the early-stages
- Physio - Orthoses - Corticosteroids - Vitamin D and Calcium supplements
28
What is the advantage of corticosteroids
Prolongs survival
29
What are individuals given in late-stage to aid with mobility
Electric wheelchair
30
What respiratory parameters should be monitored in DMD
Vital capacity
31
What is given to manage respiratory function in DMD
Non-invasive ventilation
32
What is offered from cardiology for DMD
Screening every 6-months
33
What may be seen on cardiac screening in DMD
Dilated cardiomyopathy
34
What is prognosis of DMD
Often survive until 20's, due to respiratory failure
35
What are complications of DMD
- Contractures - Resp Failure - GI: pseudoobstruction - Progressive failure resp muscles