46 Diseases of the Peripheral Nerves

Question 1

The most frequent electrodiagnostic findings in GBS?

Answer 1

1. ) Reduction in the amplitude of muscle action potentials
2. ) Slowed conduction velocity
3. ) Conduction block in motor nerves
   p. 1324

Question 2

Acute motor axonal variety has tendency to be associated with which antibodies?

Answer 2

GM1 or GD1a

p.1325

Question 3

Pharyngeal-cervical brachial associated with which antibody

Answer 3

GT1a

p.1325

Question 4

Many patients with bizarre waking dreams or hallucinations after weeks of immobilization, seen in GBS

Answer 4

Oneiric hallucinations

p.1328

Question 5

Plasma Exchange in GBS

Answer 5

removes a total of 200 to 250ml/kg of plasma in 4 to 6 treatments

p.1329

Question 6

Dose of IvIg in GBS

Answer 6

0.4 g/kg per day for 5 days

Question 7

A fairly consistent predictor of residual weakness and muscle atrophy?

Answer 7

Reduced amplitude of muscle action potentials; Widespread denervation p.1330

Question 8

An acute or subacute symmetrical polyneuropathy frequently seen in critically ill and septic patients, particularly those with failure of multiple organs

Answer 8

Critical illness polyneuropathy

p.1330

Question 9

Findings in critical illness polyneuropathy

Answer 9

Primary axonal process with early denervation, and normal CSF

Question 10

The many systemic mediators of sepsis are toxic to the peripheral nervous system, _______________has been proposed as one such endogenous toxin causing neuropathy

Answer 10

Tumor Necrosis Factor p.1330

Question 11

2 main presentations in Acute Sensory neuronopathy

Answer 11

Limb ataxia with no dysarthria or nystagmus

Generalized facial and truncal numbness that involved proximal and distal sensory areas

p.1331

Question 12

Most salient identifying feature for gangliopathy

Answer 12

Early proximal symptoms

p.1331

Question 13

Electrophysiologic studies in acute sensory neuronopathy

Answer 13

Absent or slowed sensory conduction, no abnormalities in motor nerve conduction or signs of denervation p.1331

Question 14

A severe, rapidly advancing, symmetrical and mainly motor polyneuropathy-often with abdominal pain, psychosis and convulsions

Answer 14

Porphyric polyneuropathy p.1331

Question 15

Metabolic defect in acute porphyria

Answer 15

Defect in the liver, marked by increased production and urinary excretion of Porphobilinogen, and porphyrin precursor 🔺aminolevulinic acid p.1331

Question 16

Most characteristic features of porphyric neuropathy

Answer 16

Relapsing nature, acute onset, abdominal pain, psychotic symptoms, predominant motor neuropathy, often with bibrachial distribution of weakness, truncal sensory loss and tachycardia

p.1332

Question 17

Therapy for porphyric neuropathy

Answer 17

IV Glucose a s IV hematin (4mg/kg daily for 3-14 days) p.1332

Question 18

CA most related to paraneoplastic polyneuropathy

Answer 18

Small cell CA of lung p.1334

Question 19

Antibody in paraneoplastic polyneuropathy

Answer 19

Anti-Hu antibody or ANNA-1 antinuclear neuronal antibody p.1334

Question 20

Subacute neuropathy assoc with anemia, jaundice, brownish cutaneous pigmentation, hyperkeratosis of palms and soles, and later with white transverse banding of nails (Mees lines)

Answer 20

Arsenic polyneuropathy p.1335

Question 21

Pathology in arsenic polyneuropathy

Answer 21

Dying back-axonal degeneration type p.1335

Question 22

Acute or subacute evolution of complete or almost complete sensorimotor paralysis in the distribution of a single peripheral nerve

Answer 22

Mononeuritis multiplex p.1341

Question 23

Medical findings of anemia, basophilic stippling of red blood cell precursors in the bone marrow, colicky abdominal pain, constipation

Answer 23

Lead toxicity p.1335

Question 24

Blood lead level toxicity

Answer 24

more than 70 micorgram/dL

Question 25

Autoantibodies in polyarteritis nodosa

Answer 25

p-ANCA p.1342

Question 26

Autoantibodies in Wegener granulomatosis and Chrurg-Strauss

Answer 26

C-Anca p.1342

Question 27

Nerve most involved in Wegener Granulomatosis

Answer 27

Peroneal Nerve p.1342

Question 28

Triad of cranial nerve palsies, radiculitis and aseptic meningitis is characteristic of

Answer 28

Lyme disease/neuropathy p.1345

Question 29

Painful lumbosacral polyradiculitis

Answer 29

Bannearth syndrome/Lyme polyradiculitis p.1345

Question 30

Intense inflammatory reaction in the cauda equina giving rise to sciatic, buttock pain and bladder dysfunction

Answer 30

Bannwarth syndrome p.1345

Question 31

Treatment for Lyme neuropathic syndromes

Answer 31

IV ceftriaxone 2gram/day for 1 month p.1346

Question 32

More specific testing for Lyme disease

Answer 32

Western Blot test p.1346