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FRACP short case > Basics and Upper limb neurology > Flashcards

Basics and Upper limb neurology Flashcards

1
Q

Grading of muscle power?

A 
0 = complete paralysis
1 = flicker of contraction
2 = movement without gravity
3 = movement with gravity only
4= Movement with gravity + some resistance
5 = nrmal
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2
Q

Signs of a LMN lesion?

A

Weakness
Wasting
Decreased/absent reflexes
Fasciculation

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3
Q

Signs of an UMN lesion?

A 
Weakness of muscle groups:
- upper limb = extensors
- lower limb = flexors
Spasticity
Hyperreflexia and extensor plantar response
Clonus
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4
Q

Causes of a peripheral neuropathy?

A 
Diabetes
Hereditary
Idiopathic
Drugs - isoniazid, cisplatin, vincristine
Toxins - heavy metals
Alcohol
Hypothyroidism
Porphyria
Vitamin B12 or B1 deficiency
Vitamin B6 excess
Guillain-barre syndrome
Carcinoma
Connective tissue disease - SLE
Vasculitis
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5
Q

Causes of a motor neuropathy?

A

Diabetes
Guillain-Barre syndrome
Chronic inflammatory demyelinating polyradiculoneuropathy
Lead poisoning
Multiple motor neuropathy
Porphyria
Charcot-marie tooth disease - sensory+motor

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6
Q

Causes of a sensory neuropathy?

A 
Diabetes
Carcinoma
Paraproteinaemia
Vitamin B6 intoxication
Vitamin B12 deficiency
Sjogrens
Syphilis
Idiopathic
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7
Q

Causes of a painful peripheral neuropathy?

A 
Diabetes
Alcohol
Vitamin B12 or B1 deficiency
Carcinoma
Porphyria
Arsenic or thallium poisoning
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8
Q

Nerve conduction study findings for peripheral neuropathy?

A 
Demyelinating = slow velocity --> increased latency
Axonal = decreased amplitude
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9
Q

Causes of mononeuritis multiplex?

A

Acute: - VASCULAR

  • Diabetes
  • Polyarteritis nodosa
  • SLE
  • RA

Chronic:

  • Multiple compressive neuropathies - joint deforming arthritis
  • Sarcoidosis
  • Acromegaly
  • Leprosy
  • Lyme disease
  • Idiopathic
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10
Q

Causes of thickened nerves?

A 
Hereditary motor and sensory neuropathy
Acromegaly
CIDP
Amyloidosis
Leprosy
Sarcoidosis
Neurofibromatosis
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11
Q

Causes of fasiculations?

A 
Benign idiopathic fasciculation
Motor neuron disease
Motor root compression
Malignant neuropathy
Spinal muscular atrophy
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12
Q

Features of Charcot Marie Tooth?

Hereditary motor and sensory neuropathy

A

Pes cavus - short, high arched feet with hammer toes
Distal muscle atrophy - to elbows and thighs
Absent reflexes
No sensory loss
Thickened nerves
Optic atrophy

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13
Q

Features of a complete brachial plexus injury?

A

LMN whole arm
Whole arm sensory loss
Horners syndrome

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14
Q

Features of upper Brachial plexis injury?
Erb-Duchenne lesion
C5-C6 lesion

A

Waiter’s tip pose
Loss of shoulder movement
Loss of elbow flexion
Sensory loss over the lateral aspect of the arm, forearm and thumb

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15
Q

Features of a lower brachial plexus injury?
Klumpke lesion
C8-T1 lesion

A

Claw hand - wasting and weakness of the hand
Paralysis of all intrinsic muscles of the hand
Sensory loss along the ulnar side of the forearm and hand
Horner’s syndrome

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16
Q

Features of cervical rib syndrome?

A

Claw hand
Sensory loss over the medial aspect of hand and forearm
Unequal radial pulses and BP
Subclavian bruit and loss of pulse on arm manoeuvring
Palpable cervical rib in the neck

17
Q

Features of a Radial nerve lesion?

C5-C6 lesion

A

Wrist and finger drop
Loss of elbow extension
Sensory loss over the anatomical snuff box

18
Q

Features of a medial nerve lesion

C6-T1 lesion

A

Loss of thumb abduction - LOAF muscles
Loss of index finger flexion
Sensation loss over thumb, index, middle and lateral ring finger

19
Q

Causes of carpal tunnel syndrome?

A 
Idiopathic
RA
Endocrine - hypothyroidism, acromegaly
Pregnancy
Trauma
Overuse
20
Q

Features of an ulnar nerve lesion?

A

Wasting of the intrinsic hand muscles except the thenar eminence (LOAF muscles)
Claw-like hand
Weak finger abduction and adduction
Loss of sensation to 5th and half of 4th finger

21
Q

Causes of hand wasting?

A

Nerve lesions
Hereditary motor and sensory neuropathy
Anterior horn disease - MND, spinal muscle atrophy, polio
Myopathy - dystrophia myotonica, distal myopathy
Spinal cord lesions - syringomyelia, cervical spondylosis
Disuse arthropathies
Ischaemia
Vasculitis

22
Q

Causes of myopathy?

A 
Hereditary muscular dystrophy
Paraneoplastic syndrome
EtOH
Connective tissue disease
Polymyositis
Endocrine - hypothyroid, hyperthyroid, cushings
Periodic paralysis
Osteomalacia
Steroids
Sarcoidosis
23
Q

Types of muscular dystrophy?

A 
Duchennes
Beckers
Limb girdle
Facio-scapulohumoral
Dystrophia myotonica
24
Q

Tests for myopathy?

A 
CK
EMG
Muscle biopsy
ECG
TTE

FRACP short case (11 decks)

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