Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro > CIDP, Thoracolumbar Injuries, Cauda Equina Syndr, -Myelitis > Flashcards

CIDP, Thoracolumbar Injuries, Cauda Equina Syndr, -Myelitis Flashcards

1
Q

Lambert-Eaton Myasthenic Syndrome:
Symptoms?
Reflexes??

A 
fatigue, weakness, myalgia, musc tenderness, stiffness
metallic taste and dry mouth
orthostasis
constipation
impotence

DTR absent or decr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lambert-Eaton Myasthenic Syndrome:

Treatment?

A
  1. evaluate for malignancy

2. Guanidine hydrochloride: inhibits mitochondrial Ca uptake -> Ach release (causes BM suppression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lambert-Eaton Myasthenic Syndrome gets (better/worse) with exercise

A

better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Myasthenia gravis vs Lambert-Eaton?

A
  1. MG has worse oculomotor symptoms + autonomic symptoms + weakness
  2. MG tx = antiAchAse + immunosuppressive drugs
  3. Electrodiagnostic abnormalities are more prominent in LEMS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Best marker for disease severity in Lambert-Eaton Myasthenic Syndrome?

A

Compound muscle action potential at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CAUDA EQUINA SYNDROME affects…

A

nerve roots below T10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CAUDA EQUINA SYNDROME signs/symptoms?

A
  • Multiple root involvement
  • Patchy/asymmetric LMN signs and sensory loss
    (saddle anesthesia, sexual dysf, loss of bladder or fecal control)
  • Bil loss of ankle reflexes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does CAUDA EQUINA SYNDROME occur?

A

traction and pelvic fractures following gunshot injuries, MVA, and falls from height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Disc prolapse symptoms?

A

LBP + weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should you MRI spine?

A

weakness + changed eflexes + radiculopathy signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Red Flags of myelopathy indicating MRI of spine (4):

A

loss of weight + night sweats + endemic areas + TTP on spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If no red flags associated with back pain?

A

give muscle relaxer/NSAID and see them in clinic (if come back w/ new Sx, order imaging)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute Myelopathy: signs/symptoms?

A
  • weakness
  • sensory loss below level of lesion
  • ANS dysfunction (urinary retention)
  • Anal sphincter tone + cremaster reflex + anal wink + bulbocavernosus response are lost or diminished
  • Urinary retention and bowel dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute Myelopathy: CSF?

A
  • Mild to moderate lymphocytic pleocytosis
  • incr protein
  • Normal or mildly decr glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Transverse Myelitis involves…

MC cause?

A

complete axial plane of cord = loss of all sensory/motor below lesion

viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Partial Myelitis results in…

A

Brown-Sequard Syndrome

  • Ispilateral UMN signs below lesion (CS tract)
  • Ipsilateral loss of tactile, vibration, proprioception sense (dorsal column) below lesion
  • C/L pain and T loss (ST tract) below lesion
  • LMN signs at level of lesion (flaccid paralysis)
17
Q

If above T1, Partial Myelitis results in…

A

Horner’s

18
Q

Partial Myelitis:
acute phase?
chronic phase?

A

Acute Phase: tone and reflexes of affected limb

Chronic Phase: spasticity w/ pathologic reflexes in the affected limbs

19
Q

In Partial Myelitis, sensory loss is usually…(in relation to lesion)

A

1-2 levels below actual cord lesion

20
Q

Viruses causing LMN weakness

A

polio
west nile
enterovirus

21
Q

Symptoms of Poliomyelitis?

A
  • acute, asymm weakness in legs > thoracic/abd/bulbar musc
  • decr tone
  • lost reflexes
  • bladder dysf in acute phase

**sensory is spared

22
Q

CSF in Poliomyelitis?

A
  • mild-mod lymphocytic pleocytosis (10-1000cells/mm3)
  • incr prot (100-500 mg/dL)
  • nl/mild decr glc
23
Q

Dx of Poliomyelitis?

A
  • viral PCR + ab titer
  • incr IgG
  • CSF
  • MRI (affected areas swollen and enhanced w gadolinium on T1; high signal on T2)
24
Q

Tx of Poliomyelitis?

A
  • Acyclovir for (3): EBV, VZV, HSV
  • Ganciclovir/foscarnetforCMV
  • Tx chronic spasticity = baclofen +/- BZDs +/- tizanidine
25
Q

When is IA TPA given?

A

between 4.5 - 6h

26
Q

If pt does not meet TPA criteria, give…

A

asa

27
Q

When should mechanical embolectomy be performed?

A

Up to 8 hr in the anterior circulation

Beyond 8 hrs in basilar artery stroke = patient will be posturing need to go after with IA TPA

28
Q

What should be given when >8h (out of TPA window)?

A

antiplatelets

29
Q

TPA inclusion criteria?

A

“SCANT 1/3”

  • Several TIAs (but must count from the last time he came back to normal)
  • Clinical dx stroke
  • Age > 18 yo
  • Non-contrast CT performed
  • Time of onset
  • < 1/3 dist. Of MCA (or other artery)
30
Q

TPA exclusion criteria?

A
  • NIH score 185/100
  • > 1/3 of MCA (hypodenity on CT)
  • platelets pericardial tamponade
  • etc…
31
Q

Coma:

intubate if GCS is …

A

<8

32
Q

If pt does not meet TPA criteria, give…

A

asa

33
Q

What should be given when >8h (out of TPA window)?

A

antiplatelets

34
Q

TPA exclusion criteria?

A
  • NIH score 185/100
  • > 1/3 of MCA (hypodenity on CT)
  • platelets pericardial tamponade
  • etc…
35
Q

Coma:

intubate if GCS is …

A

<8

Neuro (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions