Exam 2- Martin's lectures (HA,Peripheral Nerve,Sz/Syncope) Flashcards
True or False.
Cranial nerves are peripheral nerves.
True
The peripheral nervous system is outside of skull and
vertebral column, and includes the cranial nerves.
Autoimmune disorders tend to be ______________(asymmetrical or symmetrical)?
Symmetrical
In Myasthenia Gravis weakness occurs in ___________(involuntary/voluntary) muscles around
the eyes, skeletal muscles, and diaphragm
Voluntary
You should always think of what autoimmune disease when someone complains of diplopia, esp if it comes and goes.
Myasthenia Gravis
____________ is the drug of choice for tx of Myasthenia Gravis. This med increases acetylcholine slowing the breakdown of Ach by acetylcholinesterase.
pyridostigmine (mestinon)
Why is it vital to review a pt’s med list if you see that they have been dx with myasthenia gravis?
These pt’s cannot have certain medications like macrolides, beta-blockers, fluoroquinolones, quinines and more.
Botulism is a toxin that causes _________ paralysis
descending
_________ ________ Disease is an autoimmune disorder that causes ascending paralysis beginning in the limbs.
Guillain-Barre
The following can be triggers for Guillain-Barre Dz, EXCEPT: A. infection B. vaccine C. surgery D. swimming
D. swimming
_______________ is a bacteria thought to be linked
to guillain-barre disease. Where is this bacteria found?
Campylobacter jejuni
animal feces
If a pt has Guillain-Barre dz, their lumbar puncture would show ______ (high/low/normal) level of protein and a _______ (high/low/normal) level of WBC’s.
high protein
normal WBC’s
True or false? Guillain-Barre dz can become chronic.
True.
5% if Guillain Barre can become Chronic (Chronic
inflammatory demyelinating polyneuropathy)
___________ is a “pins and needles” sensation
Paresthesia
__________ is a burning/ painful/ uncomfortable sensation.
Dysesthesia
________ is a pain sensation to non-painful stimuli (example DM neuropathy or fibromyalgia or migraine)
allodynia
If a pt had the following s/sx's, they would likely have which form of peripheral neuropathy? Pins and needles Lost of joint position (proprioception) Loss of vibration Loss of reflexes
Large Fiber nerve
If a pt had the following s/sx's, they would likely have which form of peripheral neuropathy? Burning pain Can have normal reflexes Can affect autonomic function (BP, pulse)
Small fiber nerve
True or false? Most of the time there is a known/given cause for peripheral neuropathy.
FALSE.
Often peripheral neuropathy is idiopathic!!!
-Between 30 to 40 percent of the
remaining cases are idiopathic
What is the most common cause for peripheral neuropathy in the US?
Diabetes
_____________ is the most sensitive test for
peripheral neuropathy
Tuning fork
True or false?
Hypothyroidism, Uremia, Alcoholism, Sepsis Chemotherapy, and B12 deficiencies can cause peripheral neuropathy.
TRUE these are all other causes of neuropathy besides DM or idiopathic
________ and _________ are two infections that can cause peripheral neuropathies.
HIV/AIDS and Leprosy
True or false? Leprosy is the most common cause of peripheral neuropathy WORLDWIDE.
True.
How is leprosy transmitted?
a. blood
b. air
c. nasal secretions
d. all of the above
C. Transmission is via nasal secretions or close contact
If a pt’s leg(s) appear like Inverted champagne bottles this is a hallmark sign of what commonly inherited neurologic disorder that leads to peripheral neuropathy?
Charcot Marie-Tooth
Radial Mononeuropathy involves
the __________ and is also referred to as Saturday Night Palsy.
thumb
Carpal Tunnel Syndrome causes
tingling/pain in your _______.
Palms
Ulnar Nerve Palsy involves the _______.
Pinky
_______ _________ neuritis is a musculoskeletal cause of arm weakness associated with over head movement
Brachial plexus
_______ nerve palsies typically happens in Pregnancy
Peroneal
_________is the most common cause of syncope.
Vasovagal
All of the following are causes for a vasovagal syncopal episode EXCEPT:
a. Having a bowel movement
b. Drinking water
c. Pain
d. Standing for a long time
b. drinking water
True or false? People typically bounce back from a vasovagal episode in 12-15 mins.
False, They usu bounce back in 5 mins
Postural hypotension is defined as a drop in systolic BP by ___ or a drop in diastolic BP by ___ after standing for 3 min
20
10
Epilepsy means at least ___ seizures.
a. 2
b. 3
c. 5
a.2
True or false? Simple partial seizures do not affect your awareness
TRUE
Symptoms of a __________ lobe seizure causes nausea and deja vu.
Temporal
Symptoms of a __________ lobe seizure can cause personality changes
Frontal
Postictal paralysis (Todd’s paralysis) occurs ______ (before/after) a seizure and can last 15 mins to 24 hours.
After
Status epilepticus is when seizures last ________
more than 5 mins
True or False? Anything that scars the brain can cause a seizure.
True Seizures can be caused by: Ischemic Strokes Head bleeds Tumors (Glioblastomas) Hippocampal sclerosis Atrophy (dementia) Traumatic brain injury
True or False? EEG’s can catch a seizure disorder and can rule out a seizure disorder
False.
EEG’s can catch a seizure disorder BUT CANNOT rule
out a seizure disorder
Why would it be valid to check a metabolic panel and glucose on a pt who had a seizure?
Low glucose, sodium, magnesium and calcium can
cause seizures! (Not potassium)
TRUE OR FALSE? Psychogenic non-epileptic seizures are just “faking a seizure” and should be ignored.
False. Psychogenic non-epileptic seizures are not “faking a seizure” it is how the brain processes stress
__________ is a seizure medication that is good for stress-related seizures, because it has mood-stabilizing properties and also helps with IQ.
Lamotrigine
Lamotrigine should be started low and slow, because it can cause _______ ________ Syndrome in some pts.
Stevens Johnson Syndrome
_______ is a good seizure med for inpatient use, because it acts fast and is mostly harmless.
Keppra
_________ is another seizure medication, but is known to make pt’s feel sleepy or forget their words.
Topomax
Which two seizure drugs can be used in pregnant women?
lamotrigine and keppra
