Exam 2- Martin's lectures (HA,Peripheral Nerve,Sz/Syncope)

Question 1

True or False.

Cranial nerves are peripheral nerves.

Answer 1

True
The peripheral nervous system is outside of skull and
vertebral column, and includes the cranial nerves.

Question 2

Autoimmune disorders tend to be ______________(asymmetrical or symmetrical)?

Answer 2

Symmetrical

Question 3

In Myasthenia Gravis weakness occurs in ___________(involuntary/voluntary) muscles around
the eyes, skeletal muscles, and diaphragm

Answer 3

Voluntary

Question 4

You should always think of what autoimmune disease when someone complains of diplopia, esp if it comes and goes.

Answer 4

Myasthenia Gravis

Question 5

____________ is the drug of choice for tx of Myasthenia Gravis. This med increases acetylcholine slowing the breakdown of Ach by acetylcholinesterase.

Answer 5

pyridostigmine (mestinon)

Question 6

Why is it vital to review a pt’s med list if you see that they have been dx with myasthenia gravis?

Answer 6

These pt’s cannot have certain medications like macrolides, beta-blockers, fluoroquinolones, quinines and more.

Question 7

Botulism is a toxin that causes _________ paralysis

Answer 7

descending

Question 8

_________ ________ Disease is an autoimmune disorder that causes ascending paralysis beginning in the limbs.

Answer 8

Guillain-Barre

Question 9

The following can be triggers for Guillain-Barre Dz, EXCEPT:
A. infection
B. vaccine
C. surgery
D. swimming

Answer 9

D. swimming

Question 10

_______________ is a bacteria thought to be linked

to guillain-barre disease. Where is this bacteria found?

Answer 10

Campylobacter jejuni

animal feces

Question 11

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.

Answer 11

high protein

normal WBC’s

Question 12

True or false? Guillain-Barre dz can become chronic.

Answer 12

True.
5% if Guillain Barre can become Chronic (Chronic
inflammatory demyelinating polyneuropathy)

Question 13

___________ is a “pins and needles” sensation

Answer 13

Paresthesia

Question 14

__________ is a burning/ painful/ uncomfortable sensation.

Answer 14

Dysesthesia

Question 15

________ is a pain sensation to non-painful stimuli (example DM neuropathy or fibromyalgia or migraine)

Answer 15

allodynia

Question 16

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

Answer 16

Large Fiber nerve

Question 17

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)

Answer 17

Small fiber nerve

Question 18

True or false? Most of the time there is a known/given cause for peripheral neuropathy.

Answer 18

FALSE.
Often peripheral neuropathy is idiopathic!!!
-Between 30 to 40 percent of the
remaining cases are idiopathic

Question 19

What is the most common cause for peripheral neuropathy in the US?

Answer 19

Diabetes

Question 20

_____________ is the most sensitive test for

peripheral neuropathy

Answer 20

Tuning fork

Question 21

True or false?

Hypothyroidism, Uremia, Alcoholism, Sepsis Chemotherapy, and B12 deficiencies can cause peripheral neuropathy.

Answer 21

TRUE these are all other causes of neuropathy besides DM or idiopathic

Question 22

________ and _________ are two infections that can cause peripheral neuropathies.

Answer 22

HIV/AIDS and Leprosy

Question 23

True or false? Leprosy is the most common cause of peripheral neuropathy WORLDWIDE.

Answer 23

True.

Question 24

How is leprosy transmitted?

a. blood
b. air
c. nasal secretions
d. all of the above

Answer 24

C. Transmission is via nasal secretions or close contact

Question 25

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?

Answer 25

Charcot Marie-Tooth

Question 26

Radial Mononeuropathy involves | the __________ and is also referred to as Saturday Night Palsy.

Answer 26

thumb

Question 27

Carpal Tunnel Syndrome causes | tingling/pain in your _______.

Answer 27

Palms

Question 28

Ulnar Nerve Palsy involves the _______.

Answer 28

Pinky

Question 29

_______ _________ neuritis is a musculoskeletal cause of arm weakness associated with over head movement

Answer 29

Brachial plexus

Question 30

_______ nerve palsies typically happens in Pregnancy

Answer 30

Peroneal

Question 31

_________is the most common cause of syncope.

Answer 31

Vasovagal

Question 32

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

Answer 32

b. drinking water

Question 33

True or false? People typically bounce back from a vasovagal episode in 12-15 mins.

Answer 33

False, They usu bounce back in 5 mins

Question 34

Postural hypotension is defined as a drop in systolic BP by ___ or a drop in diastolic BP by ___ after standing for 3 min

Answer 34

20 | 10

Question 35

Epilepsy means at least ___ seizures. a. 2 b. 3 c. 5

Answer 35

a.2

Question 36

True or false? Simple partial seizures do not affect your awareness

Answer 36

TRUE

Question 37

Symptoms of a __________ lobe seizure causes nausea and deja vu.

Answer 37

Temporal

Question 38

Symptoms of a __________ lobe seizure can cause personality changes

Answer 38

Frontal

Question 39

Postictal paralysis (Todd’s paralysis) occurs ______ (before/after) a seizure and can last 15 mins to 24 hours.

Answer 39

After

Question 40

Status epilepticus is when seizures last ________

Answer 40

more than 5 mins

Question 41

True or False? Anything that scars the brain can cause a seizure.

Answer 41

``` True Seizures can be caused by: Ischemic Strokes Head bleeds Tumors (Glioblastomas) Hippocampal sclerosis Atrophy (dementia) Traumatic brain injury ```

Question 42

True or False? EEG’s can catch a seizure disorder and can rule out a seizure disorder

Answer 42

False. EEG’s can catch a seizure disorder BUT CANNOT rule out a seizure disorder

Question 43

Why would it be valid to check a metabolic panel and glucose on a pt who had a seizure?

Answer 43

Low glucose, sodium, magnesium and calcium can | cause seizures! (Not potassium)

Question 44

TRUE OR FALSE? Psychogenic non-epileptic seizures are just “faking a seizure” and should be ignored.

Answer 44

False. Psychogenic non-epileptic seizures are not “faking a seizure” it is how the brain processes stress

Question 45

__________ is a seizure medication that is good for stress-related seizures, because it has mood-stabilizing properties and also helps with IQ.

Answer 45

Lamotrigine

Question 46

Lamotrigine should be started low and slow, because it can cause _______ ________ Syndrome in some pts.

Answer 46

Stevens Johnson Syndrome

Question 47

_______ is a good seizure med for inpatient use, because it acts fast and is mostly harmless.

Answer 47

Keppra

Question 48

_________ is another seizure medication, but is known to make pt's feel sleepy or forget their words.

Answer 48

Topomax

Question 49

Which two seizure drugs can be used in pregnant women?

Answer 49

lamotrigine and keppra