Hancock Review Neuropathies

Question 1

DM neuropathy pattern:

Answer 1

Stocking and glove pattern- aka- distal symmetrical neuropathy- leads to ulcers burning nocturnal pain.
To: gabapentin, pregabalin, TCA.

Question 2

Herpes Zoster + Post herpatic neuropathy

Answer 2

Dermatome pain present before rash with vesicles show up follow one dermatome don’t cross over. TX: Gabapentin, pregabalin, duloxetine, carbamazapine.

Question 3

Vitamin B 6 deficiency in patients with TB

Answer 3

INH give Vitamin b 6

Question 4

Thiamine or Vitamin b1 deficiency

Answer 4

Wet- cardiac, lung chf in nature- responds well to tx
Dry- neurologic 
Found: ETOH, diets, bariatric surgery
*Cramping legs think deficiency 
To: Give thiamine

Question 5

Vitamin b12 cobalmin

Answer 5

Find: unsteady gait

Give vitamin b12 precursors

Question 6

Dm autonomic neuropathy

Answer 6

Impotence in men
Amputation
Gastropoeresis

Question 7

DM cranial nerves involved

Answer 7

Cranial nerve 3 oculomotor
Cranial nerve 4 and 5 trochlear and trigeminal
Findings: double vision, eye pain inability to adduct eye

Question 8

DM autonomic neuropathy lifestyle changes

Answer 8

Workout
Eat less badness
Foot care podiatry
Antiemetic

Question 9

MC small fiber neuropathy

Answer 9

DM- PAIN AND TEMP LOST

Question 10

Relapsing neuropathy

Answer 10

Porphyria

Question 11

MC inheritable neuromuscular disorder

Answer 11

Charcot Marie-tooth Dz

Question 12

Findings in Charcot Marie dz

Answer 12

High arch pues cavus, hammer toes, scoliosis FMHX

Question 13

Leprosy

Answer 13

Chronic granulomatous infectious dz affecting the skin and peripheral nerves incubation 3-7 years

Question 14

Causative agent of leprosy

Answer 14

Mycobacterium Leora

Question 15

Mode of transmission for leprosy

Answer 15

Nasal secretions

Question 16

Paucibacillary-Tuberculoid leprosy

Answer 16

Well demarcated dry patch with minimal disfigurations

Question 17

Tuberculoid leprosy tx:

Answer 17

Dapsone+ rifampine

Question 18

Lepromatous leprosy findings

Answer 18

Leon facial features thick, skin, loss of cartilage, saddle nose, claw hands

Question 19

Leprosy Leprosy tx:

Answer 19

Dapsone+rifampin+ clotazimine

Question 20

Diphtheria

Answer 20

Grey nastiness membrane in throat, descending paralysis

Tx: with abx and antitoxin

Question 21

Carpal tunnel = which nerve ?

Answer 21

Median nerve compression sx: numbness paresthesia in thumb, index and half of ring finer COMMON nocturnal awakening

Question 22

Tinnels sign

Answer 22

Tingling elicited when tapping over wrist with hammer or finger + = median nerve compression

Question 23

Phalens sign

Answer 23

Tingling elicited when wrists are flexed for 30-60 seconds + = median neuropathy

Question 24

Carpal tunnel TX

Answer 24

NSAID
Volar wrist splints
Surgical decompression

Question 25

Ulnar/ cuboidal syndrome

Answer 25

Sx: paresthesia Andy tingling at half of the 4th and entire 5th finger pain at elbow Test: tinnels at elbow To: elbow pads, avoid activity which aggravates

Question 26

Radial neuropathy

Answer 26

Wrist drop | Nerve winds down proximal humerus in spiral groove and proceeds lateral arm.

Question 27

Lateral demoral cutaneous neuropathy

Answer 27

Sx:pain and paresthesia at anterolateral thigh Compression to the femoral nerver and entrap ingunial ligament Increased pain when standing or walking relieve when sitting

Question 28

Perineal neuropathy

Answer 28

Foot drop | Helps to lose weight place ankle in brace

Question 29

Complex regional pain syndrome

Answer 29

Occurs after extremity trauma, burns, stroke, orthopedic surgeries Immobilization of the limb often proceeds sx

Question 30

Complex pain syndrome stage acute:

Answer 30

Hyperalgia exaggerated response to noicveptive stimuli out of proportion pain Edema Cold , hot limbs Tx: TCA, alendronate, prednisone

Question 31

Complex regional pain dytrophic stage:

Answer 31

Occurs 3-4 months after injury Burning pain Brawny firm edema Tx: capscasian, gabapentin

Question 32

Complex regional pain syndrome strophic stage:

Answer 32

``` Occurs 6 mo after insult Spread of pain Allodynia : pain with stimuli that is not painful Subcutaneous atrophy Tx: pain center, nerve blocks ```