HIGH YIELD Flashcards
DDx?
traumatic or entrapment neuropathy radiculopathy tarsal tunnel syndrome claudication morton neuroma
etiology?
DM
alcohol
cancer
drugs’HIV
pathophysiology?
hyperglycemia hyperlipidemia vascular larger sensory and motor ( mylineated) fibers affected small fiber (unmyelinated) affected
what are the neuropathic presentations?
sensory (loss of protective sensation); pins and needles
motor neuropathy
- intrinsic, muscle wasting
- extrinsic, atrophy of anterior compartment, contracture and stiffening of achilles tendon
autonomic neuropathy
- denervation of sympathetic nervous system, nerve hypoxia
- nitrous oxide
triad of ulceration?
neuropathy
deformity
trauma
what does the DM foot exam consist of?
musculoskeletal-hammer toes, equines
vascular-pulses (factor edema), temp, cft
dermatologic- xerotic skin, calluses, ulcers
what are the 5 neurologic assessment?
LOPS
- monofilament
- tuning fork
- pinprick
- ankle reflexes
- VPT-biothesiometer
what is this called?
nerve is stimulated and speed of impulse is measured
studies the median, ulnar, radial, femoral , peroneal, tibial nerves
indicates trauma, diabetic neuropathy, herniated discs, polyneuropathy, myasthenia gravis
nerve conduction velocity (NCV)
objective study, records electrical activity
determines sensory versus motor
focal, mulitfocal, generalized injury
electromyography
progressive and disabling motor and sensory findings
based on findings and diagnosis
sural and superficial peroneal nerves, most widely biopsied
nerve and muscle biopsy
treatment options based on?
glycemic control* pharmacologic - oral/topical evaluation and education -trauma -ill fitting shoes -thermal injuries -dry skin
what are the examples of pharmacological tx for peripheral neuropathy?
gabapentin (neurontin) pregabalin (lyrica) tricyclic antidepressants duloxetine (cymbalta) venlafaxine NSAIDs opiates lidocaine patch capsaicin biofreeze compound creams
