Hon Review Flashcards

1
Q

What’s the most common anterior horn cell disease?

A

ALS

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2
Q

What do you expect to see or hear in the patient or in their history if they have ALS?

A

weakness, gait disturbance, clumsiness

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3
Q

what are you going to see on examination of a patient with ALS?

A

fasciculations (usually later in disease), objective muscle weakness, increased reflexes, babinski response, muscle atrophy

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4
Q

do you expect to see numbness or tingling or loss of sensation with ALS? Pain?

A

no and no

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5
Q

primary lateral sclerosis- is this upper or lower motor neuron?

A

upper

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6
Q

spinal muscular atrophy, is this primarily upper or lower motor neuron?

A

lower

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7
Q

what are the 2 basic areas of the spinal cord that are involved in motor neuron diseases-especially ALS?

A

anterior horn cell and the corticospinal tracts

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8
Q

2 important diseases of the NMJ?

A

myasthenia gravis and LEMS

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9
Q

is myasthenia gravis pre-synaptic or post-synaptic?

A

post synaptic

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10
Q

is LEMS pre or post synaptic?

A

pre synaptic

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11
Q

what is the typical presentation of a patient with myasthenia gravis?

A

ptosis and diplopia, fatigable weakness

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12
Q

if you do a nerve conduction on patients with MG what are you expecting?

A

~10% decrement

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13
Q

what is the blood test to look for MG?

A

AChR antibodies

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14
Q

what is the age distribution for MG?

A

bimodal: younger women and older men

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15
Q

What would the nerve conduction studies show in a patient with LEMS?

A

incremental response to exercise (big time increment)

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16
Q

How would a patient with LEMS present?

A

proximal muscle weakness, complains of getting out of chair, difficulty climbing stairs; they also have muscle pain; worst complaint: dry mouth; diminished DTRs

17
Q

LEMS tends to be classified as what?

A

a paraneoplastic syndrome

18
Q

what is the antibody that we look for if we are looking for LEMS?

A

VGCC antibodies

19
Q

LEMS is often discovered when patients are taking exogenous what?

20
Q

what does magnesium act as?

A

a false neurotransmitter

21
Q

what kinds of cancer do we typically see with LEMS?

A

small cell lung carcinoma or breast cancer

22
Q

what is the classic presentation of a diabetic with peripheral neuropathy?

A

predominantly sensory: burning, stinging, tingling feeling that usually starts in the toes or the soles/pads of the feet

23
Q

late, late, late in peripheral neuropathy of any kind you can get dysautonomia. What is this?

A

hypotension, urinary retention, or urinary urgency/frequency

24
Q

remember that generalized sensory motor peripheral neuropathy has the so-called what distribution?

A

stocking and glove distribution- usually starts in the feet

25
what is the definition of peripheral neuropathy?
weakness, sensory loss, and impairment of reflexes caused by diffuse lesion of peripheral nerves
26
when you have B12 deficiency it can cause what?
subacute combined degeneration
27
what is subacute combined degeneration?
both upper and lower motor neuron issue
28
what is typically affected in B12 deficiency?
the posterior columns
29
what might you see on the exam of a patient with a B12 deficiency? aka how do we check the posterior columns?
an abnormal romberg test -poor balance
30
what is the most common radiculopathy in the upper extremity and at what level?
C7 nerve root; C6-7 is the level
31
what is the most common mononeuropathy in the UE?
carpal tunnel