Intoxications and Deficiencies Flashcards
1) Isoniazid (TB medicine) associated with what deficiency? Manifestations?
Pyridoxine (B6). Distal numbness and tingling, diminished proprioception
4) Patient presents with headaches, bilateral papilledema, and has recently been taking acne medication. Diagnosis? Whats the medication and its effect?
Idiopathic intracranial hypertension from vitamin A excess.
Isotretinoin (acne med) known for increasing vitamin A levels which increased CSF production
5) Globus pallidus necrosis association? (This is random as shit)
Carbon monoxide exposure/poisoning. Think of mining accidents for example
8) Clinical manifestations of lead poisoning
Extremity weakness particularly involving extensor muscles
Abdominal pain, constipation, microcytic anemia
9) Patient regularly taking seizure medications comes in with ataxic gait, horizontal nystagmus, and dysmetria. Localization? Offending medications (2)?
Phenytoin, Carbamazapine
10) Atrophic gastritis associated with which deficiency? Manifestations?
B12 deficiency
Vibration and position sense impairment along with hyporeflexia
11) Prolonged TPN associated with what derangement and clinical manifestation?
Manganese toxicity
Parkinsonian-like symptoms: cogwheel rigiditiy. From Manganese accumulation in the basal ganglia
1) Innervation of interosseous muscles of the hand?
Essentially all ulnar nerve
2) Patient with positive straight leg raise and leg and back pain that gets better as patient leans forward. Diagnosis? Mechanism of pain?
Spinal stenosis caused by hypertrophy of ligamentum flavum
5) What is anterior interosseous syndrome? Manifestation? How do you test for it in the office?
Entrapment of the anterior interosseous nerve (branch of median nerve). Supplies radial half of flexor digitorum profundus and flexor polilicis longus
Test by asking patient to make an O with thumb and index finger. No sensory loss
6) Difference between Myasthenia Gravis and Eaton-Lambert syndrome? (Clinically and pathophysiology)
MG: Weakness occurs with repeated exertion. Ab to post-synaptic ACh receptors and neuromuscular junction
Eaton-Lambert: Weakness improves with repeated exertion. Ab to pre-synaptic calcium channels
9) Lower motor neuron signs?
Loss of deep tendon reflexes, fasciculations, more focal area of atrophy than upper motor neuron signs.
9) Hallmark signs in ALS?
Both upper and lower motor neuron signs, not easily localizable
10) Patients with tetralogy of fallot at increased risk for what dangerous neurological issue?
Brain abscess!! Holy shit!
13) Patient presents after an abdominal aortic aneurysm repair with absent lower extremity reflexes, absent pinprick sensation, but relatively intact vibratory & position sense. Diagnosis? Treatment?
Anterior spinal artery occlusion (spares the posterior columns)
Rx: high dose steroids!
