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Neuro Part 1 > Lecture 19+20 + DLA 22 > Flashcards

Lecture 19+20 + DLA 22 Flashcards

1
Q

calculate conduction velocity

A

D / T2-T1 for motor and sensory

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2
Q

poliomyelitis

A

Infection causing inflammation of the gray matter in the
spinal cord leading to paralysis.

lesions of the soma

due to virus

profound asymmetrical muscle weakness and signs of LMN lesions

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3
Q

clinical features of poliomyelitis

diagnosis?

A

extensive paralysis of the trunk may occur

muscle weakness
hyporeflexia
fasciculations

mid-cervical involvement (C3,4,5)

can diagnose by PCR

elevated WBC
elevated protein
glucose is normal

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4
Q

lesions of the schwann cells?

A

Guillain barre

diphtheria

demyelination due to autoimmune attack or toxins

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5
Q

lesions of the soma and or axon

A

Lou Gehrig’s disease

poliomyelitis

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6
Q

lesions of the synaptic cleft and end plate

A

botulism
alpha latrotoxin
beta bungarotoxin
curare

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7
Q

alpha latrotoxin

A

leads to the massive release of ACh by effecting presynaptic exocytotic proteins

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8
Q

beta bungarotoxin

A

provokes the release of ACh, then followed by the depletion of ACh by acting on proteins in nerve terminals (exocytosis)

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9
Q

botulism toxin

A

reduces the release of ACh by acting on presynaptic proteins

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10
Q

Curare

A

blocks the nAChRs

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11
Q

Lambert-Eaton Syndrome (LES)

A

A presynaptic disorder of the neuromuscular junction

the release of ACh is impacted

autoimmune disorder 
(Ab attack presynaptic voltage gated Ca channels)
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12
Q

characteristics of LES

A

muscle weakness
often found in those with pulmonary small cell cancers

less ACh is released

miniEPP is unchanged
reduced amplitude of EPP
‘waxing’ response is seen in EMG

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13
Q

therapy of LES

A

removal of tumor
immunosuppressive drugs

plasma exchange

give calcium gluconate to improve calcium influx

4-aminopyridine to prolong AP and improve transmitter release

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14
Q

Congenital Myasthenias

A

present at birth and show signs before the age of 2

  1. deficiency of ACh esterase
    EPP is larger and prolonged
  2. prolonged opening of channels
    ‘slow channel syndrome’
    prolonged opening of ACh channel

muscle weakness and fatigue

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15
Q

Myasthenia Gravis

A

chronic autoimmune disease

antibodies to nAChR (reduced NMJ transmission)

can be genetic

symptoms:
weakness of somatic muscles
fatigue
restoration after rest (acute)

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16
Q

EMG of MG?

A

waning (smaller lines to the right)

17
Q

Myotonia Congenita

A

mutation of the CICN1 chloride channel

the chloride channel defect leads to increased excitability

muscular hypertrophy can occur with little physical activity

18
Q

Duchenne Muscular Dystrophy

A 
X-linked recessive 
early childhood onset 
muscle weakness 
high CK levels 
calf hypertrophy

lack of dystrophin

19
Q

positive manifestations of PNS disorders

A

an excess or distortion of normal functions

fasciculations
paresthesia
pain

20
Q

negative manifestations of PNS disorders

A

total loss or diminution of normal function

paralysis or paresis
areflexia
anhidrosis
numbness

21
Q

neurapraxia

A

mild injury due to transient compression of stretch

22
Q

axonotmesis

A

injury associated with axonal degeneration

23
Q

neurotmesis

A

injury causing complete transection of the nerve

usually due to laceration

24
Q

carpal tunnel syndrome

A

median nerve compression at the wrist (Neurapraxia)

usually occurs in middle aged women, pregnancy, or hypothyroidism

swelling and reduction in tunnel size

25
Q

Acute Peripheral Neuropathy- GBS

A

guillian barre syndrome (ex)

elevated protein seen in lumbar puncture

ascending motor and sensory loss

26
Q

Chronic Peripheral Neuropathy- leprosy

A

leprosy (hansen disease)

affects the skin and peripheral nerves
wasting and muscle weakness

multi drug antibiotic treatment

27
Q

Chronic Peripheral Neuropathy- lead poisonings

A

motor neuropathy in adults
encephalopathy in children ( 6 and younger)

bilateral focal weakness
wasting of extensor muscles of fingers, wrist, and arms

28
Q

Chronic Peripheral Neuropathy- alcoholic peripheral neuropathy

A

reflects the neurotoxic effects of alcohol or deficiencies

sensory and motor loss, symmetrical

starts with sensory, then motor

nerve conduction is normal

29
Q

Chronic Peripheral Neuropathy- DM

A

many diabetics develop polyneuropathy (both types)

most common is distal symmetrical polyneuropathy

numbness, tingling, pain

30
Q

Charcot Neuropathic Osteoarthropathy

A

also known as charcot foot
usually due to diabetic neuropathy

can lead to bone destruction, subluxation, dislocation, deformity

rocker-bottom foot is seen

Neuro Part 1 (18 decks)

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