Module 4: Weakness 5

Question 0

Adult onset muscular dystrophy’s – diagnosis?

Answer 0

#Elevated CPK
#Myopathic ENG
#Biopsy shows of regenerating fibers of various sizes

Question 1

Adult onset muscular dystrophy – important forms?

Answer 1

#Limb-girdle dystrophy (proximal weakness  presenting in the 40s)
#Fascio-scapulohumeral (weakness in the face and shoulder girdle causing winged scapula)
#Oculopharyngeal (progressive paresis of EOMs)
#Myotonic (proximal and distal weakness associated with cataracts, balding, cardiac problems)

Question 2

Treatment of adult onset muscular dystrophy’s?

Answer 2

Supportive care

Question 3

Endocrine myopathies associated with? Symptoms? Diagnosis? Treatment?

Answer 3

Thyroid, parathyroid, adrenal disorders

Proximal weakness (if hypothyroid, muscle pain)

Elevated CPK

Treatment of underlying endocrine deficiency

Question 4

Most common causes of toxic myopathies? Diagnosis? Treatment?

Answer 4

#Glucocorticoids
#Statins
#Zidovudine
#Gemfibrozil

#Elevated CPK (normal in steroid myopathy)
#Acidosis
#Azotemia

Aggressive hydration to prevent renal failure

Question 5

Patient presents with painless proximal muscle weakness – likely toxin?

Answer 5

Steroids

Question 6

Neuropathic emergencies?

Answer 6

#Myasthenia Gravis crisis
#GBS
#Cauda equina

Question 7

Causes of neuropathy?

Answer 7

#Vascular - peripheral vascular disease
#Infections – Lyme, syphilis
#Neoplasm – paraneoplastic (anti-Hu), MGUS, Waldenström's
#Drugs – land, medications
# inflammatory – GPS, CIDP
#Metabolic – thyroid dysfunction, renal/hepatic failure