MSK path I Flashcards
how do we measure actin and myosin
Creatinine kinase
mutations of myelin protein 0, peripheral myelin22 and periaxin
Charcot-Marie-Tooth disease
new nerves that were once destroyed have what different
shorter and thinner myelin
histo degenerating myelin
vaucoles
what is needed to regrow a nerve
lining by schwann cells/myelin
mononeuropathy
single nerve results in deficits in restricted distribution dictated by normal anatomy
common causes of mononeuropathy
trauma, entrapment and infections
polyneuropathies
involvement of many nerves usually symmetrically
characteristic pattern of polyneuropathy
ascending. stocking pattern
mononeuritis multiplex
disease that damages several nerves in haphazard fashion
right wrist drop from involved radial nerve and left foot drop from peroneal nerve damage
common cause of mononeuritis multiplex
vasculitis
polyradiculoneuropathies
affect nerve roots as well as peripheral nerves leading to diffuse symmetric Sx in proximal and distal parts of body
what are the inflammatroy neuropathies
gullain barre syndrome
chronic inflammatory demyelinating poly(radiculo)neuropathy
neuropathy associated with systemic autoimmune diseases
neuropathy associated with vasculitis
guillain barre is preceded by what most of the time
acute influenza like illness
which bacteria have been assoc with guillain barre
campylobacter, CMV,epstein barr, mycoplasma pneumonia, prior vaccination
clinical picture of guillain barre
ascending paralysis and areflexia
What do you check for on PE for guillain barre
loss of DTR and loss of pain sensation
nerve conduction study on guillain barre will show what
slowed because destruction of myelin segments
CSF protein levels in guillain barre
elevated from inflammation and altered permeability of microciruclation with spinal roots across subarachniod space
what cells are present on nerve Bx of guillain barre
lymphocytes
symmetrical sensorimotor polyneuropathy that persists for 2+ months
chronic inflamatory demyelinating polyradiculoneuropathy
onion bulb demyelinating
chronic inflammatory demyelinating polyneuropathy
what autoimmune diseases can be asssocaited with peripheral neuropathies
RA, sjogren, SLE
what type of inflammation can lead to neuopathy
vasculitis
what is polyarteritis nodosum
noninfectious inflammation of blood vessls that invovles peripheral nerves
fibrinoid necrosis with many eosinophils is associated with what process
vasculitis
what infections can cause neuropathies
leprosy HIV diptheria lymes varicella
black nodules on skin
kaposi sarcroma, HIV
pseudomembrane in mouth
diptheria
blisters in dermatome pattern
shingles, varicella zoster
most common cause peripheral neuropathy
DM
renal vasculitis assoc with DM
gomerulosclerosis
presentation DM polyneuropathy
sensory Sx: numbness, loss of pain sensation, difficulty with balance, paresthesias, dysthesiasj
neuropathy in DM patient at risk for
foot and ankle fractures and chronic skin ulcers, which can lead to amputations
DM autonomic neuropathy
postural hypotension
incomplete emptying o bladder
sexual dysfunction
common cc in DM autonomic neuropathy
sexual dysfunction, seeking viagra
uremic neuropathy
distal symmetric neutopathy from axonal degeneration and secondary demyelinations
presentation uremic neuropathy
muscle cramps, distal dysthesias, diminished DTRs
in renal failure
hypothyroidism can cause what neuropathies
compression mononeuropathies like carpal tunnel or sita symmetric sensory polyneuropathy
hyperthyroidism can cause what neuropathy
resembles guillain barre
Vit B12 deficiency neuropathy
subacute combined degereation with damage to long tracts in spinal cord, and peripheral nerves
What vitamine deficiencies have been associated with peripheral neuropathy
B1(thiamine) B6 (pyridoxine), folate, Vit E, copper and zinc
patient has renal failure and white dry skin all around mouth, what is this called
uremic frost
cystic degeneration with hemorrhage in alcoholic’s brain can be from what deficiency
B1 thiamine
What biologic toxins or therapeutic drugs can cause peripheral neuropathies
chemo drugs like vinca alkaloids and taxans
cisplatin-neuronopathy
microtubule inhibitors
alcohol, heave metals
what heavy metals can cause neuropathies
lead, mercury, arsenic and thalium
basophilic stipling in PBS
lead poisoning
black on hands, toxin?
arsenic
what malignancies can lead to neuropathies
direct compression of nerve
paraneoplastic
monoclonal gammopathies that can demyelinate
what tumor in apex of lung is known to cause compression of peripheral nn
pancoast
