MSK path II Flashcards

1
Q

What is most common form paraneopkastic caused neuropathy

A

sensorimotor neuronopathy

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2
Q

paraneoplastic sensorimotor neuronopathy is most commonly assoc with what tumor

A

SCC, oat cell of lung

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3
Q

What tumors secrete IgM that could demyelinate nerves

A

waldenstrom macroglobulinemia

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4
Q

what other condition secretes Ig that could damage nerves

A

multiple myeloma

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5
Q

where are SCC located inlungs typically

A

central

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6
Q

perinuclear clearing

A

waldenstrom macroglobulinemia

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7
Q

what is it called when hurts between 2nd and 3rd digit toes

A

morton neuroma

traumatic nerve injury

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8
Q

What is name for hereditary motor and sensory neuropathie

A

charcot-marie-tooth disease

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9
Q

most common inherited peripheral neuropathy

A

CMT

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10
Q

clincal signs CMT

A

distal mm atrophy
sensory loss– lots of bruises and scrapes
foot deformities– pes cavus foot

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11
Q

damage to schwanna cells is called

A

demyelinating neuropathy

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12
Q

damage to axons is called what

A

axonal neuropathy

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13
Q

damage to central neurons is called what

A

neuronopathy

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14
Q

painless weakness in eyes

A

myasthenia gravis

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15
Q

autoAb in myasthenia

A

Ab against ACh R

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16
Q

what tumor is myasthenia assoc with

A

thymoma

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17
Q

hassels corpuscles

A

thymic gland

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18
Q

young myasthenic patient with thyroid abrnomality

A

thymic hyperplasia> thymoma

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19
Q

presentation myasthenia patient with Ab against muscle specific R tyrosine kinase

A

focal muscle involvement

neck, shoulder, facial, respiratory and bulbar

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20
Q

Dx myasthenia

A

Hx
PE
autoAb
electrophysiologic studies

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21
Q

Tx myasthenia

A

ACHE Inhibitors

22
Q

Tx thymoma in myasthenia patient

A

thymectomy

23
Q

Lambert Eaton Myasthenic Syndrome

A

autoimmune caused by Ab that block Ach release by inhibiting presynaptic Ca channel

24
Q

clinical difference myasthenia gravis and LEMS

A

LEMS gets better with time

myasthenia gets worse with time

25
why does LEMS get better with time
because more stimulation will get enough Ca out to cause action
26
LEMS assocaited with
neuroendocrine carcinoma of lung-- looks like ALL in child | usually SCC
27
what microbe produces botulinum toxin
clostridium botulinum | gram +
28
curare
blcok ACh R and cause flaccid paralysis
29
Sx botulism
``` double vision, blurred vision, droopy eyelids slurred speech difficulty swallowing dry mouth muscle weakness ```
30
genetic defects in NMJ lead to what
congenital myasthenic syndromes
31
characteristics of type I skel mm fibers
slow, high lipid content, red color from myoglobin, | high oxidative capacity (low glycolytic)
32
checkerboard pattern of skel mm fibers. darker are what type
II
33
clusters of atrophic muscle fibers
neurogenic
34
perifascicular atrophy in muscle fibers
dermatomyositis
35
type II mm fiber atrophy | normal type I fibers
prolonged corticosteroid therapy or disuse
36
disorders skel muscle happen how
myopathic injury or disrupting the muscle innervation
37
increased CK MM in blood
degeneration releasing cytoplasmic enzymes (part of myofiber necrosis) segmental myofiber degeneration and regneration
38
when is myofiber hypertophy seen
physiologic adaptation to exercise or in assoc with chronic myopathic conditions
39
cytoplasmic inclusions in mm
vacuoles, aggregates protesins, clustered organelles | all suggest myopathy
40
3 main primary inflammatory myopathies
polymyositis, dermatomyositis and inclusion body myositis
41
what immune mediated disorders can cause myositis
SLE, systemic sclerosis, sarcoidosis
42
muscle fiber surrounded by blue cells
lymphocytes = inflammatory myopathy
43
dermatomyositis
systemic autoimmune disease presents with proximal muscle weakness and skin changes (swollen hands and feet)
44
what occurs in dermatomyositis that leads to muscle injury
vasculitis small vessels
45
anti Mi2 Ab
Gottron papules and heliotrope rash, dermatomyositis
46
anti Jo1 Ab
interstitial lung disease, nonerosive arthritis and skin rash called "mechanics hands" Ab against histidyl t-RNA synthetase
47
anti P155/P140 Ab
against transcriptional regulators | assoc with paraneoplastic and juvenile dermatomyositis
48
myofiber atrophy accentuated at edges of fascicles
perifascicular atrophy
49
infiltrate rich in CD4 and C'5-9 in muscle fascicles
dermatomyositis
50
what movements are hardest in begining of dermatomyositis
getting up from chair and climbing because affect proximal muscles first
51
heliotrope rash
lilac colored discoloration of upper eyelids with periorbital edema and scaling erythematous eruption dusky red patches over knucles, elbows and knees (gottron papules)
52
associated conditions with dermatomyositis
dysphagia from esophageal mm | interstitial lung disease which can lead to death