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Neuro - Pathology > Muscle and Nerve Diseases > Flashcards

Muscle and Nerve Diseases Flashcards

1
Q

symptoms of muscle disease

A 
weak skeletal muscle
short of breath (respiratory)
dysphagia
cariomyopathy
cramp, pain, stiffness
myoglobulinuria
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2
Q

signs of muscle disease

A

muscle wasting
normal or reduced tone
motor weakness

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3
Q

investigations that can be done in muscle disease

A

creatine kinase (enzyme of muscle, elevated when muscle damage)
electromyography (EMG)
muscle biopsy
genetic testing

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4
Q

muscular dystrophy is genetic/acquired

A

genetic

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5
Q

pathology of muscular dystrophy is an absence or defect of what protein

A

dystrophin - connects cytoskeleton to extracellular matrix

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6
Q

which MD is X linked

A

Duchenne’s MD

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7
Q

what is a channelopathy

A

a disorder of an ion channel. commonly those of Ca, Na, K or Cl

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8
Q 
familial hypokalemic periodic paralysis
hyperkalemic periodic paralysis
paramyotonia congenita
myotonia congenita
are all examples of what type of muscle disease
A

channelopathies

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9
Q

myotonia congenita only affects __ channels

A

Cl

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10
Q

paramyotonia congenita only affects __ channels

A

Na

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11
Q

what are metabolic muscle diseases

A

muscle cells aren’t able to metabolise fuel as well. symptoms are more caused by build up of unused metabolites than the weakness itself

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12
Q

types of muscle disease

A

metabolic
inflammatory
channelopathy
muscular dystrophy

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13
Q

how to treat inflammatory muscle disease

A

immunosuppression

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14
Q

myasthenia gravis is a disorder of what part of muscle

A

the neuromuscular junction

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15
Q

presentation of myasthenia gravis

A

FATIGUABLE WEAKNESS of limbs, eyelids, muscles of mastication, talking, breathing and eye muscles

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16
Q

eye symptom of myasthenia gravis

A

diplopia - from fatigued eye muscles

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17
Q

pathophysiology of myasthenia gravis

A

autoantibodies bind to ACh receptor

18
Q

serum antibodies in myasthenia gravis

A

anti-acetylcholine receptor antibody (ACh-R)

muscle specific receptor tyrosine kinase (MuSK)

19
Q

investigations in myaesthenia gravis

A

serum AChR and MuSK antibodies
CT for thymoma (15%)
neurophysiology test repetetive stimulation/jitter

20
Q

symptomatic treatment of myasthenia gravis

A

ACh-ase inhibitor

21
Q

treatment of myasthenia gravis

A

ACh-ase inhibitor
immunosuppression by prednisolone or azathioprine
thymectomy
immunoglobulin exchange

22
Q

what surgery may be useful in ~15% of myasthenia gravis

A

thymectomy

23
Q

what makes up peripheral nerves

A

sensory axons
motor axons
autonomic axons
myelin sheaths

24
Q

causes of peripheral neuropathy

A 
hereditary
diabetes
alcohol
B12 deficiency
HIV or leprosy
malignancy
guillain barre syndrome
chronic inflammatory demyelinating polyneuropathy
25
Q

symptoms of peripheral neuropathy

A

sensory and motor starting distally moving proximal

26
Q

symptoms from nerve root damage

A

reflex change
sensory change in dermatome
wasting of muscles innervated by that nerve

27
Q

what type of palsy is seen in MND

A

bulbar - difficulty chewing and talking

28
Q

pathophysiology of MND

A

degeneration of motor neurons in the anterior horn cells and motor cranial nuclei

29
Q

MND affects UMN/LMN

A

both - LMN signs usually predominate

30
Q

presentation of MND

A

fasciculations, wasting, weakness, increased tone, brisk reflexes

31
Q

true/false MND has sensory involvement

A

false - motor only

32
Q

true/false MND can have cognitive decline

A

true - in >10%

33
Q

prognosis of MND

A

50% die in 14 months

34
Q

treatment for MND

A

supportive for respiration, eating, mobility and speech
palliative
riluzole can be prescribed to

35
Q

what is myelopathy

A

injury to the spinal cord due to severe compression

36
Q

what is radiculopathy

A

range of symptoms from a nerve root being “pinched”

pain, weakness, numbness, tingling

37
Q

presentation of Guillain-Barre syndrome

A

weakness
pain
paraesthesiae
sensory loss starting in lower limb, reduced/absent reflexes
autonomic (reduced sweating, urinary hestitancy)

38
Q

what is Guillain-Barre syndrome

A

autoimmune demyelinating disease of PNS

39
Q

common history of Guillain-Barre syndrome

A

preceding infection of resp of GI tract. most commonly epstein barr virus, campylobacter, HIV and cytomegalovirus

40
Q

non-compressive causes of a spinal cord lesion

A

infarction, haemorrhage, transverse myelitis, HIV, polio, syphilis

41
Q

how does a ACh-ase inhibitor treat myaesthenia gravis

A

by preventing the breakdown of ACh at the neuromuscular junction

Neuro - Pathology (12 decks)

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