MUSCLE LESIONS Flashcards

1
Q

Pure Motor LMN Lesion
🧠⚡ANM ⚡

A

Anterior HORN Cell
NMJ
Muscle

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2
Q

Characteristics of NMJ Lesion
🧠⚡CDeF OP ⚡

A

⭐ Chewing Difficulty: MASSETER Muscle weakness
⭐ DIURNAL VARIATION (Fluctuating Weakness)
⭐ FATIGABILITY
⭐ Opthalmoplegia
⭐ Ptosis

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3
Q

ANTERIOR HORN CELL CHARACTERISTIC FEATURE
🧠⚡WADA FoR AHC⚡

A

⭐ Wasting and Atrophy Prominent
⭐ Distal > Proximal
⭐ ASYMMETRICAL WEAKNESS (U/L)
⭐ FASICULATIONS ➕
⭐ Reflexes ⛔

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4
Q

MUSCLE DISORDER CHARACTERISTIC FEATURE

A

⭐ SYMMETRICAL
⭐ PAINLESS
⭐ PROXIMAL > DISTAL (LIMB GIRDLE PATTERN)
⭐ WEAKNESS PREDOMINANT

⭐ REFLEXES ➕
⭐ FASICULATIONS ⛔

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5
Q

Difficulty in GETTING UP from SQUATTING POSITION
(OR)
WASHING CLOTHES
(OR)
CLIMBING STAIRS
(OR)
LIFTING OBJECTS FROM SHELF
(OR)
COMBING HAIR

REPRESENTS?

A

PROXIMAL WEAKNESS
-Muscle disorders

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6
Q

DIFFICULTY IN
✨ USING SCREWS
✨ OPENING LOCK
✨ MIXING FOOD
✨ EATING CHAPPATI
✨ GRIPPING CHAPPALS
REPRESENT?

A

Distal WEAKNESS

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7
Q

Pain SENSITIVE Structures of MUSCLE

A

⭐ Perimysium
⭐ EPIMYSIUM

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8
Q

PAIN INSENSITIVE Covering of MUSCLE

A

⭐ ENDOMYSIUM
Majority of muscle pathologies affect only endomysium

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9
Q

ACQUIRED MUSCLE DISORDERS

A

⭐ Acute to Subacute

  1. Inflammatory Muscle Disorders (Polymyositis, Dermatomyositis, Inclusion Body Myositis)
  2. Drugs and TOXINS
  3. ENDOCRINE
  4. INFECTIONS
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10
Q

INHERITED Structural PROTEIN MUSCLE DISORDERS
Pathology?

A

Structural PROTEIN Involvement
⭐ MUSCLE NECROSIS ➕
⭐ MUSCLE REPLACED BY ADIPOSE and FIBROUS DISEASE
⭐ CHRONIC PROGRESSIVE DISEASE

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11
Q

INHERITED Structural PROTEIN MUSCLE DISORDERS
Example
🧠⚡ DEMBELE FC ⚡
🧠⚡ all Es stand for the same disease⚡

A

Duchenne (XLR)
Emery Dreifuss (XLR/AD)
Myotonic (AD)
Becker (XLR)
Emery Dreifuss
Limb girdle (AD/AR)
Emery Dreifuss

Fascio-scapulo-humeral (AD)
Oculopharyngeal Muscle Dystrophy (AD)

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12
Q

INHERITED Contractile PROTEIN MUSCLE DISORDERS
(OR)
CONGENITAL MYOPATHIES
🧠⚡NCCC ⚡

A

⭐ PRESENT at BIRTH
⭐ Non-progressive / Slowly progressive

Example
✨ NEMALINE myopathy
✨ Central Core myopathy
✨ Centronuclear myopathy

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13
Q

INHERITED Metabolic PROTEIN MUSCLE DISORDERS

A

Symptoms are seen after EXERCISE
EXERCISE INTOLERANCE

-Carbohydrate MYOPATHIES
-Lipid MYOPATHIES
-Mitochondrial MYOPATHIES

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14
Q

MYOPATHIES Classification

A
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15
Q

EPISODIC MUSCLE WEAKNESS
🧠⚡ECM ⚡

A

⭐ Channelopathies
⭐ Metabolic Myopathies

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16
Q

PERSISTENT WEAKNESS

A

LONG-STANDING WEAKNESS: Dystrophies

ACUTE WEAKNESS: INFLAMMATORY MUSCLE DISEASE

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17
Q

POSITIVE SYMPTOMS OF MUSCULAR WEAKNESS
🧠⚡ M³C² ⚡

A

⭐ Myalgia
⭐ Myotonia
⭐ Myoglobinuria
⭐ Cramps
⭐ Contractures

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18
Q

NEGATIVE SYMPTOMS OF MUSCULAR WEAKNESS

A

⭐ Weakness
⭐ Fatigue
⭐ Exercise Intolerance
⭐ Muscle atrophy

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19
Q

ASYMMETRICAL MUSCLE WEAKNESS
🧠⚡In fashion ⚡

A

⭐ INCLUSION BODY MYOSITIS
⭐ FASCIO-SCAPULO-HUMORAL DYSTROPHY

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20
Q

Proximal UL and Proximal LL Weakness is seen in

A

MOST MUSCULAR LESIONS

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21
Q

Proximal UL and Distal LL Weakness is seen in
🧠⚡3 words in Name ➡️ Some ab normal ⚡

A

Fascio-Scapulo-Humeral Dystrophy

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22
Q

Distal UL and Proximal LL Weakness is seen in
🧠⚡DUL PaL Phones by MI ⚡

A

⭐ Myotonic DYSTROPHY
⭐ Inclusion Body Myositis

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23
Q

Opthalmoplegia ➕ Ptosis ➕ Dysarthria

A

⭐ Occulo-Pharyngeal Muscle Dystrophy
⭐ NMJ disorders

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24
Q

Ptosis ➕ FACIAL MUSCLE Involvement
(Without Dysarthria: Pharyngeal involvement ⛔)

A

MYOTONIC DYSTROPHY

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25
Q

ABNORMAL FATIGUABILITY AFTER TRIVIAL EXERCISE

CRAMPS and PAIN

HIGH COLOURED URINE

A

⭐ Metabolic MYOPATHIES
⭐ RHABDOMYOLYSIS

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26
Q

MYALGIA
≈ MUSCLE PAIN

A

⭐ RHEUMATOLOGICAL cause
⭐ ORTHOPEDIC Cause

⭐ Pain is not CLASSICALLY SEEN with MYOPATHY, but seen in:

✨ CONSTANT: INFLAMMATORY MUSCLE DISORDERS

✨ EPISODIC: Metabolic MYOPATHIES

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27
Q

NON-NEUROLOGICAL CAUSES OF MYALGIA

A

⭐ POLYMYALGIA RHEUMATICA
⭐ FIBROMYALGIA

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28
Q

MYALGIA WITHOUT ELEVATED ENZYMES and NORMAL ESR

A

Fibromyalgia

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29
Q

MYALGIA WITH ELEVATED ENZYMES and RAISRD ESR

A

Polymyalgia Rheumatica

30
Q

♀️ ➕ SEVERE MYALGIA

TRIGGER POINTS

FATIGUABILITY

NORMAL ENZYMES AND ESR

A

Fibromyalgia

31
Q

CRAMPS in MUSCLE DISORDERS

A

Rarely with MYOPATHY
Except
⭐ Duchenne Muscular Dystrophy

32
Q

⚡⚡ MOST COMMON CAUSE of MUSCLE CRAMPS

A

Dehydration

33
Q

Cramps: NON-NEUROLOGICAL

A
  1. Dehydration
  2. Hyponatremia
  3. Azotemia
  4. RENAL FAILURE
  5. Hypothyroidism
34
Q

NEUROLOGICAL CAUSES OF MUSCLE CRAMPS

A
  1. DMD
  2. MND Motor Neuron Disease (ALS)
35
Q

Difference BETWEEN CONTRACTURES and CRAMPS

A

CONTRACTURES
⭐ LONG LASTING
⭐ ELECTRICALLY SILENT

CRAMPS
⭐ SHORT ACTING
⭐ ELECTRICALLY ACTIVE

36
Q

CONTRACTURES in MYOPATHY

A

⭐ Emery Dreifuss Muscular Dystrophy
⭐ Metabolic Myopathy

37
Q

MYOTONIA in MYOPATHY

Myotonia is the delayed relaxation of a muscle after voluntary contraction or percussion.

A

⭐ MYOTONIC DYSTROPHY
⭐ MYOTONIA CONGENITA
⭐ CHANNELOPATHY: Hyperkalemic Periodic Paralysis

38
Q

Worsening of MYOTONIA with

Improvement of MYOTONIA with

A

Worsening of MYOTONIA with
⭐ COLD

Improvement of MYOTONIA with
⭐ EXERCISE

39
Q

Worsening of PARAMYOTONIA with

Improvement of PARAMYOTONIA with

A

Worsening of PARAMYOTONIA with
⭐ COLD
⭐ EXERCISE

Improvement of PARAMYOTONIA with
⭐ NOTHING

40
Q

Causes of PARAMYOTONIA

spells of muscle stiffness or when the muscles do not relax after contracting (myotonia). Symptoms can be triggered by exposure to the cold or after physical activity.

A

PARAMYOTONIA Congenita
Paradoxical MYOTONIA

41
Q

DISTAL MYOPATHIES
🧠⚡ WNM⚡

A

Welander: Late adult-onset DISTAL myopathy Type 1

Nonaka: Early adult-onset DISTAL myopathy Type 1

Miyoshi: Early adult-onset DISTAL Myopathy type 2

42
Q

AD Muscle Dystrophies

A

✨ Fascio-scapulo-humeral Dystrophy (AD)
✨ Oculopharyngeal Muscle Dystrophy (AD)
✨ LIMB Girdle MUSCLE Dystrophy
(AD/AR)
✨ Emery-Dreifuss Muscle Dystrophy
(XLR/AD)

43
Q

Only AR MUSCULAR DYSTROPHY

A

✨ LIMB Girdle MUSCLE Dystrophy
(AD/AR)

44
Q

XLR MUSCULAR Dystrophy

A
  1. Duchenne MUSCULAR dystrophy
  2. Becker’s MUSCULAR Dystrophy
  3. Emery-Dreifuss muscle Dystrophy
45
Q

GOWER SIGN is ➕ for

A

All PROXIMAL MYOPATHIES

46
Q

Duchenne MUSCULAR dystrophy vs BECKER’S MUSCULAR Dystrophy

A
47
Q

⚡⚡ MOST COMMON CAUSE of DEATH IN Duchenne MUSCULAR DYSTROPHY

A

ASPIRATION PNEUMONIA

Respiratory effects
✨ Nocturnal Hypoventilation
✨ Weak Cough
✨ Scoliosis: ILD
✨ Aspiration Pneumonia

48
Q

DEATH in Duchenne Muscular dystrophy seen by

A

16-18 yrs

49
Q

Wheelchair Bound in Duchenne Muscular dystrophy seen by

A

12 years

50
Q

⚡⚡ MOST COMMON CAUSE of DEATH IN BECKER’S MUSCULAR DYSTROPHY

A

Dilated CARDIOMYOPATHY

51
Q

⚡⚡ MOST COMMON type of ADULT-ONSET MUSCLE DYSTROPHY

A

Limb Girdle Muscle Dystrophy

52
Q

Limb Girdle Muscle Dystrophy
Types
🧠⚡CAVE LEne vale Dominant ⚡

A
53
Q

CARDIOMYOPATHY is PREDOMINANTLY seen in

A

⭐ BECKER’S
⭐ LIMB GIRDLE MUSCLE DYSTROPHY

54
Q

Type 2B LGMD
Protein?
Signs?

A

⭐ Dysferlin ➡️ Dysferlinopathy

SIGNS
⭐ Severe PROXIMAL weakness: BACK MUSCLES
⭐ DIAMOND on QUADRICEPS sign
⭐ DELTOID SPARING

55
Q

DIAMOND on QUADRICEPS sign

A

⭐ VASTUS LATERALIS is WASTED

⭐ VASTUS MEDIALIS is SPARED and HYPERTROPHIED

⭐ POSTERIOR COMPARTMENT of THIGH is WASTED

56
Q

DELTOID SPARING MUSCULAR DYSTROPHY

A

⭐ Type 2b Limb Girdle muscle Dystrophy
⭐ Fascio-scapulo-humeral muscle Dystrophy

57
Q

Humero-Peroneal MUSCULAR DYSTROPHY
Synonyms

A

Emery-Dreifuss MUSCULAR DYSTROPHY

58
Q

Emery Dreifuss MUSCULAR DYSTROPHY

A
59
Q

CARDIAC arrhythmias ARE ASSOCIATED WITH WHICH MUSCULAR DYSTROPHY?

A

Emery-Dreifuss muscle Dystrophy

60
Q

COATS DISEASE IS ASSOCIATED WITH WHICH MUSCULAR DYSTROPHY?

A

Fascio-scapulo-humeral muscle Dystrophy

61
Q

Chromosome involved in FSHD
🧠⚡Number of words = 4 ⚡

A

Chromosome 4q

62
Q

Fascio-scapulo-humeral muscle Dystrophy

A

⭐ Ptosis ➕ Facial Weakness
⭐ Proximal UL ➕ Distal LL weakness
⭐ ASYMMETRICAL weakness
⭐ WINGING of Scapula
⭐ Sparing of DELTOID
⭐ NO CARDIAC FEATURES
⭐ Associated with SNHL and Coat’s disease

63
Q

HATCHET FACIES
Seen in

A

Myotonic DYSTROPHY

64
Q

Trinucleotide Repeat in Myotonic DYSTROPHY

A

CTG

65
Q

Frontal Baldness seen in

A

Myotonic DYSTROPHY

66
Q

STRAIGHT/HORIZONTAL SMILE

A

Myotonic DYSTROPHY

67
Q

MYOTONIC DYSTROPHY
🧠⚡MyoTonIC Dystrophy ⚡

A
68
Q

PERCUSSION MYOTONIA
Seen in?
Meaning?

A

⭐ MYOTONIC DYSTROPHY

⭐ localized contraction which persists for FEW SECONDS and failure of RELAXATION

69
Q

Association of MYOTONIC DYSTROPHY

A
  1. Mental Retardation
  2. Cardiac conduction abnormalities
  3. CHRISTMAS TREE CATARACT
  4. GONADAL ATROPHY
  5. INSULIN RESISTANCE
  6. SNHL
70
Q

Selective ATROPHY of TYPR 1 MUSCLE FIBERS Seen in

A

MYOTONIC DYSTROPHY

71
Q

Drugs useful in MYOTONIC DYSTROPHY

A

⭐ PHENYTOIN
⭐ MEXELITINE