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Year 2- CNS > Muscle & Nerve Disease > Flashcards

Muscle & Nerve Disease Flashcards

1
Q

Which type of energy does muscle receive and what does it convert it into?

A

Chemical energy -> mechanical energy

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2
Q

In muscle disease, which symptoms would a patient present with?

A

Weakness of skeletal muscle
Cardiac symptoms
Cramps/muscle pain
Muscle stiffness
Myogloburia

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3
Q

Myogloburia?

A

Breakdown product of muscle in the urine suggesting muscle is being broken down

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4
Q

How will muscle disease present in babies?

A

Floppy, poor suck/feeding, failure to thrive

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5
Q

Are muscle diseases purely motor or sensory?

A

Motor
-> do not get sensory symptoms

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6
Q

Which investigations may be carried out to diagnose someone with muscle disease?

A

History and examination
Bloods
Electromyography (EMG)
Muscle biopsy
Genetic testing

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7
Q

What would be looked at in bloods in someone with suspected muscle disease?

A

Creatine kinase

->maybe remember that all gym lads take creatine for muscle

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8
Q

If muscle is damaged, what will creatine kinase levels be like?

A

Elevated

-> creatine kinase is a an enzyme produced when there is muscle damage

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9
Q

There are congenital and acquired causes of muscle disease.
Congenital causes tend to affect the components of muscle.
If there were congenital contractile issues, what might occur?

A

Congenital myopathies

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10
Q

There are congenital and acquired causes of muscle disease.
Congenital causes tend to affect the components of muscle.
If there were congenital structural issues, what might occur

A

Muscular dystrophies

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11
Q

There are congenital and acquired causes of muscle disease.
Congenital causes tend to affect the components of muscle.
If there were congenital coupling issues, what might occur?

A

Channelopathies

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12
Q

There are congenital and acquired causes of muscle disease.
Congenital causes tend to affect the components of muscle.
If there were congenital energy issues, what might occur?

A

Metabolic myopathies

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13
Q

Which electrolyte disturbance can cause muscle weakness?

A

High or low levels of potassium

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14
Q

Which vitamin deficiency can cause muscle weakness?

A

Vitamin D

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15
Q

Inflammatory muscle diseases are usually autoimmune. Which two types are there?

A

Polymyositis
Dermatomyositis

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16
Q

What inflammation is present in polymyositis?

A

Inflammation of muscle alone

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17
Q

What inflammation is present in dermatomyositis?

A

Inflammation of skin and muscle

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18
Q

How do inflammatory muscle diseases present?

A

Muscle weakness, rash and pain

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19
Q

What is the treatment for polymyositis and dermatomyositis?

A

Immunosuppression

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20
Q

What would be seen in bloods of someone with an autoimmune inflammatory muscle disease, like polymyositis or dermatomyositis?

A

High creatine kinase
Autoantibodies

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21
Q

Which type of inflammatory autoimmune muscle disease is associated with underlying tumour?

A

Dermatomyositis

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22
Q

Which investigations may be carried out to diagnose polymyositis and dermatomyositis?

A

Bloods
Tumour screen- especially in dermatomyositis
EMG
Biopsy

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23
Q

Which enzyme breaks down acetylcholine?

A

Cholinesterase enzyme

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24
Q

What is myasthenia gravis?

A

Rare long-term condition that causes muscle weakness

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25
Q

What is the clinical presentation of myasthenia gravis?

A

Fatigable weakness

->patients complain they get weaker as the day goes on or continue with muscular activity

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26
Q

There are two forms of myasthenia gravis. Name them.

A

Ocular myasthenia gravis.
Generalised myasthenia gravis.

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27
Q

What are the symptoms of ocular myasthenia gravis?

A

Ptosis
Diplopia

28
Q

What are the investigations used to diagnose myasthenia gravis?

A

Assess for ACh receptor or anti-MuSK antibodies in blood
Neurophysiology- EMG
CT chest

29
Q

What is the symptomatic treatment for myasthenia gravis?

A

Cholinesterase inhibitors

30
Q

What is the disease-modifying treatment for myasthenia gravis?

A

Immunoglobulin/plasma exchange
Steroids
Steroid sparing immunosuppression
Thymectomy

->these all try to get rid of the antibody causing the effects

31
Q

Name the two components of a peripheral nerve.

A

Lower motor neuron component
Sensory neuron component

32
Q

There are small and large sensory fibres in peripheral nerves. Which fibres carry pain and temperature?

A

Small fibres

33
Q

There are small and large sensory fibres in peripheral nerves. Which fibres carry joint position sense and vibration?

A

Large fibres

34
Q

RECAP- what is the function of the myelin sheath?

A

Wraps around axons to speed up electrical conduction down myelinated nerves

35
Q

If there is damage to the nerve root, this can cause root disease. What is a common cause of root disease?

A

Degenerative disc disease

36
Q

How may a single peripheral nerve get damaged?

A

-If it gets trapped or compressed (e.g. ulnar nerve getting trapped to give ulnar neuropathy or median nerve getting trapped to give median neuropathy)
-If you damage a nerve’s blood supply

37
Q

Will a generalised peripheral neuropathy affect motor or sensory components of the nerve?

A

Either or both

38
Q

In generalised peripheral neuropathy, which components of the peripheral nerve can get damaged?

A

Axonal component
Myelin sheath

39
Q

What are the most common causes of generalised peripheral neuropathy?

A

Alcohol
Diabetes

40
Q

Are inflammatory autoimmune generalised peripheral neuropathies usually axonal or demyelinating?

A

Demyelinating

41
Q

Give an example of an acute inflammatory autoimmune generalised peripheral neuropathy.

A

Guillain Barre syndrome

42
Q

Give an example of an chronic inflammatory autoimmune generalised peripheral neuropathy.

A

Chronic inflammatory demyelinating polyneuropathy

43
Q

What are some of the sensory symptoms of peripheral nerve diseases?

A

Loss of sensation/abnormal sensation
Pain

44
Q

What are some of the motor symptoms of peripheral nerve disease?

A

Muscle thinning and weakness

45
Q

What are some of the autonomic symptoms of peripheral nerve disease?

A

Skin changes e.g. discoloration/altered sweating
Blood pressure
Bowel and bladder changes

46
Q

Give some examples of sensory signs of peripheral nerve disease.

A

Reduction in light touch, temperature, joint position, vibration sensation.

47
Q

Will the motor signs in peripheral nerve disease be upper or lower motor neuron signs?

A

Lower motor neuron

48
Q

Which signs would you expect to see in someone with lower motor neuron damage?

A

Muscle wasting
Loss of tendon reflexes
Loss of muscle tone
Muscle fasciculations

49
Q

Which nerve gets damaged in carpal tunnel syndrome?

A

Median nerve

50
Q

In generalised peripheral neuropathies, are the effects initially distal or proximal?

A

Distal- effect feet first

51
Q

Which investigations may be carried out when suspecting someone of having peripheral nerve disease?

A

Blood tests
Nerve conduction studies
Lumbar puncture
Nerve biopsy
Genetic analysis

52
Q

What is the treatment for peripheral nerve disease?

A

Treat the cause e.g. stop drug, surgery for trapped nerve, etc.

53
Q

Which neurons are affected in Moto Neuron Disease?

A

Upper and lower MN

54
Q

In which part of the body does motor neuron disease typically present?

A

Limb

55
Q

After affecting the limbs, where will motor neuron disease spread to?

A

Bulbar muscles and then respiratory muscles

56
Q

In motor neuron disease, patients can present with a combination of upper and lower MN signs.
Give some examples of LMN signs they may present with.

A

Muscle fasciculation
Muscle wasting
Muscle wasting

57
Q

Q
In motor neuron disease, patients can present with a combination of upper and lower MN signs.
Give some examples of UMN signs they may present with.

A

Spasticity
Brisk reflexes
Extensor plantars

58
Q

Is there any sensory involvement in motor neuron disease?

A

No

59
Q

What is another name for motor neurons disease?

A

Amyotrophic Lateral Sclerosis

60
Q

What is the prognosis for MN Disease?

A

Median die 3-5yrs from symptom onset/ 2-3yrs from diagnosis
50% die within 14months of diagnosis

61
Q

How is MND diagnosed?

A

-Pure clinical diagnosis so based on history and particularly examination as has the unique combination of UMN and LMN signs
-EMG

62
Q

What is the treatment for MND?

A

Supportive- physio, OT, SALT, PEG feed, non invasive ventilation, care
Palliative care

63
Q

There are not many drugs to slow MND and no cure. There is only one drug licenced for use which can improve survival by approx. 6 months. What is it?

A

Riluzole

64
Q

Just to recap- in peripheral nerve disorders, what will the symptoms and signs be a mix of?

A

LMN and sensory

65
Q
A

Year 2- CNS (49 decks)

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