Muscle & Nerve Disease

Question 1

What are the symptoms associated with muscle disease?

Answer 1

Weakness of muscle 
Breathing problems 
Poor swallowing 
Cardiomyopathy
Cramp
Pain, stiffness

Question 2

What are the signs of muscle disease?

Answer 2

Wasting/ weakness
Reduced reflexes and tone
Motor weakness NOT sensory

Question 3

What investigations associated with muscle disease would you carry out?

Answer 3

CK
EMG
Muscle Biopsy

Question 4

What are some of the congenital/ genetic classes of muscle disease?

Answer 4

Muscular dystrophies
Congenital myopathies
Channelopathies
Enzyme

Question 5

What are some of the acquired causes of muscle disease?

Answer 5

Metabolic (low Ca, K)
Endocrine
Inflammatory muscle disease
Iatrogenic

Question 6

What is the mutation observed in Duchennes muscular dystrophy?

Answer 6

Dystrophin protein

Question 7

What are the different types of dystrophies?

Answer 7

Duchennes
Beckers
Myotonic dystrophy
Limb-Girdle

Question 8

What channels do channel-patties affect

Answer 8

Ca, K, Na, Cl

Question 9

In metabolic muscle disease, what are the different types?

Answer 9

Exercise induced

Fixed weakness

Question 10

What are the causes of metabolic muscle disease?

Answer 10

Disorders of CHO/ FA metabolism

Mitochondrial myopathies

Question 11

What is inflammation of the muscle called?

Answer 11

Polymyositis

Question 12

What signalling molecule observed at the NMJ?

Answer 12

Ach

Question 13

What is the clinical presentation of myasthenia gravis?

Answer 13

Fatiguable weakness 
Limbs
Eyelids
Muscles of mastication 
Swallow 
Talking
SOB 
diplopia

Question 14

What investigations are useful in MG?

Answer 14

AChR ab
Anti MuSK ab
Neurophysiology

Question 15

What is the management for MG?

Answer 15

Anticholinesterase
Immunosuppression
Prednisolone

Question 16

What fibres are present in a peripheral nerve?

Answer 16

Sensory afferent (small fibres - pain & temp, large fibres - touch, pressure, vib)
Motor efferent
Autonomic axons

Question 17

What general symptoms are observed in peripheral neuropathy?

Answer 17

Motor
Sensory
(Moves from distal to proximal)

Question 18

What are some of the causes of generalised peripheral neuropathy?

Answer 18

Diabetes
Alcohol
VitB12 déficiency 
Drugs 
Lyme disease
HIV
Guillain Barre syndrome

Question 19

What symptoms will be observed in nerve rot disease?

Answer 19

Myotomal wasting & weakness
Reflex change
Dermatomal sensory change

Question 20

What symptoms are observed in disease of individual nerve?

Answer 20

Wasting & weakness of innervated muscle

Question 21

What are some of the investigations used for nerve disease?

Answer 21

Blood tests
Nerve conduction studies
Lumbar puncture
Nerve biopsy

Question 22

What is another name for Motor Neuron disease?

Answer 22

Amyotrophic Lateral Sclerosis

Question 23

What are some characteristic of the symptoms of MND?

Answer 23

Combination of UMN & LMN signs
Sensation spared
No sphincter involvement

Question 24

What UMN lesions are observed in MND?

Answer 24

Increased tone

Brisk reflexes

Question 25

What LMN lesions are observed in MND?

Answer 25

Wasting
Fasciculations
Weakness

Question 26

What supportive treatment can be given in MND?

Answer 26

SALT
Physio
OT
PED feed
Non-invasive ventilation