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Muscle pathology Flashcards

1
Q

Thymic hyperplasia

Thymoma

A

associations of Myasthenia Gravis

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2
Q

Pathology of Myasthenia gravis

A

autoantibodies attach post synaptic AChRs

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3
Q

Diagnostics for Myasthenia Gravis

A 
AChR antibody test
Edrophonium test (rapid improvement after administration of edrophonium
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4
Q 
Fluctuating weakness (worse on exertion)
vision problems
Bulbar muscle weakness
Proximal limb weakness
Respiratory muscle weakness
Normal reflexes
A

Clinical presentation of Myasthenia Gravis

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5
Q

Neuroendocrine carcinoma of the lung
Thyroid Disease
Vitiligo

A

Associations of Lambert Eaton Syndrome

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6
Q

Pathology of Lambert Eaton Syndrome

A

Autoantibodies attack presynaptic calcium channels

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7
Q

Diagnostics for Lambert Eaton Syndrome

A

antibodies agianst voltage gated calcium channels

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8
Q

Exercise improves strength
Autonomic Dysfunction
Extremity weakness
Reduced or absent reflexes

A

Clinical Presentation of Lambert Eaton Syndrome

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9
Q

How does C. botulinum cause botulism

A

neurotoxin blocks the release of ACh from presynaptic nerve terminals by cleaving SNARE protein

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10
Q

canned foods

honey

A

associations of Botulism

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11
Q 
flaccid descending paralysis
Mydriasis
Dysphagia
Dysarthria
Xerostomia
NVD then constipation
A

Clinical presentation of Botulism

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12
Q

Major difference between Dermatomyositis and Polymyositis

A

Dermatomyositis has cutaneous involvement

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13
Q

Pathology of Dermatomyositis

A

Deposition of CD4+ T cells and MAC complex in the capillary vessels of skeletal muscle

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14
Q

Pathology of Polymyositis

A

CD8+ T cells attack skeletal muscle antigens, mostly endomysium

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15
Q

Which diagnostic of dermatomyositis yields the worst prognosis?

A

Anti M2( helicase)

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16
Q

Anti-M2
Anti-Jo1
Anti-P155/P140

A

Diagnostics suggesting Dermatomyositis

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17
Q

Increased CK, Aldolase, myoglobin, ESR/CRP, Anti-Jo1

Presence of ANA

A

Diagnostics suggestive of Polymyositis

18
Q

Morphology of Dermatomyositis

A

perifascular atrophy of muscle fibers

perimyseal inflammation

19
Q

Morphology of Polymyositis

A

Endomysial inflammation with CD8+ T cells

20
Q

Pathologic difference in Duchenne vs Becker Muscular dystrophy

A 
Duchenne= mutation causing total absence of dystrophin
Becker= mutation causing reduced dystrophin
21
Q

Diagnostic suggestive of Duchenne Muscular Dystrophy

A

elevated CK in first decade, then drops due to decrease in muscle mass

22
Q

Differentiate the onset of Duchenne Muscular Dystrophy vs Becker Muscular Dystrophy

A 
Duchenne= normal at birth and appears to slow down with developlment
Becker= sx present in late childhood or adulthood
23
Q

Differentiate the life expectancy of Duchenne Muscular Dystrophy vs Becker Muscular Dystrophy

A 
Duchenne= death before 30 y/o
Becker= Normal Life Expectancy
24
Q

Which muscular dysdtophy presents with cardiac abnormalities

25
Q

Inheritance of Muscular Dystrophy

26
Q

Mode of inheritance of Myotonic Dystrophy

A

Autosomal Recessive

27
Q

Pathology of Myotonic Dystrophy

A

Expansions of CTG triplet repeats at the 3’ noncoding region of the DNPK gene on chromosome 19

28
Q

which set of fibers undergo atrophy in myotonic dystrophy

29
Q

Clinical features of myotonic dystrophy

A 
muscle weakness/ wasting
myalgias
myotonia
cataracts
frontal balding
testicular atrophy
arrhythmias
30
Q

Pathology of Malignant Hyperthermia

A

inhales halogens cause RYR1 gene mutations, leading to increased efflux from SR

31
Q

What causes fibromyalgia

A

abnormal ascending and descending pain pathways lead to central amplification of pain signals causes widespread musculoskeletal pain without evidence of inflammation or increase in muscle enzymes

32
Q

what is used to diagnose fibromyalgia

A

11/18 tender points

33
Q 
pain primarily where muscles and tendons attach to bones
HA
fatigue
morning stiffness
unrefreshing sleep
cognitive dysfunction
paresthesias 
ANS dysfunction
A

Clincal findings of fibromyalgia

34
Q

treatment for fibromyalgias

35
Q

Northern european descent
Giant Cell arteritis
HLA-DR4

A

associations of Polymyalgia Rheumatica

36
Q

Diagnostics used to diagnose Polymyalgia Rheumatic

A 
Elevated inflammatory markers
Leukocytosis
Normochormic anemia
Normal CK
Negative Rheumatoid Factor
37
Q 
Fever
Weight loss
Night sweats 
Fatigue
Malaise
Morning stiffness in neck, shoulder, and pelvic girdle
subjective weakness
A

Clinical findings of polymyalgia rheumatica

38
Q

Toxic myopathies with elevated CK

A

Statin use

Hypothyroidism

39
Q

Which toxic myopathy yields rhabdomyolysis, renal failure and myoglobinuria

40
Q

Explain channelopathies

A

mutations in channel proteins cause decreased or increased excitability
hyper/hypotonia leads to varied potassium levels and periodic paralysis

Pathology (18 decks)

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