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neuro 23 Flashcards

1
Q

Wallerian degeneration

A

disintegration of axons and myelin distal to the site of injury

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2
Q

neuronal (or axonal) degeneration

A

distal dying of the axons and loss of myelin after damage to the cell body of the neurons

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3
Q

small nerve fibers

A

neuropathic pain (aching, shooting, throbbing or burning); distrubance of temp sensation; and autonomic dysfunction (cardiac arrythmias, orthostatic hypotension, impotence)

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4
Q

large nerve fibers

A

loss of vibration and joint position sense, weakness, fasciculations, and loss of DTRs

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5
Q

anti-ENA

A

group of antibodies (like anti-Ro and La) to screen to connective tissue diseases

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6
Q

methylmalonic acid

A

increased means vit B12 def

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7
Q

urine porphobilinogen

A

for acute intermittent porphyria

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8
Q

ANCA

A

Wegener’s granulomatosis

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9
Q

anti-Hu antibody

A

for paraneoplastic syndromes

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10
Q

anti-GM1 MAG antibody

A

for autoimmune neuropathy

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11
Q

symmetric prcimal and distal weakness with sensory loss

A

guillan barre, chronic inflamm demyelination polyradiculopathy

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12
Q

symmetric distal weakness with sensory los

A

drug or toxin-induced; metabolic neuropathy; amyloidosis

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13
Q

asymm distal weakness with sensory loss; multiple nerves

A

vasculitis; hereditary neuropathy with liability to pressure palsies; infections like leprosy, Lyme, sarcoidosis, and HIV

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14
Q

single nerve

A

compressive mononeuropathy and radiculopathy

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15
Q

asymm distal weakness without sensory loss

A

motor neuron disease, multifocal motor neuropathy

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16
Q

asymm proximal and distal weakness with sensory loss

A

polyradiculopathy or plexopahty , meningeal carcinomatosis or lymphomatosis, HNPP, hereditary neuropathies

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17
Q

symm sensory loss without weaknes

A

crytpogenic sensory polyneuropathy; metabolic, drug-induced, or toxic neuropathies; leprosy

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18
Q

asumm proprioceptive sensory loss without weakness

A

sesnory neuronopathies

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19
Q

autonomic symptoms and signs

A

diabetes, amyloidosis, GB, vincristine, porphyria, HIV-related autonomic neuropathy, idiopathic pandysautonomia

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20
Q

the most common infection to precede guillan barre is what?

A

campylobacter jejuni; others include herpes, most freq CMV or EBV

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21
Q

most frequent antibodies found in GBS

A

anti-GM1

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22
Q

clinical presentation of Guillan barre

A

ascending areflexic motor paralysis, witho or without sensory problems, including neuropathic pain

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23
Q

initial sx of GB

A

tingling and pins-and-needles sensations in the feet, sometimes with lower back pain

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24
Q

Miller fisher variant of GB

A

gait ataxia, areflexia, and external opthalmoplegia, usually without limb weakness

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25
Q

Nerve conduction studes in GB Miller fisher variant

A

normal

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26
Q

what antibodies are pos in Miller Fisher variant of GB

A

anti-GQ1b in 90% of cases

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27
Q

albuminocytologic dissociation in CSF

A

characteristic of GB

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28
Q

what do electrodiagnostic studies of GB show?

A

prolonged distal latencies, possible conduction block, and decreased motor unit recruitment on EMG

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29
Q

management of GB

A

hospitalize patient and monitor forced vital capacity and neg insp pressure; treat with IVIg or plasmapharesis; steroids are not beneficial

30
Q

chronic inflamm demyelinating polyradiculoneuropathy

A

sometimes called chronic GB

31
Q

clinical presentation of CIDP

A

slowly evolving weakness beginning in the lefs, with widespread areflexia and loss of vibratory sense (larger fiber); weakness of neck flexors; painful paresthesias can occur

32
Q

treatmen of CIDP

A

these patients respond to periodic IVIG therapy; most improve with steroids, but half will relapse

33
Q

multifocal motor neuropathy

A

pure motor multiple mononeuropathy; immune-mediated mechanism

34
Q

clinical manifestations of MMN

A

slowly progressive asymm, predominantly distal limb weakness that usually begins in the arms

35
Q

sensory problems inmultifocal motor neuropathy?

A

minor sensory symptoms are common; however, objective sensory deficits, UMN, and CN findings are absent

36
Q

diagnostic eval of multifocal motor neuropathy

A

electrodiagnostic studes show conduction block in motor nerves in areas not prone to compression. Very high IgM anti-GM1 is found in most patients

37
Q

treatment for MMN

A

IVIg, rituximab, and immunosuppressants like cyclophosphamide

38
Q

neuropathies assoc with serum monoclonal gammopathies

A

patients often have multiple myeloma, amyloidosis, macroglobulinemia, cryoglobulinemia, lymphoma, or leukemia

39
Q

clinical manifestations of neuropathies assoc with monoclonal gammopathies

A

symmetric sensorimotor neuropathies that affect the legs more than the arms; prominent large-fiber sensory loss and sensory ataxia

40
Q

diagnostic eval for neuropathies assoc with monoclonal gammopathies

A

electrodiagnositc studies show signif demyelination and axonal loss

41
Q

clinical manifestations of diabetic polyneuropathy

A

neuropathic pain and dyesthesias; distal, symm, slowly progressive sensory loss in the legs (stocking distrib); autonomic insuff; weakness is late feature

42
Q

treatment for diabetic polyneuropathy

A

glucose control; symptomtic management of pain that may respond to TCAs, duloxetine, or anticonvulsants like gabapentin, pregabalin, lamotrigine, and others

43
Q

uremic neuropathy

A

symmetric, distally predominant sensorimotor axonal polyneuropathy; foot drop and leg weakness are common

44
Q

poprphyric neuropaty

A

assoc with acute intermittent porphyria; sensorimotor axonal polyneuropathy manifested by paresthesias and dyesthesias of the extremities, sometimes with weakness or paralysis

45
Q

critical illness neuropathies

A

axonal sensorimotor polyneuropathy; patients in the ICU; unknown etiology

46
Q

Charcot-Marie-Tooth disease

A

most common inherited polyneuropathy; symmetric slowly progressive distal muscular atrophy of the legs and feet; in most cases, it eventually involves the hands

47
Q

hammer toes and pes cavus

A

common in charcot-marie-tooth

48
Q

CMT gene

A

charcot-marie-tooth

49
Q

neuropathy of leprosy

A

motor and sensory; predilection for cooler areas like nose, ears, and distal limbs; DTRs preserved; palpable nerve hypertrophy

50
Q

pandysautonomia

A

acquired disorder usually immune following a viral infection in wich the sump and parasymp systems are affected

51
Q

pathogenesis of acute pandysautonomia

A

autoantibodies against ganglionic acetylcholine receptor

52
Q

symptoms of median nerve entrapmen

A

numbness or tingling over one or more of the first 4 digits; weakness of the thenar muscles; decr sensation in the volar aspect of the first three and a half digits

53
Q

Tinel’s and Phalen’s signs

A

present in median nerve entrapment; Tinel’s- tapping on the nerve produces tingling; Phalen’s

54
Q

features of ulnar nerve entrapment

A

paresthesias and pain in the fifth digit and the medial half of the fourth; difficulty spreading the fingers; weakness and atrophy of the FDI and ADM

55
Q

what cuases unar nerve entrapment

A

compression of the ulnar nerve in the cubital tunnel in the elbow

56
Q

radial nerve entrapment

A

wrist drop and sensory loss on dorsal hand; weakness of tricpes, brachioradialis, supinatory, and wrist and finger extensors;

57
Q

cause of radial nerve entrapment

A

compression of the radial nerve at the level of the axilla (Saturday night palsy), the spiral groove, or in the forearm

58
Q

meralgia paresthetica

A

burning sensation and variable loss of sensation over the anterior thigh

59
Q

cause of meralgia paresthetica

A

entrapment of the lateral femoral cutaneous nerve near the inguinal ligament

60
Q

clinical features of femoral neuropathy

A

leg weakness on attempting to stand or walk; pain in the anterior thigh; weakness of the quads, absent or diminshed patellar reflex, and sensory loss over the anterior thigh

61
Q

cause of femoral neuropathy

A

usually trauma from surgery, stretch injury (lithotomy position in childbirht), DM, and other inflamm processes

62
Q

clinical features of peroneal neuropathy

A

foot drop with minimal sensory complaints; weakness of extensor hallucis longus, tibialis anterior, and the peroneal muscles; sens loss over the dorsal part of the foot is mild

63
Q

cause of peroneal neuropathy

A

entrapment of peroneal nerve between the neck of the fibula and the insertion of the peroneus longus muscle

64
Q

features of C5 root syndrome

A

pain in lateral shoulder, sensory loss over the deltoid; weakness of deltoid, supraspinatus, and biceps; impairment of biceps reflex

65
Q

features of C6 root syndrome

A

pain in radial side of the arm to the thumb; weakness of biceps and brachioradials; impairment of biceps reflex

66
Q

features of C7 root syndrome

A

pain between second and fourth finger; weakness of triceps, wrist extensors and flexors, pectoralis major muscles; impairment or loss of triceps reflex

67
Q

clinical features of L3 root syndrome

A

often none, sometimes medial thigh and knee sens loss; quads weakness; adductor may be affected; loss of knee jerk reflex and impaired adductor reflex

68
Q

features of L4 root syndrome

A

loss of sensation in medial leg below knee to medial maleolus; weaknes of quads and anterior tibial muscles; decreased knee jerk

69
Q

features of L5 root syndrome

A

loss of sensation over dorsm of foot to great toe; weakness of extensor hallucis longus, extensor dig longus, inversion, and eversion of foot

70
Q

features of S1 root syndrome

A

loss of sensation in lateral foot; weakness in plantar flexion, toe flexion; decreased or absent ankle jerk reflex

Neuro (43 decks)

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