NEURO WK 3

Question 1

MND

Answer 1

motor neurone disease
degenerative
weakness, older men

riluzole

Question 2

what symptom is one of the main causes of death in MND??

Answer 2

RESPIRATORY FAILURE

Question 3

Subtypes of MND (umbrella term) and what is the most common ?? **

Answer 3

ALS - most common, upper and lower
Progressive Bulbar palsy
PLS - upper
PMA - lower

Question 4

RED FLAG SIGNS OF RESPIRATORY FAILURE AND TREATMENT

Question 5

upper motor signs vs. lower motor

Answer 5

upper - hyperreflexia, hypertonia, spasticity

lower - hyporreflexia, hypotonia, muscle wasting and fasciculations (twitching)

Question 6

condition affecting the NEUROMUSCULAR JUNCTION

Answer 6

MG

Question 7

clinical features of MG

Answer 7

tiredness

Question 8

Presynaptic issues (2) - RARE

Question 9

postsynaptic issues - MORE COMMON

Question 10

diagnostic test for MG, and treatments for MG

what is associated with MG

Answer 10

• anti-AChR IgG** in serum (elisa test)
• Repetitive nerve stimulation - gradually reducing responses indicates NMJ dysfunction

ACh inhibitor - pyridostigmine
steroids
Thymectomy - association w thymoma

Question 11

WHAT DRUGS TO AVOID IN MG

Answer 11

antibiotics

fluoroquinolone antibiotics (e.g., ciprofloxacin, levofloxacin)

Question 12

examination of muscle and power grading

Answer 12

EMG

Question 13

most common muscular dystrophy??

Answer 13

duchenne’s

gower’s sign

x-linked recessive

Question 14

Be aware of treatable muscle disorders – polymyositis, dermatomyositis and rhabdomyolysis

Question 15

myotonia

Answer 15

delayed relaxation of muscles after voluntary contraction or after a mechanical stimulus

Question 16

rhabdomyolysis triad !!!

Answer 16

elderly man collapsed on ground and can’t get up

muscle pain/weakness
dark urine
decreased urine output

Question 17

Understand the differences between peripheral neuropathy, radiculopathy, mononeuropathy and mononeuritis multiplex. Where are the nerves damaged??

Question 18

GBS

Answer 18

ascending weakness
Campylobacter illness
glove and stocking distribution

IvIg and plasmapheresis

Question 19

Understand the difference between axonal and demyelinating neuropathies

Answer 19

AXONAL - affecting the axon

eg. diabetes

DEMYELINATING - affecting the myelin sheath eg. MS, GBS

Question 20

acute vs chronic demyelinating neuropathies

Answer 20

acute - GBS

chronic - MS

Question 21

Differentiate between small and large fibre neuropathies - large fibre motor, large fibre sensory, small fibre, autonomic. symptoms, power, sensation and reflexes

Question 22

KNOW THE DIFFERENT PATTERNS OF SENSORY LOSS

Answer 22

central loss

glove and stocking

Question 23

What is Parkinson’s ?? main cause? triad

Answer 23

loss of dopaminergic neurones in the substantia nigra

rigidity, bradykinesia and resting tremor

Question 24

PATHOLOGICAL HALLMARK OF PD

Answer 24

presence of Lewy bodies in certain regions of the brain, alpha synuclein
protein

Question 25

Ix and Mx of Parkinson’s

Answer 25

DaTscan (SPECT imaging)

MRI/CT scan of head

levodopa

Question 26

PARKINSON-PLUS SYNDROMES

Answer 26

MSA

PSP

DLB

Question 27

T1, T2

Question 28

definition of sleep

Answer 28

reversible loss of consciousness and reduced responsiveness to the surrounding environment.

Question 29

stages of sleep

Answer 29

non REM
REM

Question 30

what are the 2 peaks of drowsiness / peak patterns?

Answer 30

2pm-4pm
early morning