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WI18 Neuro > NeuroDz 2 > Flashcards

NeuroDz 2 Flashcards

1
Q

MC degenerative dz of motor neuron system

A

ALS

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2
Q

amyotrophy

A

atrophy of muscle fibers

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3
Q

lateral sclerosis

A

changes in lateral columns of spinal cord as UMN axons degenerate and are replaced by scarring

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4
Q

risk factor for ALS

A

smoking

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5
Q

epidemiology of ALS

A

can begin young, highest risk 75-80

caucasians, M/F almost equal

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6
Q

ALS affects ____ neurons at _____ levels of the ____ network supplying _____ regions of the body

A

ALS affects motor neurons at 2+ levels of the motor neuron network supplying multiple regions of the body

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7
Q

neuron systems ALS affects (3 different areas affected)

A
  1. LMN
  2. corticospinal UMN
  3. prefrontal motor neurons
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8
Q

ALS effect on LMN

A

progressive weakness, wasting

loss of reflexes/muscle tone

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9
Q

ALS effect on corticospinal UMN

A

precentral gyrus

brisk reflexes and spasticity in upper

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10
Q

ALS and prefrontal motor neurons

A

plan and orchestrate UMN and LMNs

results in cognitive impairment

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11
Q

areas NOT affected by ALS

A

Sphincter control
EOMS
sensory function

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12
Q

clinical picture of ALS

A

insidious loss of function or slowly progressive painless weakness in 1+ region of body

w/o sensation change and w/o another cause

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13
Q

emotional and cognitive changes in ALS

A

involuntary laughing/crying
loss of executive function
behavioral changes

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14
Q

if LE involvement ALS clinical

A

slapping gait
tripping/stumbling w/running or walking
foot drop

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15
Q

if UE involved, ALS clinical pic

A

difficulties with FINE more tasks (buttons, keys)

atrophy of hand muscles

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16
Q

natural history of ALS

A

fatal, survival 3 yrs from time of apparent muscle weakness

17
Q

ALS tx

A

supportive, multimodal

muscle spasms can be tx with antispasticity agents

riluzole/Rilutek

18
Q

riluzole brand + indication

A

Rilutek

prolongs tracheostomy in ALS pts by 2-3 months

19
Q

supportive care ALS

A

assisted respirations

PEG tube

20
Q

CRPS is characterized by

A

pain, swelling, vasomotor dysfunction of extremity

pain is constant and disproportionate to injury

21
Q

CRPS epidemiology

A

MC b/t 30-60yrs

no racial, gender differences

22
Q

inciting effects of CRPS

A

trauma (penetrating or non penetrating)

surgery (carpal tunnel release, dentistry)

systemic illness (MI, CVA, pan coasts tumor)

local disease (tissue ischemia)

spontaneous

23
Q

stages of CRPS

A

acute
subacute
chronic

24
Q

acute CRPS

A

3 mo

burning pain that limits function of extremity

swelling (cool to tough, limits movement)

demineralization (due to disuse)

25
Q

subacute CRPS

A

persistent severe pain and fixed edema

skin is cyanotic, blue, pale, dry

loss of function due to increased pain and fibrosis of the joints (chronic inflammation_

26
Q

chronic CRPS

A

1 yr after onset

pain is more variable
edema subsides over time, leaving fibrosis of the joint
loss of function and stiffness

27
Q

tx options for CRPS

A

prednisone
NSAIDS
synthetic blockage
IV Calcitonin

28
Q

prednisone CRPS

A 
daily taper (2-4 wks) 
improves mobility, pain, and stiffness

best in acute/subacute stage

29
Q

Sympathetic blockade CRPS

A

lidocaine or bupivacaine +/- epi

blocks nerve impulse and allows movement of the extremity to prevent chronic fibrosis and inflammation

30
Q

peripheral neuropathy

A

disorders that affect peripheral nerves, MC hands/feet/lower legs

cause pain, numbness, tingling, burning, weakness

31
Q

etiologies of peripheral neuropathy

A
  1. vitamine deficiencies
  2. causative meds
  3. comorbitidies
  4. diabetes
32
Q

diabetes peripheral neuropathy types

A

painful DM (LE painful to touch)

distal symmetric (stocking glove)

autonomic neuropathy (gastroparesis, urinary retention, ED, orthostatic HoTN)

isolated neuropathy (one area, Motor> sensory)

33
Q

comorbidies that cause peripheral neuropathy

A

alcohol intake
celiac dz

CKD, HIV, amyloidosis

34
Q

medications that cause peripheral neuropathy

A

chemo drugs
abx (metronidazole, fluorquinalones, isoniazid)
statins
phenytoin

35
Q

peripheral neuropathy study of choice

A

EMG/NCS

36
Q

mc inherited neuro disorder of neuropathy without metabolic cause

A

CMT

37
Q

natural hx of CMT

A

first 20 yrs = tripping over feet, freq. falls, clumsiness

foot drop and stoppage gait

distal weakness, difficulty with motor tasks

38
Q

s/s of CMT

A

wasting of muscles of legs (stork legs)
pes cavus, loss of DTRs, gait ataxia
pain/temp sensations intact

WI18 Neuro (16 decks)

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