Neuromuscular Diseases (5)

Question 1

Timing of neuromuscular diseases

Answer 1

sudden- vasucular disorders( Stroke)
1-14 days- poliomyelitis, Guillain barre syndrome, porphyria, polyarteritis
slowest- disease of the mm itself

Question 2

lab tests done in myopathies

Answer 2

CK *
Na, K, cl, hco3 (électrolytes)
creatinine (damage to mm cells)
Urea (due to pro breakdown)
Liver tests

Question 3

Main two tests for myopathies

Answer 3

Serum creatine kinase

Serum or urine myoglobin

Question 4

Rhabdomyolysis causes

Answer 4

Primary mm injury- trauma, alcohol

Hypoxia- ischarmia, carbon monoxide poisoning

• inf
• drugs (statins)

Question 5

rhabdomyolysis lab checks

Answer 5

urine blood/myoglobin
serum creatine kinase
serum myoglobin

Question 6

Early on in heat stroke what is one of the first things to be decreased

Answer 6

calcium

Question 7

MS symtoms + lab

Answer 7

mm weakness due to decreased neuromuscular signal transmission
blurred vision
judgement impaired
emotionally labile
variable course

lab- check for antibodies againt myelin

Question 8

Peripheral neuropathy causes

Answer 8

chronic kidney failure
diabetes mellitus
alcoholism
vit b12 def
drugs

Question 9

myasthenia graves s/s, tests

Answer 9

mm weakness on repetitive tasks
w>m

tests- Serum antibodies to acetyl choline receptors

Question 10

Trauma to mm lab tests

Answer 10

Lab tests- Serum CK, serum or urine myoglobin

Question 11

What lab tests are best at assessing the extent of mm damage caused by exercise (3)

Answer 11

1. CK
2. Aspirtate amino transferase
3. Lactate dehydrogenase

Question 12

what is paraneoplastic syndrome as associated s/s

Answer 12

mm weakness often accompainies neoplasia

• -paratharsia
• -pain
• -sensory loss
• -absent tendon reflexes
• -prox mm weakness

Question 13

Dermatomyositis/polymyositis- causes, s/s

Answer 13

autoimmune/inf possible
40-60 years of age w>m

facial ooedema, erythema/pink scaling eruption in dermatomyositis

Question 14

Dermatomyositis/polmyositis lab tests

Answer 14

ESR or serum CRP increased
Serum alpha2 and gamma globulins increased
Serum ANA (SLE tests tests neg)

Question 15

What does the dermatomyositis rash look like

Answer 15

localized or diffuse erythema
maculopapular eruption
heliotrope discoloration over dosum of figner jts etc
itching possible

Question 16

Periodic paralysis/potassium probs- triggers (4), lab tests

Answer 16

Exercise, food, stress, cold

lab tests- Serum and urine K during attack falls

Question 17

alcoholic myopatht s/s, lab tests

Answer 17

mm weakness
cramps
swelling
tenderness

lab tests– serum creatine kinase increased
serum and urine myoglobin increased

Question 18

how does alcohol affect mm physiology (3)

Answer 18

1. substate use increases (ATP not regen)
2. NADH increases so pyruvate is converted to lactate
3. Acetate is produced and atp used up

Question 19

Alcoholic myopathy lab monitoring for abstinese (3)

Answer 19

Serum GGT (increases w alcohol intake)
Serum carbohydrate deficient transferrrib
Serum methanol

Question 20

elevated thyroid stimulating horomone is an indication of

Answer 20

hypothyroidism

Question 21

what is teteny

Answer 21

low calcium

Question 22

Chronic fatigue syndrome causes, s/s

Answer 22

Trigger may be Epstein barr virus, viral encephalitis, herpes

• debilitating disease for more than 6 months
• extreme ehaustion