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Clinical Neurosciences > Neuromuscular Diseases-Weakness > Flashcards

Neuromuscular Diseases-Weakness Flashcards

1
Q

potassium imblanance levles

A

less than 2.5 or greater than 7

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2
Q

calcium imbalances

A

less htan 7, greater than 12

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3
Q

what is usually abnormal in myasthenia gravis patients

A

thymus

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4
Q

myasthenia gravis is associated with what other diseases

A

thyroid disease
lupus
pernicious anemia
rheumatoid arthritis

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5
Q

in addition to MG testing what should you also look for

A

thymoma

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6
Q

differential for myasthenia gravis includes…

A 
ALS
muscular dystrophy
Labert Eaton
Botulism 
organophosphate poisoning
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7
Q

treatment for MG

A

pyridostigmine, neostigmine, plasmapheresis, IV IgG, surgery and immunosuppresive drugs

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8
Q

what are the immunosuppresive drugs used for treatment of MG

A

steroids
axathioprine
cyclophosphamide
cyclosporin

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9
Q

neonates with myasthenia present with

A

weak cry, suck, respiratory insuffiency

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10
Q

neonatal myasthenia is due to

A

maternal antibodies

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11
Q

are mothers affected in congenital myasthenia

A

no

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12
Q

patients with congenital myasthenia presen with

A

opthalmoplegia
recessive inheritance suggested
no antibodies
synaptic dysfunction

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13
Q

drugs associated with drug induced myasthenia gravis

A 
D penicillamine
phenytoic
trimethadione
streptomycin
kanamycin
colistin
tetracycline
neomycin
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14
Q

is associated with cancers especially small cell lung, breast and lymphoma

A

labert eaton syndrome

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15
Q

myasthenic syndrome

A

presynpatic inhibition (voltage dependent calcium channel

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16
Q

features of myasthetic syndrome

A 
areflexia
weakness
dry mouth
metallic taste
autonomic signs
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17
Q

how do you diagnose lambert eaton syndrome

A

H and P and EMG

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18
Q

treatment of Lambert Eaton syndrome

A

IV IgG
3,4 diaminopyridine
guanidine
treat the tumor if it is present

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19
Q

presynaptic inhibition of acetylcholine release

A

botulism

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20
Q

what are the features of botulism

A

progresses 2-4 days, weakness, ophthalmoplegia, respiratory paralysis, facial diplegia, pupillary paralysis and dry mouth

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21
Q

differential diagnosis of botulism

A

myasthenia gravis
Guianne barre
diptheria

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22
Q

how do you treat botulism

A

antitoxin but usually it is just supportive because you run out of time

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23
Q

potassium associated paralysis is precipitated by

A

hunger
food
cold

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24
Q

featues of myopathy

A

proximal weakness of upper and lower extremities
difficulty arising out of a chair
difficulty climbing stairs
difficulty lifting arms over head

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25
Q

type if genetics DMD

A

x linked recessive

26
Q

symptoms usually begin before the age of three

A

DMD

27
Q

toe walking and waddling gait

A

DMD

28
Q

gowers sign

A

DMD

29
Q

are there sphincter distrubances in DMD

A

NO

30
Q

pseudohypertroph of gactrocnemius, triceps and biceps muscles

A

DMD

31
Q

diagnosis of DMD

A

H and P
Labs- CPK/LDH
muscle biopsy
EMG

32
Q

facial and shoulder muscle weakness that appears in adolescne

A

facioscapulohumeral muscular dystropy

33
Q

beevor sign

A

facioscapulohumeral muscular dystrophy

34
Q

increased lumbar lordosis

A

facioscapulohumeral muscular dystrophy

35
Q

winged scapula

A

FCH MD

36
Q

steinert disease associated with

A

chromosome 19

37
Q

what is the defect in steinert disease

A

chromosome 19

38
Q

stiffness in cold

A

Myotonic dystrophy

39
Q

hypersomnolecen, cataracts, gonadal atrophy, frontal balding and myotonia,

A

MD

40
Q

hatchet face and wasting of hands

A

MD

41
Q

how do you treat the myotonia

A

phenytoic
quinidine
procainamide

42
Q

myotonic congenita

A

autosomal dominant or recessive; generalized myotonia which is more severe than myotonic dystrophy and patients have muscular apperance

43
Q

mitochondrial cytopathies are characterized by

A

lactic acidosis
ragged red fibers
lipid droplets

44
Q

spasms due to spontaneous firing of peripheral nerves that causes muscle contraction

A

tetany

45
Q

____is associated with hypocalcemia, hypomagnesemia, and alkalosis

A

tetany

46
Q

what are the two “signs” asscoiated with tetany

A

troussaeu and chvyostek signs

47
Q

prolonged spasms of the limb muscles, seizure, curcumoral paresthesias, and laryngospasm

A

tetany

48
Q

sudden forceful, often painful muscle contractions

A

cramps

49
Q

causes of cramps

A 
vigours exercise
pregnancy
LMN
hypothyroidism
uremia
myotonic disorders
sweatiing
diarrrhea
McArdle Disease
Hemodialysis
50
Q

treatment of cramps

A 
stretching
quinine
phenytoic
diazepam
procainamide
carbamazepine
51
Q

begins with a rash of face, eyelids, extensor surfaces, knucles, elbows and knees and proximal weakness

A

dermatomyositis

52
Q

10% of dermatomyositis over the age of 40 are associated with

A

lung

breast and GI cancers

53
Q

when diagnosing dermatomyositis what should you carefully look fore

A

tumor!

54
Q

inflammatory myopathy from any cause

A

polymyositis

55
Q

polymositis usually occurs when

A

after age of 35

56
Q

are the EOM involved in polymyositis

A

NO!!!

57
Q

treatment for polymyositis

A

steroids and supportive

58
Q

what is a very common cause of myopathy

A

cholesterol agents

59
Q

what are some common causes for myopathy

A 
collagen vascular disease
HIV
L tyrptophan
Niacin
Cholesteral agents
ethanol
endorcine (thyroid)
60
Q

increased CPK is associated with hypothyroid or hyperthyroid

A

hypothyroid

61
Q

type II glycogen storage disease

A

acid maltase deficiency, cardiomyopathy, myopathy, and infancy

62
Q

type V-McArdle’s disease

A

myophosphorylase deficiency, cramps, intolerance, to intense exercise and myoglobuinuria

Clinical Neurosciences (16 decks)

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