Neuromuscular Disorders- MJ Flashcards
Which neuromuscular disorder?
•Immune-mediated (autoimmune) disorder of the CNS associated with destruction of myelin and nerve fibers.
Multiple Sclerosis
- Is MS more common in men or women?
- Age of onset?
- Women
- 15-50yrs
Is there a higher or lower incidence of MS as you move towards the equator?
lower incidence
On LP, what is seen in the CSF only in MS patients and can be used as a diagnostic marker?
(this will be on exam)
Oligoclonal bands
What are the 3 types of MS? Which one is most common?
(this will be on exam)
- Relapsing-remitting MS (RRMS)- Most common
- Secondary progressive MS (SPMS)
- Primary progressive MS (PPMSP)
The following describes which type of MS?
•Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission
Relapsing-remitting MS
The following describes which type of MS?
- Initial relapsing-remitting MS followed by gradual worsening with or without occasional relapses, minor remissions, and plateaus
- Occurs 10-20 years after disease onset
Secondary Progressive MS
The following describes which type of MS?
•Steady increase in disability without attacks
Primary progressive MS
What are the 5 main signs and sxs of MS?
(will be on exam)
- Internuclear ophthalmoplegia (delayed adduction and horizontal nystagmus of abducting eye)
- Optic neuritis (painful, monocular vision loss w/ blurring/scotoma)
3. Lhermitte’s sign (electic shock when flex neck)
- Uhthoff phenomenon (heat sensitivity)
- Fatigue (sleep 22hrs/day, very difficult to wake up)
T/F: Signs and sxs of MS can be isolated or in combination. Attacks usually last days to weeks
True
What are the 2 main components of the MS work up?
- Brain and spinal cord MRI (gadolinium enhanced)
- LP- look for _oligoclonal bands in CSF ***_
What are the 3 parts of the McDonald criteria for diagnosing MS?
- Uses MRI +/- CSF to diagnose
- Dissemination in space
- Dissemination in time
How do you treat acute exacerbations/attacks of MS?
(will be on exam
IV glucocorticoids- high dose Methylprednisolone
What is one of the MC disease modifying therapies (for RRMS)
Interferon
Which neuromuscular disorder?
- Variable combo of weakness due to antibody-mediated attack against muscle receptor for acetylcholine
- fatigable weakness
Myasthenia Gravis
Epidemiology of which neuromuscular disorder?
- Bimodal distribution: F: 2-3rd decade, M: 6-8th decade
- W > M
- Thymoma common
Myasthenia Gravis
Which muscle receptor antibody is most common in MG- AChR receptor Ab or MuSK receptor Ab?
AChR receptor Ab
In MG, when does weakness increase and when does it improve?
- Increases during repetitive use and as day progresses
- Improves during rest/sleep
What are the 2 types of MG and which one is more common?
- Ocular (weakness limited to eyelids and extraocular muscles)–> MC
- Generalized (weakness of ocular mm., bulbar, limb, and resp mm.)