Neuromuscular junction disease, Raynaud, scleroderma Flashcards
Myasthenia Gravis: frequency?
most common NMJ disorder
Myasthenia Gravis: pathphysiology?
antibodies to postsynaptic ACh receptor
Myasthenia Gravis: symptoms?
fatigable muscle weakness (proximal weakness, ptosis, diplopia, dyspnea, dysphagia)
spared reflexes
worsens with muscle use
Myasthenia Gravis: symptoms eye?
ptosis, diplopia
Myasthenia Gravis: symptom respiratory?
dyspnea
Myasthenia Gravis: reflexes?
normal
Myasthenia Gravis: worsens or improves with muscle use?
worsens
Myasthenia Gravis: what kind of muscle weaknes?
fatigable
proximal muscles
ptosis
diplopia
dyspnea
dysphagia, difficulty chewing
Myasthenia Gravis: bulbar muscle involvement leads to .. ?
dysphagia, difficulty chewing
what is dysphagia?
difficulty swallowing
Myasthenia Gravis: respiratory muscle involvement leads to .. ?
dyspnea
most common NMJ disorder
myasthenia gravis
autoantibodies against postsynaptic ACh receptor
myasthenia gravis
proximal muscle weakness with ptosis and diplopia, get worse with use. reflexes normal
what is this sugggestive oft?
Myasthenia Gravis
Myasthenia Gravis: associated with?
thymoma, thymic hyperplasia
which NMJ disease is associated with thymoma?
Myasthenia Gravis
which NMJ is associated with thymic hyperplasia?
Myasthenia Gravis
Myasthenia Gravis: AChE inhibitor administrator effect?
reverses symtomps
Myasthenia Gravis: treatment?
pyridostigmine
Pyridostigmine: treatment for what?
Myasthenia Gravis
AChE inhibitor is short for what?
achetylcholine esterase inhibitor
Lambert-Eaton myasthenic syndrome: frequency?
uncommon
Lambert-Eaton myasthenic syndrome: pathophysiology?
autoantibodies to presynaptic Ca2+ channels -> less ACh release
Lambert-Eaton myasthenic syndrome: symptoms?
proximal weakness
autonomic symptoms (dry mouth, constipation, impotence)
hypoflexia
improves with muscle use
Lambert-Eaton myasthenic syndrome: associated with?
small cell lung cancer
whatLambert-Eaton myasthenic syndrome: reflexes?
lower
Lambert-Eaton myasthenic syndrome: autonomic symptoms?
dry mouth, constipation, impotence
Lambert-Eaton myasthenic syndrome: weakness in which muscles?
proximal
Lambert-Eaton myasthenic syndrome: how do symptoms improve?
with muscle use
autoantibodies against presynaptic Ca2+ channels, effect?
Less ACh release
(Lambert-Eaton myasthenic syndrome)
proximal muscle weakness, dry mouth, hyporeflexes
improves with muscle use
suggestive of?
Lambert-Eaton myasthenic syndrome
which NMJ is associated with small cell lung cancer?
Lambert-Eaton myasthenic syndrome
which NMJ is uncommon?
Lambert-Eaton myasthenic syndrome
autoantibodies against presynaptic Ca2+ channels, less Ach release
which disease?
Lambert-Eaton myasthenic syndrome
which NMJ disorder has lowered reflexes?
Lambert-Eaton myasthenic syndrome
which NMJ disorder has normal reflexes?
Lambert-Eaton myasthenic syndrome
Lambert-Eaton myasthenic syndrome: AChE inhibitor effect?
minimal
AChE inhibitor minimal effect in which disease?
Lambert-Eaton myasthenic syndrome
Raynaud: mechanism
cold or stress -> arteriolar (small vessel) vasospasmen -> color change (white to blue to red)
what can cause symptoms of Raynaud disease?
cold or stress
what causes the color changes in Raynaud?
white - ischemia
blue - hypoxia
red - reperfusion
what causes white color in raynaud?
ischemia
what causes blue color in raynaud?
hypoxia
what causes red color in raynaud?
reperfusion
what are the color changes and order in raynaud?
white -> blue -> red
what happens to the blood vessels in raynaud?
vasospasm due to cold/stress
in which body part raynaud phenomenon?
fingers and toes
when is raynaud called ‘raynaud disease’?
when it’s primary/idiopathic
when is raynaud called ‘raynaud phenomenon’?
2nd to a disease process
raynaud can be secondary to which disease?
SLE
Systemic sclerosis (CREST)
mixed connective tissue disease
digital ulceration seen in which forms of raynaud?
secondary (SLE, SS, MCTD)
what causes digital ulceration in raynaud
critical ischemia
raynaud: treatment?
calcium channel blockers (promotes vasodilatation)
what are calcium channel blockers?
antihypertensive drugs which promote vasodilatation
scleroderma: other name?
systemic sclerosis
systemic sclerosis: other name?
scleroderma
systemic sclerosis: triad?
autoimmunity
vasculopathy
collagen deposition with fibrosis
triad of:
autoimmunity
vasculopathy
collagen deposition with fibrosis
what is this?
systemic sclerosis
systemic sclerosis: what happens to the skin?
collagen deposition with fibrosis
systemic sclerosis: how does the skin look?
puffy, taut (stretched tight) skin without wrinkles
fingertip pitting
systemic sclerosis: what happens to fingertips?
fingertip pitting
puffy, taut (stretched tight) skin without wrinkles. fingertip pitting
suggestive of?
systemic sclerosis
systemic sclerosis: can involve which systems? (besides skin)
renal
pulmonary
GI
cardiovascular
systemic sclerosis: what can happens to renal system?
scleroderma renal crisis
how to treat scleroderma renal crisis?
ACE inhibitors
systemic sclerosis: possible pulmonary pathology?
interstitial fibrosis, pulmonary hypertension
systemic sclerosis: possible GI symptoms?
less peristalsis and LES tone -> dysphagia and heart burn
what is the percentage of females with systemic sclerosis?
75%
what are the 2 major types of systemic sclerosis?
diffuse and limited (CREST)
Diffuse scleroderma: skin involvement?
widespread
diffuse scleroderma: how fast if progression?
rapid
diffuse scleroderma: visceral involvement early or late?
early
diffuse scleroderma: characteristics?
widespread skin involvement, rapid progression, early visceral involvement
(in sum: widespread skin, fast and organs also)
diffuse scleroderma: antibodies?
anti-Scl-70 antibody
anti-RNA polymerase III
anti-Scl-70 antibody
anti-RNA polymerase III
associated with what?
SS
diffuse scleroderma type
what is another name for anti-Scl-70 antibody?
anti-DNA topoisomerase-I antibody
anti-DNA topoisomerase-I antibody
another name?
anti-Scl-70 antibody
widespread skin involvement, rapid progression, early visceral involvement
characteristics of which type of SS?
diffuse
limited scleroderma: skin involvement?
limited to face and fingers
limited scleroderma: also with which syndrome?
CREST
what is the CREST syndrome?
Calcinosis cutis, anti-centromere antibody
Raynaud
Esophageal dysmotility
Sclerodactylyl
Telangiectasia
what is the C in CREST syndrome?
calcinosis cutis
anti-centromere antibody
what is the R in CREST syndrome?
raynaud
what is the E in CREST syndrome?
esophageal dysmotility
what is the S in CREST syndrome?
sclerodactyly
what is the T in CREST syndrome?
telangiectasia
Sclerodactyly, what is this?
a hardening of the skin of the hand
fingers curl inward (claw-like shape)
what are telangiectasia?
small, widened blood vessels on the skin
limited scleroderma: clinical course benigne or malignant?
benigne
SS: skin involvement only face and fingers. which type?
limited scleroderma
CREST syndrome associated with which type of SS?
limited scleroderma