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neuro year 4 > neuropathy > Flashcards

neuropathy Flashcards

1
Q

what is carpal tunnel

A

median nerve entrapment. hypothyroid, pregnancy, rheumatoid, acromegaly

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2
Q

what are the symptoms in carpal tunnel

A

nocturnal painful tingling in hand and or foream not confined to anatomical sensory territory of the nerve. weakness and wasting is a late sign

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3
Q

what is Tinels test

A

tap on the flexor aspect of the wrist get tingling and pain

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4
Q

what is Phalens test

A

symptoms on maximal wrist flexion

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5
Q

what symptoms do you get with lesions median nerve at the wrist

A

sensory loss over radial 3 1/2 fingers and palm, weakness abductor pollicis brevis

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6
Q

what is the ulnar nerve vulnerable to

A

elbow trauma. in the cubital tunnel.

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7
Q

signs of ulnar nerve damage

A

weakness/wasting of medial side wrist flexors, interossei (cant cross fingers), medial 2 lumbricals (claw hand), hypothenar wasting (weak little finger abduction), sensory loss over medial 1 1/2 fingers

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8
Q

treatment carpal tunnel

A

wrist splint at night or local steroid injections

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9
Q

treatment ulnar cubital tunnel

A

night time soft elbow splinting

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10
Q

what does the radial nerve do

A

opens the fist

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11
Q

why can radial damage take place

A

against the humerus, eg when arm draped over hard chair for several hours

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12
Q

signs radial damage

A

wrist and finger drop. sensory loss variable but can affect anatomical snuff box.

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13
Q

what is lateral cutaneous nerve of the thigh compression called

A

meralgia paraesthetica

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14
Q

lateral cutaneous nerve of the thigh compression signs

A

anterolateral burning thigh pain from entrapment under the inguinal ligament

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15
Q

lateral cutaneous nerve of the thigh roots

A

L2-L3

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16
Q

what is common peroneal nerve palsy

A

originates from sciatic nerve just above the knee. often damaged as winds around the fibular head due to trauma, cross legged sitting, yoga, in a cast

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17
Q

signs common peroneal nerve palsy

A

foot drop, weak ankle dorsiflexion/eversion. sensory loss over dorsum of the foot

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18
Q

causes of mononeuritis multiplex

A

occurs in DM, leprosy, vasculitis, amyloidosis,l malignancy, neurofibromatosis, HIV and hep C

19
Q

causes of polyneuropathies- metabolic

A

hypothyroid, DM, hypoglycaemia

20
Q

inflammatory causes of polyneuropathies

A

GBS, CIDP, sarcoidosis

21
Q

nutritional causes of polyneuropathies

A

low B1, B12, high B6, low folate

22
Q

causes of polyneuropathies malignancy

A

polycythaemia rubra ve ra, paraneoplastic syndromes

23
Q

causes of polyneuropathies infection

A

HIV, lyme disease, syphilis, leprosy

24
Q

causes of polyneuropathies vasculitides

A

RA, PAN, wegeners

25
Q

causes of polyneuropathies drugs

A

alcohol, cisplatin, vincristine, isoniazid, phenytoin, metronidazole

26
Q

what is guillain barre

A

immune mediated , symmetrical ascending muscle weakness. acute inflammatory demyelinating polyradiculopathy (AIDP)

27
Q

what can GBS follow

A

campylobacter jejuni and CMV around 1-3 weeks after

28
Q

what are the symptoms GBS

A

weakness distal limb muscles, and or distal numbness, low back pain can be an early feature. progresses proximally. loss of tendon reflexes and some autonomic

29
Q

what % GBS get facial and respiratory weakness

A

20%

30
Q

how is GBS diagnosed

A

clinically, nerve conduction studies- slowed conduction. CSF- protein increased

31
Q

what can be a variant of GBS

A

Miller Fisher Syndrome- proximal muscles- ocular motor palsy and ataxia, antibodies against GQ1b (ganglioside). CIDP- slower onset and recovery. AMAN (acute motor axonal neuropathy)- no sensory loss

32
Q

features required for diagnosis GBS

A

progressive weakness all 4 limbs, areflexia

33
Q

features excluding diagnosis GBS

A

purely sensory symptoms, diagnosis of MG, botulinism, poliomyelitis, diphtheria, porphyria, toxic neuropathy

34
Q

management GBS

A

IV Ig. plasma exchange. monitor ventilaiton (vital capacity) to see whether needs ventilatory support

35
Q

what tests can be done in polyneuropathies

A

FBC, ESR, glucose, U&E, LFT, TSH, B12, electrophoresis, ANA and ANCA, CXR, urinalysis, lead level, antiganglioside antibodies, nerve conduction- distinguish between demyelinating and axonal causes

36
Q

what neuropathies can you get in diabetes

A

distal symmetrical sensory (glove and stocking), acute painful sensory, mononeuropathy and mononeuritis multiplex, diabetic amyotrophy, autonomic neuropathy

37
Q

what can deficiency of B1 cause

A

thiamine. Wernicke-Korsakoffs. alcohol main cause is West

38
Q

signs in Wernicke Korsakoffs

A

eye signs-nystagmuc, conjugate gaze palsy; ataxia- broad based gait, cerebellar signs; cognitive- stupor and coma, confabulation and amnesia

39
Q

how to treat Wernickes Korsakoffs

A

thiamine

40
Q

genetic example of neuropathy

A

Charcot Marie Tooth

41
Q

what happens in Charcot Marie Tooth

A

distal limb wasting and weakness progresses slowly over years, mostly in legs. severe foot drop. pes cavus (high arch) and toe clawing

42
Q

what signs can be seen in autonomic neuropathy

A

postural hypotension, urinary retention, erectile dysfunction, nocturnal diarrhoea, diminished sweating

43
Q

in what can autonomic neuropathy be seen

A

diabetes, amyloidosis, GBS

neuro year 4 (19 decks)

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