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Neuro Week 4 > Neuropathy > Flashcards

Neuropathy Flashcards

1
Q

what is polyneuropathy?

A

symmetrical loss of multiple different nerves

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2
Q

what is mononeuropathy?

A

single nerve issue

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3
Q

do polyneuropathies have more distal or proximal symptoms?

A

more distal

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4
Q

is a polyneuropathy symmetrical or asymet?

A

symmetrical

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5
Q

is a polyneuropathy a disease of motor or sensory nerves?

A

BOTH..it is a mixed nerve deficit

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6
Q

other than motor and sensory deficit, what can polyneuropathy have?

A

autonomic dysfunction

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7
Q

will there be lower or upper motor neuron findings on polyneuropathy?

A

LMN

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8
Q

what is the most common demyelinating acute polyneuropathy??

A

AIDP or Guillain Barre

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9
Q

what does AIDP stand for?

A

acute inflammatory demyelinatiing polyradiculopathy

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10
Q

what two nerve types are demyelinated in ADIP?

A

spinal nerve roots and peripheral nerves

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11
Q

where does weakness mainly occur in AIDP?

A

distal limbs and advances to proximal muscles

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12
Q

what often precedes AIDP?

A

flu like illness

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13
Q

what bug is associated with AIDP?

A

campylobacter jejuni

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14
Q

what is shown in LP with AiDP?

A

elevated protein only

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15
Q

does AIDP preserve deep tendon reflexes?

A

NO…LMN issue

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16
Q

what is usual cause of death in AIDP?

A

respiratory failure

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17
Q

what is driving factor for AIDP?

A

inflammatory immune mediated

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18
Q

what is Rx for AIDP?

A

plasma exchange/IVIG

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19
Q

what is a common demyelinating chronic polyneuropathy?

A

Charcot Marie Tooth Disease

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20
Q

what happens in Charcot Marie Tooth Disease?

A

chronic demyelination of peripheral nerves

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21
Q

what are symptoms of Charcot Marie Tooth Disease?

A

foot pain and dysfunction

calves and ankles thin compared to thigh…but be aware it can be asymptomatic

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22
Q

what is foot finding in Charcot Marie Tooth Disease?

A

high arches with hammer toes

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23
Q

what is patho finding in Charcot Marie Tooth Disease?

A

onion bulb due to demyel and remyel over time

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24
Q

what portions of legs are mainly affected in Charcot Marie Tooth Disease?

A

calves and feet

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25
Q

what is mutation in Charcot Marie Tooth Disease?

A

PMP22 (CMT1)

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26
Q

is diabetic neuropathy more proximal or distal?

A

distal

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27
Q

is diabetic neuropathy more sensory or motor?

A

sensory

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28
Q

aside from sensory loss, what else can have issues in diabteic neuropathy?

A

autonomic dysfxn

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29
Q

what are the autonomic dysfxn issues in diabetic neuropathy?

A

postural hypotension
decreased bladder emptying
nausea
sexual dysfxn

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30
Q

what is a vitamin deficiency that can lead to neuropathy?

A

B12

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31
Q

carpal tunnel is due to what nerve entrapment?

A

median nerve

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32
Q

where is weakness in carpal tunnel?

A

thumb adduction and opposition

atrophy of thenar eminence

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33
Q

what are sx of carpal tunnel?

A

pain/numbness in hand/wrist…worse at night

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34
Q

what is rx for carpal tunnel?

A

NSAIDs, steroids injection, surgical decompression or splints night

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35
Q

where is pain in ulnar nerve palsy?

A

at elbow

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36
Q

what muscles are weak in ulnar nerve palsy?

A

interosseous muscle

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37
Q

what motion is weak with ulnar nerve palsy?

A

grip strength

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38
Q

what canal is compressed in ulnar nerve palsy?

A

guyons canal

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39
Q

what is main sign of radial nerve palsy?

A

wristdrop

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40
Q

what muscles are weak in radial nerve palsy?

A

finger extensors, wrist extensors, brachioradialis

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41
Q

what is another name for radial nerve palsy?

A

saturday night palsy

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42
Q

peroneal nerve palsy is caused by what commonly?

A

prolonged lying or leg cast

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43
Q

what is sign for peroneal nerve palsy?

A

foot drop

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44
Q

what is movement weakness in peroneal nerve palsy?

A

foot dorsiflexion and eversion

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45
Q

what is sensory loss in peroneal nerve palsy?

A

dorsum of foot and lateral shin

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46
Q

what is weakness in sciatic nerve palsy?

A

leg flexion..hamstrings

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47
Q

where is sensory loss in sciatic nerve palsy?

A

peroneal, tibial and sural

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48
Q

what is absent in sciatic nerve palsy?

A

ankle jerk

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49
Q

what is weak in femoral nerv palsy?

A

quads

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50
Q

where is sensory loss in femoral nerve palsy?

A

anterior/medial thigh to medial shin

51
Q

what reflex is changed in femoral nerve palsy?

A

knee jerk

52
Q

name three things that inhibit action of ACH esterase?

A

insecticides
pyridostigmine
nerve gas

53
Q

what is cause of issue in myasthenia gravis?

A

antibodies against ACh receptor on postsynaptic cell

54
Q

is myasthenia gravis pre or post synapse?

A

post syanptic issue

55
Q

what can myasthenia gravis be associated with that you should investigate?

A

thymoma

56
Q

what are symptoms of myasthenia gravis?

A 
fatigable weakness
diplopia
ptosis
bulbar weakness
proximal limb weakess
57
Q

what is bulbar weakness in myasthenia gravis?

A

all cranial nerves are weak

58
Q

what is Rx for myasthenia gravis?

A

pyridostigmine

59
Q

what is MoA of pyridostigmina?

A

blocks ACh esterase to increase ACh in NMJ

60
Q

what is issue in Lambert Eaton Myasthenic Syndrome?

A

antibodies against voltage gated Ca channels

61
Q

is Lambert Eaton Myasthenic Syndrome pre or post synaptic issue?

A

pre

62
Q

what is main feature of Lambert Eaton Myasthenic Syndrome?

A

symmetric proximal muscle weakness

63
Q

is Lambert Eaton Myasthenic Syndrome an issue with distal or proximal muscles?

A

PRoximal

64
Q

is Lambert Eaton Myasthenic Syndrome hypo or hyperreflexive?

A

Hypo

65
Q

what is Lambert Eaton Myasthenic Syndrome associated with?

A

small cell lung cancer

66
Q

what is issue in botulism?

A

presynaptic block of Ach release

67
Q

is botulism pre or post synapse?

A

presynaptic issue

68
Q

where is botulin from?

A

clostridium bacteria

69
Q

where do babies get botulin from?

A

honey

70
Q

what is main symptom of botulism?

A

descanding paralysis

71
Q

what are the four Ds that botulism can lead to?

A

diplopia, dysarthria
dyspnea
dysphagia

72
Q

what is a myopathy?

A

neuromuscular disorder where muscle weakness is due to dysfunction of muscle fibers

73
Q

is myopathy inherited or acquired?

A

can be either

74
Q

what are the three acquired myopathies to know?

A

polymyositis
dermatomyositis
inclusion body myositis

75
Q

what two drugs can cause acquired myopathy?

A

steroid or statin

76
Q

what does polymyositis lead to?

A

proximal muscle weakness

77
Q

is polymyositis proximal or distal muscles?

A

proximal

78
Q

is polymyositis symmetric or asymmetric?

A

symmetric

79
Q

what is elevated in polymyositis?

A

Creatine Kinase

80
Q

what type of pain inpolymyositis?

A

muscle pain

81
Q

dermatomyositis has what muscle involvement?

A

proximal muscle weakness

82
Q

what is dermatomyositis associated with?

A

malignancies

83
Q

other than proximal muscle weakness, what does patient experienc with dermatomyositis ?

A

skin rash

84
Q

what is issue in inclusion body myositis?

A

inflammatory myopathy

85
Q

what type of weakness does inclusion body myoitis lead to?

A

asymmetric weakness

86
Q

what two muscles are mainly affected in inclusion body myositis?

A

finger flexor and qaudriceps muscle

87
Q

what are CK levels in inclusion body myositis?

A

normal or mildly elevated

88
Q

what are CK levels in dermatomyositis?

A

elevated

89
Q

how are muscular dystrophies inherited?

A

X linked pattern

90
Q

what are the mutations in muscular dystrophy?

A

deletions

91
Q

name the three muscular dystrophies to know

A

duchenne and becker

and myotonic

92
Q

when does duchennes onset?

A

2-3yo

93
Q

who does duchenne and becker muscular dystrophy affect?

A

BOYS

94
Q

when does becker start?

A

5-15 yo

95
Q

what are clinical features of muscular dystrophy?

A

cardiomyopathy
calf hypertrophy
Gowers sign

96
Q

what is gowers sign in muscular dystrophy?

A

when patient uses their legs to crawl up on themseleves to get up

97
Q

what is myotonic muscular dystrophy?

A

features a delayed muscle relaxation after contraction

98
Q

what are signs of myotonic dystrophy?

A

weakness and muscle wasting
frontal balding
temporal wasting
cataract

99
Q

what is myotonia?

A

poor muscle relaxation after contraction

100
Q

what is inheritance pattern of myotonic dystrophy?

A

AD

101
Q

what is issue in ALS?

A

degeneration and loss of motor neurons

102
Q

where is ALS focused in the SC?

A

anterior horn cells

103
Q

do LMN or UMN get affected in ALS?

A

BOTH…clinical hallmark

104
Q

what happens to muscles in ALS?

A

atrophy

105
Q

what tract is most obviously affected in ALS?

A

lateral corticospinal

106
Q

what is usual presentation of ALS?

A

limb weakness

107
Q

does ALS involve cranial nerves?

A

yes..has bulbar involvement

108
Q

what does bulbar involvement lead to in ALS?

A

dysphagia, dysarthria, difficulty chewing, dyspnea

109
Q

what is Rx for ALS?

A

Riluzole

110
Q

what is spinal muscular atrophy?

A

inherited anterior horn cell degeneration

111
Q

who gets spinal muscular atrophy?

A

infants

112
Q

what is presentation od spinal muscular atrophy?

A

floppy baby

113
Q

what cells degenerate in spinal muscular atrophy?

A

anterior horn cells

114
Q

what causes poliomyelitis?

A

polio virus

115
Q

what is CNS destruction in poliovirus?

A

anterior horn of spinal Cord LMN!!

116
Q

what is symptom of poliomyelitis?

A

LMN weakness

117
Q

is poliomyelitis asym or sym?

A

symmetric

118
Q

can you recover from polio?

A

yes

119
Q

other than skeletal muscles what can be affected by poliomyelitis?

A

bulbar and respiratory muscles

120
Q

are reflexes normal in neuropathy?

A

no

121
Q

are reflexes normal in myopathy?

A

yes

122
Q

are sensory changes seen in myopathy?

A

no

123
Q

is neuropathy more distal or proximal?

A

more distal

124
Q

is myopathy more distal or poximal?

A

proximal

Neuro Week 4 (8 decks)

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