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Neurology > OME - Weakness > Flashcards

OME - Weakness Flashcards

1
Q

Pathology of MS?

A

Demyelinating autoimmune disease usually affecting women in 20s - 40s

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2
Q

Where can MS impact?

A

Literally anywhere in the brain / NS

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3
Q

Presenting MS?

A
  1. Women 20-40s
  2. Any neuro symptoms
  3. Separated by time: (relapsing, remitting)
  4. And space: one neurologic symptom, and another at later point related to different structures
  5. Optic neuritis - blurry painful vission
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4
Q

What to think in optic neuritis?

A

MS

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5
Q

How to work up MSI?

A

1. MRI - periventricular white matter

  • Shiny white plaques next to ventricle wall
  • Only the first time
    2. LP - Oligoclonal bands
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6
Q

What to think oligoclonal bands on LP?

A

MS

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7
Q

What to think shiny white plaques around ventricles on MRI?

A

MS

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8
Q

Treatment MS?

A 
Flare:
1. High dose, IV steroids
2. Rule out infection
Chronic:
1. Interferon
2. Glatiramer
3. Fingolanol
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9
Q

How to treat urinary retention caused in MS?

A

Bethanechol

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10
Q

How to treat urinary incontinence in MS?

A

Amitriptyline

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11
Q

How to treat spasm in MS?

A

Baclofen

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12
Q

How to treat neuropathic pain in MS?

A

Gabapentin

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13
Q

What is guillain Barre?

A
  • Autoimmune demyelinating disease

- Distal ascending paralysis up to diaphragm which can kill y a

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14
Q

What to think if watery diarrhea / flu shot then ascending paralysis?

A
  1. Diarrhea then ascending paralysis

2. Flu shot then ascending with HYPOreflexia

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15
Q

Organism often causing GBD?

A

Campylobacter

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16
Q

Diagnosis GBD?

A
  1. Lp with lots of protein with very few cells
17
Q

Rx GBD?

A
  1. Intubation
  2. IVIG or Plasmapheresis
    * Never Give Steroids
18
Q

2 Demyelinating disorders?

A
  1. MS

2. GBD

19
Q

How does the signaling work at NMJ?

A
  1. ACH stored in presynaptic neuron
  2. ACH receptors at the postsynaptic
  3. Nerve conduction cause pre Ca channels to open
  4. ACH spills from presynaptic
20
Q

Pathology Myasthenia Gravis?

A
  1. Autoimmune disease against postsynaptic ACH receptors
  2. Block AcH binding so harder to transmit the signal
  3. More ACh needed to over come
  4. Pre synaptic usually runs out of Ach
  5. Signals no longer transmitted
21
Q

Presentation MG?

A

Fatigability in:

  1. Eyes
  2. Throat
  3. Fine movement distal extremities
    - Due to Ach depletion at end plate
22
Q

Diagnosis MG?

A
  1. Anti Ach receptor Ig
  2. EMG with great amplitudes that fall off
  3. CT scan looking for thymoma
23
Q

When is thymoma often seen?

A

MG

24
Q

Rx MG?

A
  1. Cholinesterase inhibitors “stigmines”
  2. Steroids
  3. Remove Thymoma
25
Q

Rx myasthenic crisis?

A

Can’t swallow of breathe:

1. IVIg = plasmapheresis

26
Q

Pathophys Eaton Lambert?

A
  • Often paraneoplastic syndrome
  • Ig against presynaptic Ca channels
  • Harders to release ACh
27
Q

Stander person with Eaton Lambert?

A
  1. 50 or older
  2. Improvement with use
  3. Least used muscles are worst: proximal muscles
28
Q

What to think if cant rise out of chair, trouble combing hair, gettings things from high shelf?

A

Eaton Lambert

29
Q

Diagnosis Eaton?

A
  1. Antibodies
  2. EEG with amplitude increasing with use
  3. CT looking for small cell cancer
30
Q

When will you see small cell lung cancer?

A

Eaton Lambert

31
Q

Treatment Eaton Lambert?

A
  1. Treat cancer
32
Q

Presentation ALS?

A
  1. Combined UMN and LMN lesions AT SAME TIME at different levels
    - Different limbs with different presentation
  2. Sensation spared
33
Q

What happen in LMN lesion?

A
  1. Areflexia
  2. Weakness
  3. Fasciculations
34
Q

What happens in UMN lesion?

A
  1. Hyperreflexia

2. Weakness

35
Q

How to diagnose ALS?

A

EMG

36
Q

Treatment ALS?

A
  1. Supportive - will die of respiratory failure

2. Riluzole - can add three weeks to life

Neurology (37 decks)

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