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Pathology 2 > Peripheral nerves and muscles > Flashcards

Peripheral nerves and muscles Flashcards

0
Q

PNS injuries typically cause what effect?

A

Injuries causing flacid and hyptotonia

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1
Q

Typically CNS injuries cause what effect?

A

spasticity and overactivity

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2
Q

True or false; the neuron is the parenchyma of the PNS

A

true

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3
Q

What is axonal neuropathology

A

direct injury to axon, degeneration of peripheral segment

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4
Q

Repair from axonal neuropathy involves what?

A

axonal regrowth and remyelination

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5
Q

True or false when an axon repairs following axonal neuropathy there is a decrease in amplitude

A

true

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6
Q

Demyelinating neuropathy causes damage to what?

A

Schwann cell or myelin (spares axon)

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7
Q

True or false; demyelinating neuropathy causes damage uniformly along total nerve

A

false

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8
Q

What is mononeuropathy and what is a common example?

A

single nerve effected

Entrapment: carpal tunnel syndrome

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9
Q

Is mononeuropathy asymmetric?

A

yes

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10
Q

Diffuse/symmetric axonal loss best describes what?

A

polyneuropathy

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11
Q

“stocking and glove” appearance commonly appears with what pathology?

A

polyneuropathy

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12
Q

What is polyneuritis multiplex?

A

damage randomly affecting portions of individual nerves

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13
Q

True or false; polyneuritis multiplex is a autoimmune disorder

A

true

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14
Q

A common acute motor neuron demyelination causing ascending paralysis

A

Guillain-Barre syndrome (GBS)

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15
Q

True or false; there appears to be a autoimmune function with Guillain-Barre syndrome (GBS) - with macrophages near nerve roots

A

true

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16
Q

What is relapsing or chronic Guillain-Barre syndrome (GBS)

A

Chronic inflammatory demyelinating polyneuropathy (CIDP)

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17
Q

A 50 year old male presents with ataxia (poorly coordinated movements) and onion-skin Schwann cells - what is the patient most likely suffering from

A

Chronic inflammatory demyelinating polyneuropathy (CIDP)

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18
Q

What is the #1 cause of peripheral neuropathy

A

Diabetic peripheral neuropathy (50% diabetes myletis)

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19
Q

True or false; environmental toxins typically damaged very short neurons

A

false; typically effect longest neurons

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20
Q

True or false; 1/3 of all vasculitis patients have peripheral neuropathy

A

true

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21
Q

PMP22 gene mutations can typically lead to what?

A

peripheral neuropathy (Charcot-Marie-tooth disease)

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22
Q

What is Myasthenia gravis?

A

Auto-immune disorder degrading post-synaptic ACh receptors

23
Q

What symptoms are associated with myasthenia gravis?

A

Diplopia (double vision) and ptosis (drooping eyelid)

24
Q

True or false; Myasthenia gravis is commonly associated with thymic lesions

A

true (60% hyperplasia - thymoma 20%)

25
Q

True or false; symptoms with myasthenia gravis typically get worse as the day goes on

A

true

26
Q

Is myasthenia gravis more common in one sex?

A

yes - females

27
Q

What is Lambert-Eaton syndrome?

A

Autoimmune disorder - autoantibodies inhibit pre-synaptic Ca++ channels - decreasing ACh release

28
Q

True or false; a thymectomy can sometimes help patients with Myasthenia gravis

A

true

29
Q

Lambert-Eaton syndrome and Myasthenia gravis are both autoimmune disorders effecting ACh receptors - which has a worse prognosis

A

Lambert-Eaton syndrome - Myasthenia gravis has a 95% 5-year survival rate

30
Q

True or false; a thymectomy can greatly help a patient with Lambert-Eaton syndrome

A

false; it can help those with Myasthenia gravis though

31
Q

What is the difference between myasthenia gravis and lambert-eaton syndrome

A

Myasthenia gravis is autoimmune disease effecting post-synaptic ACh receptors

Lambert-Eaton- autoimmune disease effecting pre-synaptic ACh receptors

32
Q

What does a Tetanus infection cause in human body

A

Increased ACh release

33
Q

What does a botulism infection cause in human body

A

decreased ACh release

34
Q

True or false; Botulism causes ascending paralysis

A

false; it causes descending paralysis (eyes-throat-respiration)

Guillian-Barre syndrome causes ascending paralysis

35
Q

What kind of fibers are muscle fiber type 1? What about type 2?

A

Type 1: slow twitch, dark, aerobic, fat metabolism

Type 2: fast twitch, white, anaerobic, glycogen metabolism

36
Q

Grouped atrophy causing fewer and larger motor units is characteristic of what?

A

neuropathic changes

37
Q

Disuse atrophy primarily effects what kind muscle tissue?

A

Primarily type 2 fibers (following localized fracture - or generalized disuse from quadriplegia)

38
Q

Glucocorticoid atrophy primarily effects what kind of muscle tissue? How does this kind of atrophy typically occur?

A

Primarily effects type 2 fibers

Typically occurs because of exogenous reasons (mis-use of corticosteriods - steroids used to inhibit inflammation)

Can also occur by endogenous reasons like Cushing disease

39
Q

True or false; muscular dystrophy is typically congenital?

A

false; it is rarely congenital - typically occurs after ~5 years of age

40
Q

What is muscular dystrophy?

A

An inherited, progressive disorder - MC due to dystrophinopathies (not producing dystrophin)

41
Q

What is dystrophin? What are the two common disorders dealing with it?

A

Dystrophin is one of the longest genes in human genome; codes for protein vital in cytoskeleton

Duchenne Muscular dystrophy and Becker muscular dystrophy

42
Q

What is the difference between Duchenne muscular dystrophy and Becker?

A

Duchenne is more severe - dystrophin gene completely absent - fatal by early adulthood

Becker just abnormal dystrophin - possible normal lifespan

43
Q

What are some keynote symptoms to muscular dystrophy

A

Clumsiness, “can’t keep up”, pseudohypertrophy of calf muscles and “Gower sign” (using hands to push on legs to stand)

44
Q

What is polymyositis?

A

Autoimmune disorder (T cells attack endomysium) causes dysphagia (difficulty swallowing), proximal muscle weakness (45-60 yrs old)

45
Q

True or false; polymyositis, Dermatomyositis, and Inclusion body myositis are all examples of inflammatory myopathies

A

true

46
Q

What is the MC inflammatory myopathy in elderly

A

Inclusion body myositis (tau proteins in cytoplasm, progressive weakness, dysphagia)

47
Q

What is the MC inflammatory myopathy in children

A

Dermatomytositis; autoimmune, muscle & skin inflammation, proximal muscle weakness

48
Q

True or false; thyrotoxic myopathy, ethanol myopathy, and drug myopathy are all examples of toxic myopathies

A

true

49
Q

Overproduction of thyroxine, goiter or Graves disease, acute or chronic best describes what?

A

Thyrotoxic myopathy

50
Q

True or false; peripheral nerve sheath tumors are MC in adults

A

true

51
Q

True or false; schwannomas are commonly malignant

A

false; they are almost always benign (1% malignant)

52
Q

Schwannomas are benign peripheral nerve sheath tumors, they are MC involved with which C.N.?

A

VIII (vestibular schwannoma)

53
Q

What is the difference between Neurofibromatosis 1 & 2

A

1 - causes neurofibromas all over body (very pronounced)

2 - Bilateral vestibular schwannomas (vision and hearing problems)

Both are autosomal dominant

54
Q

What is a neurofibroma

A

benign nerve sheath tumor

55
Q

True or false; 50% of all cases of malignant peripheral nerve sheath tumors arise in neurofibromatosis type 1 patients

A

true

Pathology 2 (5 decks)

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