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Foundations-Neuro > Peripheral neuropathies > Flashcards

Peripheral neuropathies Flashcards

1
Q

What is the MC hereditary disease of the PNS?

A

Charcot Marie Tooth

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2
Q

Presentation of Charcot Marie Tooth

A

Progressive loss of motor and sensory function of UE/LE

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3
Q

Physical exam findings in Charcot Marie Tooth

A

Pes cavus with:

  1. Hammer toes
  2. Foot drop
  3. Stork leg
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4
Q

What is a positive stocking-glove distribution in diabetic neuropathy?

A

Burning, prickling pain, tingling

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5
Q

What is a negative stocking-glove distribution in diabetic neuropathy?

A

Feelings of numbness or deadness, “stocking glove” pattern

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6
Q

What is an early symptom of foot weakness/motor issues in diabetic neuropathy?

A

Foot slapping and toe scuffling

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7
Q

List some autonomic sx’s in diabetic neuropathy

A
  1. CV: Orthostatic hypotension
  2. GI: Gastoparesis, N/V/D, constipation
  3. GU: Incontinence
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8
Q

What dos the inability to perceive a tuning fork in a diabetic patient indicate?

A

increased risk for a foot ulcer

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9
Q

DTR physical exam findings in diabetic neuropathy

A

Hypoactive or absent DTRs

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10
Q

Nerve pain treatment in diabetic neuropathy

A
  1. Gabapentin, Pregabalin
  2. Tricyclic antidepressant
  3. NSAIDs
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11
Q

Orthostatic hypotension treatment diabetic neuropathy

A

Alpha 1 agonist

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12
Q

Bladder dysfunction treatment in diabetic neuropathy

A

Oxybutnin

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13
Q

What causes Vitamin B12 deficiency?

A
  1. Inadequate absorption=MC: Celiac dz, IBS
  2. Inadequate intake: Vegans
  3. Inadequate utilization: Liver d/o, enzyme deficiencies
  4. Drugs: Metformin, NO,antacids
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14
Q

What is the classic triad of sx’s in Vitamin B12 deficiency?

A
  1. Weakness
  2. Sore tongue
  3. Paresthesia
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15
Q

Early stages of Vitamin B12 deficiency PN?

A
  1. Decreased position and vibratory sense in extremities
  2. Weakness
  3. Hyporeflexia
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16
Q

Late stages of Vitamin B12 deficiency PN?

A
  1. Spasticity, ataxia
  2. Irritable/depressed
  3. Paranoia: “Megaloblastic madness”
17
Q

What is the initial test for diagnostic work-up in Vitamin B12 deficiency

A

Serum B12 (Cobalamin)

18
Q

CBC findings in Vitamin B12 deficiency

A

Megaloblastic anemia

19
Q

Why do we want to order folate in Vitamin B12 deficiency?

A

R/O Folate deficiency as these both cause Megaloblastic anemia

20
Q

Schilling test

A

Dx intrinsic factor deficiency

21
Q

Define “Wet” Thiamine B1 deficiency

A

Cardiovascular:

  1. Peripheral edema
  2. Tachycardia
  3. JVD
  4. SOB
22
Q

Define “Dry” Thiamine B1 deficiency

A

Nerves:

  1. Paralysis
  2. Weakness
  3. Confusion
  4. Eye movements
  5. Pain
23
Q

Thiamine B1 Deficiency treatment

A
  1. Thiamine Replacement: 50 Imx several days, followed by 2.5-5 mg/day for maintenance
  2. Brown rice

Foundations-Neuro (5 decks)

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