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3 nervous system > PERIPHERAL NEUROPATHY > Flashcards

PERIPHERAL NEUROPATHY Flashcards

1
Q

Nerve Fibers Types

A
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2
Q

Nerve FIBER SUSCEPTIBILITY
🧠⚡MOST SUSCEPTIBLE: PALAC helps to raise HB ⚡
🧠⚡ POL⚡

A

Pressure a > b > c
Hypoxia b > c > a
Local Anaesthesia c > b > a

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3
Q

Ascending TRACTS

A
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4
Q

⚡⚡ MOST COMMON CAUSE of MONONEUROPATHY

A

Carpal Tunnel Syndrome

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5
Q

CTS in MALE is ASSOCIATED with

A

Amyloidosis

✨CTS in Female is MORE COMMON

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6
Q

Causes of CTS
🧠⚡MEDIAN TRAP ⚡

A
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7
Q

Site of COMPRESSION of Nerves in MONONEUROPATHY

A
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8
Q

Entrapment Neuropathies are seen commonly in
MEDIAN TRAP

A

Diabetes
Myxedema
Acromegaly
Amyloidosis
Hereditary Neuropathies susceptible to Pressure palsy
Pregnancy
Rheumatoid arthritis

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9
Q

Multiple MONONEUROPATHIES/ Mononeuritis MULTIPLEX

A

Involvement of multiple nerves without any organization or association

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10
Q

⚡⚡ MOST COMMON CAUSE of MONONEURITIS MULTIPLEX

A

LEPROSY

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11
Q

Causes of MONONEURITIS MULTIPLEX
🧠⚡WARDS PLC ⚡

A
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12
Q

All MONONEUROPATHY and MONONEURITIS MULTIPLEX are AXONAL except
🧠⚡ MAX: MCD⚡

A

Demyelinating conditions:
✨ Multi focal motor neuropathy with Conduction block MMN-CB

✨ Carpal Tunnel Syndrome

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13
Q

⚡⚡ MOST COMMON TYPE OF NEUROPATHY

A

POLYNEUROPATHY

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14
Q

Cause of Polyneuropathy
🧠⚡DANG THERAPIST ⚡

A
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15
Q

LARGE FIBER NEUROPATHY
involves A alpha
➕
A BETA fibers damage

A

Motor activity affected
Reflexes LOST
Proprioception lost

⭐ Vibration lost
Fine touch Lost

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16
Q

LARGE FIBER PREDOMINANT NEUROPATHY (A-ALPHA, A-BETA)
synonyms

A

ATAXIC NEUROPATHIES

Responsible for:
Muscle weakness
Reflex lost
Proprioception
Joint Pain
Fine touch
Vibration

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17
Q

LARGE FIBER PREDOMINANT NEUROPATHY (A-ALPHA, A-BETA)
🧠⚡PVT Friedrich SC⚡

A

✨ Pyridoxine toxicity
✨ Vitamin B12 deficiency
✨ Taxanes
✨ Friedrich’s ATAXIA

✨ Sjogren’s SYNDROME
✨ Cisplatin

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18
Q

SMALL FIBER PREDOMINANT NEUROPATHY (A-DELTA, C type)
Features

A

SYMMETRICAL
REFLEXES PRESERVED
MOSTLY SENSORY

Pain
Temperature sensation altered
ANS involvement
Reflex Loss MINIMAL

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19
Q

LARGE FIBER PREDOMINANT NEUROPATHY (A-ALPHA, A-BETA)

✨ Positive Symptoms
✨ Negative Symptoms

A

⭐ positive
Tingling and COTTON wool like sensation
Paresthesia
Dysasthesia

⭐ NEGATIVE
-Numbness
-Sensory Ataxia
-Romberg’s sign / Washbasin phenomenon / Pseudoathetosis

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20
Q

SMALL FIBER PREDOMINANT NEUROPATHY (A-DELTA, C)
Positive features

A

Positive Symptoms
✨ Burning PAIN : Stocking and Glove pattern
✨ ANS Manifestation
-erectile dysfunctions
-postural Hypotension
-Tachy-Brady syndromes
-sweating
-nocturnal diarrhea
-gustatory sweating

NEGATIVE SYMPTOMS
✨ BURNS
✨ Non Healing ulcer
✨ Charcot Joints

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21
Q

Stocking and Glove pattern

Glove and Stocking pattern

A

⭐ Small fiber neuropathy

⭐ Cervical Compressive Myelopathy

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22
Q

⚡⚡ MOST COMMON which fiber polyneuropathy

A

SMALL FIBER POLYNEUROPATHY

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23
Q

Small Fiber Neuropathy is AXONAL or DEMYELINATING

A

Axonal
Length dependent ➕ Distal to Proximal
Symmetrical
Distal fibers involved

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24
Q

VASCULITIS USUALLY PRESENT WITH WHICH NEUROPATHY

A

Polyneuropathy
Except
PAN
Cryoglobulinemia
EGPA

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25
Q

VASCULITIS presenting with MONONEURITIS MULTIPLEX
🧠⚡PCC ⚡

A

⭐ PAN
✨ Churg Strauss SYNDROME (EGPA)
✨ Cryoglobulinemia

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26
Q

Middle Molecules

A

Molecules that are larger than pore size

They remain in the body even after dialysis

-Uremic Toxins : Causes NEUROPATHY in UREMIA
-AB2 microglobulin : causes DIALYSIS associated AMYLOIDOSIS

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27
Q

Causes of SMALL FIBER NEUROPATHY
🧠⚡FADU VALTS H² ⚡

A

Fabry’s disease
Amyloidosis
Diabetes (⚡⚡ MOST COMMON)
Uremia

✨ VASCULITIS (except PAN)
A ✨ Idiopathic Pandysautonomias
✨ Leprosy
✨ Tangier’s disease
✨ Sjogren’s syndrome

✨ HIV
✨ Hereditary sensory and autonomic neuropathy

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28
Q

⚡⚡ MOST COMMON presentation of LEPRSOSY

⚡⚡MOST COMMON CAUSE of MONONEURITIS MULTIPLEX

A

⭐ SMALL FIBRE POLYNEUROPATHY

⭐ LEPROSY

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29
Q

⚡⚡ MOST COMMON NEUROLOGICAL PRESENTATION IN HIV

A

Small fiber Polyneuropathy

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30
Q

POSTEROLATERAL CORD SYNDROME

A

✨ Vitamin B12 DEFICIENCY
✨ Vitamin E deficiency
✨ COPPER deficiency

Extensor PLANTAR (UMN Feature)
➕
LARGE FIBER NEUROPATHY(LMN Feature)
(LOSS OF REFLEXES)

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31
Q

PAIN PREDOMINANT SMALL FIBER NEUROPATHY
🧠⚡ Fab! Hd TV⚡

A

⭐ Fabry’s Disease

Others
⭐ TANGIER’S disease
⭐ HIV
⭐ VASCULITIS

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32
Q

All Neuropathy caused by drugs are AXONAL except:
🧠⚡ DAXO⚡
🧠⚡CAGe : causes DEMYELINATING NEUROPATHY ⚡

A

Chloroquine
Amiodarone
Gold

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33
Q

Combined SMALL and LARGE FIBER NEUROPATHY
🧠⚡ CHVT (CHUTiya)⚡

A

✨ Carcinomatous sensory NEUROPATHY
✨ Hereditary Sensory Motor NEUROPATHY
✨ VINCRISTINE
✨ TAXANES

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34
Q

NEUROPATHY classification
Based on structure involved

A

⭐ AXONAL NEUROPATHY
⭐ DEMYELINATING NEUROPATHY

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35
Q

PURE HEREDITARY DEMYELINATING CONDITION
🧠⚡when it gets DE-Myelinated, it soon Re-Forms ⚡

A

Refsum’s Disease

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36
Q

Charcot Marie Tooth Disease shows which type of NEUROPATHY

A

Axonal
and
DEMYELINATING

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37
Q

RELAPSING NEUROPATHIES
🧠⚡CRP ⚡

A

⭐ DEMYELINATING:
CIDP
REFSUM’S DISEASE

⭐ AXONAL
PORPHYRIA

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38
Q

Only ACUTE NEUROPATHY which is AXONAL
⚡AXONAL are usually CHRONIC⚡

A

Porphyria

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39
Q

⭐ All CHRONIC NEUROPATHIES ARE AXONAL except
(OR)
⭐ CHRONIC NEUROPATHY THAT IS DEMYELINATING
🧠⚡ CND is CID⚡

A

Demyelinating Neuropathy
CIDP ➡️ 2° CAUSES : POEMS, Multiple Myeloma, MGUS

40
Q

PURE SENSORY NEUROPATHY

A

GANGLIONOPATHY

41
Q

MOTOR PREDOMINANT NEUROPATHY

🧠⚡Acute DEMYELINATING conditions are MOTOR PREDOMINANT ⚡
🧠⚡ Acute AXONAL conditions are MOTOR⚡

A
  1. GBS
  2. PORPHYRIA
  3. LEAD
  4. DAPSONE
  5. MMN with CB
  6. DIPHTHERIA
  7. DIABETIC AMYOTROPHY
42
Q

PURE MOTOR NEUROPATHY
🧠⚡ LDM⚡

A

Lead
Dapsone
MMN with Conduction Block
(Multi focal motor neuron disease)

43
Q

AUTONOMIC PREDOMINANT NEUROPATHY

🧠⚡Small fiber ➡️ sympathetic fibers ➡️ AXONAL(Small fibers involved) ⚡

A

✨ DIABETES
✨ AMYLOID
✨ PORPHYRIA

✨ VINCRISTINE (combined small and Large fiber)
✨ FABRY’S
✨ HIV

44
Q

7 IMPORTANT QUESTIONS

A
45
Q

Axonal NEUROPATHY
CS²D
⚡⚡ MOST COMMON CAUSE?

A

Diabetes MELLITUS
✨ CHRONIC ( > 2months)
✨ SENSORY PREDOMINANT
✨ SMALL FIBER NEUROPATHY
✨ DISTAL > PROXIMAL weakness
✨ REFLEXES ➕
✨ Muscle WASTING ➕

46
Q

Which reflex is not preserved in AXONAL NEUROPATHY

A

Ankle JERK

47
Q

DEMYLINATION NEUROPATHY
⚡⚡ MOST COMMON CAUSE
🧠⚡Gand me PD - DALA ⚡

A

⭐GBS: Acute Inflammatory Demyelinating Polyneuropathy

✨ Acute onset ( < 1month)
✨ LARGE FIBER
✨ MOTOR ➕ SENSORY
✨ PROXIMAL ➕ DISTAL weakness
✨ AREFLEXIA
✨ NO WASTING

48
Q

Axonal vs Demyelinating

A
49
Q

Causes of ACUTE DEMYELINATING NEUROPATHY
MYELINOPATHIES

A

⭐ AIDP
⭐ DIPTHERIA
⭐ AMIODARONE
⭐ CHLOROQUINE
⭐ GOLD

50
Q

Causes of Chronic DEMYELINATING NEUROPATHY
MYELINOPATHIES

A

✨ CIDP ➡️ POEMS, Myeloma, MGUS
✨ HIV

51
Q

Causes of Inherited DEMYELINATING NEUROPATHY
MYELINOPATHIES
🧠⚡CRL ⚡

A

✨ Charcot Marie Tooth Disease
✨ Refsum’s Disease
✨ Leukodystrophies

52
Q

Word SUBSTITUTION in NEUROPATHY

-Symmetrical 🧠N-M
-Asymmetrical 🧠 GRP
-Proximal weakness
-Distal weakness 🧠 DAR
-Proximal ➕ Distal 🧠 Plus means aDD
-Pure Motor 🧠ANM
-Pure Sensory
-Sensorimotor 🧠 GRP N

A

-Symmetrical: NEUROPATHY

-Asymmetrical : Ganglionopathy, Radiculopathy, Plexopathy

-Proximal weakness :

-Distal weakness : AXONAL/Small fiber, RADICULOPATHY

-Proximal ➕ Distal: DEMYELINATING/Large Fiber

-Pure Motor: Anterior Horn Cell, NMJ, Muscle disorder

-Pure Sensory: Ganglionopathy

-Sensorimotor : Radiculopathy, Plexopathy, Neuropathy

53
Q

Electro diagnostic features of AXONAL vs DEMYELINATING
🧠⚡FAT C²D ⚡
🧠⚡Amplitude is ⬇️ ⬇️ in A ⚡

A

Fasiculation, fibrillation ➕ in AXONAL DEGENERATIOM

54
Q

Diseases ASSOCIATED with CIDP
🧠⚡SIP A HDL ⚡

A
55
Q

NERVE CONDUCTION STUDIES
Electrodes
🧠⚡you can only MAP anything if you are in the central part of it ⚡
🧠⚡if you are at the periphery, you can only take a SNAP! ⚡

A

G1 : On MUSCLE BELLY ➡️ CMAP
Compound Motor Action Potential

G2 : On TENDON ➡️ SNAP
Sensory Axonal Action Potentials

56
Q

INHERITED NEUROPATHIES
🧠⚡PeRFeCT ⚡

A

➕ HEREDITARY SENSORY AND AUTONOMIC NEUROPATHIES

57
Q

💡🪔CLINICAL POINTER🪔
SEVERE SENSORY INVOLVEMENT ON NCS
➕
NO SENSORY SYMPTOMS FELT BY PATIENT
➕
LONG DURATION OF MOTOR Symptoms
20-30yrs

A

Charcot Marie Tooth Disease

58
Q

Peripheral Nerve Fiber Thickening
➕
PES CAVUS
➕
HAMMER TOE
➕
SCOLIOSIS

A

Charcot Marie Tooth Disease

59
Q

PROXIMAL WEAKNESS

A

⭐ PORPHYRIA
⭐

60
Q

DISTAL WEAKNESS
DARC

A

⭐ Axonal NEUROPATHY / Small Fiber NEUROPATHY
⭐ Charcot Marie Tooth Disease

61
Q

PROXIMAL ➕ DISTAL weakness
🧠⚡ Plus means aDD⚡

A

⭐ PLEXOPATHY
⭐ DEMYELINATING NEUROPATHY

62
Q

Patterns of Charcot Marie Tooth Disease

A

HMSN Motor Sensory
HSAN Sensory Autonomic

63
Q

Types of Charcot Marie Tooth Disease
🧬 MODE OF INHERITENCE 💉
🧠⚡ Start as DOMINANT, later becomes RECESSIVE⚡

A

Type
1 AD
2 AD
3 AD/AR
4 AR

64
Q

⚡⚡ MOST COMMON type of Charcot Marie Tooth Disease

A

Type 1
AD
DEMYLINATION NEUROPATHY

65
Q

Which CMT is ASSOCIATED with ONION BULB FORMATION IN NERVE BIOPSY

A

Type 1 CMT

66
Q

AXONAL DEGENERATION TYPE OF CHARCOT MARIE TOOTH DISEASE

A

Type 2 CMT

67
Q

Dejerine Sottas Syndrome
Synonyms

A

CONGENITAL HYPOMYELINATING NEUROPATHY
TYPE 3 CMT

68
Q

Inverted CHAMPAGNE LEG appearance seen in

A

Charcot Marie Tooth disease
DUE TO: Distal > Proximal

69
Q

Ankle JERK ABSENT
➕
UPPER LIMB REFLEXES NORMAL or Decreased

A

Motor weakness in CMT

70
Q

Upper limb INVOLVEMENT in CMT in which decade

A

2nd to 3rd Decade

71
Q

In NCS,

UNIFORM SLOWING

PATCHY SLOWING
🧠⚡ pAtCh⚡

A

⭐ HEREDITARY NEUROPATHY

⭐ ACQUIRED NEUROPATHY

72
Q

Familial AMYLOID POLYNEUROPATHY
🧠⚡ A for A⚡

A

Axonal > > DEMYELINATING

73
Q

Numbness ➕ Painful Paresthesia
➕
Severe ANS SYMPTOMS
➕
AXONAL Symptoms

A

FAP

74
Q

PORPHYRIA that cause NEUROPATHY
🧠⚡HAV ⚡

A
  1. Hereditary Coproporphyria
  2. AIP
  3. Variegate Porphyria
75
Q

⚡⚡ MOST COMMON PORPHYRIA associated WITH NEUROPATHY

A

Acute INTERMITTENT PORPHYRIA

76
Q

5Ps of AIP

A
77
Q

Tangier Disease
⭐ Gene Defect
⭐ Inheritance

A

⭐ ABCA1 gene
⭐ AR

78
Q

🧑🏻‍⚕️ Clinical Features of TANGIER Disease

A

⭐ CHOLESTEROL accumulation in MACROPHAGES (esp. TONSILS)
⭐ Hepatospleenomegaly
⭐ Sensory POLYNEUROPATHY
⭐ Premature ASCVD (AtheroSclerotic Cardiovascular Disease)

79
Q

NERVE FIBER THICKENING
🧠⚡ LA²ND²S RC⚡

A

Leprosy
Amyloidosis
Acromegaly
Neurofibromatosis
Diabetes
Dejerine Sottas disease
Sarcoidosis
IDIOPATHIC

Refsum’s disease
Relapsing GBS
CIDP
Charcot-Marie Tooth Disease

80
Q
A

Plexiform Neurofibromas

81
Q

Prophylactic drug given to patient of ATT Isoniazid therapy

A

Pyridoxine 10mg/day to prevent NEUROPATHY

82
Q

1st LINE DRUGS in Treatment of painful sensory neuropathies
🧠⚡DLGT ⚡

A

First-line:
⭐ Lidoderm 5% patch
⭐ Tricyclic antidepressants (e.g., amitriptyline, nortriptyline)
⭐ Gabapentin, Pregabalin
⭐ Duloxetine

83
Q

2nd LINE DRUGS for PAINFUL NEUROPATHY
🧠⚡C-PVT doctor ⚡

A

Second-line:
⭐ Carbamazepine
⭐ Phenytoin
⭐ Venlafaxine
⭐ Tramadol

84
Q

3rd LINE DRUGS for PAINFUL NEUROPATHY
🧠⚡MIX drug ⚡

A

Third-line:
Mexiletine

85
Q

Role of GLUCOSE CONTROL in Diabetic NEUROPATHY

A

Prevents development of NEUROPATHY

86
Q

Score used to Assess DIABETIC NEUROPATHY

A

Michigan Diabetic NEUROPATHY Score

87
Q

Cranial Neuropathy in DIABETES

A

⚡⚡ MOST COMMON nerve involved is OCCULOMOTOR NERVE

88
Q

Motor neuropathy with symmetrical weakness

A

⭐️ SPINAL MUSCLE ATRROPHY
⭐️ HEREDITARY MOTOR NEUROPATHY (Atypical Charcot Marie Tooth Disease)(Distal spinal muscle atrophy)

89
Q

Symmetrical + Distal weakness)with Sensory Loss

A

Acute Immune Demyelinating Polyneuropathy
ACUTE Form: GBS (AIDP)
CHRONIC form: CIDP

90
Q

⭐ HSAN

⭐ HMSN

A

⭐ HSAN: Hereditary Sensory Autonomic NEUROPATHY Type 1-5

⭐ HMSN: Hereditary Motor Sensory NEUROPATHY aka CHARCOT MARIE TOOTH DISEASE

91
Q

Burning FOOT SYNDROME

A

⭐ Vitamin B5 Deficiency

⭐ HSAN 1

92
Q

Burning Sensation of Feet, Specially at NIGHT
➕
Sensory Loss
➕
Foot Ulcers

A

HSAN 1

93
Q

HSAN 1
🧬 MODE OF INHERITENCE 💉
Age group

A

AD

⭐ Adolescent or Adulthood

94
Q

Riley Day Syndrome

A

HSAN 3

95
Q

Child with LABILE BP
➕
Decreased TEARING
➕
HYPERHIDROSIS
➕
REDUCED SENSTIVITY TO PAIN
➕
AREFLEXIQ

A

Riley Day Syndrome

96
Q

Even after Multiple myeloma treatment

A

Polyneuropathy does not resolve

3 nervous system (40 decks)

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